Full-body Skin Examination Research Articles

Epithelioid Angiosarcoma: A Diagnostic Dilemma with Clinically and Histopathologically Overlapping Features

Cutaneous angiosarcoma is a rare malignancy of endothelial cell origin that commonly presents in the head and neck region of elderly individuals and is known for high rates of lymph node metastasis and mortality. There is significant variability in the histopathologic features, and immunohistochemistry is necessary to help differentiate epithelioid angiosarcoma from lesions it may clinically mimic. Here, we report a rare case of poorly differentiated epithelioid angiosarcoma on the trunk initially diagnosed as poorly differentiated squamous cell carcinoma (SCC) on shave biopsy. A 56-year-old man presented for a full-body skin examination significant for a 5.6 x 2.8 mm brown-black macule on the left superomedial posterior trunk and a 5.0 x 2.7 mm pink, ulcerated papule on the right inferior posterior trunk. On histopathology, one lesion was found to be melanoma in situ, and the other showed ulcerated and infiltrative, poorly differentiated SCC. Post-excision histologic analysis of the right inferior back lesion revealed tumor cells immunoreactive to vimentin, ERG, and CD31 (PECAM-1). These findings suggested that the lesion previously diagnosed as SCC was an invasive, poorly differentiated epithelioid angiosarcoma. The patient underwent 40 sessions of radiotherapy. Epithelioid angiosarcoma occurring outside of the conventional epidemiologic profile is believed to portend higher mortality rates. This case highlights the importance of thorough clinical evaluation and appropriate histopathologic diagnosis of an aggressive neoplasm unlikely to present in this location. Further studies are required to explore potential risk factors, effective treatments, and long-term outcomes in patients with epithelioid angiosarcoma.

The ethics of full body skin examinations

Full body skin examinations (FBSEs) are part of the purview of a dermatologic examination. Because this involves examination of sensitive or intimate areas, there are many ethical issues involved. Herein, we discuss whether screening patients with an FBSE is ethical and consistent with the ethical tenet of distributive justice, how to ethically deal with our patients with disabilities, how to ethically navigate patients who have been emotionally or physically traumatized in the past, and the ethical ramifications of the use of a chaperone.

Perspectives on Full-Body Skin Examinations Among Sexual and Gender Minority Patients

This survey study assesses full-body skin examination rates among sexual and gender minority patients and investigates their comfort with and reasons for discomfort during these examinations.

The Prevalence and Awareness of Regular Follow Up of Patients Treated with Phototherapy for Skin Cancer Surveillance.

Regular full-body skin examination is commonly ignored in patients post-phototherapy, despite ultraviolet (UV) radiation being carcinogenic. Our objectives are to assess the prevalence of regular follow-up and full-body skin examination for patients treated with phototherapy, as well as the relationship between phototherapy exposure and the development of skin cancer in Saudi Arabia. This was a cross-sectional retrospective study conducted from January 2022 to July 2022. The study included 99 patients, selected via simple random sampling, from King Saud University Medical City, Riyadh, Saudi Arabia, who underwent phototherapy for at least 8 weeks and were followed for a minimum of 18 months post-treatment. Patients who met the inclusion criteria were called and given a questionnaire. Out of 99 patients, only 26 (26.26%) underwent full-body skin examinations by their physicians after phototherapy treatment. The average follow-up time after phototherapy was 3.2 years. Most study participants (85.85%) were unaware that cancer was a possible complication of phototherapy. Participants with knowledge about skin cancer complications were more likely to have undergone a full-body exam (P = 0.001). None of the participants developed any type of skin cancer after phototherapy. Patients treated with phototherapy had no adequate information about the risk of skin cancer. The incidence of skin cancer was zero in our small cohort. Dermatologists in Saudi Arabia do not have an evidence-based notion regarding the risk of skin cancer among the Arab population after phototherapy. Since There is a lack of data examining the relationship between phototherapy and skin cancer in the Arab region, this study should trigger future studies with large populations and longer follow up periods.

Онлайн-обучение врачей неонкологических специальностей по профилактике и ранней диагностике злокачественных новообразований кожи.

