Skin Lesion Detection Algorithms in Whole Body Images.

Melanoma is one of the most lethal and rapidly growing cancers, causing many deaths each year. This cancer can be treated effectively if it is detected quickly. For this reason, many algorithms and systems have been developed to support automatic or semiautomatic detection of neoplastic skin lesions based on the analysis of optical images of individual moles. Recently, full-body systems have gained attention because they enable the analysis of the patient's entire body based on a set of photos. This paper presents a prototype of such a system, focusing mainly on assessing the effectiveness of algorithms developed for the detection and segmentation of lesions. Three detection algorithms (and their fusion) were analyzed, one implementing deep learning methods and two classic approaches, using local brightness distribution and a correlation method. For fusion of algorithms, detection sensitivity = 0.95 and precision = 0.94 were obtained. Moreover, the values of the selected geometric parameters of segmented lesions were calculated and compared for all algorithms. The obtained results showed a high accuracy of the evaluated parameters (error of area estimation <10%), especially for lesions with dimensions greater than 3 mm, which are the most suspected of being neoplastic lesions.

The use of reflectance confocal microscopy in selected inflammatory skin diseases.

Reflectance confocal microscopy is a modern, non-invasive diagnostic method that enables real-time imaging of the epidermis and upper layers of the dermis with nearly histological precision and high contrast. The application of this technology to skin imaging during the last years has resulted in progress of dermatological diagnosis, providing virtual access to living skin, without the need for conventional histopathology. The presented method potentially has broad application in the diagnosis of skin diseases. This article provides a summary of the latest reports and previous achievements in the field of reflectance confocal microscopy. General characteristics of confocal images in selected inflammatory skin diseases are presented.

Mast cells in systemic and cutaneous lupus erythematosus.

Mast cells (MCs) are known to be regulators of inflammation and immunity, due to the released mediators and expressed cell surface molecules. Lupus erythematosus (LE) is a group of diseases which can be systemic or limited to the skin. Due to the fact that cytokines and chemokines produced by inflammatory cells contribute to the pathogenesis of LE, we quantified the number of mast cells present in the skin. The aim of the study was to compare the chymase-positive and tryptase-positive mast cell counts within skin biopsies from patients with systemic lupus erythematosus (SLE), discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE). The material consisted of 45 skin biopsies: 6 with SLE, 34 with DLE and 5 with SCLE. Chymase- and tryptase-positive cells were stained by immunohistochemistry and counted. The mean count of chymase-positive mast cells was 85.14 hpf for the whole group, 35.83 for SLE, 88.48 for DLE and 121.6 for SCLE. The mean count of tryptase-positive cells was 120.05 hpf for the entire group, 59.17 for SLE, 126.42 for DLE and 149.8 for SCLE. The differences between groups were significant for chymase- and tryptase-positive cells.

The use of reflectance confocal microscopy for examination of benign and malignant skin tumors.

Reflectance confocal microscopy (RCM) is a modern, non-invasive diagnostic method that enables real-time imaging of epidermis and upper layers of the dermis with a nearly histological precision and high contrast. The application of this technology in skin imaging in the last few years has resulted in the progress of dermatological diagnosis, providing virtual access to the living skin erasing the need for conventional histopathology. The RCM has a potential of wide application in the dermatological diagnostic process with a particular reference to benign and malignant skin tumors. This article provides a summary of the latest reports and previous achievements in the field of RCM application in the diagnostic process of skin neoplasms. A range of dermatological indications and general characteristics of confocal images in various types of tumors are presented.

Elevated cerebrospinal fluid interleukin-17A and interferon-γ levels in early asymptomatic neurosyphilis.

