Stricklin S.M.,University of Missouri |
Stoecker W.V.,University of Missouri |
Stoecker W.V.,Stoecker And Associates |
Stoecker W.V.,Dermatology Center |
And 5 more authors.
Journal of the American Academy of Dermatology | Year: 2012
Background: Studies have shown that the incidence of melanoma in situ (MIS) is increasing significantly. Objective: This study analyzes selected clinical and demographic characteristics of MIS cases observed in private dermatology practices in the United States. Methods: This study collected 257 MIS cases from 4 private dermatology practices in the United States from January 2005 through December 2009, recording age, gender, anatomic location, lesion size, patient-reported change in lesion, and concern about lesion. Case totals for invasive melanoma during the same period were recorded. Results: The data collected showed a higher incidence of MIS in sun-exposed areas of older patients, especially men. The median age of patients at the time of MIS detection was 69 years. The most common site for MIS was the head-neck region. The number of MIS cases collected exceeded the number of invasive malignant melanoma cases during the study period, with an observed ratio of 1.35:1. Limitations: For 136 patients, data were collected retrospectively for lesion size, location, gender, and age. For these patients, patient-reported change in lesion and concern about lesion were not collected. Patients often did not consent to a full body examination, therefore, it is possible that MIS lesions may have been missed in double-clothed areas. Conclusion: Careful attention to pigmented lesions, even lesions less than 4 mm, on sun-exposed areas, including scalp, trunk, and feet, will facilitate earlier diagnosis of MIS. As only 30.4% of male patients and 50% of female patients had concern about these lesions, it still falls to the dermatologist to discover MIS. © 2011 by the American Academy of Dermatology, Inc. Source
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 800.52K | Year: 2010
DESCRIPTION (provided by applicant): Envenomations by the brown recluse spider, Loxosceles reclusa, are a significant source of morbidity in endemic regions of the United States, and misdiagnoses are common. A survey of physicians in the endemic area has shown the economic viability of an accurate diagnostic test for these spider bites. Development and testing of an optimized Loxosceles venom assay will present significant challenges. Unlike the routine construction of ELISAs dedicated to the detection of a single protein, this ELISA will detect venom containing multiple proteins, including a unique physiologically active protein- sphingomyelinase D (SMD) abundantly present in the venom. In preliminary research, our polyclonal assay has shown good sensitivity and good in-vitro specificity. Our research shows that identifiable amounts of venom in clinical envenomations are present for at least seven days. In rabbits, our polyclonal assay allows identification of venom on the surface for as long as two weeks. The limits of sensitivity, in-vivo specificity, and the duration of detection are unknown. Phase I should allow determination of the smallest amount of venom detectable as well as the clinical time limits for in-vivo duration of sensitivity and specificity of the assay. Monoclonal antibodies will be isotyped and quantities raised in a bioreactor to perform checkerboard analysis. This analysis will allow determination of an optimal combination of L. reclusa monoclonal and polyclonal antibodies. A kit assay will result from Phase I, allowing multi-site testing in Phase II. These clinical studies will allow development of a lateral flow assay or microtiter plate assay, with the goal of FDA device approval and marketing. Clinical application of an optimized assay would save the morbidity and expense due to inappropriate diagnosis and treatment of various skin conditions with presentations similar to Loxosceles envenomations. Techniques used in the successful detection of this spider venom are directly applicable to bites from S. American Loxosceles species, responsible for additional deaths each year. The swab venom assay technique could be applicable to envenomations from numerous species PUBLIC HEALTH RELEVANCE: Bites of the brown recluse spider, Loxosceles reclusa, cause considerable morbidity and occasional mortality in the Midwest. Many lesions can appear similar and mimic spider bites, including bacterial and fungal skin infections as well as skin cancer. The goal of this project is to develop a commercially viable test for brown recluse spider bites using a painless and simple swab test for the spider venom on the surface of the skin.
Stoecker And Associates, University of Missouri, U.S. Air force and University of Michigan | Date: 2010-04-08
Methods and immunoassays for diagnosing a bite or sting of a venomous organism in a patient having symptoms consistent with such a bite or sting are provided. A sample of venom is collected from the area of the suspected bite or sting using a swab and then contacted with an antibody that specifically binds to an antigenic site on venom present in the sample. Binding is then detected. The invention is illustrated by examples showing diagnosis of brown recluse spider bite, distinguishing it from other diagnoses with which it is often confused. This extremely sensitive test can detect venom antigens down to about 20 picograms even after the sample has been shipped and stored for periods of up to three weeks during the summer.
Stoecker And Associates | Date: 2015-06-03
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 999.20K | Year: 2006
DESCRIPTION (provided by applicant): Malignant melanoma, with an estimated growth in incidence of about 6% per year for decades, causes considerable loss of life. Yet melanoma can be easily cured if detected early. Digital dermoscopy has shown promise for more accurate detection, particularly at an early stage. Recent conferences have highlighted a general agreement on definition of dermoscopic features and moderate agreement on the most useful structural features. Automatic detection of these specific structures that are critical for early diagnosis and are used in various dermoscopic diagnostic algorithms would be desirable. Yet little work has been published on automatic detection of any specific dermoscopic structures. Although specific colors figure prominently in the definition of the most critical dermoscopic structures, little work has been done on finding the specific regions or region combinations in the color space where colors are located, particularly with reference to the surrounding skin. The work in Phase I and after Phase I successfully segmented the border within 5% of the range of the dermatologists' borders, found several highly accurate dermoscopy features, and brought mean diagnostic accuracy on difficult early lesions to a high level. This proposal seeks to develop a digital dermosocopy system by 1) comparing classifiers 2) testing border accuracy and modifying segmentation if needed 3) developing an algorithm that uses a three-dimensional representation of a probability density function to specify single and paired melanoma colors via cluster methods and fuzzy logic techniques 4) identifying critical structural features including brown globules, abrupt border cutoff, granularity, regression, and pigment asymmetry with high accuracy 5) developing a clinical interface for acquisition of images within the clinic 6) testing the new algorithms in six dermatology clinics including two pigmented lesion clinics with both EpiLight and DermLite II Pro dermoscopy images taken in the clinic. Key features of the research include dermatopathology confirmation of specific structures and the use of relative color analysis. If successful, software will be marketed to the growing number of dermatologists with digital dermoscopy capability. The commercial software package will be ready for marketing as a diagnostic adjunct for digital camera dermoscopy attachments. Malignant melanoma, with an estimated growth in incidence of about 6% per year for decades, causes considerable loss of life. Melanoma can be easily cured if detected early, and this project seeks to develop a digital dermoscopy device that can detect very early melanomas. The project goal is to develop inexpensive melanoma detection software and test it in multiple dermatology clinics.