One of the reasons for the late diagnosis of malignant skin neoplasms (hereinafter referred to as MNS) is the insufficient knowledge of doctors in non-oncology specialties [1], [2]. The sensitivity for recognizing cutaneous melanoma (hereinafter referred to as MNS) during a visual examination by primary care physicians is 40,2% [3]. The sensitivity of recognizing MNS for an inexperienced dermatologist is 69%, compared to the sensitivity of diagnosing MNS by an experienced dermatologist is 92% [4]. Also, the reason for the late diagnosis of MNS is an insufficiently complete examination of patients. Evidence suggests that doctors do not routinely offer full body mole screening. Up to 63% of patients diagnosed with MK visited their GP in the year before diagnosis. Only 30% of dermatologists perform a full body skin examination on all of their patients [5]. Thus, an important method is the education of doctors of non-oncology specialties in the form of training programs in the principles of early diagnosis of cancer, which in turn can help improve the oncological epidemiological situation [9]. The purpose of this study is to study the effectiveness of organizing an 8-hour online training aimed at raising the awareness of nononcology doctors on the prevention and early diagnosis of cancer. Material and methods. An 8-hour online course «Early diagnosis of skin tumors» was conducted for doctors, created by a group of authors on the platform «Personal Account of a Doctor at the Volga Research Medical University.» The training course included the following issues: risk factors for MK and other cancers, a description of the diagnostic algorithm using the ABCDE method with an illustration of each sign on photographic images, differential diagnosis of skin tumors, prevention with an emphasis on protection from ultraviolet radiation. The course used 82 photographs of MNS. The illustrated material consisted of 30 images of MK, 25 images of basal cell skin cancer (BCSC), 15 images of seborrheic keratoma of the skin, 12 images of skin hemangiomas. Conclusion. As a result of online training, one can note an improvement in the level of knowledge of doctors after completing an online course aimed at the prevention and early diagnosis of cervical cancer. Increasing the specificity of diagnosing nevi (0,846, 0,953) before and after, respectively, can help reduce costs in the “secondary level” of healthcare. The topic of prevention presented in the course also contributes to conducting preventive conversations with patients and correct patient routing. Thus, conducting online training has a number of advantages and shows good learning results. The diagnostic methods discussed in the course, aimed at clarifying the diagnosis of cancer, especially in the early stages of the disease, predetermine the choice of optimal treatment tactics and are the key to ensuring the best prognosis of the disease.

Full-body skin examination in screening for cutaneous malignancy: a focus on concealed sites and the practices of Australian dermatologists.

Full-body skin examination (FSE) is a vital practice in the diagnosis of cutaneous malignancy. Precisely how FSE should be conducted with respect to concealed site inclusion remains poorly elucidated. To establish the approach of Australian dermatologists to concealed site examination (CSE). A cross-sectional study was performed consisting of an online self-administered 11-question survey delivered to fellows of the Australasian College of Dermatologists. There were 237 respondents. Anogenitalia was the least often examined concealed site (4.6%), and 59.9, 32.9, and 14.3% reported always examining the scalp, breasts, and oral mucosa, respectively. Patient concern was the most frequently cited factor prompting examination, while many cited low incidence of pathology and limited chaperone availability as the main barriers to routine examination of these sites. Most Australian dermatologists do not routinely examine breasts, oral mucosal, or anogenital sites as part of an FSE. Emphasis should be made on identifying individual patient risk factors and education regarding self-examination of sensitive sites. Aconsensus approach to the conduct of the FSE, including concealed sites, is needed to better delineate clinician responsibilities and address medicolegal implications.

43251 Duration of acceptable delay until subsequent full body skin examination, given prior history of skin cancer or lesions suspicious for skin cancer

43251 Duration of acceptable delay until subsequent full body skin examination, given prior history of skin cancer or lesions suspicious for skin cancer

High rate of incidental detection of skin cancer following teledermatology consultation: Full body skin examination may detect more skin cancers than a referral-based approach

High rate of incidental detection of skin cancer following teledermatology consultation: Full body skin examination may detect more skin cancers than a referral-based approach

Prevalence of and racial/ethnic distribution of full-body skin examination among sexual and gender minority patients.

