Journal articles on the topic 'Video dermatoscopy'

Background/aim: Nailfold video capillaroscopy is considered as a reliable method for evaluating peripheral microangiopathy in rheumatologic diseases. In this study, we aimed to demonstrate the utility of handheld dermatoscopy as an easy-to-use nailfold capillaroscopic instrument in patients with rheumatoid arthritis.Materials and methods: This cross-sectional study included patients with rheumatoid arthritis and healthy subjects. A handheld dermatoscopic examination of proximal nail fold was performed in each subject. The possible correlation of capillaroscopic findings with disease activity was evaluated using the disease activity score 28 (DAS28).Results: A total of 59 patients with rheumatoid arthritis and 60 healthy subjects were enrolled in the study. The presence of capillaryenlargement, avascular areas, capillary deformities, and capillary vascular anomalies in the group of patients showed a statistically significant difference when compared with the healthy subjects. No correlation was found between the nail fold capillaroscopic findings and DAS28 score.Conclusion: Hand-held dermatoscopy seems to be a useful technique in the evaluation of nail fold capillary changes. We suggest that in patients with rheumatoid arthritis, when capillaroscopic examination is needed, it can be evaluated using handheld dermatoscopy. Selected patients who showed findings using this method can be further examined with classical capillaroscopy to obtain more quantitative data.

The authors present a review of up-to-date non-invasive visualization methods used in diagnostics of diseases of skin and its appendages. They describe physical principles forming the basis for non-invasive visualization methods such as dermatoscopy, confocal laser scanning microscopy, optical video monitoring, optical topometry, optical coherent tomography, ultrasound scanning, 3D-modeling. They also describe the potential of practical application of these diagnostics methods at the current stage of their development. The authors have demonstrated that it is possible to reduce the clinicians need in biopsy diagnostics due to the high information value of non-invasive visual diagnostics methods.

The results of the study of biorevitalization effectiveness of the facial skin in women aged 30 to 40 years are presented. Material and methods. In the 1st group (n = 30) hyaluronic acid (HA) was used along the face oval, in the zone of the cheekbone, along the nasolabial folds, along the longitudinal wrinkles in the forehead area with the use of “micro-puncture” and “short-linear” techniques in the medium-deep layers of the dermis. The distance between injections is 1 cm. Injection schemes are standard, proposed by manufacturing companies - once a week, in total 6 procedures. In group 2 (n = 30), the HA was administered with the Legato apparatus, where two technologies were successively used: radio frequency and ultrasound, once every 2 weeks, with a course of 5-6 procedures. Both groups used HA in a concentration of 2 mg/ml Gialripyer-07M/mesolift. Instrumental studies of the functional properties of the skin included assessment of hydration of the epidermis (corneometry), deformation and elastic properties of the skin (cutometry), assessment of transepidermal loss of moisture (TEVA-metry), assessment of seboregulatory function of the epidermis (sebometry) using Multi Skin Test Center® MC750; dermatoscopy on a digital video camera Aramo SG, providing a computer image of the texture of the skin and its moisture level; ultrasound scanning of the skin using a digital high-definition system DUB (“TPM GmbH”, Germany) and a high-frequency linear 17 MHz sensor in SmParts Superfic scanning mode with a resolution of 78 microns. Results. The study shows the superficial effect of mesotherapy procedures: improving the morphofunctional properties of the skin, they have no effect on the thickness, echogenicity and relief of the dermis. At the same time, the obtained results of instrumental studies of the structural and functional parameters of the skin make it possible to justify the use of modern technology Legato (radio frequency and ultrasound) for intradermal administration of HA preparations, with the help of which it is possible to obtain in a short time a positive dynamics of the indices of structural and functional parameters of not only surface layers of skin, but also at the level of the dermis.

