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Comparison of different non-invasive diagnostic techniques used for HMME-PDT in the treatment of port wine stains
摘要： Background: Hemoporfin-mediated photodynamic therapy (HMME-PDT) is an effective method for treating port wine stains (PWS). While, it still lacks methods to evaluate the treatment of HMME-PDT for PWS effectively and objectively. Objective: This study aimed to compare the value of different non-invasive diagnostic techniques used for HMME-PDT treatment evaluation in PWS. Methods: Thirty-one lesions of 22 patients with PWS were treated with HMME-PDT. Four non-invasive diagnostic techniques including VISIA-CRTM system, dermoscopy, high-frequency ultrasound (HFUS) and laser speckle imager (LSCI) were used to obtain standard radiographic data containing skin color, skin thickness, blood vessel morphology, blood vessel distribution and blood perfusion from lesions and normal skin surrounded before and after HMME-PDT. Results: The standard image pattern of VISIA-CRTM system showed color change of the lesions of PWS after HMME-PDT. RBX-red image of VISIA-CRTM system showed that erythema was highly aggregated even on invisible lesions at baseline but decreased after HMME-PDT. The erythema index reduced value d was related to the efficacy rating (γ=0.631, P＜0.05). Dermoscopy showed that the number of spot-like and irregular linear vessels increased correlated with increase of clinical classification. After HMME-PDT, vascular rupture was observed by dermoscopy. The response rate of lesions with vascular rupture was 100.00% (20/20). And the response rate of lesions without vascular rupture was 63.64% (7/11). Vascular rupture sign was correlated with better efficacy (P＜0.05). High-frequency ultrasound showed that dermis of PWS thickened and arranged loosely with scattered linear hypoechoic signal. After HMME-PDT, the dermal layer of the lesions became thinner with the linear hypoechoic signal decreased. The response rate of lesions with linear hypoechoic signal was 76.92% (10/13), and that without linear hypoechoic signal was 94.44% (17/18). The lesions without linear hypoechoic signal in dermis showed better efficacy (P＜0.05). In some lesions, Laser speckle contrast showed high blood perfusion signal in PWS lesions and a blood perfusion reduction after HMME-PDT. Conclusion: VISIA-CRTM system can be used to observe not only visible but also invisible lesions of PWS. Moreover, lesions fading after HMME-PDT treatment can be described objectively by VISIA-CRTM system. Dermoscopy played an important role in the clinical classification of PWS, including assessing vascular injury after HMME-PDT, guiding the adjustment of therapeutic dose, and selecting the end point of treatment. HFUS and LSCI can be both used to assist the treatment response evaluation of HMME-PDT.
关键词： dermoscopy,port-wine stains,laser speckle contrast imaging,hemoporfin-mediated photodynamic therapy,VISIA-CRTM system,high-frequency ultrasound
更新于2025-09-23 15:23:52
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[IEEE 2018 International Conference on Control, Power, Communication and Computing Technologies (ICCPCCT) - Kannur (2018.3.23-2018.3.24)] 2018 International Conference on Control, Power, Communication and Computing Technologies (ICCPCCT) - Identification of Melanoma in Dermoscopy Images Using Image Processing Algorithms
摘要： Skin cancer is the most common of all human cancers and is always misunderstood with other kind of skin diseases, so accurate early detection of skin cancer is essential. The main objective of this paper is to segment the lesion and identify melanoma from dermoscopy images. A total of 170 dermoscopy images are used in this research. Firstly, the input images are enhanced for better processing then, the lesion portion is segmented from the enhanced image by two methods 1.Otsu thresholding 2.Morphological operations. The descriptive features are extracted from the segmented lesion. The extracted feature values are used to compute the Total Dermatascopy Score (TDS), which is used to find the presence or absence of melanoma in dermoscopy images. Classification accuracy is calculated to assess the performance of the proposed algorithm.