10557 Background: Skin cancer disproportionately affects sexual and gender minorities in the United States. A full-body skin examination (FBSE) can help detect early signs of skin cancer and is an important prevention method. However, there are no national guidelines of routine FBSE for skin cancer. Further, data on FBSE participation among lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) patients are lacking, and little is known about the racial/ethnic distribution of FBSE in this patient population. Methods: Cross-sectional survey data on FBSE participation and key characteristics were collected from patients who were recruited at clinics and community centers or via social media from August 2022 to January 2023. Eligibility criteria included being at least 18 years old and self-identifying as LGBTQ+. Receipt of an FBSE, assessed by asking patients whether they had ever received an FBSE in the past, was dichotomized as yes and no. Descriptive statistics, i.e., mean (SD) and count (%), were calculated, with distribution comparisons using Student’s t, Pearson’s Chi-square, or Fisher’s exact tests as appropriate. Results: A total of 124 LGBTQ+ patients responded to the survey. The mean age was 32.4 (SD = 12.1) years. Overall, 41.5% of the patients reported ever having received an FBSE in the past. By race/ethnicity, 62.5% of Non-Hispanic Black patients reported ever having received an FBSE, followed by 52.1% of Non-Hispanic White, 28.6% of Hispanic or Latino, 28.6% of multiple races, and 10.5% of Asian ( p= 0.005). By gender identity, 61.5% of transgender male patients reported receipt of an FBSE in the past, followed by 57.1% of transgender female, 39.3% of cisgender female, 35.4% of cisgender male, and 35.0% of genderqueer, non-binary, or gender non-conforming. Comparing patients who reported ever having received an FBSE, those who did not were more likely to not be employed (47.9% vs. 26.0%, p= 0.046), to be on Medicaid (18.5% vs. 6.1%, p= 0.074), to not have visited a dermatologist in the past (41.7% vs. 7.8%, p< 0.001), and to not have been told at an increased risk for skin cancer (87.3% vs. 43.2%, p< 0.001). No significant differences in educational attainment or sexual orientation were observed between patients who reported ever having received an FBSE and those who did not. Conclusions: The prevalence of FBSE was higher among Non-Hispanic Black or Non-Hispanic White LGBTQ+ patients than among those who are Hispanic or Latino, multiracial, or Asian. In addition, our findings suggest that low socioeconomic status and health care utilization may influence FBSE access or participation in LGBTQ+ patients. Strategies for improving equitable access to FBSE among LGBTQ+ patients, particularly among those with ethnic minority background or low socioeconomic status and health care utilization, may be needed.

Community outreach in vulnerable populations: Skin cancer screening for firefighters.

e21587 Background: Firefighters have both an increased risk (21%) and 20-year younger median age (42) at diagnosis of melanoma compared to the general population. The World Health Organization classifies firefighters’ occupational exposures as "carcinogenic to humans," but there is limited knowledge regarding sun protection habits, skin cancer history, and community outreach in this at-risk population. Methods: Free, full-body skin examinations conducted by board-certified dermatologists using the American Academy of Dermatology’s SPOT Skin CancerTM screening form were offered to firefighters from 26 cities and towns in Massachusetts on two separate days in August 2021 and October 2022. Data from the screening form and subsequent skin biopsy results were obtained and reported. Results: Of 195 firefighters screened, 30 (15.4%) were referred for biopsy. All were white males, mean age was 44.7 years, 26.7% had prior tanning bed exposure, 80% had prior blistering sunburns, 20% used sunscreen regularly, 86.7% did not have a regular dermatologist, and 6.7% had a history of keratinocyte-based skin cancer. Nineteen (63.3%) had biopsies, most frequently on the back or face, which resulted in three nodular basal cell carcinomas and 11 dysplastic nevi (seven moderate-to-severe). Conclusions: Firefighters are an underrecognized vulnerable population for the development of skin cancer. Community outreach in the form of free skin cancer screenings is a successful model for increasing awareness and early diagnosis of skin cancer among this population. In addition to providing access to care, community screenings offer tailored educational opportunities that promote skin cancer prevention in this high-risk group.

