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1.
Background
Sun exposure is critical for vitamin D synthesis and is a major risk factor for the development of non-melanoma skin cancer (NMSC). NMSC is the most common type of cancer in Brazil and coexists with a very high prevalence of vitamin D deficiency.Objectives
The present study aimed to assess serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with a recent diagnosis of NMSC.Materials & methods
The serum 25(OH)D concentration of patients with a histological diagnosis of NMSC, made between September 2016 and September 2017, was measured by chemiluminescence up to 60 days after diagnosis and compared to healthy individuals without NMSC matched by age, sex, BMI, and skin phototype.Results
Forty-one patients with NMSC and 200 healthy controls were evaluated. Most of the patients were men (56.1%) and most had basal cell carcinoma (90.2%). Patients were 67 years old on average (21-87 years) with skin Phototype 2 or 3 (80.6%). Mean serum 25(OH)D concentration inNMSCpatientswas significantly higher than in healthy controls (p<0.001). Most of the patients with NMSC (65.9%) had vitamin D deficiency (25[OH]D <30 ng/mL). No association was identified between histological type, time from diagnosis, or a previous history of skin neoplasm and 25(OH)D measurements.Conclusion
Patients with recently diagnosed NMSC had significantly higher serum levels of 25(OH)D when compared to healthy controls. On the other hand, most of the NMSC patients were still considered to have vitamin D insufficiency.2.
Anke Scheel-Sailer Angela Frotzler Gabi Mueller Simon Annaheim René Michel Rossi Siegfried Derler 《Journal of tissue viability》2017,26(2):89-94
Aim of the study
To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.Study design
An experimental controlled study with a convenience sample.Setting
A Swiss acute care and rehabilitation clinic specializing in SCIs.Materials and methods
We determined hydration, redness, elasticity and perfusion of the unloaded skin in the sacral region of 6 SCI/PU patients (affected and healthy skin), 20 SCI/PA patients and 10 able-bodied controls. These measures were made by two trained examiners after the patients were lying in the supine position.Results
The affected skin of SCI/PU patients showed elevated redness: median 595.5 arbitrary units (AU) (quartiles 440.4; 631.6) and perfusion: 263.0 AU (104.1; 659.4), both significantly increased compared to the healthy skin in SCI/PA patients and CON (p < 0.001). Similarly, healthy skin of SCI/PA patients showed elevated redness (p = 0.016) and perfusion (p < 0.001) compared to CON. On the other hand, differences in redness and perfusion between the affected and unaffected skin in SCI/PU patients were not significant. The results for skin hydration and skin elasticity were similar in all groups.Conclusions
Skin perfusion and redness were significantly increased in grade 1 PUs and for healthy skin in both SCI/PA patients and CON participants; thus, these are important in understanding the pathophysiology of PUs and skin in SCI. 相似文献3.
Shereen Farouk Gheida Yomna Mazid El-Hamd Neinaa Dareen Abd El-Aziz Mohammed 《Dermatologica Sinica》2018,36(4):179-184
Background
Caveolin-1 (CAV-1) is a key structural and functional membrane protein that is thought to play a role in controlling cellular proliferation and differentiation.Objective
To study the immunohistochemical expression of caveolin-1 in psoriasis and the two common types of non-melanoma skin cancers (NMSCs); basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in comparison to normal control skin and to correlate their expression with disease severity and progression.Patients and methods
This study included 90 patients and paraffin blocks (30 psoriasis, 30 BCC and 30 SCC) and 30 normal control skin specimens. Skin biopsy specimens were taken from all and examined for immunohistochemical expression of caveolin-1.Results
Significant reduction of caveolin-1 expression was detected in all studied patients groups in comparison to control group. Caveolin-1 expression in psoriasis showed significant downregulation with progression of Psoriasis Area and Severity Index (PASI) score. In addition, caveolin-1 expression was significantly decreased in aggressive types of BCC compared to non-aggressive types. Furthermore, poorly differentiated SCC showed significantly reduced caveolin-1 expression compared to moderately and well differentiated SCC.Conclusion
Caveolin-1 downregulation may increase the susceptibility to both benign and malignant hyperproliferative skin disorders. It could be useful as predictive biomarker of disease severity and progression. 相似文献4.
