bluuebunny/crossref_metadata_2025_split huggingface dataset:
BI36 An infiltrative subcutaneous mass presenting as the first sign of relapse in a patient with T prolymphocytic leukaemia
Authors: Yoo Li Jie Helena , Kearney Nicola , Quinn John , Raghallaigh Siona Ni 
Published: June 2024

Abstract
T prolymphocytic leukaemia (TPLL) is a rare form of post-thymic T-cell neoplasm, often involving the peripheral blood, bone marrow and spleen. Cutaneous involvement can be found in 25–35% of patients (Mallet RB, Matutes E, Catovsky D et al. Cutaneous infiltration in T-cell prolymphocytic leukaemia. Br J Dermatol 1995; 132: 263–6). Cutaneous features are not well recognized in dermatological literature and have been reported only in a limited number of case series (Herling M, Valbuena JR, Jones D, Medeiros LJ. Skin involvement in T-cell prolymphocytic leukemia. J Am Acad Dermatol 2007; 57: 533–4). There is a predilection towards the face and trunk, and reported morphologies include oedema, macules, papules, infiltrative erythema, nodules and erythroderma. A 76-year-old woman was admitted with a 6-week history of a nontender, indurated rash on her left upper arm, feeling generally unwell with vomiting and diarrhoea. Prior to admission, she was treated with flucloxacillin, doxycycline and co-amoxiclav with presumed cellulitis, but with no relief. On examination, a well-demarcated indurated plaque with central clearing and expanding erythema resembling erythema migrans was noted on her left upper arm. A symmetrical petechial rash and erythematous plaques on her legs were also present. The patient had been diagnosed with TPLL 18 months previously and had completed six cycles of alemtuzumab with disease remission. Blood investigations on this admission revealed a haemoglobin of 10.5 g dL−1, lymphocytosis of 11.20 × 109 L−1, acute kidney injury with creatinine 160 µmol L−1, elevated lactate dehydrogenase 546 IU L−1 and C-reactive protein 15 mg L−1. Her blood cultures were negative. Blood film revealed atypical lymphocytosis consistent with relapse of TPLL. Given the induration associated with the left-upper-arm lesion, an ultrasound and magnetic resonance imaging were performed, which revealed a 5 × 3 × 7-cm mass infiltrating her triceps brachialis. Core biopsy showed atypical lymphocytic infiltration in the dermis and grenz zone with positive CD3, CD4, CD5 and CD7, consistent with TPLL infiltration of the skin. Skin biopsy from her lower limb also showed cutaneous TPLL infiltration. Computed tomography of the thorax, abdomen and pelvis revealed diffuse lymphadenopathy and splenomegaly. Bendamustine was started for relapsed TPLL with significant reduction in the size of her left-upper-arm mass. This case highlights the various morphologies of cutaneous eruption that can present in a patient with TPLL. To our knowledge, this is the second case reported in the literature in a patient with TPLL presenting with a subcutaneous mass. Cutaneous features of TPLL may herald disease relapse with an ensuing aggressive clinical course. A high index of suspicion and low threshold for biopsy are needed, as extranodal involvement itself meets the criteria for active TPLL warranting treatment.
H08 Post vacancy: Dublin’s first dermatologist
Authors: Howard-James Claudine 
Published: June 2024