BACKGROUND: The mechanisms underlying the process of Treponema pallidum clearance from the central nervous system have not yet been established. Considering that neurosyphilis is associated with mild cerebrospinal fluid (CSF) pleocytosis with a lymphocytic predominance, it has been suggested that cells involved in the adaptive immune response may play a role in this process. In the current study, we assessed the cytokine production profile of T-helper cells in the serum and CSF of patients with early syphilis, with and without CSF abnormalities. METHODS: Cerebrospinal fluid and blood samples were collected from 33 patients with secondary and early latent syphilis. Five patients (15%) had a reactive CSF Venereal Disease Research Laboratory test without any accompanying neurological symptoms. According to the Centers of Disease Control and Prevention classification, they were diagnosed with asymptomatic neurosyphilis. Serum and CSF levels of interferon-γ (IFN-γ; Th1-type cytokine), interleukin-4 (IL-4; Th2-type cytokine), and interleukin-17A (IL-17A; Th17-type cytokine) were determined by enzyme-linked immunosorbent assay. RESULTS: Patients with asymptomatic neurosyphilis had significantly higher levels of IL-17A (8-fold) and IFN-γ (7.8-fold) in the CSF compared with patients in the no-neurosyphilis group. Six individuals had CSF pleocytosis but a negative CSF Venereal Disease Research Laboratory test result (presumptive neurosyphilis group). In this group, CSF IFN-γ and CSF IL-17A levels were also significantly elevated when compared with no-neurosyphilis group. There was no correlation between serum and CSF concentrations of IL-17A. However, CSF pleocytosis correlated positively with both CSF IL-17A (r = 0.4, P = 0.01) and IFN-γ (r = 0.42, P = 0.01). CONCLUSIONS: Increased CSF levels of IFN-γ and IL-17A in syphilitic patients with CSF abnormalities suggest that cells of adaptive immunity (probably T-helper cells producing IFN-γ and IL-17) may contribute to the inflammatory response associated with neurosyphilis. In addition, the lack of correlation between serum and CSF IL-17A levels suggests intrathecal production of this cytokine. Further studies are needed to establish the exact nature of the immune response accompanying neurosyphilis and its clinical significance.

[Type I and II collagens and mast cells expression in the skin lesions from the patients with localized scleroderma]. / Ekspresja kolagenów typu I i III oraz mastocytów w zmianach skórnych u chorych na twardzine skórna.

Morphea en plaques (MP) and atrophoderma Pasini-Pierini (APP) are by most researchers regarded as specific types of localized scleroderma (LS), but their clinical picture is completely different. Fibrosing process is very complicated, and is connected with presence of collagen (I and III type) and extracellulare matrix deposits in the dermis. Probably mast cells also play an important role in this process. The aim of the study is estimation of the expression of type I and III collagens and number of mast cells in lesions from patients with APP and MP. 36 patients were enrolled to the study. Immunohistochemical tests were performed to observe presence of type I and III collagens and presence of mast cells in the dermis. We observed that patients with APP showed lower expression of the I and III type collagens in the dermis than patients with MP. Expression of I type collagen decreases with time only among patients with MP. There was no similar relation for type III collagen. High and very high expression of type I and III collagen was observed more frequently in the active phase of the disease in patients with MP. Number of mast cells was higher in patients with APP than in MP. The number of the mast cells increases with time of disease in patients with MP, and there is correlation between high number of mast cells and low expression of the I and III collagens in the patients with MP.

[The clinical picture of morphea]. / Obraz kliniczny twardziny skórnej.

Skin scleroderma (LS) is characterised by stiffness of skin and/or deeper tissues. As opposed to systemic scleroderma, the involvement of internal organs and Raynaud phenomenon are predominately not observed in morphea. LS is quite rare disease, more frequent in women and young people. There are several useful classifications of skin scleroderma in literature, however the classification which concerns the shape and extension of LS lesion and depth of stiffness is concerned to be the most clear. LS is divided into: plaque morphoea, generalised morphoea, blistering morphoea, linear morphoea and deep morphoea. Different types of skin scleroderma lesions can be observed in one patient or can combine linear and deep fibrosis. Presented classification is clinically useful and it has prognostic and therapeutic implications.

[Eosinophilic fasciitis--current database]. / Eozynofilowe zapalenie powiezi--aktualny stan wiedzy.

For the first time eosinophilic fasciitis (EF) was described by Shulman. It occurs predominantly in young men, rarely in older women and sporadically in children. The illness was characterised by swelling of the extremities, skin changes, myalgia, and elevation of the peripheral blood eosinophils count and hypergammaglobulinemia. It is followed by rapidly progressive cutaneous and subcutaneous indurations. The histopathologic examination of affected skin shows thickening of the fascia, deep dermal fibrosis and infiltration mainly consists of lymphocytes, plasmocytes, eosinophils. It is suggested that the cells from infiltration induce fibrosis. The tryptophan disturbance has significant influence on development of EF in predisposed persons. Eosinophilic fasciitis is classified into wide spectrum of scleroderma disorders by many authors. The authors tried to show differences between EF, morphea and systemic scleroderma.

