Ioanna Lefaki - Academia.edu (original) (raw)
Papers by Ioanna Lefaki
Journal of the European Academy of Dermatology and Venereology, 2000
Objective A double-blind, single-site, split-face clinical study was organized and carried out in... more Objective A double-blind, single-site, split-face clinical study was organized and carried out in order to evaluate the efficacy, tolerability, and safety of a glycolic acid containing scalp lotion in conjunction with a betamethasone (as the 17-valerate) scalp application against conditions of psoriasis. Background α-hydroxy acids (AHA) have been proposed as therapeutic modalities against skin exfoliative conditions such as ichthyosis, xeroderma, and psoriasis. AHAs are hereby clinically investigated as therapeutic modalities adjuvant to corticosteroids in order to diminish systemic and topical adverse sideeffects most frequently associated with use of the latter. Methods Twenty patients suffering from scalp psoriasis and other psoriatic conditions were included in a double-blind, split-face clinical study, using combinations of a 10% (w/w) glycolic acid scalp lotion, placebo lotion (excipients only), and a 0.1% (w/w) betamethasone scalp application, applied twice daily without any bandage for a period of 8 weeks. Clinical assessments were carried out by highly experienced physician evaluations based on a four-grade scale, prior to treatment and after 2, 4, 6 and 8 weeks. Results Improvement was observed in all cases included in the study following treatment with the 10% glycolic acid lotion. However, when equal parts of the 0.1% betamethasone lotion were combined, most of the treated sites were healed. Moreover, the duration of treatment required for healing was in this case reduced to approximately half of that needed when the glycolic acid or the betamethasone lotions were used separately for treatment. Conclusions The present clinical study demonstrates for the first time that the effective and well tolerated therapeutic efficacy of glycolic acid scalp lotions is enhanced when used in conjunction with a 0.1% betamethasone scalp application against scalp psoriasis. This potential offers the practising dermatologist with novel treatment modes against severe skin conditions by combining topical corticosteroid with exfoliative agent therapy.
Journal of the European Academy of Dermatology and Venereology
BackgroundReal‐world data in patients with moderate psoriasis treated with apremilast is limited.... more BackgroundReal‐world data in patients with moderate psoriasis treated with apremilast is limited.ObjectivesTo evaluate the effectiveness and safety of apremilast in bio‐naïve patients with moderate psoriasis in real‐world clinical settings.MethodsThis was a 52‐week multicenter, observational, prospective study of adult outpatients with moderate psoriasis {[10% < body surface area < 20% or 10 < psoriasis area severity index (PASI) < 20] and 10 < dermatology quality of life index (DLQI) < 20} initiated on apremilast ≤7 days before enrollment. Missing data were imputed using the last observation carried forward method.ResultsA total of 287 eligible patients (median age: 54.2 years; median psoriasis duration: 9.8 years) were consecutively enrolled. At baseline, the median DLQI and PASI scores were 12.0 and 11.8, respectively. The 52‐week DLQI ≤ 5 and PASI75 response rates were 68.3% and 61.0%. At 52 weeks, 70.8% and 72.7% of the patients shifted from moderate/severe/ve...
Journal of the European Academy of Dermatology and Venereology, 1995
Annales de dermatologie et de vénéréologie, 1996
Perforating necrobiosis lipoidica is a rare clinical form of necrobiosis lipoidica and is almost ... more Perforating necrobiosis lipoidica is a rare clinical form of necrobiosis lipoidica and is almost always associated with diabetes. Necrotized tissue is usually eliminated via transfollicular perforations. We report two cases of perforating necrobiosis lipoidica associated with type II diabetes mellitus. The characteristic clinical feature was the presence of keratotic plugs around the periphery of the lesions. Transfollicular perforation predominated in the first case. The second also presented epidermal perforation. There have been only 6 cases of perforating necrobiosis lipoidica in the literature. To our knowledge, this is the first case report of transepidermal elimination. We confirmed the constant association between this perforation type and diabetes mellitus.
