Background Skin adnexal tumours (SATs) comprise a diverse range of neoplasms, which are difficult to diagnose clinically. They present in paediatric and adult populations, and may be indicative of an underlying genetic syndrome. There is a lack of recent data on the presentation of these tumours in clinical practice in European populations. Objectives To characterize the clinical and pathological features of SATs received at a single tertiary centre over a 5-year period. Methods A retrospective health record audit of SATs received at the Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, during the period November 2012 to October 2017 was performed. Results In total, 107 144 skin cases were received during the audit period. A total of 1615 cases of SATs from 1359 patients were included; 1570 (97Á2%) were benign and 45 (2Á8%) were malignant. Overall, the average age at presentation was 55 years (range 11 months to 97 years) and the male to female ratio was 0Á77 : 1. Sweat gland and hair follicle SATs were most frequently excised; in adults, the most frequent tumour was hidrocystoma, and in children, pilomatrixoma occurred most often. Prebiopsy diagnosis was correct in 28% of cases. Benign SATs are often markers of an associated genetic condition, which warrants improved discrimination of sporadic from genetically related SATs. Conclusions SATs are difficult to diagnose clinically, and clinicopathological correlation may help enhance discrimination of genetically related SATs from sporadic cases. These data have implications for clinical and dermatopathological training provision, the development of reporting standards, and genetic assessment of selected patients.What is already known about this topic?• Skin adnexal tumours (SATs) comprise a diverse range of neoplasms, which arise from the hair follicle, sebaceous and eccrine glands.• Clinical diagnosis is difficult owing to the lack of discriminatory features.• Selected SATs are recognized markers of underlying genetic conditions, but the proportion of these tumours occurring in unselected European populations is not known.

No abstract

Potential therapies used in MIS-A include intravenous immunoglobulin (IVIg), aspirin, anticoagulation, corticosteroids and tocilizumab. 1 With our evolving understanding of K-MIS-A, treatment protocols are yet to be standardized. Although we gave only anticoagulants to our patient, he recovered completely without any cardiac sequelae, as seen at follow-up. The CDC's detailed data on 27 cases of MIS-A included two cases with deranged inflammatory markers, ECG and TTE changes, which recovered on only anticoagulants without IVIg or steroids. 1 Hence, there might be a subset of patients with K-MIS-A who may recover spontaneously without conventional therapies. The focus of our case is to reiterate the possibility of COVID-19-associated K-MIS-A and timely diagnosis through early identification of dermatological manifestations and antibody testing, even when COVID-19 RT-PCR is negative. Further information on the investigations is available on direct request.

No abstract

Automatic segmentation of lesions in head CT provides key information for patient management, prognosis and disease monitoring. Despite its clinical importance, method development has mostly focused on multi-parametric MRI. Analysis of the brain in CT is challenging due to limited soft tissue contrast and its mono-modal nature. We study the under-explored problem of fine-grained CT segmentation of multiple lesion types (core, blood, oedema) in traumatic brain injury (TBI). We observe that preprocessing and data augmentation choices greatly impact the segmentation accuracy of a neural network, yet these factors are rarely thoroughly assessed in prior work. We design an empirical study that extensively evaluates the impact of different data preprocessing and augmentation methods. We show that these choices can have an impact of up to 18% DSC. We conclude that resampling to isotropic resolution yields improved performance, skull-stripping can be replaced by using the right intensity window, and affine-to-atlas registration is not necessary if we use sufficient spatial augmentation. Since both skull-stripping and affine-to-atlas registration are susceptible to failure, we recommend their alternatives to be used in practice. We believe this is the first work to report results for fine-grained multi-class segmentation of TBI in CT. Our findings may inform further research in this under-explored yet clinically important task of automatic head CT lesion segmentation.