J.M. Ortiz-Salvador D.S. Ferrer M. Saneleuterio-Temporal A.M. Victoria Martínez A.P. Ferriols J.J. Vilata Corell V. Alegre de Miquel 《Actas dermo-sifiliográficas》2018,109(4):340-345
Background
The risk of skin cancer in patients treated with narrowband (NB) UV-B phototherapy is not well understood. Although experimental studies have shown that there is a risk, clinical studies have not detected an increased incidence of cancer following treatment. The aim of this study was to determine the incidence of nonmelanoma skin cancer (NMSC) in patients treated with NB UV-B phototherapy at a tertiary care hospital in the Mediterranean area.Material and methods
We conducted a retrospective chart review of 474 patients who received whole-body NB UV-B phototherapy at our hospital between 2002 and 2016 and identified those diagnosed with NMSC during follow-up. We calculated the corresponding crude and standardized incidence rates and compared these with rates in the general population in a similar geographic area.Results
Of the 474 patients, 193 (40.7%) were men and 281 (59.3%) were women. The mean (SD) follow-up period was 5.8 (3) years. The prevalence of NMSC at the end of the study period was 1.9% and the standardized incidence was 108.3 cases per 100 000 patient-years. The SIR of 1.9 in the study group was not significantly different from that of the general population. The number of patients who needed to be treated with NB UV-B phototherapy for 1 case of NMSC to occur was 1900.Conclusion
NB UV-B phototherapy does not appear to be associated with an increased risk of NMSC 相似文献5.
M. Schario T. Tomova-Simitchieva A. Lichterfeld H. Herfert G. Dobos N. Lahmann U. Blume-Peytavi J. Kottner 《Journal of tissue viability》2017,26(2):150-155
Background
Pressure Ulcers (PUs) are a severe form of skin and soft tissue lesions, caused by sustained deformation. PU development is complex and depends on different factors. Skin structure and function change during prolonged loading on PU predilection sites and surfaces being in direct contact with skin are likely to have an impact as well. Little is known about the influence of fabrics on skin function under pressure conditions.Objectives
To investigate skin responses to sustained loading in a sitting position and possible differences between two fabrics.Methods
Under controlled conditions 6 healthy females (median age 65.0 (61.0–67.8) years) followed a standardized immobilization protocol of a sitting position for 45 min on a spacer and on a cotton fabric. Before and after the loading period skin surface temperature, stratum corneum hydration, transepidermal water loss (TEWL), erythema, skin elasticity and ’relative elastic recovery‘ were measured at the gluteal areas.Results
A 45 min sitting period caused increases of skin surface temperature and erythema independent of the fabric. Loading on spacer fabric showed a two times higher increase of TEWL compared to cotton. Stratum corneum hydration showed slight changes after loading, skin elasticity and ’relative elastic recovery’ remained stable.Conclusions
Sitting on a hard surface causes skin barrier changes at the gluteal skin in terms of stratum corneum hydration and TEWL. These changes are influenced by the fabric which is in direct contact to the skin. There seems to be a dynamic interaction between skin and fabric properties especially in terms of temperature and humidity accumulation and transport. 相似文献6.
7.
Dimitri Beeckman 《Journal of tissue viability》2017,26(1):47-56
Background
Incontinence-Associated Dermatitis (IAD) is one of the clinical manifestations of Moisture- Associated Skin Damage (MASD). IAD is a common problem in aged patients with fecal and/or urinary incontinence.Aim
Update about IAD terminology, etiology, epidemiology, observation, prevention, and treatment.Methods
Integrative review.Results
The lack of an ICD-10 code and an internationally validated and standardized method for IAD data collection contribute to a variation in epidemiological data. Frequent episodes of incontinence (especially fecal), occlusive containment products, poor skin condition, reduced mobility, diminished cognitive awareness, inability to perform personal hygiene, pain, pyrexia, certain medications (antibiotics, immunosuppressants), poor nutritional status, and critical illness are associated with IAD. Correctly diagnosing IAD and distinguish it from pressure ulcers is difficult. Even though the clinical presentation of partial thickness pressure ulcers and IAD is similar, the underlying etiologic factors differ. However, incontinence and IAD were found to be risk factors for pressure ulcer development. IAD management should essentially focus on skin cleansing to remove dirt, debris and microorganisms; skin moisturization to repair or augment the skin's barrier; and the application of a skin barrier product to prevent skin breakdown by providing an impermeable or semi-permeable barrier on the skin. The body of evidence is still limited, but growing since the last decade.Conclusion
Incontinence causes disruptions of the skin barrier function and leads to superficial skin damage. Macerated skin and superficial skin changes due to incontinence are associated with pressure ulcer development. Skin maceration, chemical irritation, and physical irritation should be targeted to effectively prevent and treat IAD. 相似文献8.