Abstract
William Wallace (1791–1837), later known internationally as ‘Wallace of Dublin’, was Dublin’s first dermatologist. Born in County Down, he studied at the Royal College of Surgeons in Ireland (RCSI) from 1810 to 1813. During his time at RCSI, he was apprenticed to Charles Hawkes Todd, lecturer and surgeon in the Richmond and Lock Hospitals, both institutions experiencing high volumes of venereal and skin disease. Following receipt of his licence from RCSI in June 1813, Wallace travelled to London. Here he studied under established dermatologist Thomas Bateman (himself a pupil of Robert Willan), surgeon John Pearson, and expert venereal disease physician Joseph Adams, among others. Gaining significant experience in cutaneous and venereal disease during this time, he returned to Dublin in 1817 with the intention of utilizing this knowledge to establish a hospital. In his own words, the hospital’s mission was to ‘at once afford relief to the poor; supply the means of extending our knowledge of cutaneous diseases, by accurate clinical investigation and extensive observation; and establish a school for the instruction of medical students’. The following year, he personally founded and funded the Dublin Infirmary for Diseases of the Skin at 20 Moore Street, the first hospital in Europe or the British Empire exclusively devoted to skin disease. By 1837, an estimated 25 000 cases had been treated in the Dublin Skin Infirmary. Wallace made two internationally recognized contributions to medicine: introducing potassium iodide to the materia medica for treatment of syphilitic lesions and demonstrating the infectivity of secondary syphilis. The latter he proved unethically by the inoculation of ‘secretions from exanthematic sores’ into healthy individuals, demonstrating its transmissibility and incubation period. His publications include Observations on Sulphurious Fumigations as a Remedy in Rheumatism and Diseases of the Skin (1820) and A Treatise on the Venereal Disease and its Varieties (1833). During this time he was also appointed surgeon at Jervis Street Hospital, where he does not appear to have been an easy colleague; there were public rows with fellow surgeon James O’Beirne, complaints about the hospital’s cleanliness, and an increase in skin-related admissions while Wallace was on service, with a colleague commenting ‘certainly not one case of diseases of the skin was fit for an hospital’. While his ethics and behaviour as a colleague are at times questionable, his contribution to modern dermatology is undeniable. His sudden and untimely death in 1837 from typhus brought an end to the Dublin Skin Infirmary as his post lay vacant, owing to his habit of independence.
H09 Sir Jonathan Hutchinson’s melanotic whitlow: evolution of Hutchinson’s sign
Authors: Smith Abbey , Smith Hayley , Mitra Angana 
Published: June 2024

Abstract
‘It needs sometimes, the eye of faith to recognize the narrow band of black which borders the inflamed part’. – Hutchinson J. Notes towards the formation of clinical group of tumors. Am J Med Sci 1886; 91: 470.
This groundbreaking observation by Sir Jonathan Hutchinson in 1886, initially termed the ‘melanotic whitlow’, refers to pigmentation change in the nailfold, often accompanied by painful inflammation. Historically such lesions were considered traumatic; however, through careful clinical observation and meticulous documentation, Hutchinson recognized that this manifestation could be associated with malignancy. The melanotic whitlow later evolved into the eponymous Hutchinson sign, which we continue to use in today’s assessment of melanonychia. Sir Jonathan Hutchinson was born in 1882 in Selby, emerging from a modest background to become a pioneering figure in 19th-century medicine. He was a distinguished British surgeon and pathologist with an interest in dermatology, ophthalmology, neurology and the study of syphilis. More than a clinician, Hutchinson was a dedicated teacher, writer and philanthropist, actively sharpening medical education and research, with his medical bibliography consisting of over 1000 published reports. His work traversed a diverse range of medical domains, with numerous eponyms across various fields attributed to him. In dermatology, we commonly know him for Hutchinson freckle (lentigo maligna) and use Hutchinson sign to describe the periungual extension of a longitudinal pigmented band onto the nailfold, typically representing progression of subungual melanoma. Although it remains a crucial diagnostic marker of subungual melanoma, our understanding of this phenomenon and our ability to detect it have evolved over the last century. Over time the term ‘pseudo-Hutchinson sign’ has been coined as a mimic of Hutchinson sign due to the reflection of pigmentation of the nailbed and nail matrix through a transparent nailfold. This is seen in nonmelanoma conditions such as Bowen disease, ethnic melanonychia, nail naevi, subungual haematoma, Peutz–Jeghers or Laugier–Hunziker syndrome, and other inflammatory pathologies. Further evolution of this eponym can also be attributed to the advent of dermoscopy. The aptly named micro-Hutchinson sign, describes the dermoscopic detection of subtle cuticular pigmentation, often elusive to conventional naked-eye examination, and is thought to be indicative of malignancy. Hutchinson’s detailed description of the melanotic whitlow has contributed significantly to our assessment of nail pigmentation and melanoma. From his first description of the ‘narrow band of black’ to Hutchinson sign, we now have three variations of this eponymous term, used widely by modern-day dermatologists and aiding in the analysis of melanonychia.
H13 One scar too far: the perception of scarring through time
Authors: Long Alison , Long Amy 
Published: June 2024

