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ABSTRACT Cutaneous melanoma is responsible for the vast majority of skin cancer-related deaths in the United States. Known risk factors include genetic defects, environmental exposures, and a combination of both. Among environmental risks, exposure to ultraviolet rays is the most important and the most modifiable risk factor. Several genetic syndr...
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Context 1
... concerning items within a patient' s history that should alert the examining physician include a past medical history of cutaneous malignancy, chronic sun exposure, history of blistering sun burns, use of tanning salons, family history of melanoma, pancreatic cancer, other familial syndromes, or a procedural history of prior skin biopsies. Finally, it should be noted that patients with fair skin (Fitzpatrick type I) are at increased risk of melanoma compared with those with darker skin (Fitzpatrick type VI) (Table 1) (13)(14)(15). ...Citations
... For each participant, following the SKIN-PEDIC study Phase 2 protocol, the following data were collected at one data point: age (age groups: <4 years, 4 to <8 years, 8 to <13 years, 13 to 18 years), gender, method of insulin therapy, type of IP and CGM and the duration of their use (<6 months, 6 months to <1 year, 1 year to 3 years, >3 years), type of insulin administered, other products used to insert and remove the glucose sensor and IIS and the presence of other dermatological problems (e.g., dry skin or keratosis pillars). In each individual, we assessed the skin type according to Fitzpatrick [15] and the skin condition at the site of device insertion for skin problems categorized into the following: wounds, old scars, lipoatrophy, lipohypertrophy, eczema, changes suggesting infection, or other reactions. ...
The study aimed to estimate the prevalence of skin problems in children and adolescents with type 1 diabetes (T1D) using insulin pumps (IPs) and/or continuous glucose monitoring (CGM) in our center and analyze their association with various factors. As part of the international ISPAD JENIOUS-initiated SKIN-PEDIC project, we interviewed and examined patients who visited the regional pediatric diabetes center in Opole (Poland) for four weeks regarding the use of IP and/or CGM and the presence of skin problems. Body mass index (BMI) and glycemic parameters were obtained retrospectively from medical records. Among 115 individuals (45.2% girls, 83.5% IP users, 96.5% CGM users), old scars were the most common skin problem (IP users 53.1%; CGM users 66.4%), while ≥2 types of skin problems co-occurred (IP users 40.6%; CGM users 27.3%). Longer IP use was associated with a higher prevalence of skin problems (50% for IP < 1 year, 98.1%-IP 1–3 years, 100% for IP > 3 years; p < 0.001), pointing out extra attention with IP use > 1 year. No significant associations were found between skin problems and gender, age, BMI centile and glycemic parameters. Dermatological complications were common among children using IP and CGM in our center, highlighting the need for vigilant monitoring and early intervention to manage these skin-related issues effectively.
... Early diagnosis and treatment are crucial in cases of malignant melanoma, as it can pose a life-threatening risk. Distinguishing between benign and malignant melanocytic lesions is essential to guiding appropriate management strategies and establishing prognosis (Ward et al., 2017). ...
Melanoma, accounting for just 1% of skin cancers, disproportionately contributes to the majority of skin cancer-related deaths in the United States, often originating in normal skin rather than preexisting moles, with nearly 70% of cases not commencing in a mole. Over the past three decades, its diagnosis has surged, outpacing most other cancer types in growth rates. Traditional melanoma recognition methods are cumbersome and costly, but the potential of computer-assisted techniques offers optimism for swift and efficient early-stage identification. Leveraging a standard phone camera for skin image capture and subsequent analysis using computer vision models emerges as a promising approach. In a groundbreaking study, researchers introduced a hybrid model, BiTDense, amalgamating DenseNet121 and Big Transfer R101x1 for early melanoma classification. DenseNet's distinctive dense connections between layers establish direct connections with matching feature-map sizes, while Big Transfer incorporates Group Normalization (GN), dividing channels into groups for mean and variance computation, ensuring computational independence of batch sizes and stability across diverse ranges. BiTDense, with its 93.07% accuracy, 99.43% precision, remarkable 98.87% recall rate, and exceptional F1 Score of 99.15%, not only enhances precise melanoma diagnosis but also signifies a noteworthy advancement in skin cancer detection, owing to its sophisticated architecture involving pre-trained models and custom adaptations.
