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Biomedical subjects

Henrik F Lorentzen

Publications and source records attributed to Henrik F Lorentzen.

6 recordsLinked to original sources

[Dynamic dermoscopy].

Dermoscopy of early-stage melanoma can be challenging, and repeated examination at three-month intervals may disclose subtle changes. In patients with atypical nevus syndrome or more than 50 nevi, repetitive excision of benign lesions does not guarantee that melanomas will be identified at an early stage and exposes patients to potentially disfiguring surgery. We present the case of a high-risk patient where repeated dermoscopy of an in situ melanoma showed that part of the pigment network had coarsened, even though the lesion had not changed macroscopically.

Adult↗

[Imiquimod treatment of lentigo maligna to dermoscopic and histologic clearance].

Imiquimod is an immune system-modifying drug that switches the immune system to a Th1 response, enabling it to defeat virus-infected and neoplastic cells. We report on a 94-year-old woman with a large lentigo maligna (LM) on her cheek whom we treated with imiquimod 5% cream. Dermoscopy was used to identify the most suspect areas of the lesion for biopsy and in follow-up. By week 19 the lesion was cleared, and no remnants of the lesion were seen by dermoscopy or histology. Published LM cases treated with imiquimod are reviewed.

Adjuvants, Immunologic↗

[The shadow rule and appropriate sun behavior].

INTRODUCTION: Sun lotions have not been effective in preventing the alarming increase in the incidence of melanoma, possibly, because of incorrect use, lack of protection from UVA and increased exposure times caused by reduced penetration of erythemogenic UVB. Seeking shade prevents deleterious effects from the sun's ultraviolet rays. MATERIAL AND METHODS: We examined the association between UV intensity and the ratio of shadow length to object height. A linear model fitted the data (R = 0.95). With an astronomical navigation equation for the calculation of altitude of the sun and substituting altitude with UV intensity we developed a model predicting the UV load from the point of observation, the time of the year (declination) and the time of day (hour angle). Accumulated UV doses can be calculated by integration. RESULTS: When the shadow to object ratio is 0.5, skin types I and II will experience erythema after a few minutes, when the ratio is 1 erythema appears after 20-30 minutes, and when the ratio is 2 erythema appears after about one hour. In the Mediterranean, accumulated UV exposure from sunrise to sunset in late summer will be 30-50 times the minimal erythema dose (skin types I + II) of which more than 60% is in the interval where the shadow is shorter than its object. DISCUSSION: The shadow rule (short shadows--seek shade) is simple and universal and children can be taught it. A rule of thumb is: when shadows are shorter than objects throwing them, avoid direct sunlight, when shadow and object are of equal length restrict sun exposure to half an hour, and when shadows are twice the length of objects an hour in the sun is permissible.

Erythema↗

Clinical assessment of infection in nonhealing ulcers analyzed by latent class analysis.

The distinction between bacterial colonization and infection relies on clinical judgement. Determining sensitivity and specificity of this judgement are problematic as no gold standard exists. Six specialists in wound management independently assessed 120 nonhealing chronic wounds. Sixty-five (54.2%) patients had venous ulcer, 18 (15%) arterial ulcers, 15 (12.5%) ulcerative pyoderma gangraenosum, 12 (10%) neuropathic or pressure ulcers, six (5%) vasculitis ulcers, and four patients had ulcers caused by a primary or metastatic cancer disease. Unrestricted latent class analysis was used for determining sensitivity and specificity in the observer's assessment of hypergranulation, redness, and overall impression of infection. Interrater agreement among observers was determined by restricted latent class analysis. The observers used the diagnoses (redness, hypergranulation, and overall impression of infection with different frequencies (p<0.001, Cochrane's Q test). A two latent class model fitted data. Sensitivity for hypergranulation ranged from 3 to 82%, for redness from 34 to 91% and for overall impression of infection from 37 to 90%. None of the observers were interchangeable. These results indicate that clinical assessment of chronic wounds for the presence of infection are difficult tasks accompanied by great variability and low reliability.

Humans↗