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Kurzhals JK, Christiansen B, Langan EA. Bringing the risk of dermatoscope-related infection under the magnifying glass. Clin Exp Dermatol 2022; 47:1720-1721. [PMID: 35396744 DOI: 10.1111/ced.15216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ewan A Langan
- Department of Dermatology, UKSH, Luebeck, Germany.,Dermatological Sciences, University of Manchester, UK
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2
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Abstract
The emergence of the coronavirus disease 2019 pandemic has led to a change in the whole world order. The key actors and occupational groups most at risk during this period have been health care professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families, and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectants and long-term use of masks. In hospitals, only emergency patients had been admitted for treatment in all units during the pandemic, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow up and treatment of chronic dermatologic diseases, as well as what interventional and cosmetic procedures may performed. Guidelines issued by various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have pros and cons. Finally, one of the issues to ponder in the long term seems to be how we should pursue online education.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Ataşehir Memorial Hospital, Istanbul, Turkey.
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Prof Dr Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden Academic Teaching Hospital of the Technical University, Freidrichstrasse, Dresden, Germany
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Quadros MD, Bugs RCF, Soares RDO, Rossato AM, Rocha LDL, d'Azevedo PA. Identifying gram-positive cocci in dermatoscopes and smartphone adapters using MALDI-TOF MS: a cross-sectional study. An Bras Dermatol 2020; 95:298-306. [PMID: 32303433 PMCID: PMC7253918 DOI: 10.1016/j.abd.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 11/09/2019] [Indexed: 01/15/2023] Open
Abstract
Background The increasingly frequent use of dermoscopy makes us think about the possibility of transfer of microorganisms, through the dermatoscope, between doctor and patients. Objectives To identify the most frequent gram-positive cocci in dermatoscopes and smartphone adapters, as well as the resistance profile, and to evaluate the factors associated with a higher risk of bacterial contamination of the dermatoscopes. Methods A cross-sectional study was carried out with 118 dermatologists from Porto Alegre/Brazil between September 2017 and July 2018. Gram-positive cocci were identified by MALDI-TOF MS and habits of use of the dermatoscope were evaluated through an anonymous questionnaire. Results Of the dermatoscopes analysed, 46.6% had growth of gram-positive cocci on the lens and 37.3% on the on/off button. The microorganisms most frequently found were S. epidermidis, S. hominis and S. warneri. Attending a hospital, using the dermatoscope at the hospital, with inpatients and in the intensive care unit were significantly associated with colonisation by gram-positive cocci. The highest resistance rates were observed for penicillin, erythromycin and sulfamethoxazole-trimethoprim. Study limitations The non-search of gram-negative bacilli, fungi and viruses. Moreover, the small number of adapters did not make it possible to better define if the frequency differences were statistically significant. Conclusion Coagulase-negative staphylococci were frequently identified. S. aureus was detected only on the lens.
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Affiliation(s)
- Maurício de Quadros
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Department of Dermatology, Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Roberto Carlos Freitas Bugs
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Renata de Oliveira Soares
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Adriana Medianeira Rossato
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Lisiane da Luz Rocha
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Pedro Alves d'Azevedo
- Gram-positive Cocci Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Chattopadhyay M, Blackman Northwood M, Ward B, Sule J, Burrows NP. Are dermatoscopes a potential source of nosocomial infection in dermatology clinics? Clin Exp Dermatol 2015; 39:401-3. [PMID: 24635085 DOI: 10.1111/ced.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 12/01/2022]
Affiliation(s)
- M Chattopadhyay
- Department of Dermatology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Masood A, Al-Jumaily AA. Computer aided diagnostic support system for skin cancer: a review of techniques and algorithms. Int J Biomed Imaging 2013; 2013:323268. [PMID: 24575126 PMCID: PMC3885227 DOI: 10.1155/2013/323268] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/30/2013] [Indexed: 11/17/2022] Open
Abstract
Image-based computer aided diagnosis systems have significant potential for screening and early detection of malignant melanoma. We review the state of the art in these systems and examine current practices, problems, and prospects of image acquisition, pre-processing, segmentation, feature extraction and selection, and classification of dermoscopic images. This paper reports statistics and results from the most important implementations reported to date. We compared the performance of several classifiers specifically developed for skin lesion diagnosis and discussed the corresponding findings. Whenever available, indication of various conditions that affect the technique's performance is reported. We suggest a framework for comparative assessment of skin cancer diagnostic models and review the results based on these models. The deficiencies in some of the existing studies are highlighted and suggestions for future research are provided.