Abstract
The English word, ‘scar,’ has roots in several languages: Latin (eschara), Old French (escharre), Greek (έσχάρα or eskhara), Middle English (skar) and Old Norse (skarð). Ancient civilizations such as the Romans, Greeks and Egyptians viewed scars in a sacred light, as scars were often linked to ritualistic practices. The Ancient Egyptians even employed scarring as a mark of authentication, to be displayed and observed. In Ancient Rome, the symbology of scarring was a practical element in ratifying democratic office after the fall of the Tarquin kings; scars demonstrated that these politicians were not godly as kings wished to be. If scars were to be treated in ancient times it was for symptomatic relief of pain or itching, rather than for aesthetic reasons. In more recent times, society has grown less accepting of facial imperfections and scarring. One example we often see is how scarring is portrayed on screen, highlighting the dichotomy between good and evil. There is a statistically higher preponderance for scarring in antagonistic characters vs. protagonists. Some movies go as far as to name the villain after their imperfections, such as Scar in The Lion King, and Al Pacino’s Scarface. When the ‘good guys’ are shown to have scarring it typically highlights their virtuousness, and can underpin an image of bravery, such as Harry Potter’s famous forehead scar. Recently, films have been criticized by their use of facial scarring on villains. In the James Bond film No Time To Die, the villain played by Rami Malek once again displays facial disfigurement. This was met with backlash for the villain cliché, resulting in the British Film Institute no longer funding films with facially scarred villains from 2018. Scars are often used as a shorthand for villainy, repeatedly exaggerated to depict a character flaw or convey an element of disquiet. Perpetuating these negative ideas will serve to bolster unsavoury views, foster prejudices and deepen the psychological impact that scarring can have. We now have various treatments that can be utilized to improve the appearance of scars, including medicated dressings, corticosteroid injection, laser therapy and surgery. However, scarring cannot be cured and so we must endeavour to promote a more accepting landscape for patients struggling with distressing scars.
PS07 (P107) Updating the Assessment of the Psychological and Social Effects of Acne (APSEA) through factor analysis: developing the novel APSEA-3
Authors: Jones Georgina , Morgan Jim , Lau Eva , Latt Moe , Lee Natasha , El-Mansori Ibtessam , Layton Alison 
Published: June 2024

Abstract
Health-related quality of life is now recognized as an essential outcome to assess in acne trials and practice. Many patient-reported outcomes exist, including the Assessment of the Psychological and Social Effects of Acne (APSEA), which is an acne-specific measure (Layton AM, Seukeran D, Cunliffe WJ. Scarred for life? Dermatology 1997; 195: 15–21). APSEA was developed in 1990s and subsequently psychometric standards and methods have progressed. The purpose of this study is to conduct an updated psychometric analysis of the APSEA among a cohort of patients being treated for acne in routine clinical practice. Exploratory factor analysis (EFA), a method of classical test construction, was carried out (n = 993). To test the adequacy of the sample size for undertaking factor analysis, values for the Kaiser–Meyer–Olkin test and Bartlett’s test of sphericity were calculated, as well as Cronbach’s alpha. Following the EFA and generation of the proposed scales, the individual domains were calculated and transformed onto a scale of 0–100 by summing the items within the scale, dividing by the total possible score within that domain. A confirmatory factor analysis (CFA) was then undertaken using a new second dataset (n = 501) to test the factor conceptual framework, using MPlus 8.6 software (http://www.statmodel.com). Descriptive statistics and tests of internal consistency reliability and construct validity (concurrent) were also undertaken using a priori hypotheses and comparisons with the Dermatology Life Quality Index (DLQI) and Patient Health Questionniare-9 (PHQ-9). The EFA suggested a three-domain model (anxiety and depression, body image and self-esteem, and social functioning), which was confirmed in the CFA analysis whereby the goodness of fit indices all indicated good model fit (root mean square error of approximation = 0.038, comparative fit index = 0.96, Tucker–Lewis index = 0.96, standardized root mean squared residual = 0.048). Cronbach’s alpha values exceeded 0.70, and item-total correlations exceeded 0.40 for all three domains, indicating good internal consistency reliability. All three APSEA domains were also positively correlated with the DLQI and the PHQ-9, indicating good construct validity of the tool. This EFA study has demonstrated the validity and reliability of a novel version of APSEA, which we have termed APSEA-3 to reflect the three unique domains it captures. Preliminary results show that the tool is responsive to change and useful for measuring the psychosocial impact of acne.
SG13 Managing cutaneous manifestations of FH-associated tumour predisposition syndrome: a systematic review of case reports
Authors: O’Brien Amber , Schirwani Schaida 
Published: June 2024