关键词： Dermoscopy,Segmentation,Total Dermatoscopy Score(TDS),Feature Extraction,Melanoma,Skin cancer
更新于2025-09-23 15:22:29
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Reflectance confocal microscopy of cutaneous melanoma. Correlation with dermoscopy and histopathology
摘要： In vivo Confocal Microscopy is a method for non-invasive, real-time visualization of microscopic structures and cellular details of the epidermis and dermis, which has a degree of resolution similar to that obtained with histology. We present a case of cutaneous melanoma in which diagnosis was aided by confocal microscopy examination. We also correlate the observed features with the dermoscopic and histopathological findings. Confocal microscopy proved to be an useful adjunct to dermoscopy, playing an important role as a method 'between clinical evaluation and histopathology'.
关键词： Melanoma,Diagnosis,Dermoscopy,Confocal microscopy
更新于2025-09-23 15:22:29
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Prospective Study of Q Switched Alexandrite Laser 755a?ˉnm and V Beam Pulsed Dye Laser 595a?ˉnm in Dermatofibroma
摘要： Pulsed dye and carbon dioxide lasers have been applied in dermato?broma with clinical improvement. We treated 23 dermato?bromas two times at a 4-week interval with Q-Switched alexandrite laser 755 nm (7.5 J/cm2, 3 mm, 50 ms). V Beam pulsed dye laser with a wavelength of 595 nm was used for the residual erythema (10-11 J/cm2, 7 mm, 1.5 ms). A partial attenuation of brown colour was observed in 9 patients and complete disappearance of brown colour in 14 patients. Patient satisfaction was very high. Fifteen patients felt a decrease in hardening of dermato?broma after treatment. A pigment network in dermoscopy was observed in all patients before treatment and no one after treatment. A combined treatment using both V Beam pulsed dye laser and Q-Switched alexandrite laser may be a therapeutic option to reduce the aesthetic effect of dermato?broma with a high patient satisfaction and good cosmetic outcomes.
关键词： Q Switched alexandrite,Laser,Dermato?broma,Dermoscopy,V Beam pulsed dye
更新于2025-09-23 15:21:01
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Apport de la microscopie confocale par réflectance et de l’OCT dans le diagnostic d’un carcinome basocellulaire nodulaire kystique
摘要： The role of reflectance confocal microscopy and OCT in the diagnosis of nodular kystic BCC
关键词： Basal cell carcinoma,Noninvasive imaging,Optical coherence tomography,In vivo confocal microscopy,Dermoscopy,In vivo reflectance confocal microscopy,Cystic basal cell carcinoma
更新于2025-09-19 17:15:36
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Immediate post‐irradiation dermoscopic vascular changes versus purpura as a therapeutic endpoint in pulsed‐dye laser treatment of port wine stains
摘要： Pulsed-dye laser (PDL) is the treatment of choice for port wine stain (PWS), and the development of purpura is considered a therapeutic endpoint. Changes in PWS vasculature observed by dermoscopy immediately after laser irradiation have been suggested to predict the minimal effective fluence. The current study aimed at comparing these changes with purpura as a therapeutic endpoint. Fifty-six PWS patients, randomized into two groups, received five monthly PDL sessions (595 nm and 10 mm spot size). At the first visit, patients received multiple gradually increasing test irradiations. Patients in the first group were treated with the lowest dose that resulted in 24-hr-lasting purpura, while patients in the second group were treated with the lowest dose that resulted in vessel disappearance observed by dermoscope. No statistically significant differences were observed between the two groups (the dermoscopic and the purpuric) regarding mean average improvement (42.4 and 37.32%, respectively, p = .32), grade of improvement (p = .44), and the rate of side effects (0 and 13.79%, respectively, p = .13). In conclusion, the immediate post-irradiation vessel disappearance (detected by dermoscope) is comparable, in safety and efficacy, to purpura as a therapeutic endpoint and maybe more time-saving and more accepted cosmetically.