Journal of the European Academy of Dermatology and Venereology, 1993
Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was,... more Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was, firstly, to assess the advisability of carrying out specific serological testing in the case of skin conditions certainly or possibly related to Borrelia burgdorferi (Bb) and, secondly, to evaluate the necessity and efficacy of treatment. Our research was carried out between 1988 and 1991 on 68 patients suffering from cutaneous diseases generally related to Bb and 57 control subjects. Specific IgM and IgG antibodies were detected by indirect immunofluorescence assay (IFA) and titers > 1/256 were considered as positive. All 57 control subjects were negative. Eighteen out of the 68 patients (26.5%) were positive. Eive out of the eight patients (62.5%) with cutaneous diseases certainly related to Bb, and 13 out of the 60 patients (21.6%) with skin diseases possibly related to Bb, were positive. The high percentage (26.5%) in skin diseases generally related to Bb suggests that patients with all these diseases should be tested by IFA. Negative results in control patients confirm the specificity of IFA and indicate that it is unnecessary to perform this investigation in the absence of specific clinical manifestations. Even though we regard scleroderma to be a late form of cutaneous borreliosis, it shows a favorable response to therapy, whereas granuloma annulare, even after titer elimination, remains clinically unchanged. Treatment should be administered not only to patients with high titers, but must be regarded as essential in all seropositive cases with dermatoses generally related to borreliosis, in view of the possibility of a late manifestation of the disease.
Journal of the European Academy of Dermatology and Venereology, 1997
The ultrastructure of dermal lymphatics in psoriasis was studied in two patients, Skin biopsies w... more The ultrastructure of dermal lymphatics in psoriasis was studied in two patients, Skin biopsies were taken from psoriatic plaques as well as apparently normal skin. The lymphatics were generally more conspicuous in the lesions than in the normal appearing skin. The wall of the lymphatic was lined by endothelial cells with many gap junctions. Valves like structures were seen protruding into the lumen. Irregular bands of frayed elastic fibers surrounded the lymphatic vessel. The ultrastructure changes were identical in psoriatic skin and in normal skin of psoriatic patients. The presence of excess gaps allows free access to and from the interstitial spaces. The abnormal or destroyed elastic fibers may contribute to disease morphology by way of lymphatic malformation. I P108 Clinical study of cyclosporin therapy on psoriasis: Comparative study between long-term continuous and interment therapies. The report on fourth-year results
Journal of the European Academy of Dermatology and Venereology, 2021
Apremilast is an oral phosphodiesterase‐4 inhibitor indicated for patients with moderate‐to‐sever... more Apremilast is an oral phosphodiesterase‐4 inhibitor indicated for patients with moderate‐to‐severe chronic plaque psoriasis and active psoriatic arthritis.
Granuloma faciale (GF) is a rare benign chronic inflammatory dermatosis that usually develops as ... more Granuloma faciale (GF) is a rare benign chronic inflammatory dermatosis that usually develops as a solitary brownish-red infiltrated plaque on the face. It clinically mimics, and is often misinterpreted as, sarcoidosis, lupus erythematosus, lupus vulgaris, lymphoma or basal cell carcinoma. 1 Dermoscopy allows better visualization of dermal vascular structures and color variations. Therefore, in recent years it is gaining appreciation in the era of inflammatory skin diseases. 2
Journal of the European Academy of Dermatology and Venereology, 2012
Early stage mycosis fungoides (MF) is difficult to be clinically differentiated from chronic derm... more Early stage mycosis fungoides (MF) is difficult to be clinically differentiated from chronic dermatitis (CD) in a high proportion of patients. Dermoscopy is a rapid, cheep, non-invasive and widely used method for the evaluation of skin tumours and, recently, of inflammatory skin diseases, as well. To describe the dermoscopic pattern of early stage MF and compare it with the dermoscopic features observed in CD. This was a retrospective study. Dermoscopic images of lesions that were clinically equivocal between MF and CD were evaluated for the presence of predefined morphologic criteria. Diagnosis had been histopathologically and immunohistochemically confirmed in all cases. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of mycosis fungoides. A total of 67 dermoscopic images were selected for dermoscopic evaluation. Mycosis fungoides lesions exhibited a characteristic dermoscopic pattern consisting of fine short linear vessels (sensitivity 93.7%, specificity 97.1%) and orange-yellowish patchy areas (sensitivity 90.6%, specificity 99.7%). A characteristic vascular structure resembling spermatozoa was also found to be highly specific for the diagnosis of mycosis fungoides. CD was typified by a different dermoscopic pattern, usually consisting of dotted vessels. These observations provide a first indication that early stage MF exhibits a characteristic dermoscopic pattern which is different from CD. Prospective studies with long term follow-up are needed to determine the value of these dermoscopic criteria in the differentiation between the two entities in the daily routine.
