1
|
Stan MS, Gamal A, Honda K. Dermatopathology Trends in African Americans: A Retrospective Analysis of Biopsies. Am J Dermatopathol 2024; 46:185-188. [PMID: 38153289 DOI: 10.1097/dad.0000000000002592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
ABSTRACT In a retrospective analysis of biopsies from January 1, 2019 to December 31, 2020, at University Hospitals Cleveland Medical Center, we aimed to determine the frequency of dermatologic conditions biopsied in African Americans (AA). Given that AAs constitute 13.4% of the US population, understanding the skin disease profile within this significant demographic is crucial. From a total of 1701 biopsies collected from 1442 AA patients, benign neoplasms emerged as the most common diagnosis, accounting for 26.7%, predominantly in females. Notably, cutaneous T-cell lymphoma was the most frequently biopsied malignancy, whereas pigmentary disorders were the least common at 1.4%. The study highlighted the higher occurrence of squamous cell carcinoma compared with basal cell carcinoma in AA, contrasting trends in other racial demographics. Moreover, recognizing the unique presentations of skin disorders in different racial backgrounds is essential, especially because disparities have been reported in skin of color training among dermatology residency programs. Understanding these racial differences in skin diseases can assist clinicians in refining their diagnostic approach. Future research could further explore the potential gaps between clinical expectations and histologic findings, improving diagnostic accuracy.
Collapse
Affiliation(s)
| | - Ahmed Gamal
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Kord Honda
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH
| |
Collapse
|
2
|
Pudasaini P, Paudel S, Gc S, Adhikari S, Pudasaini P, Das K, Pietkiewicz P. Dermatoscopy of primary localised cutaneous amyloidosis - A cross-sectional study in a setting of South Asian public dermatology department. SKIN HEALTH AND DISEASE 2024; 4:e316. [PMID: 38312259 PMCID: PMC10831549 DOI: 10.1002/ski2.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/04/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024]
Abstract
Background Amyloidosis, deposition of misfolded protein in body, is a fairly common condition. The deposition of misfolded proteins in skin which occurs in absence of systemic comorbidities, namely Primary Cutaneous Amyloidosis (PCA) is also a well-known entity in skin of colour patients of Asian subcontinent. Primary Cutaneous Amyloidosis is usually diagnosed with good clinical acumen and typical clinical phenotype and involved site. Dermoscope has been used as an adjunct non-invasive tool to confirm cases with diagnostic uncertainty and in those in whom biopsy is deferred. Typical dermoscopic features of PCA helps differentiate it from other pigmentary dermatoses and avoids unwanted invasive biopsies and investigations especially in resource poor settings with financial constraints. Objectives This study aims to identify and corroborate clinically, typical dermoscopic features in PCA in 42 patients which includes Macular Amyloidosis (MA) and Papular Amyloidosis (PA) predominantly in skin of colour patients from government based hospital of a south east Asian country. Materials and methods Patients with classic clinical features of PCA were selected. Primary Cutaneous Amyloidosis was subclassified into MA or PA and their corresponding clinically corroborative dermoscopic features were enlisted respectively. All patients (treatment naïve and previously treated), who consented to participate in the study were included. Patients were diagnosed based on the prototypical clinical features. Dermoscopy was done using DermLite III DL3N Polarised and Fluid Dermoscope w/PigmentBoost Brand (3Gen, DermLite LLC, San Juan Capistrano, CA, USA) and images were obtained to create digital dermoscopy system by attaching camera-equipped mobile device via an optional connection kit (Redmi Note 11, MIUI version 13.0.5, CHINA) and the findings were enlisted concurrently. Results In this study of dermoscopic findings of PCA, 42 patients were evaluated for their clinical lesions along with its corroboration with the dermoscopic features. Macular Amyloidosis was seen in 30 patients and 12 patients had typical cutaneous phenotypic and dermoscopic feature of PA. The most common dermoscopic finding seen in patients with MA was shiny to dull white, circular or oval central hub surrounded with halo of light brown dots. Most common configuration of brownish pigmentation around central hub was fine streak type. Also eccrine clues were seen in some cases of MA, which was a unique finding. Similarly in the PA subtype, the central hub was replaced by scar like structureless translucent white area surrounded by brownish black dot like structures, especially in those with large and thick plaques. Conclusion Dermoscopic findings of PCA and their clinical corroboration is a much-needed aspect in treating patients with pigmentary disorders and in those with skin of colour, especially in developing countries. Utilization of dermoscope in clinical settings of low income countries and in government based hospitals will decrease the add on economic burden of invasive diagnostic modalities like biopsy and other inadvertent tests done to rule out pigmentary conditions.