... Melanoma represents a malignant tumor caused by uncontrolled melanocytic proliferation that is most commonly found in the cutaneous organ but may also affect extracutaneous 2 of 10 sites, such as the mucous membranes, the eyes, and the leptomeninges. The main subtypes of this oncological pathology comprise superficial spreading melanoma (SSM, 70% of cases), nodular melanoma (NM, 5%), lentigo maligna melanoma (LMM, 4-15%), acral lentiginous melanoma (ALM, 5%), amelanotic melanoma (AM, 4%), and desmoplastic melanoma (DM, <4%) [1]. ...
Introduction: Melanoma, a malignant tumor arising from uncontrolled melanocytic proliferation, commonly found in the skin but capable of affecting extracutaneous sites, ranks fifth among diagnosed oncological entities and is a significant cause of cancer deaths, constituting over 80% of skin cancer mortality. Genetic factors and ultraviolet radiation (UVR) exposure, from both natural and artificial sources, are the primary risk factors. Case Presentation: We reported the case of a 25-year-old female with numerous pigmented nevi and notable changes attributed to extensive indoor tanning sessions. Dermatological examinations and dermoscopic evaluations revealed atypical features in two pigmented nevi, leading to surgical excision. Histopathological and immunohistochemical analyses confirmed a compound nevus in one lesion and superficial spreading melanoma in the other, emphasizing the importance of vigilant follow-up and the correct use of immunohistochemistry. Discussion: Indoor tanning significantly elevates the cutaneous melanoma risk, with initiation before age 35 amplifying the risk by up to 75%, especially in young women. The risk escalates with cumulative sessions, particularly exceeding 480, and individuals undergoing over 30 sessions face a 32% higher risk. UVR induces DNA damage, genetic mutations, and immunosuppression, contributing to oncogenesis. Genetic factors, like the PTCHD2 gene, may influence the tanning dependency. Legislation targeting minors has been enacted globally but only with partial efficacy. Tanning accelerators, though associated with minor side effects, correlate with high-risk behaviors. The case underscores the urgency of addressing indoor tanning risks, emphasizing targeted awareness efforts and legislative improvements. Conclusions: In conclusion, the reported case highlights the increased risk of cutaneous melanoma linked to indoor tanning, particularly among young women and specific sociodemographic groups. Despite legislative measures, challenges persist, suggesting the potential efficacy of online campaigns involving relatable influencers to raise awareness and discourage artificial tanning.
... For demonstrating the 2D and 3D in vivo superficial vascular imaging performance of our LCF-based LED-PA imaging reconstruction algorithm, we performed a human volunteer imaging study, following the internal imaging protocol (CYD_PAI_04578) of CYBERDYNE, INC (Rotterdam, The Netherlands). In this experiment, we imaged the right foot dorsum of a 54 year volunteer (Japanese male with Fitzpatrick type 3 skin type 40 ) as shown in Figure 3. The foot was immersed in a water tank and the AcousticX PA/US probe was placed F I G U R E 3 Schematic of the experiment in which the foot dorsum of a 54 year human volunteer (Japanese male with Fitzpatrick type 3 skin type) was imaged using AcousticX PA/US probe. ...
Background
Owing to its portability, affordability, and energy‐efficiency, LED‐based photoacoustic (PA) imaging is increasingly becoming popular when compared to its laser‐based alternative, mainly for superficial vascular imaging applications. However, this technique suffers from low SNR and thereby limited imaging depth. As a result, visual image quality of LED‐based PA imaging is not optimal, especially in sub‐surface vascular imaging applications.
Purpose
Combination of linear ultrasound (US) probes and LED arrays are the most common implementation in LED‐based PA imaging, which is currently being explored for different clinical imaging applications. Traditional delay‐and‐sum (DAS) is the most common beamforming algorithm in linear array‐based PA detection. Side‐lobes and reconstruction‐related artifacts make the DAS performance unsatisfactory and poor for a clinical‐implementation. In this work, we explored a new weighting‐based image processing technique for LED‐based PAs to yield improved image quality when compared to the traditional methods.
Methods
We are proposing a lag‐coherence factor (LCF), which is fundamentally based on the combination of the spatial auto‐correlation of the detected PA signals. In LCF, the numerator contains lag‐delay‐multiply‐and‐sum (DMAS) beamformer instead of a conventional DAS beamformer. A spatial auto‐correlation operation is performed between the detected US array signals before using DMAS beamformer. We evaluated the new method on both tissue‐mimicking phantom (2D) and human volunteer imaging (3D) data acquired using a commercial LED‐based PA imaging system.