Photoaging adalah salah satu faktor ekstrinsik terbesar yang menyebabkan penuaan kulit dini. Penuaan kulit dini ditandai dengan adanya kerutan pada kulit. Gel dengan kandungan antioksidan merupakan salah satu sediaan yang digunakan sebagai kosmetik dalam merawat wajah. Bahan antioksidan banyak terdapat dari alam, salah satunya yang dilaporakan memiliki kadar antioksidan tinggi adalah jeruk nipis. Penelitian ini bersifat true experiment dengan tujuan menghitung angka kerutan pada kulit dengan menggunakan metode video dermatoscope. Hasil pengujian berdasarkan uji stabilitas fisik, formula 1, 2 dan 3 stabil selama penyimpanan. Sedangkan berdasarkan hasil uji aktivitas antioksidan, sediaan dengan antioksidan paling baik adalah formula 3 dengan nilai IC50 sebesar 68,85 ppm yang termasuk pada kategori antioksidan kuat. Hasil pengujian aktivitas anti-wrinkle menunjukkan formula terbaik yaitu formula 3 dapat menurunkan angka kerutan pada kulit responden yaitu dengan angka penurunan nilai entropi sebesar -0,00087. Kata kunci: Anti Wrinkle, Gel, Video Dermatoscope

Introduction. Burns of various etiologies are on the 3-4 place in frequency among all injuries, they are associated with a high percentage of complications, disability and mortality. Currently, a single algorithm for objective verification of the depth of skin damage has not been developed. Numerous diagnostic technologies used to solve this problem require systemic analysis.The aim of study was to analyze current literature data on technologies for instrumental diagnostics of the depth of thermal damage to the skin.Materials and methods. A search for literary sources in databases was conducted using eLIBRARY.RU, PubMed, Cyberleninka databases. The period of publications was limited to 2011-2020.Results. The method of objective "gold standard" verification of thermal damage to the skin remains a biopsy followed by morphological examination, but the method's traumaticity does not allow it to be used for monitoring the course of the process in dynamics, for multi-focal studies. Among non-invasive methods, dermatoscopy and video microscopy are noted, but the small imaging area and the need for direct contact of the device with the skin surface limit the use of these methods. Laser Doppler flowmetry and imaging are fairly accurate non-contact methods that allow assessing the condition of a burn wound in real time. The method is not applicable to wounds with blisters, insufficient sanitation. Laser speckle contrast imaging is used to evaluate blood flow and is based on the analysis of speckle structure fluctuations. The method allows determining the degree of burn damage depending on changes in the blood flow. However, the method is difficult to apply with a vessel diameter sized 40 microns. The method is sensitive to movement and internal factors. Infrared and Raman spectroscopy are technique for evaluating vibrational patterns in a particular spectrum, these can be used to identify a molecule or determine its structure. Simultaneous use of spatial frequency visualization and speckle imaging demonstrated a high level of correlation with the results of histological research, which makes the use of these methods promising. Ultrasound also provides a proper correlation with histological data, but it is an imperfect method due to inaccuracies in determining the thickness of the epidermis, dermis, and scar condition. Optical coherence tomography (OCT) is a non-invasive optical method that allows obtaining high-resolution images of skin architecture in real time. The high level of compliance of the visualized structures, in particular, layers, appendages and vessels of the skin, with histological findings, gave this method a name "optical biopsy". Anatomical congruence of normal and damaged skin was established in an experiment between histology and OCT.Conclusion. Early assessment of the depth of thermal damage to the skin is crucial for choosing a personalized treatment strategy for the burned. None of the modern diagnostic methods is universal. Multimodal approaches to diagnostics are the most effective.

Plant-based hair coloring is a natural hair coloring method, which allows to obtain a variety of colors and additionally nourishes the scalp and hair. The aim of the study was to present the knowledge on the available dyeing methods using plant materials and to investigate the color potential of particular herbs. Lawsonia inermis, Hibiscus sabdariffa, Rheum officinale, Sambucus nigra, and Chamomilla recutita were selected to the research. A video dermatoscope was used to demonstrate the influence of the coloring process on the structure, appearance of the cortex, areola, and the core of the hair. The natural method of dyeing hair is characterized by a lower allergenic potential as compared to the synthetic method. However, taking into account the color limitations of the selected plant materials, obtaining the effect of full coverage of the hair with color, is not always possible. It was shown that the selection of additives with an appropriate pH value allows to obtain favorable results.