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Affiliation(s)
- Ammara Masood
- School of Electrical, Mechanical and Mechatronic Engineering, University of Technology, Broadway Ultimo, Sydney, NSW 2007, Australia
| | - Adel Ali Al-Jumaily
- School of Electrical, Mechanical and Mechatronic Engineering, University of Technology, Broadway Ultimo, Sydney, NSW 2007, Australia
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6
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Mun JH, Park SM, Ko HC, Kim BS, Kim MB. Prevention of possible cross-infection among patients by dermoscopy: a brief review of the literature and our suggestion. Dermatol Pract Concept 2013; 3:33-4. [PMID: 24282661 PMCID: PMC3839829 DOI: 10.5826/dpc.0304a07] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Je-Ho Mun
- Department of Dermatology, Pusan National University Yangsan Hospital, Republic of Korea
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7
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Penso-Assathiany D, Gheit T, Prétet JL, Aubin A, Tommasino M, Mougin C, Braun R, Chosidow O, Aubin F. Presence and persistence of human papillomavirus types 1, 2, 3, 4, 27, and 57 on dermoscope before and after examination of plantar warts and after cleaning. J Am Acad Dermatol 2013; 68:185-6. [DOI: 10.1016/j.jaad.2012.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 07/13/2012] [Accepted: 07/18/2012] [Indexed: 10/27/2022]
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Tschandl P, Argenziano G, Bakos R, Gourhant JY, Hofmann-Wellenhof R, Kittler H, Rosendahl C, Minas S, Zalaudek I. Dermoscopy and entomology (entomodermoscopy). J Dtsch Dermatol Ges 2009; 7:589-96. [PMID: 19614811 DOI: 10.1111/j.1610-0387.2009.07027.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although dermoscopy has been primarily designed for aiding the in vivo diagnosis of skin tumors, recent advances indicate it is also useful in the diagnosis of common skin infections and infestations. As such, dermoscopy connects the research fields of dermatology and entomology into one field of "entomodermoscopy". In this article we give an overview on the current applications of entomodermoscopy.
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Affiliation(s)
- Philipp Tschandl
- Department of Dermatology and Venereology, Medical University of Vienna, Austria
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Zalaudek I, Giacomel J, Cabo H, Di Stefani A, Ferrara G, Hofmann-Wellenhof R, Malvehy J, Puig S, Stolz W, Argenziano G. Entodermoscopy: A New Tool for Diagnosing Skin Infections and Infestations. Dermatology 2007; 216:14-23. [DOI: 10.1159/000109353] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Accepted: 05/17/2007] [Indexed: 11/19/2022] Open
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Abstract
BACKGROUND Dermatoscopes are applied directly to cutaneous or mucocutaneous surfaces with immersion fluid (IF) such as oil or alcohol to reduce light reflection. Recently, Staphylococcus aureus has been isolated from dermatosopes that used mineral oil as the IF. Thus, dermatoscopes might be a potential source of nosocomial infection. OBJECTIVE In this study we propose the use of an alcohol-based antibacterial gel to reduce nosocomial infection transmission while optimizing optical resolution during dermatoscopic examination. MATERIALS AND METHODS Aerobic bacterial cultures were performed on three dermatoscopes used in an outpatient setting after routine examination of 31 patients with an alcohol-based antibacterial gel as IF. RESULTS There was no bacterial growth after using the antibacterial gel with the dermatoscopes. The optical resolution for the antibacterial gel appeared equal to the 'dermatoscopy oil' and superior to alcohol wipes. CONCLUSIONS Alcohol-based antibacterial gel appears to inhibit bacterial colonization while offering excellent optical resolution during dermoscopic examination. The use of alcohol-based IF appears to obviate the risk of nosocomial infections.
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Affiliation(s)
- Susan C Kelly
- Department of Dermatology, Dartmouth Hitchcock, Keene, New Hampshire 03431, USA.
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11
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Prevention of Nosocomial Infection During Dermoscopy? Dermatol Surg 2006. [DOI: 10.1097/00042728-200604000-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hausermann P, Widmer A, Itin P. Dermatoscope as Vector for Transmissible Diseases – No Apparent Risk of Nosocomial Infections in Outpatients. Dermatology 2006; 212:27-30. [PMID: 16319470 DOI: 10.1159/000089018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2004] [Accepted: 03/19/2005] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To determine nonpathogenic and potentially pathogenic bacterial growth isolated from dermatoscopes of dermatologists using oil as contact medium in the daily routine at two outpatient sections in Switzerland. METHODS We investigated the microbiologic colonization of dermatoscopes (Dermatoskop Delta 10, Heine Optotechnik, or Dermogeniusbasic, Rodenstock) during routine use in the outpatient sections of the Departments of Dermatology at the University of Basel and Kantonsspital Aarau. 112 swabs (4 from Aarau, 108 from Basel) taken under standardized conditions were microbiologically worked up in the same laboratory. Oil (101) and 63% isopropyl alcohol (11) were used as contact medium. RESULTS 39 of 112 swabs showed no bacterial growth. 73 of 112 showed growth of nonpathogenic bacteria (skin flora). Additionally to the cultivation of nonpathogenic bacteria, 3 swabs showed growth of oxacillin-sensitive potentially pathogenic Staphylococcus aureus. Of 11 swabs taken after using 63% isopropyl alcohol as a contact medium, 6 revealed no bacterial growth and 5 showed the growth of skin flora. CONCLUSIONS The potential risk of nosocomial infection related to the routine use of dermatoscopes in outpatients is small, and the use of oil as a contact medium for dermatoscopy to enhance the optical quality seems to be unproblematic.