Collapse
Affiliation(s)
| | - Sushil Paudel
- Department of DermatologyCivil Service HospitalKathmanduNepal
| | - Sagar Gc
- Department of DermatologyCivil Service HospitalKathmanduNepal
| | - Sadiksha Adhikari
- Department of DermatologyGandaki Medical College and Teaching HospitalPokharaNepal
| | | | | | | |
Collapse
|
3
|
Andelic M, Marchi M, Marcuzzo S, Lombardi R, Faber CG, Lauria G, Salvi E. Archival skin biopsy specimens as a tool for miRNA-based diagnosis: Technical and post-analytical considerations. Mol Ther Methods Clin Dev 2023; 31:101116. [PMID: 37808256 PMCID: PMC10550798 DOI: 10.1016/j.omtm.2023.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023]
Abstract
Archived specimens, taken by standardized procedures in clinical practice, represent a valuable resource in translational medicine. Their use in retrospective molecular-based studies could provide disease and therapy predictors. Microfluidic array is a user-friendly and cost-effective method allowing profiling of hundreds of microRNAs (miRNAs) from a low amount of RNA. However, even though tissue miRNAs may include potentially robust biomarkers, non-uniformed post-analytical pipelines could hinder translation into clinics. In this study, epidermal RNA from archival skin biopsy specimens was isolated from patients with peripheral neuropathy and healthy individuals. Unbiased miRNA profiling was performed using RT-qPCR-based microfluidic array. We demonstrated that RNA obtained from archival tissue is appropriate for miRNA profiling, providing evidence that different practices in threshold selection could significantly influence the final results. We showed the utility of software-based quality control for amplification curves. We revealed that selection of the most stable reference and the calculation of geometric mean are suitable when utilizing microfluidic arrays without known references. By applying appropriate post-analytical settings, we obtained miRNA profile of human epidermis associated with biological processes and a list of suitable references. Our results, which outline technical and post-analytical considerations, support the broad use of archived specimens for miRNA analysis to unravel disease-specific molecular signatures.
Collapse
Affiliation(s)
- Mirna Andelic
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- School of Mental Health and Neuroscience, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - Margherita Marchi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Stefania Marcuzzo
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Raffaella Lombardi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Catharina G. Faber
- Department of Neurology and School for Mental Health and Neuroscience, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - Giuseppe Lauria
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20133 Milan, Italy
| | - Erika Salvi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Data Science Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| |
Collapse
|
4
|
Tomasini CF, Michelerio A, Isoletta E, Barruscotti S, Wade B, Muzzi A. A Clinico-Pathological Multidisciplinary Team Increases the Efficacy of Skin Biopsy and Reduces Clinical Risk in Dermatology. Dermatopathology (Basel) 2023; 10:153-167. [PMID: 37366798 DOI: 10.3390/dermatopathology10020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/14/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
A clinical risk is an inherent risk in healthcare processes, including skin biopsy procedures, and may lead to misdiagnoses, increased healthcare costs and potential harm to patients. Indeed, clinical and histopathological data must be integrated if we are to reduce clinical risks and improve diagnostic accuracy in the diagnosis of dermatologic diseases. Although dermopathology services used to be part of a dermatologist's duty, the recent centralization of these laboratories has caused a loss of expertise and increased both complexity and safety issues. Some countries have implemented clinical-pathological correlation programs aimed at facilitating communication between clinicians and dermatopathologists. However, Italy has regulatory and cultural barriers that make the implementation of these programs difficult. Therefore, an internal analysis was carried out to assess the efficacy and impact that skin biopsy procedures for inflammatory and neoplastic conditions have on the quality of care in our dermatology department. As the analysis evidenced a high number of descriptive pathologic reports and discordant diagnoses, a multidisciplinary group of four dermatologists, four general pathologists and one dermatopathologist was set up. Herein, we present the results of this analysis and project and describe the structure of the multidisciplinary group. We also discuss the pros and cons, possibilities and limitations of our project, including the regulatory barriers of the Italian National Health System.
