Paweł Piłat

Bio: Paweł Piłat is an academic researcher from Medical University of Lublin. The author has contributed to research in topics: Nevoid basal-cell carcinoma syndrome & Basal cell carcinoma. The author has an hindex of 2, co-authored 6 publications receiving 13 citations.

High-frequency ultrasound in the diagnosis of selected non-melanoma skin nodular lesions.

Abstract: Introduction Ultrasonographic examination is commonly used in an outpatient setting, possibly due to its low cost, low risk for patients and the possibility to obtain real time images. Typically used heads have the frequency ranging from 7.5 to 12 MHz. Higher frequencies ensure higher resolution, yet they are limited by the penetration depth - reaching from several to several tens of millimetres into the skin. High-frequency ultrasonography (HFUS) appears to be a promising method for the detection and differential diagnostics of selected nodular skin lesions. Aim The study aimed at a comparison of the data obtained by using HFUS, histopathological and dermatoscopic images of selected skin lesions to determine their common features. Material and methods Nodular lesions classified as potentially malignant were subjected to clinical, dermatoscopic and high-frequency ultrasonographic examinations. Then the patients were referred for surgical removal with histopathological assessment. Results A total of 54 nodular lesions were examined, out of which 34 were diagnosed as non-melanoma. The most common lesions were melanocytic naevi dermatofibroma, nodular basal cell carcinoma and pyogenic granuloma. Other examined lesions included blue naevus, seborrheic wart, xanthogranuloma juvenile and Spits naevus. In all lesions except Spitz naevus, HFUS images corresponded at least with dermatoscopic or histopathology images. Conclusions HFUS can be used as a supporting diagnostic tool ensuring better pre-operative proceedings. HFUS is a non-invasive, easy and inexpensive screening method for the determination of different skin cancers as it provides valuable information allowing to determine the cutting margins and lesion shape.

Skin melanoma imaging using ultrasonography: a literature review.

Abstract: Melanoma is one of the most unpredictable tumours, as regards both morphology and the course of disease. It may have different clinical forms making it very difficult to diagnose. Therefore, it often surprises even the most experienced dermatologists. Despite numerous attempts, no efficient treatment of advanced stages have been elaborated, and early detection and removal of a skin lesion currently constitutes the most efficient treatment method. Diagnostics uses different types of dermoscopic techniques characterised by considerable sensitivity and specificity in detecting melanoma at an early developmental stage. A continuous development of medical technologies leads to improving many methods of skin lesion imaging. Ultrasonography is one of these methods, enabling evaluation of the thickness of melanoma in vivo with high precision. Change thickness is the decisive factor influencing 5-year survival. The paper evaluates the usefulness of high-frequency ultrasonography (HFUS) in pre-operative melanoma imaging on the basis of literature review. Additionally, the use, role and placement of HFUS in skin melanoma diagnostics is determined.

Evaluation of the clinical usefulness of high-frequency ultrasonography in pre-operative evaluation of cutaneous melanoma - a prospective study.

Abstract: Introduction There are many papers in the available literature on the pre-operative evaluation of malignant melanoma (MM) using a 20 MHz probe. In many Western European countries, this examination is standard in the diagnosis of such lesions in terms of the resection margin. However, few papers describe and compare the results of melanoma thickness measurements using 20 and 50 MHz frequency probes. Aim The aim of the study was to evaluate the thickness of melanoma using 20 and 50 MHz probes. In addition, the obtained values were evaluated in comparison to the thickness values obtained in the histopathological examination. Material and methods Melanoma malignum was confirmed histopathologically in 19 out of 72 patients. Then only those 19 patients were enrolled in the study. Results A correlation was demonstrated between the thickness of the melanoma measured with the 20 and 50 MHz probes, expressed in mm, and the thickness obtained in the histopathological examination expressed in millimeters (Breslow's scale). It was 0.759 (p < 0.001) and 0.734 (p < 0.001), respectively. The average thickness of melanomas obtained in ultrasound examination was identical for both probes and was 0.74 mm. Conclusions It seems that both types of probes can be used to assess melanoma thickness. The demonstrated correlation of high-frequency ultrasonography (HFUS) thickness with Breslow's scale indicates that the HFUS evaluation can be used in determination of melanoma resection margins as a repeatable, painless, non-invasive test.