Clinical and Experimental Dermatology, 2011
has been used in a wide variety of dermatological surgery procedures, both cosmetic and noncosmet... more has been used in a wide variety of dermatological surgery procedures, both cosmetic and noncosmetic, to achieve safe and effective anaesthesia. The classic tumescent anaesthesia described by Klein, with a standard formula of 0.05% lignocaine and 1 : 1 · 10 epinephrine plus sodium bicarbonate (8.4%) in 1 L of saline (0.9%) works well for liposuction procedures. The sodium bicarbonate is added to adjust the solution to a more physiological pH, closer to the pKa of lignocaine. This technique provides anaesthesia for up to 24 h, reducing the need for postoperative analgesia and also allowing use of higher doses of lignocaine without risk of systemic side-effects. We use this modified tumescent technique regularly for wide and deep primary excisions and for large scar re-excisions on scalp, trunk and limbs. Varying volumes of 0.9% saline, between 10 and 200 mL, can be used in preparing the tumescent solution. In conclusion, we report use of tumescent anaesthesia in a dermatological surgical procedure. We feel that the extra time required in using modified tumescent anaesthesia is worthwhile because of the benefits it produces in wide and deep excisions in dermatological surgery. M. S. Shareef and A. Affleck* Department of Dermatology, Leeds General Infirmary, Leeds, UK; and *Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK E-mail: m.shareef@nhs.net Conflict of interest: none declared. Accepted for publication 22 July 2011
Clinical and Experimental Dermatology, 2014
British Journal of Dermatology, 2012
Journal of Investigative Dermatology, 2019
In this study, we investigated what exposure period to common pollutants and meteorological param... more In this study, we investigated what exposure period to common pollutants and meteorological parameters has the strongest association with eczema severity or probability of admission to hospital with eczema. Using two datasets from an urban population: local eczema patient emergency department (ED) visits (n¼ 1057) and data from a phenotyping study in an immigrant population (n¼363), we looked at the relationship of admission rates, eczema severity and local pollution/weather station data e 10 mm particulate matter (PM10) 2.5 mm
British Journal of Dermatology, 2014
Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell car... more Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell carcinoma (sBCC) after nonablative therapies has not been sufficiently assessed. Certain dermoscopic criteria, namely pigmented structures, ulceration and arborizing vessels, have been suggested to predict the presence of residual disease [residual disease-associated dermoscopic criteria (RDADC)]. We aimed to assess this hypothesis. Lesions exhibiting RDADC 3 months after treatment were biopsied and in the case of histopathological confirmation were excised. Lesions characterized by white/red structureless areas, superficial fine telangiectasias, or lacking any dermoscopic criterion, were monitored for 12 months. At the 3-month evaluation, one or more of the RDADC were detected in 25/98 (25·5%) sBCCs, in which histology confirmed tumour persistence. In 45 (61·6%) of the 73 remaining lesions, dermoscopy showed white/red structureless areas and/or superficial fine telangiectasias. Twenty-eight lacked any dermoscopic criterion of sBCC. The two latter groups entered follow-up. In total, disease recurred in 13 (17·8%) of the 73 lesions. RDADC accurately predict residual disease. Absence of dermoscopic criteria of sBCC safely predicts complete histopathological clearance. Detection of white/red structureless areas and/or superficial fine telangiectasias warrants close monitoring to recognize early recurrence.
British Journal of Dermatology, 2012
Background Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to... more Background Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to the field of inflammatory skin disorders. Plaque psoriasis (PP), dermatitis, lichen planus (LP) and pityriasis rosea (PR) are common inflammatory skin diseases, but little is currently known about their dermoscopic features. Objectives To determine and compare the dermoscopic patterns associated with PP, dermatitis, LP and PR and to assess the validity of certain dermoscopic criteria in the diagnosis of PP. Methods Patients with PP, dermatitis, LP and PR were prospectively enrolled. The single most recently developed lesion was examined dermoscopically and histopathologically. Variables included vascular morphology, vascular arrangement, background colour, scale colour, scale distribution and presence of Wickham striae. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves. Results Eighty-three patients with PP and 86 patients with either dermatitis, LP or PR were included in the study. Dotted vessels in a regular arrangement over a light red background and white scales were highly predictive for the diagnosis of PP, whereas dermatitis more commonly showed yellow scales and dotted vessels in a patchy arrangement. PR was characterized by yellowish background, dotted vessels and peripheral scales; whitish lines (Wickham striae) were seen exclusively in LP. Conclusions PP, LP, PR and dermatitis show specific dermoscopic patterns that may aid their clinical diagnosis. Certain combinations of dermoscopic features can reliably predict the diagnosis of PP.
