Background:The cutaneous presentation of Langerhans cell histiocytosis (LCH) is very rare and can be highly variable among individuals, which can often lead to a delay in diagnosis.Objective:To dis...

Langerhans Cell Histiocytosis

Background: It is often difficult to differentiate early melanoma from benign pigmented lesions of similar clinical appearance. Objective: Our purpose was to develop a computer image analysis system that has the potential for use as an adjunct to the clinical distinction of melanoma from less serious pigmented lesions. Methods: The system, consisting of a hand-held device incorporating a color video camera and color frame grabber mounted in a microcomputer, was used in a pigmented lesion clinic. Analysis software extracted features relevant to the size, color, shape, and boundary of each lesion, and these features were correlated with clinical and histologic characteristics on which standard diagnoses of skin tumors are based. For discriminant analysis based on image analysis measurements, equal prior probabilities were assigned to two specified diagnostic groups, namely melanoma and "other pigmented lesions," most of which were melanocytic nevi. Results: In a 20-month period, video images of 164 unselected pigmented lesions for which complete diagnostic data were available were successfully captured using the camera. Sixteen of 18 melanomas, and 89% of pigmented lesions overall, were correctly classified by the image analysis system, compared with 83% based on clinical gradings of lesion characteristics. Conclusion: Computer image analysis has the potential to provide a valuable diagnostic aid that could enable clinicians to make highly sensitive and specific diagnoses of early, curable melanoma.

https://genepi.qimr.edu.au/contents/p/staff/CV142.pdf

Computer image analysis in the diagnosis of melanoma

Background: Skin cancer is the most common cancer in the United States. Increasing evidence suggests that screening for malignant melanoma is effective, but its cost-effectiveness has not been determined. Objective: We attempted to determine the effectiveness and costs of a visual screen to diagnose malignant melanoma in high-risk persons. Methods: We developed a decision analysis comparing no skin cancer screen with a single screen by a dermatologist. Clinical outcomes included malignant melanoma, nonmelanoma skin cancer, or no skin cancer. Life expectancy and costs of care were projected on the basis of clinical findings. Results: Skin cancer screening increased average discounted life expectancy from 15.0963 years to 15.0975 years. Based on the prevalence of malignant melanoma, however, this translates into an increased discounted life expectancy of 0.9231 years for each person with diagnosed melanoma. Using a cost of $30 per screen, total skin cancer–related costs for a cohort of 1 million people increased from $826 million with no screen to $861 million with screening, with an increase of 1200 years of life. This results in an incremental cost-effectiveness ratio of $29,170 per year of life saved (YLS) with screening. Sensitivity analysis showed that the cost-effectiveness ratio for screening remained below $50,000/YLS if the prevalence of melanoma in the screened population was at least 0.0009, the probability that a melanoma detected in screening was localized was at least 94.8%, or the cost of each screen was below $57. Conclusion: Skin cancer screening in high-risk patients is likely to be associated with a small increase in discounted life expectancy and is reasonably cost-effective compared with other cancer screening strategies. (J Am Acad Dermatol 1999;41:738-45.)

https://www.jaad.org/article/S0190-9622(99)70010-1/pdf

Screening for malignant melanoma: A cost-effectiveness analysis.

A definitive diagnosis of Langerhans cell histiocytosis (LCH) requires a combination of clinical presentation, histology, and immunohistochemistry. The inflammatory infiltrate contains various proportions of LCH cells, the disease hallmark, which are round and have characteristic "coffee-bean" cleaved nuclei and eosinophilic cytoplasm. Positive immunohistochemistry staining for CD1a and CD207 (langerin) are required for a definitive diagnosis. Isolated cutaneous disease should only be treated when symptomatic, because spontaneous resolution is common. Topical steroids are first-line treatment for localized disease of skin and bone. For multifocal single-system or multisystem disease, systemic treatment with steroids and vinblastine for 12 months is the standard first-line regimen. Current research is seeking more effective regimens because recurrence rates, which increase the risk of sequelae, are still high (30-50%) in patients with multisystem disease. An active area of research is the use of targeted therapy directed at the mitogen-activated protein kinase pathway. Adequate follow-up to monitor for disease progression, relapse, and sequelae is recommended in all patients.

https://www.jaad.org/article/S0190-9622(17)31931-X/pdf

Langerhans cell histiocytosis in children: Diagnosis, differential diagnosis, treatment, sequelae, and standardized follow-up.