9.
M. Turkmen B. Gerceker Turk I. Kilinc Karaarslan B. Yaman F. Ozdemir 《Dermatologica Sinica》2018,36(3):136-139
Background
Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white population. The typical dermoscopic features of pigmented BCCs have been well known. In the literature a new dermoscopic pattern of BCC has been reported as “blue-white variant”.Objective
In this study, we aimed to evaluate the blue-white variant of BCC's seen in our cases at our Dermato-oncology Unit.Methods
Patient files between the years 2003–2011 were searched for the cases with the histopathologic diagnosis of BCC. Among them, the cases that were compatible with the diagnosis of blue-white variant of BCC were determined. The morphological and clinical features of the lesions, dermoscopic images together with the histopathological slides were all evaluated.Results
Among 350 histopathologically proven BCCs, 3.1% of them showed diffuse blue-white areas, namely “the blue-white variant”. On histopathological examination, typical aggregates of basaloid cells with nuclear atypia connected focally to the epidermis were observed. To our knowledge, this is the first research about the blue-white variant of pigmented BCC.Conclusion
The blue-white variant of pigmented BCC seems to be the most challenging type of BCC in the diagnosis for the clinician. 相似文献10.
Background
The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned.Objectives
To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration.Design
Judgement Analysis.Setting
UK community and primary care nursing services.Participants
18 community non-specialist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses.Methods
Using judgement analysis methods, 18 community non-specialist nurses and 18 community tissue viability specialist nurses made diagnoses and treatment judgements about compression therapy for 110 clinical scenarios and indicated their confidence for each judgement. An expert panel made consensus judgements for the same scenarios and these judgements were used as a standard against which to compare the participants. Confidence analysis was used to assess the nurses' confidence about their diagnostic judgements and treatment choices.Results
Despite being very experienced, both non-specialist nurses' and specialist tissue viability nurses' levels of confidence were not well calibrated with their levels of accuracy.Conclusion
The results of this study are important as errors resulting from both over and under-confidence at the diagnostic phase of management may influence treatment choices, and thus increase the chances of treatment error. 相似文献11.
Background
Chronic inflammatory conditions, such as psoriasis, may pose an increased risk of cancer due to impaired immunosurveillance resulting from chronic inflammation and immunosuppressive medications.Objectives
To compare the risk of non-melanoma skin cancer (NMSC) in a retrospective cohort of 72,739 psoriasis patients and 25,956 non-dermatological patients.Materials & methods
Arecord linkagewas performed for data on hospitalizations, and the occurrence ofNMSCwas compared by computing the relative risk (RR) and modelled using multiple logistic regression.Results
Overall, the occurrence of NMSC was 9.6‰ (95% CI: 8.9-10.3‰) in psoriasis patients and 19.6‰ (95% CI: 18.0-21.4‰) in non-dermatological patients (RR = 0.49; 95% CI: 0.44-0.55). The simultaneous adjustment for gender, age, and phototherapy yielded a RR of 0.84 (95% CI: 0.75-0.95). With regards to phototherapy, the occurrence of NMSC was significantly higher among psoriasis patients who underwent phototherapy relative to those who did not (27.0‰ vs. 9.3‰).Conclusions
In this large retrospective study, we found that patients with psoriasis had a 16% lower probability of having NMSC when compared to a group of non-dermatological patients. Further studies, preferably with a prospective longitudinal design to collect more precise data, are needed to corroborate our findings.12.
Zahra Beygom Mousavi Abolfath Mehrabian Fereshteh Golfakhrabadi Foroogh Namjoyan 《Dermatologica Sinica》2018,36(4):196-199
Background/Objective
Genital warts are caused by human papilloma virus (HPV) and usually have no promising cure. Garlic (Allium sativum) belongs to Liliaceae family, which has a long history of medicinal use. The garlic extract had antiviral and anticarcinogenic effects and can be effective on complete resolution of cutaneous wart. The aim of this clinical study was to compare the garlic extract effect with cryotherapy in the treatment of male genital wart.Methods
35 male patients aged 20–54 years old with clinically diagnosed genital warts who had more than two warts on both sides of genital region enrolled in the study. Cryotherapy with liquid nitrogen (?196 °C temperature) was performed for all right sided warts and 10% garlic extract was applied on all left-sided warts for 2 months.Results
Regarding response to treatment, at the end of weeks 2, 4, 6 and 8 there was no significant difference between two groups (P > 0.05). 69.7% and 78.8% of patients showed complete clearing of the lesions in the garlic and cryotherapy groups respectively (P value, 0.39).Conclusions
The present study revealed 10% garlic extract after 2 months duration therapy on the male genital warts had the similar effect in compare to cryotherapy. 相似文献13.