Collapse
Affiliation(s)
- Carlo Francesco Tomasini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Andrea Michelerio
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Eugenio Isoletta
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Barbara Wade
- Department of Science of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Alba Muzzi
- Department of Quality and Risk Management, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| |
Collapse
|
5
|
Talwar A, Ballambat SP, Rao R, Shetty VM. Clinico-Pathological Correlation in Dermatological Disorders: A Retrospective Audit of 332 Skin Biopsies from a Tertiary Care Center. Indian Dermatol Online J 2022; 14:61-66. [PMID: 36776159 PMCID: PMC9910537 DOI: 10.4103/idoj.idoj_241_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/27/2022] [Accepted: 07/23/2022] [Indexed: 12/30/2022] Open
Abstract
Background Skin biopsy is a frequently employed tool by the dermatologists with several factors that are known to influence its diagnostic yield as well as interpretation. The objective of our study was to analyze the clinico-pathological concordance and discordance rates in various dermatological conditions and study the factors affecting the same. Materials and. Methods We retrospectively analyzed 332 biopsies conducted over a period of 1 year and looked for clinico-pathological correlation and tabulated the results. Results The overall concordance rate observed in the present study was 70.48% (234 out of 332). Out of 234 concordant cases, 175 of them (74.8%) were concordant with the first differential diagnosis mentioned on the histopathology requisition form, thus revealing an acceptable level of clinico-pathological correlation. The concordance was observed to be 66.87% when only one differential was mentioned on the requisition forms, whereas it increased to 73.96% when more than one diagnosis was offered (P = <0.00001). However, the adequacy of clinical description on the histopathological requisition form was not observed to significantly impact the clinico-pathological correlation in the present study. Conclusion An acceptable level of clinico-pathological concordance was observed in the present study thus reinforcing skin biopsy as an indispensable tool in the dermatological practice. However, continuous effort in the form of regular audits in the department, interdepartmental discussions between pathologists and clinicians, and repeat biopsies in case of discordancy would help in identifying and addressing the deficiencies that impact the diagnostic yield of histopathology and which would ultimately result in better patient care.
Collapse
Affiliation(s)
- Akanksha Talwar
- Department of Dermatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sathish Pai Ballambat
- Department of Dermatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Raghavendra Rao
- Department of Dermatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Varsha Mahabala Shetty
- Department of Dermatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India,Address for correspondence: Dr. Varsha Mahabala Shetty, Associate Professor, Department of Dermatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal - 576 104, Karnataka, India. E-mail:
| |
Collapse
|
6
|
Sopjani S, Akay BN, Daka A. A Review Study Toward Clinical and Histopathological Diagnosis Agreement in Skin Diseases. Med Arch 2022; 76:438-442. [PMID: 36937613 PMCID: PMC10019864 DOI: 10.5455/medarh.2022.76.438-442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Background It is important to evaluate the agreement between clinical diagnosis and histopathological diagnosis. The aim of this study was to review studies and to calculate the degree of agreement between clinical and histopathological diagnosis. Objective The aim of this review was to find out the concordance level between clinical and histopathological diagnosis; to find out in which type of pathology concordance was the highest; to identify the types of pathologies for which biopsy was mostly performed and the anatomical region selected for biopsy. Results and Discussion Review was carried out in accordance with the PRISMA 2020 flow diagram for the selection of articles that met the criteria (years 2005-2021). Articles were found in Google scholar, PubMed, Scopus databases using different keywords. The main criterion was to involve studies that reported data about clinical and histopathological diagnosis. A mean concordance value was calculated and resulted of 72.8 % (95% CI). Conclusion To our knowledge, our study was the first review done regarding concordance between clinical and histopathological diagnosis in skin diseases with the aim to provide researchers with enriched literature and encourage them to bring about an appropriate systematic review study.
