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At least 163 records · Page 9Linked to original sources
PubMed2004

Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms: store-and-forward teledermatology vs face-to-face dermatology.

OBJECTIVE: To determine the relative efficacy of store-and-forward teledermatology vs face-to-face dermatology consultations in triage decisions about the need for a biopsy of neoplastic skin changes. DESIGN: Prospective study of consecutive patients judged by an internist to require dermatologic consultation for a skin growth. SETTING: Private primary care and dermatology practices and an academic dermatology practice. PATIENTS: Patients requiring dermatology consultation for evaluation of skin growths. Patients were seen by a single primary care physician between July 10, 1998, and August 4, 2000. INTERVENTION: Digital photographs of skin growths were obtained by the primary care physician and evaluated by a teledermatologist. The patient was then seen face-to-face by a dermatologist. A biopsy was performed if either dermatologist favored biopsy. MAIN OUTCOME MEASURES: Decisions to perform a biopsy. Agreement between the dermatologists was assessed. RESULTS: Of the 49 patients with evaluable photographs, the face-to-face dermatologist and teledermatologist recommended a biopsy for the same 26 patients, yielding a sensitivity of the teledermatologist of 1.00 (95% confidence interval [CI], 0.87-1.00) and a specificity of 1.00 (95% CI, 0.85-1.00). The agreement between the dermatologists (kappa) was 1.00 (95% CI, 0.72-1.00). CONCLUSION: Store-and-forward teledermatology may provide an accurate and cost-effective method of determining whether skin growths in patients presenting to primary care physicians should undergo biopsy.

Biopsy↗
PubMed2002

Telomerase expression in benign and malignant skin neoplasms: comparison of three major subunits.

Telomerase is a specialized ribonucleoprotein polymerase that plays an important role in maintaining cellular immortality. The multifactorial activation of telomerase, a critical step in human carcinogenesis, is not fully understood. Many studies have shown increased telomerase activity in various skin cancers. To study the regulation of telomerase in cutaneous malignancy, we used the reverse transcription polymerase chain reaction (RT-PCR) with specific primers to analyze the mRNA expression of three major telomerase subunits: human telomerase RNA (hTR), telomerase-associated protein (TP1) and human telomerase reverse transcriptase (hTERT). Clinical skin specimens were taken from 62 Taiwanese patients with a variety of skin diseases, including five from normal skin, 27 from benign tumors, 17 from malignant tumors, six from premalignant tumors, and seven from inflammatory skin diseases. TP1 was detected in 61 of 62 specimens (98.4%) and hTR was found in 58 specimens (93.6%). hTERT was more often found in specimens from malignant and premalignant tumors (73.9%, 17/23) compared to those from benign tumors (7.4%, 2/27; p < 0.0001). None of the normal skin specimens showed hTERT expression. These results indicate that expression of hTERT, but not TP1 and hTR, is highly associated with cutaneous malignancy.

Adolescent↗