Background Teledermatology can increase patient access; however, its optimal implementation remains unknown. Objective This study aimed to describe and evaluate the implementation of a pilot virtual clinic teledermatology service at Duke University. Methods Leaders at Duke Dermatology and Duke Primary Care identified a teledermatology virtual clinic to meet patients’ access needs. Implementation was planned over the exploration, preparation, implementation, and sustainment phases. We evaluated the implementation success of teledermatology using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and prioritized outcome collection through a stakeholder survey. We used the electronic health record and patient surveys to capture implementation outcomes. Results Our process consisted of primary care providers (PCPs) who sent clinical and dermatoscopic images of patient lesions or rashes via e-communication to a teledermatology virtual clinic, with a subsequent virtual clinic scheduling of a video visit with the virtual clinic providers (residents or advanced practice providers, supervised by Duke Dermatology attending physicians) within 2-5 days. The teledermatology team reviews the patient images on the day of the video visit and gives their diagnosis and management plan with either no follow-up, teledermatology nurse follow-up, or in-person follow-up evaluation. Implementation at 4 pilot clinics, involving 19 referring PCPs and 5 attending dermatologists, began on September 9, 2021. As of October 31, 2021, a total of 68 e-communications were placed (50 lesions and 18 rashes) and 64 virtual clinic video visits were completed. There were 3 patient refusals and 1 conversion to a telephonic visit. Participating primary care clinics differed in the number of patients referred with completed visits (range 2-32) and the percentage of providers using e-communications (range 13%-53%). Patients were seen soon after e-communication placement; compared to in-person wait times of >3 months, the teledermatology virtual clinic video visits occurred on average 2.75 days after e-communication. In total, 20% of virtual clinic video visits were seen as in-person visit follow-up, which suggests that the majority of patients were deemed treatable at the virtual clinic. All patients who returned the patient survey (N=10, 100%) agreed that their clinical goals were met during the virtual clinic video visits. Conclusions Our virtual clinic model for teledermatology implementation resulted in timely access for patients, while minimizing loss to follow-up, and has promising patient satisfaction outcomes. However, participating primary care clinics differ in their volume of referrals to the virtual clinic. As the teledermatology virtual clinics scale to other clinic sites, a systematic assessment of barriers and facilitators to its implementation may explain these interclinic differences. Acknowledgments We are grateful to the Private Diagnostic Clinic and Duke Institute for Health Innovation for their support. Conflicts of Interest None declared.

Abstract Sustained demand for dermatologic care throughout military medicine, in conjunction with increasing dermatologic provider shortages, has led to increase use of teledermatology in military treatment facilities (MTFs). Initially used to aid in the differentiation of suspicious melanocytic lesions, dermoscopy has found increasing clinical utility in an expanding realm of general dermatologic conditions. We demonstrate the use of synchronous teledermoscopy within a remote MTF by repurposing webcam technology already available at most MTFs. Two patients were seen in clinic at a remote naval primary care clinic with limited subspecialties. Once written consent was retrieved, an on-site dermatologist evaluated each patient and performed a history and skin exam with dermoscopy. Synchronous consultations were conducted with the Global Med Cart (GlobalMed(R) Clinical Access Station with TotalExam(R) 3 HDUSB camera), and Cisco webcam video jabber (Cisco TelePresence PrecisionHD USB Camera part number TTC8-03). The patients then underwent individual synchronous teledermatology consultations with an off-site U.S. Navy dermatologist located in the continental United States. The methodology for the consultation involved the use of a standard dermatoscope and jabber webcam. Two synchronous teledermatology consultations were completed successfully on patients in MTFs with limited subspecialty capabilities. Both cases, with two lesions of concern per case, had 100% concordance between the on-site and teleconsulted dermatologist. Through observing inter-rater agreements between the on-site and remote dermatologists, this small study demonstrates a novel application of technology readily available at most MTFs.