Results
Our novel correlation‐based weighting technique showed LED‐based PA image quality improvement when it is combined with conventional DAS beamformer. Both phantom and human volunteer imaging results gave a direct confirmation that by introducing LCF, image quality was improved and this method could reduce side‐lobes and artifacts when compared to the DAS and coherence‐factor (CF) approaches. Signal‐to‐noise ratio, generalized contrast‐to‐noise ratio, contrast ratio and spatial resolution were evaluated and compared with conventional beamformers to assess the reconstruction performance in a quantitative way. Results show that our approach offered image quality enhancement with an average signal‐to‐noise ratio and spatial resolution improvement of around 20% and 25% respectively, when compared with conventional CF based DAS algorithm.
Conclusions
Our results demonstrate that the proposed LCF based algorithm performs better than the conventional DAS and CF algorithms by improving signal‐to‐noise ratio and spatial resolution. Therefore, our new weighting technique could be a promising tool to improve the performance of LED‐based PA imaging and thus accelerate its clinical translation.
... Sometimes it does so before it gets noticed at the primary sites. In developed nations, the damage it causes to the skin it arises from can sometimes be so subtle that it's detected incidentally or it might even be difficult to spot it at all [4]. On the contrary, the scenario here in our setup is consistently different. ...
... To mitigate the delay in the diagnosis of melanoma and its attendant complications, numerous researches suggest the following activities: conducting information campaigns that increase population awareness about melanoma, community engagement, health promotion campaigns focusing on skin self-examination and awareness of signs of melanoma, as well initiating professional programs involving routine skin surveillance and prompt referral of suspicious lesions for diagnostic biopsy [4,9]. Locally advanced acral lentiginous melanomas. ...
Cutaneous melanoma is the most aggressive cancer of the skin arising from pigment-producing cells, known as melanocytes. It is notorious for spreading early to distant locations. Survival of patients with melanoma largely depends on the thickness of the lesion at the primary site thus spotting it early is crucial. Early diagnosis of melanoma, with an improved quality of life and treatment outcomes, is being achieved in some developed nations through screening and health education. On the contrary, as practicing pathologists in a resource-scarce country, we frequently encounter patients with locally advanced melanoma manifesting as ulceration, bleeding, fungation, and bone erosion. Several factors, including low socioeconomic status, medical mistrust, inaccessibility of health facilities, and absent screening and surveillance services can be attributed to the delayed diagnosis. Therefore to alleviate the burden and complications caused by the late presentation of cutaneous melanoma, an urgent massive community mobilization, information campaigning, and the provision of accessible basic primary health care are urgently needed.
... The histopathological assessment included (1) TNM stage; (2) Breslow thickness: a measure of tumor thickness and the degree of invasion into the skin, measured in millimeters; and (3) Clark level: range from Level I (superficial) to Level V (deep), with higher levels indicating more severe tumors. Level I lesions are confined to the epidermis (melanoma in situ), while Level V lesions have invaded the underlying structures, including the dermis, subcutaneous fat, lymph nodes, and even muscle or bone, (4) mitotic rate (<5 and ≥5 mitosis/high-power field), and (5) ulceration [51,52]. ...
Cutaneous melanoma is a severe and life-threatening form of skin cancer with growing incidences. While novel interventions have improved prognoses for these patients, early diagnosis of targeted treatment remains the most effective approach. MicroRNAs have grown to good use as potential biomarkers for early detection and as targets for treatment. miR-155 is well-studied for its role in tumor cell survival and proliferation in various tissues, although its role in melanoma remains controversial. In silico data analysis was performed in the dbDEMC v.3 to identify differentially expressed miRNA. We validated gene targets in melanoma using TarBase v8.0 and miRPath v3.0 and determined protein-protein interactions of the target genes. One hundred forty patients (age range 21–90 years) with cutaneous melanoma who underwent resection were included. Molecular assessment using Real-Time RT-qPCR, clinicopathological associations, and a literature review for the different roles of miR-155 in melanoma were performed. Analysis of the dbDEMC reveals controversial findings. While there is evidence of upregulation of miR-155 in primary and metastatic melanoma samples, others suggest decreased expression in later-stage melanoma and cases with brain metastasis. miR-155 has been overexpressed in prior cases of melanoma and precancerous lesions, and it was found to be dysregulated when compared to benign nevi. While miR-155 expression was associated with favorable outcomes in some studies, others showed an association with metastasis. Patients with high levels of miR-155 also noted reduction after receiving anti-PD-1 treatment, correlated with more prolonged overall survival. In our patient’s cohort, 22.9% relapsed during treatment, and 45% developed recurrence, associated with factors such as lymph node infiltration, high mitotic index, and positive staining for CD117. Although overall analysis revealed miR-155 downregulation in melanoma specimens compared to non-cancer tissues, increased expression of miR-155 was associated with cases of superficial spreading melanoma subtype (p = 0.005) and any melanoma with a high mitotic rate (p = 0.010). The analysis did not identify optimum cutoff values to predict relapse, recurrence, or mortality. In conclusion, miR-155 could have, in part, a potential prognostic utility in cutaneous melanoma. Further mechanistic studies are required to unravel the multifunctional role of miR-155 in melanoma.