Objective To compare the accuracy of dermatologists and primary care physicians (PCPs) in identifying pigmented lesions suggestive of melanoma and making the appropriate management decision to perform a biopsy or to refer the patient to a specialist. Data Sources Studies published between January 1966 and October 1999 in the MEDLINE, EMBASE, and CancerLit databases; reference lists of identified studies; abstracts from recent conference proceedings; and direct contact with investigators. Medical subject headings includedmelanoma, diagnosis, screening, primary care, family practitioner, general practitioner, internal medicine, dermatologist, andskin specialist. Articles were restricted to those involving human subjects. Study Selection Studies that presented sufficient data to determine the sensitivity and specificity of dermatologists' or PCPs' ability to correctly diagnose lesions suggestive of melanoma and to perform biopsies on or refer patients with such lesions. Data Extraction Two reviewers independently abstracted data regarding the sensitivity and specificity of the dermatologists and PCPs for diagnostic and biopsy or referral accuracy. Disagreements were resolved by discussion. The quality of the studies was also evaluated. Data Synthesis Thirty-two studies met inclusion criteria; 10 were prospective studies. For diagnostic accuracy, sensitivity was 0.81 to 1.00 for dermatologists and 0.42 to 1.00 for PCPs. None of the studies reported specificity for dermatologists; one reported specificity for PCPs (0.98). For biopsy or referral accuracy, sensitivity ranged from 0.82 to 1.00 for dermatologists and 0.70 to 0.88 for PCPs; specificity, 0.70 to 0.89 for dermatologists and 0.70 to 0.87 for PCPs. Receiver operating characteristic curves for biopsy or referral ability were inconclusive. Conclusions The published data are inadequate to demonstrate differences in dermatologists' and PCPs' diagnostic and biopsy or referral accuracy of lesions suggestive of melanoma. We offer study design suggestions for future studies.

https://jamanetwork.com/journals/jamadermatology/articlepdf/478587/dea10008.pdf

A comparison of dermatologists' and primary care physicians' accuracy in diagnosing melanoma: a systematic review.

Although screening for melanoma/skin cancer is theoretically of value, few data are available to evaluate its effectiveness or the value of a visual exam by a dermatologist as a cancer screening tool. From the 2560 persons screened for melanoma/skin cancer in Massachusetts in 1986 and 1987, the authors followed the positive screenees to determine their final diagnosis. The authors obtained information on 85% of these persons, and found nine malignant melanomas, 91 non-melanoma skin cancers, 39 dysplastic nevi, and three congenital nevi. The sensitivity of the visual exam by a dermatologist was 89% to 97% and the predictive value positive was 35% to 75% for skin cancer. The authors conclude that the yield of screening is equivalent to that of other major cancer screening efforts and that the sensitivity and predictive value of the visual examination by the dermatologist is appropriate for a cancer screening tool.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%2819900115%2965%3A2%3C375%3A%3AAID-CNCR2820650233%3E3.0.CO%3B2-Z

Evaluation of melanoma/skin cancer screening in Massachusetts. Preliminary results

Adult cutaneous Langerhans cell histiocytosis responsive to topical imiquimod.

Iconography : Adult cutaneous Langerhans cell histiocytosis responsive to topical imiquimod

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Frederick D. Wax

Author Tools

Chat about Author

Papers

Evaluation of melanoma/skin cancer screening in Massachusetts. Preliminary results

Adult cutaneous Langerhans cell histiocytosis responsive to topical imiquimod.

Iconography : Adult cutaneous Langerhans cell histiocytosis responsive to topical imiquimod