Recent reports have confirmed higher levels of growth hormone (GH) receptor (GHR) transcripts in malignant melanomas (MM), yet the role of GH in the pathogenesis of MM remains controversial. Although melanocytes appear to be hormonally responsive, the effects of GH on MM cells are less clear. A direct correlation between GH administration and the development of melanoma seems possible. Our study aimed to assess whether GH supplementation in children with growth hormone deficiency (GHD) could induce changes in the melanocytic lesions both from a dimensional and dermoscopic point of view. The study population consisted of 14 patients sorted into two groups. The experimental group consisted of seven GHD pediatric patients who underwent dermatological examination with epiluminescence through the use of digital video recording of all melanocytic lesions before and after 12 months of GH supplementation, whilst the control group consisted of seven healthy pediatric patients matched for age, sex and phototype. All patients were evaluated according to auxological and dermatological features. A total of 225 melanocytic lesions were examined in the experimental group and 236 in the control group. Our study shows a significant increase in the mean size values of the lesions in the study group but not in the control group. Increases in the dermoscopic ABCD Score and in BMI correlated to an increase in the size of the melanocytic lesions and the dermoscopic parameters. The increase in SDS Height correlated with ABCD Score changes and with dermoscopic score structures. No differences were found compared to the control group. Dimensional/structural modifications in melanocytic lesions of patients treated with GH were closely related to weight and statural growth and can be considered a normal physiological process induced by GH supplementation.

Internet of Things (IoT) is regarded as a next-generation wave of Information Technology (IT) after the widespread emergence of the Internet and mobile communication technologies. IoT supports information exchange and networked interaction of appliances, vehicles and other objects, making sensing and actuation possible in a low-cost and smart manner. On the other hand, cyber-physical systems (CPS) are described as the engineered systems which are built upon the tight integration of the cyber entities (e.g., computation, communication, and control) and the physical things (natural and man-made systems governed by the laws of physics). The IoT and CPS are not isolated technologies. Rather it can be said that IoT is the base or enabling technology for CPS and CPS is considered as the grownup development of IoT, completing the IoT notion and vision. Both are merged into closed-loop, providing mechanisms for conceptualizing, and realizing all aspects of the networked composed systems that are monitored and controlled by computing algorithms and are tightly coupled among users and the Internet. That is, the hardware and the software entities are intertwined, and they typically function on different time and location-based scales. In fact, the linking between the cyber and the physical world is enabled by IoT (through sensors and actuators). CPS that includes traditional embedded and control systems are supposed to be transformed by the evolving and innovative methodologies and engineering of IoT. Several applications areas of IoT and CPS are smart building, smart transport, automated vehicles, smart cities, smart grid, smart manufacturing, smart agriculture, smart healthcare, smart supply chain and logistics, etc. Though CPS and IoT have significant overlaps, they differ in terms of engineering aspects. Engineering IoT systems revolves around the uniquely identifiable and internet-connected devices and embedded systems; whereas engineering CPS requires a strong emphasis on the relationship between computation aspects (complex software) and the physical entities (hardware). Engineering CPS is challenging because there is no defined and fixed boundary and relationship between the cyber and physical worlds. In CPS, diverse constituent parts are composed and collaborated together to create unified systems with global behaviour. These systems need to be ensured in terms of dependability, safety, security, efficiency, and adherence to real‐time constraints. Hence, designing CPS requires knowledge of multidisciplinary areas such as sensing technologies, distributed systems, pervasive and ubiquitous computing, real-time computing, computer networking, control theory, signal processing, embedded systems, etc. CPS, along with the continuous evolving IoT, has posed several challenges. For example, the enormous amount of data collected from the physical things makes it difficult for Big Data management and analytics that includes data normalization, data aggregation, data mining, pattern extraction and information visualization. Similarly, the future IoT and CPS need standardized abstraction and architecture that will allow modular designing and engineering of IoT and CPS in global and synergetic applications. Another challenging concern of IoT and CPS is the security and reliability of the components and systems. Although IoT and CPS have attracted the attention of the research communities and several ideas and solutions are proposed, there are still huge possibilities for innovative propositions to make IoT and CPS vision successful. The major challenges and research scopes include system