Combination therapy of basal-cell carcinoma in 31-year-old patient with nevoid basal cell carcinoma syndrome – Case study

Abstract: Nevoid basal cell carcinoma syndrome (NBCCS) is a rare genetic disease that is manifested in a number of disorders concerning the skin, skeleton, cardiovascular and nervous systems. Various defects which can be observed at first contact with a patient visiting a dermatologist or dentist may help to diagnose this syndrome. Frequent problems with odontogenic cysts and metastatic basal-cell carcinomas result in patients being under the constant care of a specialist. This short study presents the case of 31-year-old patient with Gorlin-Goltz syndrome treated with combination therapy using CO2 laser and photodynamic therapy.

Linear verrucous epidermal nevi—effects of carbon dioxide laser therapy

Abstract: Linear epidermal nevus is a congenital malformation characterized by linear, often one-sided arrangement. The lesions are localized along the Blaschko's lines, are present at birth, or appear in early childhood. They can be single or multiple, and have various colors-from skin color to dark brown. These lesions persist through the whole life making a significant cosmetic defect. Here, we present three clinical cases of epidermal nevus treated with CO2 laser. In a female patient, verrucous, dark brown skin eruptions were observed at the back of earlobe and down the neck. In the cases of the male patients, the lesions were located in the area of the neck and left blade. The removal of nevi was performed in stages, by cutting and evaporation using a CO2 laser. A very good therapeutic effect was obtained. CO2 laser treatment is the method of choice for the removal of extensive epidermal nevi. It is characterized by high efficacy and safety.

High-frequency ultrasound in clinical dermatology: a review.

Abstract: Ultrasound was first introduced in clinical dermatology in 1979. Since that time, ultrasound technology has continued to develop along with its popularity and utility. Today, high-frequency ultrasound (HFUS), or ultrasound using a frequency of at least 10 megahertz (MHz), allows for high-resolution imaging of the skin from the stratum corneum to the deep fascia. This non-invasive and easy-to-interpret tool allows physicians to assess skin findings in real-time, enabling enhanced diagnostic, management, and surgical capabilities. In this review, we discuss how HFUS fits into the landscape of skin imaging. We provide a brief history of its introduction to dermatology, explain key principles of ultrasonography, and review its use in characterizing normal skin, common neoplasms of the skin, dermatologic diseases and cosmetic dermatology. As frequency advancements in ultrasonography continue, the broad applications of this imaging modality will continue to grow. HFUS is a fast, safe and readily available tool that can aid in diagnosing, monitoring and treating dermatologic conditions by providing more objective assessment measures.

Xantogranuloma juvenil: una entidad con amplio espectro clínico

Abstract: Resumen El xantogranuloma juvenil es un trastorno benigno poco frecuente, que pertenece al amplio grupo de las histiocitosis de celulas no Langerhans. Se presenta con uno o mas nodulos eritematosos o amarillentos, ubicados preferentemente en la cabeza y el cuello. La mayoria de los casos se inician durante el primer ano de vida, incluyendo lesiones congenitas. La afectacion extracutanea es rara, sugiriendose tradicionalmente en la literatura estudiar el compromiso ocular. El diagnostico del xantogranuloma juvenil es fundamentalmente clinico, sin embargo, en ocasiones se requiere confirmarlo con biopsia de piel. Las lesiones cutaneas son autolimitadas, por lo que suelen no requieren tratamiento. En la presente revision, se describen los distintos aspectos clinicos y terapeuticos de esta enfermedad, resaltando la evidencia respecto al estudio diagnostico del compromiso extracutaneo.

Usefulness of High-Frequency Ultrasonography in the Diagnosis of Melanoma: Mini Review.

Abstract: High-frequency equipment is characterized by ultrasound probes with frequencies of over 10 MHz. At higher frequencies, the wavelength decreases, which determines a lower penetration of the ultrasound beam so as to offer a better evaluation of the surface structures. This explains the growing interest in ultrasound in dermatology. This review examines the state of the art of high-frequency ultrasound (HFUS) in the assessment of skin cancer to ensure the high clinical approach and provide the best standard of evidence on which to base clinical and policy decisions.

Non-invasive diagnostic techniques in pigmentary skin disorders and skin cancer.