... Melanomas are histologically classified according to the tumor, node, and metastasis system (TNM) regulated by the American Joint Committee on Cancer (AJCC), which determines the stage of the tumor (T) through specific and universal characteristics such as tumor thickness, ulceration, and mitosis in lesions. Other parameters used for the classification of this pathology concern its ability to involve the lymph node system (N) and the possible presence of metastases (M) distant from the primary tumor [16][17][18]. ...
... The melanoma clinical stage depends on the involvement of the lymph node system and the infiltrating capacity of the disease; indeed, stage I-II-III melanomas include patients characterized by the absence or microscopic presence of lymph node and/or distal metastases whereas stage IV provides for the massive presence of distal metastases [17]. The less favorable prognoses are obviously linked to the more advanced stages of the disease. ...
Precision medicine has driven a major change in the treatment of many forms of cancer. The discovery that each patient is different and each tumor mass has its own characteristics has shifted the focus of basic and clinical research to the singular individual. Liquid biopsy (LB), in this sense, presents new scenarios in personalized medicine through the study of molecules, factors, and tumor biomarkers in blood such as circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), exosomes and circulating tumor microRNAs (ct-miRNAs). Moreover, its easy application and complete absence of contraindications for the patient make this method applicable in a great many fields. Melanoma, given its highly heterogeneous characteristics, is a cancer form that could significantly benefit from the information linked to liquid biopsy, especially in the treatment management. In this review, we will focus our attention on the latest applications of liquid biopsy in metastatic melanoma and possible developments in the clinical setting.
... It has a high potential to metastasize and is responsible for over 80% of deaths caused by skin cancers [3]. Cutaneous melanoma may be classified into the following subtypes: superficial spreading (considered to develop mostly on preexisting nevi), nodular, lentigo maligna, acral lentiginous (higher incidence in dark-skinned patients), amelanotic, and desmoplastic (rare subtype found in older individuals-formed by scant spindle cells with minimal cellular atypia) [1,4]. Tumoral thickness (Breslow index) is one of melanoma's most important prognostic factors [3]. ...
... Certain studies attest to a linear progression, from nevi, atypical nevi, to melanoma, that may occur under mutational factors that are not yet fully understood [5]. This linear progression, although rare and controversial, is stated to apply to melanomas developing on preexisting nevi (20-30% are nevus-associated melanomas (NAM)), as the majority of melanomas develop de novo (approximately 70% are de novo melanomas (DNM)) [4,[6][7][8]. Dermoscopy can help discover hints of melanomagenesis and may also aid in differentiating between DNM and NAM [6][7][8]. Besides the assessment of skin tumors (for patient monitoring, early skin cancer diagnosis, estimation of tumoral thickness), dermoscopy can also be used to examine perilesional skin (for example, for assessing solar damage), inflammatory conditions, and dermatoses (psoriasis, dermatitis-which can help differentiate these conditions from actinic keratoses or an in situ squamous cell carcinoma), hair and scalp (trichoscopy), skin infestations and infections (entomodermatoscopy), and nails [1]. ...
... Cutaneous melanoma may be classified into the following subtypes: superficial spreading, nodular, lentigo maligna, acral lentiginous, amelanotic, and desmoplastic (rare subtype formed by scant spindle cells with minimal cellular atypia) [4]. The dermatoscopic diagnosis of melanoma is based on the recognition of its chaotic appearance and morphological asymmetry and/or one or more of the following characteristics: atypical network, irregular blotch, irregular dots/globules, irregular streaks/pseudopods, regression structures, white shiny streaks, blue-white veil, atypical vascular pattern, irregular hyperpigmented areas, prominent skin markings, and polygons/angulated lines [10]. ...