design and implementation, computing and communication, system architecture and integration, application-based implementations, fault tolerance, designing efficient algorithms and protocols, availability and reliability, security and privacy, energy-efficiency and sustainability, etc. It is our great privilege to present Volume 21, Issue 3 of Scalable Computing: Practice and Experience. We had received 30 research papers and out of which 14 papers are selected for publication. The objective of this special issue is to explore and report recent advances and disseminate state-of-the-art research related to IoT, CPS and the enabling and associated technologies. The special issue will present new dimensions of research to researchers and industry professionals with regard to IoT and CPS. Vivek Kumar Prasad and Madhuri D Bhavsar in the paper titled "Monitoring and Prediction of SLA for IoT based Cloud described the mechanisms for monitoring by using the concept of reinforcement learning and prediction of the cloud resources, which forms the critical parts of cloud expertise in support of controlling and evolution of the IT resources and has been implemented using LSTM. The proper utilization of the resources will generate revenues to the provider and also increases the trust factor of the provider of cloud services. For experimental analysis, four parameters have been used i.e. CPU utilization, disk read/write throughput and memory utilization. Kasture et al. in the paper titled "Comparative Study of Speaker Recognition Techniques in IoT Devices for Text Independent Negative Recognition" compared the performance of features which are used in state of art speaker recognition models and analyse variants of Mel frequency cepstrum coefficients (MFCC) predominantly used in feature extraction which can be further incorporated and used in various smart devices. Mahesh Kumar Singh and Om Prakash Rishi in the paper titled "Event Driven Recommendation System for E-Commerce using Knowledge based Collaborative Filtering Technique" proposed a novel system that uses a knowledge base generated from knowledge graph to identify the domain knowledge of users, items, and relationships among these, knowledge graph is a labelled multidimensional directed graph that represents the relationship among the users and the items. The proposed approach uses about 100 percent of users' participation in the form of activities during navigation of the web site. Thus, the system expects under the users' interest that is beneficial for both seller and buyer. The proposed system is compared with baseline methods in area of recommendation system using three parameters: precision, recall and NDGA through online and offline evaluation studies with user data and it is observed that proposed system is better as compared to other baseline systems. Benbrahim et al. in the paper titled "Deep Convolutional Neural Network with TensorFlow and Keras to Classify Skin Cancer" proposed a novel classification model to classify skin tumours in images using Deep Learning methodology and the proposed system was tested on HAM10000 dataset comprising of 10,015 dermatoscopic images and the results observed that the proposed system is accurate in order of 94.06\% in validation set and 93.93\% in the test set. Devi B et al. in the paper titled "Deadlock Free Resource Management Technique for IoT-Based Post Disaster Recovery Systems" proposed a new class of techniques that do not perform stringent testing before allocating the resources but still ensure that the system is deadlock-free and the overhead is also minimal. The proposed technique suggests reserving a portion of the resources to ensure no deadlock would occur. The correctness of the technique is proved in the form of theorems. The average turnaround time is approximately 18\% lower for the proposed technique over Banker's algorithm and also an optimal overhead of O(m). Deep et al. in the paper titled "Access Management of User and Cyber-Physical Device in DBAAS According to Indian IT Laws Using Blockchain" proposed a novel blockchain solution to track the activities of employees managing cloud. Employee authentication and authorization are managed through the blockchain server. User authentication related data is stored in blockchain. The proposed work assists cloud companies to have better control over their employee's activities, thus help in preventing insider attack on User and Cyber-Physical Devices. Sumit Kumar and Jaspreet Singh in paper titled "Internet of Vehicles (IoV) over VANETS: Smart and Secure Communication using IoT" highlighted a detailed description of Internet of Vehicles (IoV) with current applications, architectures, communication technologies, routing protocols and different issues. The researchers also elaborated research challenges and trade-off between security and privacy in area of IoV. Deore et al. in the paper titled "A New Approach for Navigation and Traffic Signs Indication Using Map Integrated Augmented Reality for Self-Driving Cars" proposed a new approach to supplement the technology used in self-driving cards for perception. The proposed approach uses Augmented Reality to create and augment artificial objects of navigational signs and traffic signals based on vehicles location to reality. This approach help navigate the vehicle even if the road infrastructure does not have very good sign indications and marking. The approach was tested locally by creating a local