Cell proliferation is commonly assayed in the laboratory for research purposes, but is increasingly used clinically to gauge tumor aggressiveness and potentially guide care. Therefore, both researchers and clinicians should have a basic understanding of techniques used to assess cell proliferation. Multiple cell proliferation assays exist, and the choice of method depends on the laboratory resources available, the types of cells/tissues to be studied, and the specific experimental goals. In this article, we identify four overarching categories of cell proliferation assays that signify various stages of the cell cycle: nucleoside-analog incorporation, cell cycle-associated protein detection, use of cytoplasmic proliferation dyes, and indirect measures of cell proliferation. Each method has strengths and limitations that should guide the dermatology investigator's choice of assay.
3 Brown Univ, Providence, RI The incidence of keratinocyte carcinoma (KC), the most common malignancy in the U.S., continues to rise. Because KC impacts a significant portion of the population but has a low mortality rate, it is important to quantify skin-related quality of life (QoL) in those affected. We aim to determine if KC, actinic keratoses (AK), and several demographic and health-related factors are associated with skin-related QoL in those at high risk for KC. We used data from a double-blind, placebo-controlled trial in which 930 veterans with a history of multiple KCs were randomized to apply a single course of topical 5-fluorouracil (5-FU) or vehicle control cream to the face and ears. Skin-related QoL was measured at baseline, 12, 24, and 36 months using Skindex-29 and Skin Cancer Index and participants received complete skin examinations semiannually. At baseline, worse skin-related QoL was strongly associated (p0.01) with younger age and greater functional impairments (e.g. inability to bathe, walk). It was also associated with higher comorbidities, increased sun-sensitivity and history of 5-FU use, but almost entirely unrelated to number of AKs and prior KCs. However, participants who developed new KCs during the trial had a greater worsening of skin-related QoL, or a lesser degree of improvement, compared to those who did not develop new KCs, particularly in year 1. Similar results were seen in participants who developed increased AKs. Our ability to detect these relationships in longitudinal analyses but not in baseline cross-sectional analyses may indicate the importance of the more precise control of potential confounding factors that is inherent in comparing each individual to their own prior state. These findings suggest that in addition to chronic conditions of sun damage, additional KCs and increased AKs may worsen skin-related QoL in individuals with a history of multiple KCs. Also, as skin-related QoL is particularly diminished in those with greater functional impairments, it is especially important to address their dermatologic needs. 173Teledermatology as a tool to improve access to care for medically underserved populations: A retrospective descriptive study In medically underserved populations, teledermatology (TD) can be utilized to broaden access to care via "tele-triage". Our group evaluated the capacity of the Los Angeles County Department of Health Services (LAC DHS) TD platform to "tele-triage" consults, with a goal of increasing access to urgent dermatologic care in a health care system where the wait for a non-urgent visit often exceeds six months. This was a retrospective descriptive study involving manual review of 9,499 TD consults placed by primary care physicians (PCPs) in the LAC DHS TD system between July 2012 and May 2014. The primary outcome variable was percentage of consults referred for an in-person appointment with a dermatologist versus those in which the patient's needs were addressed remotely. 68% of all consults were referred face-toface, while 29% of consult...
Allergic contact dermatitis (ACD) affects 20% of patients and combined with irritant contact dermatitis (ICD) account for more than 90% of occupational skin diseases. Patch testing is the gold standard for diagnosis of ACD but result interpretation may be patient and physician dependent. The purpose of this study is to examine whether noninvasive tape stripping can be used to differentiate ACD, ICD, and normal skin. We examined 39 immune and barrier genes expressed in various skin layers. Patients referred to the Massachusetts General Hospital Contact Dermatitis Clinic with confirmed diagnosis of ACD through patch testing were recruited. 100% petrolatum vehicle served as control and 2% and/or 4% sodium lauryl sulphate was used to induce ICD. 20 consecutive tape strips were collected on sites of ACD, ICD, and vehicle-control skin. Tape strip samples were extracted to isolate total RNA and profiled by quantitative real-time PCR to analyze molecular biomarkers. A total of 9 patients, 7 females and 2 males; mean age, 38.6 years (range, 24-72 years), had at least one ACD reaction on patch testing. 13 ACD, 10 ICD, and 9 vehicle-control samples were obtained from 9 patients. All 39 biomarkers were detected amongst the samples with 4/39 markers significantly different between ACD and vehicle-control samples. Our analysis revealed that CD1A (Langerhans cell marker) was significantly increased, whereas loricrin (skin barrier component), KRT1 (suprabasal epidermal keratin), and KRT14 (basal epidermal keratin) were significantly decreased in ACD relative to vehicle-control samples (p<.05). In comparison of ACD and ICD samples, loricrin and KRT1 demonstrated significant differences (p<.05). These findings illustrate divergent epidermal molecular differences associated with ACD, ICD, and normal skin. We propose skin tape stripping as a novel strategy that potentially enables noninvasive and molecular marker-based diagnosis of ACD.
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