Collapse
Affiliation(s)
- Sidita Sopjani
- Medical Faculty, University of Prishtina & Department of Dermatovenerology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Bengü Nisa Akay
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aferdita Daka
- Medical Faculty, University of Prishtina & Department of Dermatovenerology, University Clinical Center of Kosovo, Prishtina, Kosovo
| |
Collapse
|
7
|
Ozcan Y, Ozlu E, Karagun E, Uyar B, Gamsizkan M. Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: a Single Center Experience of 2184 Cases. Dermatol Pract Concept 2022; 12:e2022186. [PMID: 36534561 PMCID: PMC9682974 DOI: 10.5826/dpc.1204a186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Although a trained eye can easily identify typical skin lesions, histopathological examination and clinicopathological correlation are critical in challenging cases. OBJECTIVES The primary objective is to organize the final diagnoses reached following clinicopathological consensus in clinically challenging cutaneous lesions, identifying the most common diagnostic scenarios encountered by dermatopathologists and discussing their diverse differentials submitted by clinicians. The secondary objective is to investigate how the case profile and clinician decision-making processes evolved during the COVID-19 pandemic. METHODS Skin and mucosa samples collected by the dermatology department between 2016 and 2020 were classified based on pathology reports. For frequent diagnoses, preliminary diagnoses stated by clinicians on pathology requisition forms were reviewed. The years preceding and following the first nationally reported COVID-19 case were compared to investigate the pandemic's impact on the distribution of dermatology and dermatopathology cases. RESULTS One thousand nine hundred and eighty-nine reports were classified into 4 major categories: inflammatory (49.8%), neoplastic (30.1%), other diseases (7.1%), and non-diagnostic (12.8%). We further classified inflammatory diseases based on major tissue reaction patterns and neoplasms based on cell origin. We analyzed the leading diagnoses in each category, discussed their differential diagnoses, and provided clinicians with clues to reduce errors in practice. Following the pandemic, the overall number of pathology reports and patient admissions dropped dramatically, with significant changes in case profiles. CONCLUSIONS We presented and discussed the frequently encountered confounding cases to sketch the diagnostic landscape. In the authors' experience, clinicopathological correlation can increase the rate of reaching the diagnosis by up to 75.3%.
Collapse
Affiliation(s)
- Yunus Ozcan
- Department of Dermatology, Duzce Ataturk State Hospital, Duzce, Turkey
| | - Emin Ozlu
- Department of Dermatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Ebru Karagun
- Department of Dermatology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Belkiz Uyar
- Department of Dermatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Mehmet Gamsizkan
- Department of Pathology, Faculty of Medicine, Duzce University, Duzce, Turkey
| |
Collapse
|
8
|
Guo R, Hou M, Han Y, Feng XL. Access, charge and quality of tele-dermatology e-consults in China: A standardized patients study. Digit Health 2022; 8:20552076221140763. [PMID: 36465986 PMCID: PMC9716584 DOI: 10.1177/20552076221140763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE Direct-to-consumer telemedicine is rapidly changing the way that patients seek medical care. This study provided the first report on access, cost and quality of text- and image-based tele-dermatology e-consults, in China. METHODS We adopted the Standardized Patients approach to evaluate the services of tele-dermatology e-consults in two metropolitan cities, that is, Beijing and Hangzhou, in China. We measured quality from four dimensions: service process, diagnosis accuracy, prescription and treatment comprehensiveness, based on China's national clinical guidelines. We performed logistic regressions to investigate factors that were associated with high-quality care. RESULTS For 114 physicians eligible for inclusion, we succeeded in 87 (76%) validated visits. The median waiting time was 100 minutes (IQR 19-243 minutes) and the median length of consultation was 636 minutes (about 10 hours, IQR 188-1528 minutes). Per visit costs varied from $0 to $38, with a median of $8 (IQR 4-9). Among all, 15% of visits showed high quality in service process, 84% arrived in the correct diagnosis, 24% provided high-quality prescriptions and 71% provided comprehensive treatment. Providing images was associated with high quality in service process (OR 7.22, 95% CI 1.49-34.88). Visits in metropolitan Beijing and on non-work days had better prescription quality than that in metropolitan Hangzhou (OR 6.05, 95% CI 1.75-20.95) and that on workdays (OR 3.75, 95%CI 1.27-11.04), respectively. CONCLUSIONS Tele-dermatology e-consults seem to be easy to access and less expensive in China. However, great efforts are warranted to ensure that service processes and prescriptions adhere to clinical guidelines.