navigational system and a smartphone based augmented reality app. The approach performed better than the conventional method as the objects were clearer in the frame which made it each for the object detection to detect them. Bhardwaj et al. in the paper titled "A Framework to Systematically Analyse the Trustworthiness of Nodes for Securing IoV Interactions" performed literature on IoV and Trust and proposed a Hybrid Trust model that seperates the malicious and trusted nodes to secure the interaction of vehicle in IoV. To test the model, simulation was conducted on varied threshold values. And results observed that PDR of trusted node is 0.63 which is higher as compared to PDR of malicious node which is 0.15. And on the basis of PDR, number of available hops and Trust Dynamics the malicious nodes are identified and discarded. Saniya Zahoor and Roohie Naaz Mir in the paper titled "A Parallelization Based Data Management Framework for Pervasive IoT Applications" highlighted the recent studies and related information in data management for pervasive IoT applications having limited resources. The paper also proposes a parallelization-based data management framework for resource-constrained pervasive applications of IoT. The comparison of the proposed framework is done with the sequential approach through simulations and empirical data analysis. The results show an improvement in energy, processing, and storage requirements for the processing of data on the IoT device in the proposed framework as compared to the sequential approach. Patel et al. in the paper titled "Performance Analysis of Video ON-Demand and Live Video Streaming Using Cloud Based Services" presented a review of video analysis over the LVS \& VoDS video application. The researchers compared different messaging brokers which helps to deliver each frame in a distributed pipeline to analyze the impact on two message brokers for video analysis to achieve LVS & VoS using AWS elemental services. In addition, the researchers also analysed the Kafka configuration parameter for reliability on full-service-mode. Saniya Zahoor and Roohie Naaz Mir in the paper titled "Design and Modeling of Resource-Constrained IoT Based Body Area Networks" presented the design and modeling of a resource-constrained BAN System and also discussed the various scenarios of BAN in context of resource constraints. The Researchers also proposed an Advanced Edge Clustering (AEC) approach to manage the resources such as energy, storage, and processing of BAN devices while performing real-time data capture of critical health parameters and detection of abnormal patterns. The comparison of the AEC approach is done with the Stable Election Protocol (SEP) through simulations and empirical data analysis. The results show an improvement in energy, processing time and storage requirements for the processing of data on BAN devices in AEC as compared to SEP. Neelam Saleem Khan and Mohammad Ahsan Chishti in the paper titled "Security Challenges in Fog and IoT, Blockchain Technology and Cell Tree Solutions: A Review" outlined major authentication issues in IoT, map their existing solutions and further tabulate Fog and IoT security loopholes. Furthermore, this paper presents Blockchain, a decentralized distributed technology as one of the solutions for authentication issues in IoT. In addition, the researchers discussed the strength of Blockchain technology, work done in this field, its adoption in COVID-19 fight and tabulate various challenges in Blockchain technology. The researchers also proposed Cell Tree architecture as another solution to address some of the security issues in IoT, outlined its advantages over Blockchain technology and tabulated some future course to stir some attempts in this area. Bhadwal et al. in the paper titled "A Machine Translation System from Hindi to Sanskrit Language Using Rule Based Approach" proposed a rule-based machine translation system to bridge the language barrier between Hindi and Sanskrit Language by converting any test in Hindi to Sanskrit. The results are produced in the form of two confusion matrices wherein a total of 50 random sentences and 100 tokens (Hindi words or phrases) were taken for system evaluation. The semantic evaluation of 100 tokens produce an accuracy of 94\% while the pragmatic analysis of 50 sentences produce an accuracy of around 86\%. Hence, the proposed system can be used to understand the whole translation process and can further be employed as a tool for learning as well as teaching. Further, this application can be embedded in local communication based assisting Internet of Things (IoT) devices like Alexa or Google Assistant. Anshu Kumar Dwivedi and A.K. Sharma in the paper titled "NEEF: A Novel Energy Efficient Fuzzy Logic Based Clustering Protocol for Wireless Sensor Network" proposed a a deterministic novel energy efficient fuzzy logic-based clustering protocol (NEEF) which considers primary and secondary factors in fuzzy logic system while selecting cluster heads. After selection of cluster heads, non-cluster head nodes use fuzzy logic for prudent selection of their cluster head for cluster formation. NEEF is simulated and compared with two recent state of the art protocols, namely SCHFTL and DFCR under two scenarios. Simulation results unveil better performance by balancing the load and improvement in terms of stability period, packets forwarded to the base station, improved average energy and extended lifetime.