[Eosinophilic fasciitis--current knowledge]. / Eozynofilowe zapalenie powiezi--aktualny stan wiedzy.

First time eosinophilic fasciitis (EF) was described by Shulman. It occurrences predominantly in young men, rarely older women, sporadic in children. The illness was characterised by swelling of the extremities, skin changes, myalgia, and elevation of the peripheral blood eosinophil count and hypergammaglobulinemia. It is followed by rapidly progressive cutaneous and subcutaneous induration. The histopathologic examination in the region of affected skin shows thickening of the fascia, deep dermal fibrosis and infiltration mainly consists of lymphocytes, plasmocytes, eosinphils. It is suggested that the cells from infiltration induce fibrosis. The tryptophan disturbance has significant influence on development of EF in predisposed persons. Eosinophilic fasciitis is classified to wide spectrum of scleroderma disorders by many authors. The authors tried to show differences between EF, morphea and systemic scleroderma.

[Contemporary, noninvasive methods of wrinkles treatment, possibilities and esthetic dermatology]. / Wspólczesne metody niechirurgicznego leczenia zmarszczek; mozliwosci dermatologii estetycznej.

Wrinkles are the most visible sign of the aging skin. The author presented characteristic changes in the epithelium and dermis for that type of skin and therapeutic possibilities utilised in the esthetic dermatology. They also undertook an attempt to classify patients for particular types of revitalization interventions (implants, botulin toxin, peelings).

[Presence of the antinuclear antibodies and antibodies to Borrelia burgdorferi among patients with morphea en plaque, deep linear scleroderma and atrophoderma Pasini-Pierini]. / Obecnosc przeciwcial przeciwjadowych i przeciw Borrelia burgdorferi u chorych z twardzina plackowata, linijna gleboka i atrophoderma Pasini-Pierini.

Circumscribed scleroderma belongs to the groups of the diseases characterized by fibrosis of the skin and the deeper tissue. According to the published data, 47% to 76% patients with circumscribed scleroderma present antinuclear antibodies (ANA) as well as antibodies to Borrelia burgdorferi which is believed to be causative factor of the disease. The study was conducted in the group of 50 consecutive patients with circumscribed sclerosis (en plaque, deep linear, atrophoderma Pasini-Pierini). Antinuclear antibodies were detected in 18% of the patients in the titer of 1:40 to 1:320. There was statistically significant correlation between activity of the disease and extensiveness of the skin lesions as well as location on the lower extremities although there was no correlation to the clinical symptoms of the disease. In 28.5% of the patients we found antibodies to Borrelia burgdorferi with any correlation to the type of localized scleroderma or its activity. The role of the ANA with no distinctive specificity and antibodies to Borrelia burgdorferi in the localized scleroderma is still unclear.

[Esophageal scintigraphy in patients with systemic sclerosis: clinical symptoms correlated with the esophagus noted by the patients]. / Badanie scyntygraficzne przelyku u chorych z twardzina ukladowa; korelacje z objawami klinicznymi ze strony przelyku zglaszanymi przez chorych.

Systemic sclerosis (SSc) is a multisystem connective tissue disorder characterized by excessive accumulation of the extracellular matrix. About 90% of the patients with SSc have detectable gastrointestinal tract involvement, 50% of these patients have clinically important manifestations. The aim of the study was estimation of the connection between subjective symptoms from the esophagus and results of the esophageal scintigraphy. 30 patients with systemic sclerosis were comprised to the study. Esophageal scintigraphy was performed in each patients, as well as questionnaire about type, intensity and frequency of esophageal dysmotility. Also it estimated was stiffness of the skin according to modified Rodnan score. Independent of esophageal dysmotility symptoms which were noted by patients, esophageal scintigraphy registered changes in 97% of the patients. The most often esophageal dysmotility was observed in lower part of the esophagus. Statistically Dysmolity of the central portion of the esophagus was observed more often in patients with diagnosed ISSc.

[Clinical types of acanthosis nigricans]. / Typy kliniczne rogowacenia ciemnego.

Acanthosis nigricans is a rare disease, occurring with the same frequency in females and males. Eight clinically practical types of this disease have been presented. Authors also observed a coexistence of this disease with neoplasms, which obligates doctors to perform more accurate diagnosis of the patient. The clinically practical scale of the intensification of skin lesions in acanthosis nigricans has been also presented. This scale is helpful in therapy monitoring.