Collapse
Affiliation(s)
- Rui Guo
- School of Public Health, Capital Medical University, Beijing, China
| | - Mengchi Hou
- China Aerospace Science & Industry Corporation 731 Hospital, Beijing, China
| | - Yangyang Han
- Beijing Chinese Medical Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
9
|
Jeong SH, Oh DY, Kim KJ, Kim KH, Park EJ. Clinico-Pathological Concordance Rate of Scalp Lesions Showing Alopecia. Indian J Dermatol 2022; 67:324-327. [PMID: 36578761 PMCID: PMC9792002 DOI: 10.4103/ijd.ijd_112_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Some alopecic diseases can be diagnosed by detailed history taking and physical examination, but in many cases, biopsy must be performed to make a definite diagnosis. Aims and Objectives This study aimed to evaluate the clinico-pathological concordance of scalp lesions showing alopecia. Materials and Methods We retrospectively reviewed the electronic medical records and biopsy slides of patients who underwent biopsy for evaluating scalp lesions showing alopecia. Based on the definitions of clinico-pathological concordances, scalp alopecic disease was evaluated. Results A total of 121 patients were enrolled in the study. A total of 203 clinical differential diagnoses were made before performing a biopsy. Thirty-one patients showed full concordance, and 58 patients showed partial concordance; thus overall concordance was shown in 89 patients (73.55%). Folliculitis decalvans and alopecia areata showed a higher full concordance rate than average (P < 0.05), whereas dissecting folliculitis showed a lower overall concordance rate than average, and folliculitis decalvans showed a higher overall concordance rate than average (P < 0.05). The overall concordance rate of alopecia areata was 100% (P = 0.061). Conclusion In diagnosing folliculitis decalvans and alopecia areata, which showed high full and overall concordance, performing a biopsy to make a definite diagnosis is not always necessary, especially when patients show typical clinical features. Dissecting folliculitis, which showed low overall concordance, was less likely to be suspected as a clinical differential diagnosis, making it difficult to distinguish based on clinical findings alone. Therefore, when it is suspected, a detailed evaluation including a biopsy is recommended.