Abstract
The cutaneous manifestations of fumarate hydratase (FH)-associated tumour predisposition syndrome, otherwise called hereditary leiomyomatosis and renal cell carcinoma (HLRCC), can be managed in a variety of ways including surgical excision, oral and topical analgesia, laser therapy and cryotherapy. While some of these methods are considered well established, others are less widely used and there is little evidence reported comparing the outcomes after treatment. This systematic review of case reports aims to determine how symptom burden after surgical excision of the cutaneous lesions differs from symptom burden after analgesic treatment or other methods. The databases OVID MEDLINE, Embase and Scopus were searched with terms such as ‘HLRCC’, ‘cutaneous’, ‘leiomyoma’ and ‘management’. In total, 19 case reports with a total of 23 patients diagnosed with HLRCC and cutaneous manifestations, for example leiomyomas, were included in this systematic review. These case reports were dated between 2009 and 2022. Eleven of these patients had their cutaneous lesions treated with surgical excision, eight were treated with analgesia and nine were treated with ‘other methods’. ‘Other methods’ was defined as any treatment that was not surgical or simple analgesia, and included carbon dioxide laser therapy, erbium laser therapy, liquid nitrogen cryotherapy, phototherapy, botulinum toxin, electrocoagulation, and immunosuppression with azathioprine. Some patients were treated with a combination of methods. Surgical excision showed the poorest symptom outcomes after treatment, with 9% of patients showing improvement of symptom control after treatment compared with 75% of patients having symptom improvement with analgesic treatment and 89% after ‘other methods’. When surgical excision was combined with analgesia or ‘other methods’, symptom control was improved compared with surgical excision when used alone. This review shows that surgical excision may not provide optimal symptom control for patients with cutaneous manifestations of HLRCC, and other treatments should be considered. Surgical excision of cutaneous lesions allows histopathological confirmation of leiomyomata and therefore has an important role in the diagnosis of HLRCC, so it should not be excluded from treatment recommendations. However, clinicians should consider combining excision with another treatment, for example analgesia with agents such as gabapentin. Further research in the form of a large cohort study or randomized control trial is necessary to confirm the observations made by this systematic review by providing more quantitative data.
BT25 Successfully utilizing a novel teledermatology pathway in a suspected skin cancer clinic: improving patient experience and reducing time from referral to assessment
Authors: Holloran Sophie , Quaresma Catarina , Roberts James , Ponpandian Dheeksha , Kordi Yousef , Ko Emily , Whitley Helen , Zakaraite Jolita 
Published: June 2024

Abstract
In the UK the incidence of skin cancer has increased by 26.1% since 2013, with 225 000 cases diagnosed in 2019. In response to the rising demand we must adapt our service pathways to ensure patients have a reliable, responsive service that meets the National Health Service Faster Diagnosis Standard. Prior to adapting our service, we had 600–900 referrals per month, with an increasing backlog of patients who were waiting to be seen, missing the 14-day target. For several years, an effective collaborative partnership with our plastic surgery colleagues has greatly improved our skin cancer service; patients were seen face to face, with dermatology and plastic surgery consultants working side by side in a polyclinic format. Despite this, the pressure on services still resulted in a backlog, with only 0.7% of referrals seen within 14 days in July 2023. In July, we introduced a teledermatology service to run in tandem to our face-to-face service; this allowed for increased capacity and also improved our referral response times. There are several exclusion criteria for our new pathway. If a general practitioner refers a lesion with a high level of concern for malignancy, if the patient is over 85 years old, or if there are multiple lesions, patients are assessed face to face; the remainder are reviewed via teledermatology. Within 7 days of referral, the patient is assessed face to face by an experienced dermatology healthcare assistant. They complete a skin cancer assessment and take macro and dermoscopic images of the lesion. This information is uploaded onto our electronic medical record and reviewed by a consultant within 5 days. If the lesion is concerning for malignancy or the diagnosis is unclear, patients are booked for face-to-face review within 14 days. The patient can also be directly listed for surgery; for those directly listed, they are sent a letter with our minor surgery patient leaflet and offered a face-to-face appointment prior to their procedure only if they desire. For benign lesions, the patient is discharged directly following teledermatology review. Our system has been designed to be flexible; if it is felt there are other lesions of concern by the healthcare authority, or if there is insufficient information or subquality images, the patient can be easily and quickly transferred to a face-to-face review. Within 6 months, we are now seeing over 95% of our referrals within 14 days. Our data demonstrate that by adapting our service and introducing a teledermatology pathway, we have significantly improved time from referral to assessment and improved the experience for patients. We aim to continually improve and adapt the service, adjusting it as needed with service demand.
Controversy. On pump or off pump: what will I do when I grow up? A narrative systematic review
Authors: Calafiore Antonio Maria , Torregrossa Gianluca , Salerno Tomas A , Prapas Sotirios , Benetti Federico , Angelini Gianni D , Lima Ricardo De Carvalho , Di Mauro Michele , Taggart David , Gaudino Mario , Puskas John D 
Published: June 2024