Granuloma faciale (GF) is a rare benign inflammatory dermatosis that usually develops as a solita... more Granuloma faciale (GF) is a rare benign inflammatory dermatosis that usually develops as a solitary brownish-red plaque on the face. It clinically mimics and is often misinterpreted as, sarcoidosis, lupus erythematosus, lupus vulgaris, lymphoma or basal cell carcinoma. Dermoscopy, which is valuable for evaluation and differentiation between malignant and benign skin tumors, allows better visualization of dermal vascular structures and color variations. In this context, it might serve as an adjuvant diagnostic tool in the differentiation of inflammatory disorders, too. In the current manuscript, we present the dermoscopic features observed in a lesion of GF and discuss them in correlation with the underlying histopathological alterations. (J Dermatol Case Rep. 2012; 6(2): 59-60)
Journal of the American Academy of Dermatology
Dermatology Practical & Conceptual, 2016
A 65-year-old woman presented in our department with a threeyear history of a new, slowly growing... more A 65-year-old woman presented in our department with a threeyear history of a new, slowly growing asymptomatic lesion on her vulva. The physical examination revealed a 10 mm sized,
Case Reports in Dermatological Medicine
We report a case report of lupus vulgaris (LV) presented on the extremities of an 80-year-old man... more We report a case report of lupus vulgaris (LV) presented on the extremities of an 80-year-old man. He was misdiagnosed as having psoriasis and referred to our department for a second-opinion evaluation. The discrepancy between the clinical manifestation which was misleading and the dermatoscopic findings raised the suspicion of an underlying granulomatous disease and we proceeded to skin biopsy. The histopathologic examination set the diagnosis of LV.
Journal of the European Academy of Dermatology and Venereology, 2000
Objective A double-blind, single-site, split-face clinical study was organized and carried out in... more Objective A double-blind, single-site, split-face clinical study was organized and carried out in order to evaluate the efficacy, tolerability, and safety of a glycolic acid containing scalp lotion in conjunction with a betamethasone (as the 17-valerate) scalp application against conditions of psoriasis. Background α-hydroxy acids (AHA) have been proposed as therapeutic modalities against skin exfoliative conditions such as ichthyosis, xeroderma, and psoriasis. AHAs are hereby clinically investigated as therapeutic modalities adjuvant to corticosteroids in order to diminish systemic and topical adverse sideeffects most frequently associated with use of the latter. Methods Twenty patients suffering from scalp psoriasis and other psoriatic conditions were included in a double-blind, split-face clinical study, using combinations of a 10% (w/w) glycolic acid scalp lotion, placebo lotion (excipients only), and a 0.1% (w/w) betamethasone scalp application, applied twice daily without any bandage for a period of 8 weeks. Clinical assessments were carried out by highly experienced physician evaluations based on a four-grade scale, prior to treatment and after 2, 4, 6 and 8 weeks. Results Improvement was observed in all cases included in the study following treatment with the 10% glycolic acid lotion. However, when equal parts of the 0.1% betamethasone lotion were combined, most of the treated sites were healed. Moreover, the duration of treatment required for healing was in this case reduced to approximately half of that needed when the glycolic acid or the betamethasone lotions were used separately for treatment. Conclusions The present clinical study demonstrates for the first time that the effective and well tolerated therapeutic efficacy of glycolic acid scalp lotions is enhanced when used in conjunction with a 0.1% betamethasone scalp application against scalp psoriasis. This potential offers the practising dermatologist with novel treatment modes against severe skin conditions by combining topical corticosteroid with exfoliative agent therapy.