Collapse
Affiliation(s)
- Soo Hyun Jeong
- From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
| | - Dong Yeol Oh
- From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
| | - Kwang Joong Kim
- From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
| | - Kwang Ho Kim
- From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
| | - Eun Joo Park
- From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea,Address for correspondence: Dr. Eun Joo Park, 22 Gwanpyeong-ro 170beon-gil Dongan-gu, Anyang-si Gyeonggi-do, South Korea. E-mail:
| |
Collapse
|
10
|
Epidemiological Patterns of Skin Disease in Saudi Arabia: A Systematic Review and Meta-Analysis. Dermatol Res Pract 2020; 2020:5281957. [PMID: 33193756 PMCID: PMC7641721 DOI: 10.1155/2020/5281957] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Large epidemiological studies on patterns of skin diseases in Saudi Arabia are scarce. Therefore, this systematic review and meta-analysis was conducted to gather available epidemiologic data describing the pattern of skin diseases in different geographical areas in Saudi Arabia. Methods A comprehensive literature search of articles was conducted in PubMed, SCOPUS, and Web of Science through October 2019. We included all published cross-sectional studies that provided data on relevant incidence or prevalence of skin disease in Saudi Arabia. The risk of bias within the included cross-sectional studies was assessed using the Hoy tool for the prevalence studies. All statistical analysis was performed using the Comprehensive Meta-analysis software. Results The present meta-analysis included 14 studies that reported the frequency of the skin disease patterns in different regions in Saudi Arabia with a total sample size of 30436 patients with an overall low risk of bias. The diseases of skin appendages and dermatitis were the most commonly reported skin diseases in Saudi Arabia (24.8% (95% CI, 24.3–25.3) and 24% (95% CI, 23.6%–24.6%), respectively). Skin infection represented about 18.5% (95% CI, 18.1%–19%), while the papulosquamous disorders represented 5.3% (95% CI, 5%–5.6%) of the skin diseases in Saudi Arabia. Skin cancers were pooled from only two studies. Basal cell carcinoma and squamous cell carcinoma were the most common malignant neoplasm in Saudi Arabia (51.4% and 22.5% of the malignant neoplasm, respectively), while malignant melanoma represents only 3.8% of the malignant skin cancer. Conclusion Adnexal disorders and dermatitis are the most common skin disease in Saudi Arabia, followed by skin infection and pigmentary disorders. While skin cancer is more frequent than other countries, awareness campaigns should be initiated to increase knowledge about the harmful effect of long-term sun exposure.
Collapse
|
11
|
Malik A, Siraj F, Shruti S, Gupta P, Khullar G, Ramesh V. Clinicopathological Concordance in 2216 Cases of Skin Biopsy over One Year: An Indian Experience. Cureus 2020; 12:e7752. [PMID: 32455069 PMCID: PMC7243079 DOI: 10.7759/cureus.7752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction To determine the spectrum of diseases and the level of clinicopathological concordance in skin biopsies received over a period of one year. Methods A total of 2216 skin biopsy cases received over a period of one year at a tertiary care center were retrospectively analyzed. The cases were further divided into further categories in levels of concordance based on the agreement between the clinical and histopathological diagnosis rendered. Results Of the cases, 61.01% showed clinicopathological concordance. Cases with a descriptive pathological diagnosis, not matching the clinical diagnosis, constituted 31.54%, whereas 4.02% of cases had a definitive pathological diagnosis, which was discordant with the clinical differentials; 3.29% biopsies were inadequate. Conclusion This study highlights the clinicopathological concordance in all the biopsies received from dermatology. It emphasizes the importance of skin biopsies in arriving at the diagnosis. However, it is a tool that must be used judiciously. Skin biopsies are also pivotal in flagging malignancies that may mimic benign lesions.
