The clinical and histopathological features of disseminate and recurrent infundibulo-folliculitis are described in 2 patients. The lesions are confined to the trunk and consist of discrete, small, follicular papules. The condition is self-limited but recurrent, and histologically characterized by an infundibular folliculitis. The deposition of glycogen in the infundibular and perifollicular epithelium is reported.
Background and study aims The majority of patients with 10 or more cumulative colorectal adenomas have uninformative genetic testing and meet criteria for colonic adenomatous polyposis of unknown etiology (CPUE). The yield of upper gastrointestinal screening in patients with CPUE after multi-gene panel testing is unknown and our objective was to characterize this.
Patient and methods A multicenter, retrospective analysis of screening upper endoscopies in adults with CPUE after multi-gene panel testing was performed. Those with a history of gastroduodenal neoplasia prior to CPUE diagnosis were excluded. Demographic and clinical variables were collected and compared.
Results One hundred and twenty-eight patients with CPUE were included from five participating centers. Nine (7.0 %) had gastroduodenal neoplasia on initial screening upper endoscopy. Those with over 100 colorectal adenomas had a significantly higher rate of gastroduodenal neoplasia than those with 20–99 or 10–19 colorectal adenomas (44.4 % vs 4.1 % vs 4.4 %, P = 0.002). Similar results were seen when the analysis was restricted to only duodenal or ampullary adenomas. The only malignancy was a gastric cancer in a patient with 20 to 99 colorectal adenomas. When comparing patients with gastroduodenal neoplasia to those without, the only significantly different characteristic was the cumulative number of colorectal adenomas.
Conclusions We found a 7 % rate of gastroduodenal neoplasia in patients with CPUE after multi-gene panel testing. Although patients with ≥ 100 colorectal adenomas had a significantly higher risk, over 4 % of patients with 10 to 99 colorectal adenomas had gastroduodenal neoplasia. Given this, we recommend a screening upper endoscopy at the time of a colonoscopy after CPUE diagnosis.
A verrucose lesion that developed over the forehead of a middle-aged man showed, on histological examination, changes characteristic of verruca vulgaris and Darier’s disease. The significance of this unusual association is discussed.
Introduction:The adenoma detection rate (ADR) is a strong predictor of cancer prevention. The use of artificial intelligence could increase the detection of colorectal polyps. The Computer-Aided Polyp Detection systems (CADe) have shown high accuracy in polyp detection when retrospectively applied to endoscopy videos or images, but their live performance is still under scrutiny. There are other ways in which technology has helped in performance and efficiency, Linked Color Imaging (LCI) is a modern image-enhancing technology, its use along with artificial intelligence could be another tool in the detection of precancerous lesions. Methods: A prospective observational study was conducted on 637 subjects undergoing screening colonoscopies, follow up colonoscopies, or work-up from a fecal occult blood test, from January 2021 through June 10 th , 2022, in a nonacademic center in the Dominican Republic. Colonoscopies performed during 2021 did not use the CADe technology, while patients in 2022 were exposed to the CADe technology, in addition, each patient was alternatively assigned to either LCI or white light colonoscopy. Two endoscopists performed the procedures during these two years. The primary outcome evaluated was the ADR using LCI vs. white light colonoscopy both with and without the use of artificial intelligence. Secondary outcomes were polyp detection rate (PDR) and average withdrawal time. Results: The ADR in patients not exposed to CADe (2021) was 56.6%, while patients exposed to CADe ( 2022) presented an ADR of 54.5%. PDR in 2021 was 72.3%, and in 2022 the result was 70.6%. The average withdrawal time in 2021 was 13 minutes and 14 minutes in 2022. When it comes to the use of LCI and white light without the use of AI ( 2021), the ADR with LCI was 52%, while the use of white light colonoscopy resulted in an ADR of 50.9%. The ADR in patients exposed to LCI with AI (2022) was 61.1%, while patients exposed to white light with AI presented an ADR of 61%.
Conclusion:The polyp and adenoma detection rates calculated were higher than the average considered for a high-quality colonoscopy both with and without the use of artificial intelligence. When it comes to the use of other technologies like LCI, ADR was higher with LCI when compared to white light colonoscopy, while the NNT was 90. When comparing the use of both technologies, there was still no significant difference. Further studies are still needed to assess these new technologies and their effect on colonoscopy and polyp detection.
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