Abstract Background Systemic sclerosis and dermatomyositis are autoimmune connective tissue diseases affecting the skin and various internal organs. Systemic sclerosis is characterized by fibrotic arteriosclerosis of peripheral and visceral vasculature. Objective Analysis of video dermatoscopic picture of systemic sclerosis and dermatomyositis patients and find a characteristic feature for both. Assess serum vascular endothelial growth factor (VEGF) in these patients using enzyme linked immunosorbent assay (ELISA) kits. Perform a statistical analysis of the results to find a relation between video dermatoscopic Picture of systemic sclerosis and dermatomyositis patients and their serum VEGF to help in diagnosis, grading, prognosis and management. Patients and Methods Our case control study included 25 patients with SSc or DM (2555 years) recruited from Ain Shams University Hospitals and 25 apparent healthy controls with matched age and sex. After the study had been approved by Ain shams University of Medical Sciences Research Ethics Committee, all the subjects signed an informed consent before inclusion in the study. Results Serum VEGF level was highly significant in patients than in controls. This may be explained by the excessive release of VEGF in patients due to hypoxia caused by microvascular occlusion that not present in healthy controls. Conclusion Microvascular abnormalities are the earliest features of SSc and DM with elevation of serum VEGF level indicating its role in disease pathogenesis and disturbance of microvessls. Videodermoscopy and measurement of serum VEGF are effective tools in diagnosis, prognosis and grading of autoimmune connective tissue diseases as SSc and DM.

Abstract Background Most subsequent new primary or recurrent melanomas might be self-detected if patients are trained to systematically self-examine their skin and have access to timely medical review (patient-led surveillance). Routinely scheduled clinic visits (clinician-led surveillance) is resource-intensive and has not been shown to improve health outcomes; fewer visits may be possible if patient-led surveillance is shown to be safe and effective. The MEL-SELF trial is a randomised controlled trial comparing patient-led surveillance with clinician-led surveillance in people who have been previously treated for localised melanoma. Methods Stage 0/I/II melanoma patients (n = 600) from dermatology, surgical, or general practice clinics in NSW Australia, will be randomised (1:1) to the intervention (patient-led surveillance, n = 300) or control (usual care, n = 300). Patients in the intervention will undergo a second randomisation 1:1 to polarised (n = 150) or non-polarised (n = 150) dermatoscope. Patient-led surveillance comprises an educational booklet, skin self-examination (SSE) instructional videos; 3-monthly email/SMS reminders to perform SSE; patient-performed dermoscopy with teledermatologist feedback; clinical review of positive teledermoscopy through fast-tracked unscheduled clinic visits; and routinely scheduled clinic visits following each clinician’s usual practice. Clinician-led surveillance comprises an educational booklet and routinely scheduled clinic visits following each clinician’s usual practice. The primary outcome, measured at 12 months, is the proportion of participants diagnosed with a subsequent new primary or recurrent melanoma at an unscheduled clinic visit. Secondary outcomes include time from randomisation to diagnosis (of a subsequent new primary or recurrent melanoma and of a new keratinocyte cancer), clinicopathological characteristics of subsequent new primary or recurrent melanomas (including AJCC stage), psychological outcomes, and healthcare use. A nested qualitative study will include interviews with patients and clinicians, and a costing study we will compare costs from a societal perspective. We will compare the technical performance of two different models of dermatoscope (polarised vs non-polarised). Discussion The findings from this study may inform guidance on evidence-based follow-up care, that maximises early detection of subsequent new primary or recurrent melanoma and patient wellbeing, while minimising costs to patients, health systems, and society. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000176864. Registered on 18 February 2021.