关键词： pulsed-dye laser,port wine stain,dermoscopy
更新于2025-09-19 17:13:59
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Clinical & ultrastructural evaluation of the effect of fractional CO2 laser on facial melasma
摘要： Melasma represents the most obvious and disfiguring change of the face leading to psychological problems especially in females. Ablative lasers have also been used by many professionals to treat melasma, although there is few scientific data supporting this indication. The exact mechanism of action of ablative lasers in melasma is not yet clear enough. We aimed to evaluate the ultra- structural effect of fractional ablative CO2 (FrCo2) laser on facial melasma. Eleven melasma patients evaluated clinically by clinical modified area and severity index (MASI) score, treated by two sessions of fractional CO2 laser one month a part. Two punch biopsies of 2 mm diameter were obtained from all subjects one before and the other 3 months after treatment. All biopsies were analyzed by light and electron microscopy. Clinically, significant improvement of pigmentation and 48% reduction of (MASI) score were observed after two sessions of laser treatments. Light microscopic analysis of specimens revealed significant decrease in melanocyte count after treatment. Electron microscopic analysis of specimens after treatment revealed significant decrease in the number and size of melanocytes and significant decrease or complete absence of melanin granules in the surrounding keratinocytes compared to pre-treatment specimens. No scarring or post inflammatory hyper or hypopigmentation. We concluded that repeated application of Fractional CO2 laser on melasma skin may result in long lasting improvement due to its destructive effect on melanocytes.
关键词： electron microscopy,Melasma,dermoscopy
更新于2025-09-16 10:30:52
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Simultaneous Blood Flow Measurement and Dermoscopy of Skin Lesions Using Dual-Mode Dermascope
摘要： Dermascopes are commonly utilized for the qualitative visual inspection of skin lesions. While automated image processing techniques and varied illumination strategies have been used to aid in structural analysis of lesions, robust quantification of functional information is largely unknown. To address this knowledge gap, we have developed a compact, handheld dermascope that enables real-time blood flow measurements of skin during conventional visual inspection. In-vitro characterization demonstrated that the dermascope is capable of quantifying changes in flow across a physiologically relevant range even when used in a handheld manner with clinic lighting and dermascope LEDs on. In a small pilot clinical study, we demonstrated the dermascope’s ability to detect flow differences between two distinct lesion types.
关键词： Skin Lesions,Laser Speckle Contrast Imaging,Functional Information,Dermoscopy,Blood Flow Measurement
更新于2025-09-11 14:15:04
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Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy
摘要： Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the revisited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
关键词： Melanoma,Basal cell carcinoma,Reflectance confocal microscopy,Dermoscopy,Noninvasive diagnosis
更新于2025-09-10 09:29:36
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[IEEE 2018 IEEE 20th International Conference on e-Health Networking, Applications and Services (Healthcom) - Ostrava, Czech Republic (2018.9.17-2018.9.20)] 2018 IEEE 20th International Conference on e-Health Networking, Applications and Services (Healthcom) - Learning Based Segmentation of Skin Lesion from Dermoscopic Images
摘要： Segmentation is the pre-requisite process in most of the computer aided diagnosis systems for medical imaging. Presence of different artifacts makes segmentation of skin lesion very difficult. Abnormal growth of artifacts can appear as false positives and can degrade the performance of the diagnosis systems. It can be avoided only when false structures are removed while extracting the lesion. To address this issue, this paper proposes deep leaning for skin lesion segmentation. Within this framework, automated skin lesion segmentation is proposed which achieves high accuracy segmentation of skin lesion. Our proposed architecture is 31 layers deep with same filter size. The validity of the proposed techniques is tested on two publically available databases of PH2 and ISIC 2017. Experimental results show the efficiency of the proposed approaches. The proposed method gives Dice Coefficient of 92.3% for PH2 Dataset while Dice Coefficient of 85.5% for ISIC 2017 Dataset.
关键词： Dice Coefficient,Deep Learning,Melanoma,Dermoscopy,Automatic segmentation,Convolution Neural Network
更新于2025-09-10 09:29:36