Background/Objective
Idiopathic guttate hypomelanosis (IGH) is a common disease that appears mainly in trunk, arms, and legs. IGH is a benign leukoderma characterized by multiple, hypo- or depigmented discrete macules. Although melanocytes have been reported to decrease in number in the IGH macules, changes in melanoblast number are not known. Moreover, satisfactory therapies for this disease have not been established. In this study, we investigated the presence of melanoblasts in the IGH macules, and tried to treat the IGH macules by mini-punch grafting using a machine (mMG) in combination with narrow-band ultraviolet B (NB-UVB) therapy.Methods
Mini-punch biopsies of the lesional skin of five patients (11–72-year-old men and woman) were fixed and processed to dopa and combined dopa-premelanin reactions to detect melanocytes and melanoblasts.Results
Although similar melanocyte density was observed in the lesional epidermis compared with the normal epidermis, melanoblast density was dramatically decreased. Moreover, epidermal melanin accumulation was greatly reduced in the lesional skin. For the treatment of the IGH macules, numerous mini-punch biopsies were removed from both recipient lesional skin and donor normal scalp skin, and then the donor biopsies were placed into the holes of the lesional skin. After 1 week, we started to expose NB-UVB to the lesional skin and continued the exposures. Excellent color-matched repigmentation was soon obtained.Conclusion
These results suggest that melanoblast proliferation and/or differentiation in addition to the melanosome transfer are defected in IGH, and the mMG and NB-UVB can support the excellent color-matched repigmentation. 相似文献14.
Background
Skin cancer incidence is rising, placing a burden on healthcare systems worldwide. This problem may even be more extensive than expected, since registration of (pre)malignancies of the skin is poor.Objective
To provide insight into the numbers of (pre)malignancies in patients with actinic keratosis (AK) or basal cell carcinoma (BCC) in 2 university and 2 general hospitals.Methods
The types and numbers of previous tumours and of tumours during a two-year follow-up were collected from 574 patients.Results
Mean time between the first diagnosed (pre)malignancy and time of inclusion was 6.6 years. Overall, 60% had multiple types of (pre)malignancies. In BCC patients, 61% had multiple BCCs, in patients with squamous cell carcinoma (SCC), 40% had multiple SCCs. The combination ‘BCC and SCC’ occurred in 10%, ‘BCC and AK’ in 47%, ‘SCC and AK’ in 14%.Conclusion
High numbers of patients with multiple (pre)malignancies were found in this patient population in university and general hospitals, which may well reflect the Dutch hospital population.We conclude that skin cancer patients are more extensively affected than was expected up till now. Consequently, the management of skin cancer may be in need of adaptation in near future and the question arises whether dermatologists have the capacity for providing care for all these patients.15.
Andrea Lichterfeld-Kottner Elisabeth Hahnel Ulrike Blume-Peytavi Jan Kottner 《Journal of tissue viability》2017,26(1):6-19
Background
Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far.Objectives
The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years).Methods
A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used.Results
Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed.Conclusions
Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was identified. Because of the overall low methodological quality clear cut conclusions cannot be drawn. Robust and large scales economic evaluations about skin conditions and disease in aged populations are needed in the future. 相似文献16.
Christopher Heard Wendy Chaboyer Vinah Anderson Brigid M. Gillespie Jennifer A. Whitty 《Journal of tissue viability》2017,26(1):79-84
Background
Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness.Objective
To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial.Methods
An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained.Results
Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates.Conclusions
NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds.Australian and New Zealand trial registration number
ACTRN12612000171819. 相似文献17.