Dermoscopy is a non-invasive method of examination that aids the clinician in many ways, especially in early skin cancer detection. Melanoma is one of the most aggressive forms of skin cancer that can affect individuals of any age, having an increasing incidence worldwide. The gold standard for melanoma diagnosis is histopathological examination, but dermoscopy is also very important for its detection. To highlight the many roles of dermoscopy, we analyzed 200 melanocytic lesions. The main objective of this study was to detect through dermoscopy hints of melanomagenesis in the studied lot. The most suspicious were 10 lesions which proved to be melanomas confirmed through histopathology. The second objective of this study was to establish if dermoscopy can aid in estimating the Breslow index (tumoral thickness) of the melanomas and to compare the results to the histopathological examination. We found that the tumoral thickness may be estimated through dermoscopy, but the histopathological examination is superior. To conclude, the aim of this study was to showcase the versatility and many roles of dermoscopy, besides being one of the most important tools for early melanoma diagnosis.
... The epidemiology of CM is more documented than NMSC. According to Ward et al., [64] the incidence of MSC has increased by 4-6% annually in fair-skinned people of North America, Northern Europe, Australia, and New Zealand. According to GLOBOCAN 2020, there were 324,635 new cases and 57,043 deaths due to MSC. [65] The mortality rate associated with MM is 90% and has a survival rate of fewer than 10 years when getting into metastasis. ...
Melanoma skin cancer (MSC) is considered the most aggressive among all skin cancers due to its
tendency to fast growth, metastasis, and high relapse rate. Although MSC is treatable if identified
early, several side effects and aesthetic issues associated with its treatment impose a psychological
burden and compromise patients’ quality of life. Thus, there is a dire need for primary prevention by
adopting alternative remedies, which are accessible, safe, and cost-effective. The present review
emphasizes the role of selected Ayurveda herbs, viz., Azadirachta indica A. Juss, Ocimum tenuiflorum
L., Phyllanthus emblica L., Santalum album L., Tinospora cordifolia (Willd.) Hook. F. and Thoms., and
Withania somnifera L. Dunal, which are long being utilized in the Indian traditional system to tackle
diverse health problems in preventing MSCs. PubMed and Google Scholar were used to search
various research articles on the anti-oncogenic and chemopreventive roles of Ayurveda herbs. This
review emphasizes the beneficial effects of Ayurveda herbs so that the ordinary public includes these
herbs in their routine to prevent MSC and other cancers. The available literature clearly states that
these herbs are beneficial in preventing MSCs. However, the scarcity of clinical trials on these herbs
warrants extensive research in this area to obtain an efficacious drug.
... Skin cancer is a kind of cancer that affects the skin. In the US, more than 5 million skin cancer cases are reported [1]. One of the most lethal kinds of skin cancer is melanoma. ...
... It contributes to 4% of deaths worldwide [2]. Melanoma is responsible for nearly 10,000 deaths a year in the US alone [1]. Melanoma can be treated if detected early. ...
... However, it is still challenging for an experienced dermatologist to detect melanoma at the early stages. Dermatologists use ABCDE and Seven-point checklist [1,5] to diagnose melanoma in dermoscopic images. This process is time-consuming and might not yield accurate results. ...
Skin cancer is one of the leading causes of death worldwide. Malignant melanoma is the most lethal form of skin cancer which can spread to other areas of the body. Although it is rare, still 75% of skin cancer deaths are caused due to malignant melanoma. Early detection can help to combat melanoma. However, early detection is very challenging due to various visual similarities between melanoma and non-melanoma. In this paper, we present an automated system for early melanoma detection. Our technique is based on deep transfer learning, in which we utilized a pre-trained neural network model named as NASNet. The features from the pre-trained model are transferred to the new dataset to detect melanoma. We modified the original architecture and added global average pooling and our classification layers. To overcome issues of a smaller dataset, we use carefully selected label and feature-preserving geometric transformations to increase images. The proposed model is trained on dermoscopic images from the International Skin Imaging Collaboration (ISIC 2020) dataset. As compared to the prior methods, our proposed model is efficient and shows state-of-the-art performance with an accuracy of more than 97% on the test dataset.