Collapse
Affiliation(s)
- Akanksha Malik
- Pathology, All India Institute of Medical Sciences, Rishikesh, IND.,Pathology, National Institute of Pathology, New Delhi, IND
| | - Fouzia Siraj
- Pathology, National Institute of Pathology, New Delhi, IND
| | - Sharma Shruti
- Pathology, National Institute of Pathology, New Delhi, IND
| | - Pooja Gupta
- Pathology, National Institute of Pathology, New Delhi, IND
| | - Geeti Khullar
- Dermatology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - V Ramesh
- Dermatology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| |
Collapse
|
12
|
Al-Saif FM, Binsufayan SA, Alhussain AH, Alkaff TM, Alshaikh HM, Aldosari MS, Binsufayan SA, AlTaleb RM, Alotaibi HM, Alshahwan MA. Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports. Ann Saudi Med 2019; 39:388-394. [PMID: 31804136 PMCID: PMC6894459 DOI: 10.5144/0256-4947.2019.388] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The accuracy of clinical diagnoses of skin diseases has not been researched in Saudi Arabia. OBJECTIVES Assess concordance between the histopathological and clinical diagnosis in skin diseases. DESIGN Retrospective. SETTING Academic tertiary care center. METHODS Demographic, clinical and pathological data were collected from the medical record for the period 1997-2013. MAIN OUTCOME MEASURES Concordance between the pathological and clinical diagnosis. SAMPLE SIZE 4268 cases. RESULTS Of 4268 biopsies, 2440 (58.1%) were females. The mean age (SD) of patients was 36.9 (17.8) years. The three most common locations from which skin biopsies were retrieved in descending order were the lower extremity (1123; 29.1%), head, neck, scalp and hair (1033; 26.7%) and trunk (853; 22.1%). Overall concordance was 75.9% (partial concordance 47.6%, full concordance 28.3%). Biopsies from the oral mucosa and lips had the lowest concordance (overall 58.5%, full 26.4%) at P=.004. Overall concordance was highest for the following three diagnoses: malignant neoplasms, 88%; vesiculobullous diseases 87%; urticarias, erythemas, and purpuras 87%. CONCLUSION There is considerable variability in concordance among different histopathological diagnoses. The full concordance between the clinical diagnosis and the pathological diagnosis is low. This is a reflection of the fact that the biopsies were obtained only in cases where the clinical diagnosis was a dilemma. LIMITATIONS Single center, retrospective, incomplete medical records, low percentage of biopsies were assessed by dermatopathologists. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Fahad Mohammed Al-Saif
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Salman Abdulaziz Binsufayan
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Hasan Alhussain
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Tuqa Morad Alkaff
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Hesham Mohammed Alshaikh
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Mosfer Saeed Aldosari
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Saud Abdulaziz Binsufayan
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Rawan Murshed AlTaleb
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Hend Metia Alotaibi
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Abdulaziz Alshahwan
- From the Department of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,From the Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Nwako-Mohamadi MK, Masenga JE, Mavura D, Jahanpour OF, Mbwilo E, Blum A. Dermoscopic Features of Psoriasis, Lichen Planus, and Pityriasis Rosea in Patients With Skin Type IV and Darker Attending the Regional Dermatology Training Centre in Northern Tanzania. Dermatol Pract Concept 2019; 9:44-51. [PMID: 30775148 PMCID: PMC6368079 DOI: 10.5826/dpc.0901a11] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Papulosquamous skin diseases can be challenging to diagnose, especially in dark skin. Dermoscopy is reported to be helpful, but few data are available on its use in skin type IV or darker. Objective To describe dermoscopic features in plaque-type psoriasis (PP), lichen planus (LP), and pityriasis rosea (PR) patients attending the Regional Dermatology Training Centre in Moshi, Northern Tanzania, and to compare findings with published data. Methods A descriptive cross-sectional study was conducted at a tertiary hospital from October 2016 to June 2017. Fifty-six patients with PP, 25 with LP, and 9 with PR were enrolled consecutively. Clinical diagnosis was confirmed with histopathology in 74.4%. Dermoscopic vascular and nonvascular features from 225 lesions were analyzed. Results Of the 90 patients enrolled, 58.9% were male and the median age was 50 (interquartile range 32.8–60.0) years. In PP lesions, red dots were found in 64.2% and white scale in 45.5%. In LP lesions the background was violet in 45.5% and 58.2% revealed Wickham striae. In PR lesions a dull red background was found in 50.0%, white scale in 83.3%, but no vessels were detectable. Conclusion Dermoscopy features in PP, LP, and PR in dark skin are mostly similar to those in light skin.
Collapse
Affiliation(s)
- Maitseo K Nwako-Mohamadi
- Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John E Masenga
- Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - David Mavura
- Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Ola F Jahanpour
- School of Public Health, Department of Epidemiology and Biostatistics, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | | | - Andreas Blum
- Public, Private, and Teaching Practice of Dermatology, Konstanz, Germany
| |
Collapse
|