Summary
The transition from the second to the third millennium happened to be a turning point in the history of myocardial revascularization on a beating heart, which moved from technical development to critical evaluation. This article describes how the initial acceptance and spread of off-pump coronary artery bypass grafting (OPCABG) was followed by the general perception that the technique could not fulfill the expectations placed in it and provides some insight on what should we do with the know-how of OPCABG in the present and the future of coronary surgical revascularization.
Modeling the evolution of Schizosaccharomyces pombe populations with multiple killer meiotic drivers
Authors: López Hernández José Fabricio , Rubinstein Boris Y , Unckless Robert L , Zanders Sarah E 
Published: June 2024

Abstract
Meiotic drivers are selfish genetic loci that can be transmitted to more than half of the viable gametes produced by a heterozygote. This biased transmission gives meiotic drivers an evolutionary advantage that can allow them to spread over generations until all members of a population carry the driver. This evolutionary power can also be exploited to modify natural populations using synthetic drivers known as “gene drives.” Recently, it has become clear that natural drivers can spread within genomes to birth multicopy gene families. To understand intragenomic spread of drivers, we model the evolution of 2 or more distinct meiotic drivers in a population. We employ the wtf killer meiotic drivers from Schizosaccharomyces pombe, which are multicopy in all sequenced isolates, as models. We find that a duplicate wtf driver identical to the parent gene can spread in a population unless, or until, the original driver is fixed. When the duplicate driver diverges to be distinct from the parent gene, we find that both drivers spread to fixation under most conditions, but both drivers can be lost under some conditions. Finally, we show that stronger drivers make weaker drivers go extinct in most, but not all, polymorphic populations with absolutely linked drivers. These results reveal the strong potential for natural meiotic drive loci to duplicate and diverge within genomes. Our findings also highlight duplication potential as a factor to consider in the design of synthetic gene drives.
Hereditary nature of death-feigning frequency in a parasitoid wasp Heterospilus prosopidis using sib analysis
Authors: Fujioka Haruna , Miyatake Takahisa , Ohkubo Yusaku , Shimada Masakazu 
Published: June 2024

Abstract
Death feigning, a state of immobility observed in many animals in response to external stimuli, is an anti-predator behaviour. Although previous studies showed that death-feigning behaviours are quantitative genetic traits, the knowledge of the heritable basis of death-feigning behaviour is lacking. To investigate the heritable basis of death-feigning behaviour, we used 3 laboratory strains of a braconid parasitoid wasp, Heterospilus prosopidis. The heritable basis using half-sib analysis, and the effects of different geographical backgrounds, rearing conditions in the laboratory, and host age were evaluated. The results of the half-sib analysis showed that the frequency of death feigning varied among sires, suggesting a certain extent of additive genetic variance. Also, the frequency of death feigning varied between geographical backgrounds and among strains. Death-feigning frequency was not affected by the age of the host. Our findings highlight the importance of genetic factors underlying the basis of the death-feigning behaviour and provide support for the genetic alterations of traits from the perspective of evolution in various animal species.