Emek Kocatürk Etikan Piril Taskapan Oktay Atakan Nilgun Erdem Teoman Utas Serap Savk Ekin Bulbul Baskan Emel Koca Rafet Aktan Sebnem 《Dermatologica Sinica》2018,36(2):70-74
Background/Objectives
Chronic spontaneous urticaria (CSU) is a common skin disorder which represents a challenge both for the patients and physicians. Guidelines and treatment algorithms have been created to help physicians to ease management. Our aim was to determine Turkish dermatologists' approach to CSU with regard to treatment, search for causative factors and use of instruments to assess the quality of life and severity of the disease.Methods
This was a cross-sectional methodological study which was performed by delivery of a questionnaire including ten questions about the management of CSU.Results
Analyses of 314 questionnaires revealed that the most common first-line treatments were non-sedating antihistamines in standard doses (65.6%), while second-line treatment was updosing antihistamines (59.9%) followed by addition of sedative-antihistamines (26.4%) and systemic steroids (19.1%). Third-line treatment option was omalizumab in 35% followed by systemic steroids. Twenty-two percent of the dermatologists referred the patients to a center experienced in urticaria. Most of them were performing laboratory testing for underlying causes including thyroid function tests, C-reactive protein, thyroid auto-antibodies, stool analyses, infection markers. Urticaria activity score and chronic urticaria quality of life questionnaire were used by 30 and 13%, respectively, while 56% were using none of the instruments.Conclusion
Our study showed that the therapeutic management of Turkish dermatologists was parallel to the European Urticaria Guidelines. The high utility of omalizumab as a third line regimen improved patient care. Nevertheless there is a need for centers experienced in urticaria to refer antihistamine-resistant patients where third-line treatment options can not be implemented. 相似文献18.
Yoshiko Takahashi Tetsuya Nemoto Fumihiro Mizokami Katsunori Furuta Yusuke Murasawa Masahiko Yoneda Zenzo Isogai 《Journal of tissue viability》2017,26(1):75-78
Aim
A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. Although the external forces and bony prominences differ depending on ulcer location, the way in which these anatomical differences affect pressure ulcer development is not well studied.Methods
To clarify the location-dependent factors for pressure ulcer development, we focused on superficial injuries that develop over an undermining lesion, which we have termed them bilayer pressure ulcers. Because it is thought that a deep pressure ulcer is caused by ischemia at the deep lesion and a shallow pressure ulcer is caused by shear force to the superficial skin, a bilayer pressure ulcer can be considered a mixed phenotype, induced by both pressure and shear force. We retrospectively examined the frequency of bilayer pressure ulcers by location in a total of 568 pressure ulcers.Results
The ratio of bilayer pressure ulcers to deep pressure ulcers staged III or more was significantly larger for pressure ulcers over the sacrum.Conclusion
A new concept, the relative position between the external force and bony prominence, could explain the frequency and developmental mechanism of bilayer pressure ulcers. The external forces, shape of the bony prominence, and mobility of the soft tissue may be responsible for this concept. 相似文献19.
E.C. Cortés-Peralta J. Ocampo-Candiani O.T. Vázquez-Martínez I.M. Gutiérrez-Villarreal I. Miranda-Maldonado V. Garza-Rodríguez 《Actas dermo-sifiliográficas》2018,109(1):47-51
Background
Histological diagnosis of a clinically suspected nonmelanoma skin cancer (NMSC) is recommended before treatment. For NMSC, concordance between the histological subtype of the preoperative biopsy and the excision specimen of basal cell carcinoma (BCC) has been reported to range from 10% to 81%. No large study on the concordance between NMSC histology seen in a preoperative biopsy with the following tumour specimen from Mohs micrographic surgery (MMS) has been performed in a Latin American population.Objective
The aim of this study was to analyse and compare the histological subtype of the incisional biopsies reviewed by the dermatopathologist with the histological subtype of the tumour specimen obtained during MMS interpreted by the dermatopathologist and the Mohs surgeon.Methods
A retrospective analysis of 320 NMSC was performed. The interobserver correlation was based on kappa values.Results
The mean weighted kappa value between the preoperative NMSC biopsy and intraoperative histological subtype of the tumour specimen from MMS analysed by the Mohs surgeon and the dermatopathologist was 0.22 and 0.24, respectively. The correlation in the histologic subtype of the intraoperative tumour specimen from MMS that was interpreted by the dermatopathologist and Mohs surgeon was 0.58.Conclusions
Dermatologists need to be aware of the limited value of incisional biopsies to accurately diagnose the histological subtype of a NMSC. The concordance rate in the histological diagnosis of the tumour specimens that were obtained from MMS between the Mohs surgeon and the dermatopathologist is moderate. However, the correlation is low compared with incisional biopsy subtypes. 相似文献20.