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Affiliation(s)
- P Hausermann
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Marghoob AA, Swindle LD, Moricz CZM, Sanchez Negron FA, Slue B, Halpern AC, Kopf AW. Instruments and new technologies for the in vivo diagnosis of melanoma. J Am Acad Dermatol 2003; 49:777-97; quiz 798-9. [PMID: 14576657 DOI: 10.1016/s0190-9622(03)02470-8] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The principal objective of screening individuals at risk for melanoma is detection of cutaneous melanoma during the curable stages of its early evolution. Unaided visual inspection of the skin is often suboptimal at diagnosing melanoma. Improving the diagnostic accuracy for melanoma remains an area of active research. These research efforts have focused on both the detection of early melanoma and the in-depth evaluation of suspicious pigmented lesions for the presence or absence of melanoma. Numerous instruments are under investigation to determine their usefulness in imaging and ascertaining a correct in vivo diagnosis of melanoma. It is anticipated that some of these tools, alone or in combination, will improve our ability to differentiate, in vivo, melanoma from its simulators. Ultimately, these advances may prevent unnecessary biopsies (increased specificity) while increasing the sensitivity for diagnosing melanoma. This article reviews the current instruments and new technologies for the in vivo diagnosis of melanoma. Learning objective At the conclusion of this learning activity, participants should be acquainted with the instruments designed to facilitate the early detection of melanoma. They should also be familiar with the basic technology behind these instruments and should recognize the potential benefits and limitations inherent in each.
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14
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Abstract
BACKGROUND Dermoscopy, a noninvasive technique used to help physicians better visualize pigmented skin lesions, is becoming widely used by dermatologists. Yet despite its popularity, to our knowledge basic aspects such as the best immersion fluid (IF) to use and proper procedures for applying the IF and dermatoscope have never been the subject of a systematic investigation. OBJECTIVES To determine the best techniques for application of IF and the dermatoscope; to discover which IF results in the least amount of air inclusions; to determine which IF provides the best image quality. MATERIALS AND METHODS This study was divided into three phases. Phase I examined several techniques of taking digital dermoscopic photographs in an attempt to eliminate air bubbles. Phase II tested seven IFs to analyse quantitatively the number of air inclusions for each IF. Phase III investigated these same IFs to judge the image quality for each. RESULTS Phase I: in our hands, the best technique to apply an IF is to use an eyedropper and place the IF directly onto the skin in combination with a 'roll-on technique': the dermatoscope's edge is placed on the skin first and is then rotated until the glass plate lies flat against the skin. Phase II: the alcoholic IF resulted in the least amount of air bubble inclusions (70% ethanol, 90% isopropanol and alcoholic disinfectant), while liquid paraffin (a mineral oil) resulted in the most air bubbles. Phase III: dermoscopic structures were equally clear with alcohols and liquid paraffin, but slightly blurry with ultrasound gel and water. CONCLUSIONS Although 90% isopropanol performed slightly better in terms of air inclusions, we prefer to use 70% ethanol in most circumstances because it has the advantage of being odourless, unlike its counterpart. Additionally, ethanol will not stain clothing, does not crystallize on the dermatoscope, disinfects and evaporates immediately (does not need to be wiped off). For certain local considerations, such as dermoscopy on mucosa or the nail, we prefer to use ultrasound gel because it will not flow.
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Affiliation(s)
- A J Gewirtzman
- Pigmented Skin Lesion Clinic, Department of Dermatology, University Hospital Geneva, 24, rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland
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Stolz W, Semmelmayer U, Johow K, Burgdorf WHC. Principles of dermatoscopy of pigmented skin lesions. SEMINARS IN CUTANEOUS MEDICINE AND SURGERY 2003; 22:9-20. [PMID: 12773010 DOI: 10.1053/sder.2003.50001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There has been a dramatic increase in the incidence of malignant melanoma in most parts of the world. Because the tumor thickness is the most important prognostic factor for the prognosis of the malignant melanoma, the early detection of thin melanomas is essential. Dermatoscopy allows the physician to discriminate between melanocytic and nonmelanocytic lesions with high diagnostic accuracy and to detect initial malignant melanomas. We review the principles of dermatoscopy and the differential diagnosis of pigmented skin lesions. Before using the ABCD rule of dermatoscopy to classify melanocytic lesions into benign, suspicious, or malignant, the distinction between melanocytic and nonmelanocytic lesions is necessary. An essential prerequisite for the usefulness of this technique is adequate training.
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Affiliation(s)
- Wilhelm Stolz
- Department of Dermatology, Hospital Munich-Schwabing, Munich, Germany
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