Journal of the European Academy of Dermatology and Venereology
BackgroundReal‐world data in patients with moderate psoriasis treated with apremilast is limited.... more BackgroundReal‐world data in patients with moderate psoriasis treated with apremilast is limited.ObjectivesTo evaluate the effectiveness and safety of apremilast in bio‐naïve patients with moderate psoriasis in real‐world clinical settings.MethodsThis was a 52‐week multicenter, observational, prospective study of adult outpatients with moderate psoriasis {[10% < body surface area < 20% or 10 < psoriasis area severity index (PASI) < 20] and 10 < dermatology quality of life index (DLQI) < 20} initiated on apremilast ≤7 days before enrollment. Missing data were imputed using the last observation carried forward method.ResultsA total of 287 eligible patients (median age: 54.2 years; median psoriasis duration: 9.8 years) were consecutively enrolled. At baseline, the median DLQI and PASI scores were 12.0 and 11.8, respectively. The 52‐week DLQI ≤ 5 and PASI75 response rates were 68.3% and 61.0%. At 52 weeks, 70.8% and 72.7% of the patients shifted from moderate/severe/ve...
Journal of the European Academy of Dermatology and Venereology, 1995
Annales de dermatologie et de vénéréologie, 1996
Perforating necrobiosis lipoidica is a rare clinical form of necrobiosis lipoidica and is almost ... more Perforating necrobiosis lipoidica is a rare clinical form of necrobiosis lipoidica and is almost always associated with diabetes. Necrotized tissue is usually eliminated via transfollicular perforations. We report two cases of perforating necrobiosis lipoidica associated with type II diabetes mellitus. The characteristic clinical feature was the presence of keratotic plugs around the periphery of the lesions. Transfollicular perforation predominated in the first case. The second also presented epidermal perforation. There have been only 6 cases of perforating necrobiosis lipoidica in the literature. To our knowledge, this is the first case report of transepidermal elimination. We confirmed the constant association between this perforation type and diabetes mellitus.
Journal of the European Academy of Dermatology and Venereology, 1993
Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was,... more Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was, firstly, to assess the advisability of carrying out specific serological testing in the case of skin conditions certainly or possibly related to Borrelia burgdorferi (Bb) and, secondly, to evaluate the necessity and efficacy of treatment. Our research was carried out between 1988 and 1991 on 68 patients suffering from cutaneous diseases generally related to Bb and 57 control subjects. Specific IgM and IgG antibodies were detected by indirect immunofluorescence assay (IFA) and titers > 1/256 were considered as positive. All 57 control subjects were negative. Eighteen out of the 68 patients (26.5%) were positive. Eive out of the eight patients (62.5%) with cutaneous diseases certainly related to Bb, and 13 out of the 60 patients (21.6%) with skin diseases possibly related to Bb, were positive. The high percentage (26.5%) in skin diseases generally related to Bb suggests that patients with all these diseases should be tested by IFA. Negative results in control patients confirm the specificity of IFA and indicate that it is unnecessary to perform this investigation in the absence of specific clinical manifestations. Even though we regard scleroderma to be a late form of cutaneous borreliosis, it shows a favorable response to therapy, whereas granuloma annulare, even after titer elimination, remains clinically unchanged. Treatment should be administered not only to patients with high titers, but must be regarded as essential in all seropositive cases with dermatoses generally related to borreliosis, in view of the possibility of a late manifestation of the disease.
Journal of the European Academy of Dermatology and Venereology, 1997
The ultrastructure of dermal lymphatics in psoriasis was studied in two patients, Skin biopsies w... more The ultrastructure of dermal lymphatics in psoriasis was studied in two patients, Skin biopsies were taken from psoriatic plaques as well as apparently normal skin. The lymphatics were generally more conspicuous in the lesions than in the normal appearing skin. The wall of the lymphatic was lined by endothelial cells with many gap junctions. Valves like structures were seen protruding into the lumen. Irregular bands of frayed elastic fibers surrounded the lymphatic vessel. The ultrastructure changes were identical in psoriatic skin and in normal skin of psoriatic patients. The presence of excess gaps allows free access to and from the interstitial spaces. The abnormal or destroyed elastic fibers may contribute to disease morphology by way of lymphatic malformation. I P108 Clinical study of cyclosporin therapy on psoriasis: Comparative study between long-term continuous and interment therapies. The report on fourth-year results
Journal of the European Academy of Dermatology and Venereology, 2021
Apremilast is an oral phosphodiesterase‐4 inhibitor indicated for patients with moderate‐to‐sever... more Apremilast is an oral phosphodiesterase‐4 inhibitor indicated for patients with moderate‐to‐severe chronic plaque psoriasis and active psoriatic arthritis.