Abstract: Background Diagnosis of pigmentary skin disorders, pre-cancerous and cancerous skin diseases is traditionally relied on visual assessment. The most widely applied invasive diagnostic technique is the skin biopsy. There have been significant technological advances in non-invasive diagnostic methods for skin disorders. Objective The objective of this article is to discuss different non-invasive diagnostic modalities, used in the diagnosis of pigmentary skin disorders and cutaneous cancers. Methods Comprehensive literature search was performed to screen articles related to non-invasive diagnostic techniques in pigmentary skin disorders and cutaneous cancers. Articles published in journals indexed in PubMed were searched along with those in Google Scholar. Clinical trials, review articles, case series, case reports and other relevant articles were considered for review. References of relevant articles were also considered for review. Results Dermoscopy and ultrasonography were the only non-invasive diagnostic and imaging techniques available to dermatologists for many years. The advent of computed tomography (CT) and magnetic resonance imaging (MRI) augmented the visualization of deeper structures. Confocal laser microscopy (CLM) and reflectance spectrophotometers have showed promising results in the non-invasive detection of pigmented lesions. Optical coherence tomography (OCT), electrical impedance spectroscopy (EIS), multispectral imaging, high frequency ultrasonography (HFUS) and adhesive patch biopsy aid in the accurate diagnosis of benign, as well as neoplastic skin diseases. Conclusion There have been significant advancements in non-invasive methods for diagnosis of dermatological diseases. These techniques can be repeatedly used in a comfort manner for the patient, and may offer an objective way to follow the course of a disease.

Al18F-labeled alpha-melanocyte-stimulating hormone (α-MSH) peptide derivative for the early detection of melanoma.

Abstract: Early detection plays a role in the prognosis of melanoma, the most aggressive skin cancer. 64Cu- and 68Ga-labeled alpha-melanocyte-stimulating hormone (α-MSH) analogs targeting the melanocortin-1 receptor are promising positron emission tomography (PET) tracers for detecting melanoma, and the use of 18F-labeling will further contribute to the detectability and availability. However, the high radiochemistry demand related to the conventional 18F-labeling methods has restricted the development of 18F-labeled α-MSH analogs. A recently developed radiofluorination method using aluminum-fluoride (Al18F) offers a simple, efficient, and time-saving labeling procedure compared to the conventional 18F-labeling methods. Herein, we sought to establish a simple preparation method for an 18F-labeled α-MSH analog using Al18F, and we examined its potential for the early detection of melanoma. A 1,4,7-triazacyclononane-N,N′,N″-triacetic acid (NOTA)-conjugated α-MSH analog (NOTA-GGNle-CycMSHhex) was prepared by the Fmoc solid-phase strategy. NOTA-GGNle-CycMSHhex was labeled with Al18F by heating at 105 °C using a microwave synthesizer for 15 min. Biodistribution study was conducted on B16/F10-luc melanoma-bearing mice at 30 min, 1 h and 3 h after injection of Al18F-NOTA-GGNle-CycMSHhex. PET imaging was conducted on melanoma-bearing mice at 1 h post-injection. One day prior to the PET imaging, bioluminescence imaging was also performed. Al18F-NOTA-GGNle-CycMSHhex was readily prepared with a high radiochemical yield (94.0 ± 2.8%). The biodistribution study showed a high accumulation of Al18F-NOTA-GGNle-CycMSHhex in the tumor at 30 min and 1 h post-injection (6.69 ± 1.49 and 7.70 ± 1.71%ID/g, respectively). The tumor-to-blood ratio increased with time: 3.46 ± 0.89, 12.67 ± 1.29, and 35.27 ± 9.12 at 30 min, 1 h, and 3 h post-injection, respectively. In the PET imaging, Al18F-NOTA-GGNle-CycMSHhex clearly visualized the tumors and depicted very small tumors (< 3 mm). We successfully prepared Al18F-NOTA-GGNle-CycMSHhex in a simple and efficient manner. Al18F-NOTA-GGNle-CycMSHhex showed high tumor accumulation and clearly visualized very small tumors in melanoma-bearing mice. These findings suggest that Al18F-NOTA-GGNle-CycMSHhex will be a promising PET tracer for melanoma imaging at an earlier stage.