Granuloma faciale (GF) is a rare benign chronic inflammatory dermatosis that usually develops as ... more Granuloma faciale (GF) is a rare benign chronic inflammatory dermatosis that usually develops as a solitary brownish-red infiltrated plaque on the face. It clinically mimics, and is often misinterpreted as, sarcoidosis, lupus erythematosus, lupus vulgaris, lymphoma or basal cell carcinoma. 1 Dermoscopy allows better visualization of dermal vascular structures and color variations. Therefore, in recent years it is gaining appreciation in the era of inflammatory skin diseases. 2
Journal of the European Academy of Dermatology and Venereology, 2012
Early stage mycosis fungoides (MF) is difficult to be clinically differentiated from chronic derm... more Early stage mycosis fungoides (MF) is difficult to be clinically differentiated from chronic dermatitis (CD) in a high proportion of patients. Dermoscopy is a rapid, cheep, non-invasive and widely used method for the evaluation of skin tumours and, recently, of inflammatory skin diseases, as well. To describe the dermoscopic pattern of early stage MF and compare it with the dermoscopic features observed in CD. This was a retrospective study. Dermoscopic images of lesions that were clinically equivocal between MF and CD were evaluated for the presence of predefined morphologic criteria. Diagnosis had been histopathologically and immunohistochemically confirmed in all cases. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of mycosis fungoides. A total of 67 dermoscopic images were selected for dermoscopic evaluation. Mycosis fungoides lesions exhibited a characteristic dermoscopic pattern consisting of fine short linear vessels (sensitivity 93.7%, specificity 97.1%) and orange-yellowish patchy areas (sensitivity 90.6%, specificity 99.7%). A characteristic vascular structure resembling spermatozoa was also found to be highly specific for the diagnosis of mycosis fungoides. CD was typified by a different dermoscopic pattern, usually consisting of dotted vessels. These observations provide a first indication that early stage MF exhibits a characteristic dermoscopic pattern which is different from CD. Prospective studies with long term follow-up are needed to determine the value of these dermoscopic criteria in the differentiation between the two entities in the daily routine.
Clinical and Experimental Dermatology, 2011
has been used in a wide variety of dermatological surgery procedures, both cosmetic and noncosmet... more has been used in a wide variety of dermatological surgery procedures, both cosmetic and noncosmetic, to achieve safe and effective anaesthesia. The classic tumescent anaesthesia described by Klein, with a standard formula of 0.05% lignocaine and 1 : 1 · 10 epinephrine plus sodium bicarbonate (8.4%) in 1 L of saline (0.9%) works well for liposuction procedures. The sodium bicarbonate is added to adjust the solution to a more physiological pH, closer to the pKa of lignocaine. This technique provides anaesthesia for up to 24 h, reducing the need for postoperative analgesia and also allowing use of higher doses of lignocaine without risk of systemic side-effects. We use this modified tumescent technique regularly for wide and deep primary excisions and for large scar re-excisions on scalp, trunk and limbs. Varying volumes of 0.9% saline, between 10 and 200 mL, can be used in preparing the tumescent solution. In conclusion, we report use of tumescent anaesthesia in a dermatological surgical procedure. We feel that the extra time required in using modified tumescent anaesthesia is worthwhile because of the benefits it produces in wide and deep excisions in dermatological surgery. M. S. Shareef and A. Affleck* Department of Dermatology, Leeds General Infirmary, Leeds, UK; and *Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK E-mail: m.shareef@nhs.net Conflict of interest: none declared. Accepted for publication 22 July 2011
Clinical and Experimental Dermatology, 2014
British Journal of Dermatology, 2012
Journal of Investigative Dermatology, 2019
In this study, we investigated what exposure period to common pollutants and meteorological param... more In this study, we investigated what exposure period to common pollutants and meteorological parameters has the strongest association with eczema severity or probability of admission to hospital with eczema. Using two datasets from an urban population: local eczema patient emergency department (ED) visits (n¼ 1057) and data from a phenotyping study in an immigrant population (n¼363), we looked at the relationship of admission rates, eczema severity and local pollution/weather station data e 10 mm particulate matter (PM10) 2.5 mm
British Journal of Dermatology, 2014
Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell car... more Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell carcinoma (sBCC) after nonablative therapies has not been sufficiently assessed. Certain dermoscopic criteria, namely pigmented structures, ulceration and arborizing vessels, have been suggested to predict the presence of residual disease [residual disease-associated dermoscopic criteria (RDADC)]. We aimed to assess this hypothesis. Lesions exhibiting RDADC 3 months after treatment were biopsied and in the case of histopathological confirmation were excised. Lesions characterized by white/red structureless areas, superficial fine telangiectasias, or lacking any dermoscopic criterion, were monitored for 12 months. At the 3-month evaluation, one or more of the RDADC were detected in 25/98 (25·5%) sBCCs, in which histology confirmed tumour persistence. In 45 (61·6%) of the 73 remaining lesions, dermoscopy showed white/red structureless areas and/or superficial fine telangiectasias. Twenty-eight lacked any dermoscopic criterion of sBCC. The two latter groups entered follow-up. In total, disease recurred in 13 (17·8%) of the 73 lesions. RDADC accurately predict residual disease. Absence of dermoscopic criteria of sBCC safely predicts complete histopathological clearance. Detection of white/red structureless areas and/or superficial fine telangiectasias warrants close monitoring to recognize early recurrence.
British Journal of Dermatology, 2012
Background Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to... more Background Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to the field of inflammatory skin disorders. Plaque psoriasis (PP), dermatitis, lichen planus (LP) and pityriasis rosea (PR) are common inflammatory skin diseases, but little is currently known about their dermoscopic features. Objectives To determine and compare the dermoscopic patterns associated with PP, dermatitis, LP and PR and to assess the validity of certain dermoscopic criteria in the diagnosis of PP. Methods Patients with PP, dermatitis, LP and PR were prospectively enrolled. The single most recently developed lesion was examined dermoscopically and histopathologically. Variables included vascular morphology, vascular arrangement, background colour, scale colour, scale distribution and presence of Wickham striae. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves. Results Eighty-three patients with PP and 86 patients with either dermatitis, LP or PR were included in the study. Dotted vessels in a regular arrangement over a light red background and white scales were highly predictive for the diagnosis of PP, whereas dermatitis more commonly showed yellow scales and dotted vessels in a patchy arrangement. PR was characterized by yellowish background, dotted vessels and peripheral scales; whitish lines (Wickham striae) were seen exclusively in LP. Conclusions PP, LP, PR and dermatitis show specific dermoscopic patterns that may aid their clinical diagnosis. Certain combinations of dermoscopic features can reliably predict the diagnosis of PP.
Granuloma faciale (GF) is a rare benign inflammatory dermatosis that usually develops as a solita... more Granuloma faciale (GF) is a rare benign inflammatory dermatosis that usually develops as a solitary brownish-red plaque on the face. It clinically mimics and is often misinterpreted as, sarcoidosis, lupus erythematosus, lupus vulgaris, lymphoma or basal cell carcinoma. Dermoscopy, which is valuable for evaluation and differentiation between malignant and benign skin tumors, allows better visualization of dermal vascular structures and color variations. In this context, it might serve as an adjuvant diagnostic tool in the differentiation of inflammatory disorders, too. In the current manuscript, we present the dermoscopic features observed in a lesion of GF and discuss them in correlation with the underlying histopathological alterations. (J Dermatol Case Rep. 2012; 6(2): 59-60)
Journal of the American Academy of Dermatology
Dermatology Practical & Conceptual, 2016
A 65-year-old woman presented in our department with a threeyear history of a new, slowly growing... more A 65-year-old woman presented in our department with a threeyear history of a new, slowly growing asymptomatic lesion on her vulva. The physical examination revealed a 10 mm sized,
Case Reports in Dermatological Medicine
We report a case report of lupus vulgaris (LV) presented on the extremities of an 80-year-old man... more We report a case report of lupus vulgaris (LV) presented on the extremities of an 80-year-old man. He was misdiagnosed as having psoriasis and referred to our department for a second-opinion evaluation. The discrepancy between the clinical manifestation which was misleading and the dermatoscopic findings raised the suspicion of an underlying granulomatous disease and we proceeded to skin biopsy. The histopathologic examination set the diagnosis of LV.