Longitudinal Assessment of the Prevalence of Actinic Keratosis and Extensive Risk Factor Evaluation: An Update from the Rotterdam Study

Limited population-based studies are available to analyze the prevalence, risk factors, and longitudinal outlook of actinic keratoses (AK). These aforementioned features were assessed using Rotterdam Study participants aged 40 and older who underwent a full-body skin examination (FBSE) by a dermatology trained physician. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for the associations between risk factors and the presence of AK. Among 8,239 eligible participants, the prevalence of one or more AKs was 21.1% (95% CI: 20.2-22.0) and was higher in men. Male sex, age, lighter hair and eye color, baldness, genetic risk score (GRS), and digital photoaging measures (digitally-assessed pigmented spots, telangiectasias and global facial wrinkling) had a positive association with AK. Cigarette smokers had reduced odds of having AK, with current smokers having the lowest risk. Among patients with two AK assessments, there was no difference in the presence of AK during follow-up between treated and untreated participants. In conclusion, GRS and digital photoaging measures showed associations with increased lesion count. At the individual level, patients were most likely to decrease in AK severity group (i.e. with less AKs) over time, possibly regardless of whether or not participants were treated.

Importance of a Total Body Skin Examination by Exposing a Patient for the Diagnosis of Tick-mediated Infectious Disease

An 81-year-old man was found unconscious in a bathtub by his wife after having taken a long bath. He was rescued by his wife and son, and they dressed him while calling for an ambulance. On arrival, he was in a shock state with convulsion. After exposing him, he was found to have multiple macular skin rashes with eschar with a red halo on his lower right abdomen. He was treated with anticonvulsant and massive infusion. He had had right lower abdominal skin lesions for more than two weeks, general fatigue and skin rash for one week, and a fever for four days before the arrival. A biochemical analysis of his blood on arrival indicated inflammation, hepatic, renal disturbance, and coagulopathy. As he had the triad of tick-mediated infectious diseases, he received minocycline. His general condition improved, and he regained his consciousness on day 6. On day 9, we obtained positive results for scrub typhus. Finally, he was discharged home. Physicians should perform a full body skin examination of patients with a coma or fever in order not to miss fatal diseases.

Sun protective behaviors in sun-sensitive individuals: a cross-sectional study examining for ethnic and racial differences.

The rates of non-melanoma skin cancer continue to rise in the United States. We investigated if differences exist in skin cancer preventive behaviors among sun-sensitive non-Hispanic whites and other racial and ethnic groups. The National Health Information Survey was used to perform the cross-sectional study. Outcomes of interest included multiple sun-protective methods. Individuals were determined to be sun-sensitive if Fitzpatrick skin phototype (SPT) I/II. Multivariable logistic regression was used to examine the associations between the use of sun-protective practices and race and ethnicity, SPT, and survey year. The study included 67,471 individuals. Adjusted prevalences of skin cancer preventive behaviors revealed that across all SPTs, non-Hispanic whites were more likely to use sunscreen, undergo physician-administered FBSE, and have multiple sunburns or tan indoors in the past year compared to corresponding SPT other racial and ethnic groups. In contrast, other racial and ethnic groups with any SPT were more likely to practice sun avoidance than corresponding SPT non-Hispanic whites. Additionally, other racial and ethnic groups with SPT III+ were more likely to wear sun-protective clothing than non-Hispanic white individuals with similar SPTs. For all SPT and racial and ethnic groups, there were significant increases in sunscreen use and decreases in past-year indoor tanning. Full body skin examination prevalence, regardless of sun sensitivity, increased for all non-Hispanic whites, but remained unchanged for sun-sensitive other racial and ethnic groups. Adjusted prevalence of multiple sunburns and use of protective clothing remained unchanged for all racial and ethnic groups across all SPT categories. There are differences in sun-protective behaviors among sun-sensitive individuals by race and ethnicity with the magnitude of some of these differences increasing. Future research and public health campaigns are needed on photosensitive individuals and the relationship between skin protective behaviors and race/ethnicity. When discussing sun protection, care providers should not only consider the influence of sun-sensitivity, but also race and ethnicity, and its impact on sun prevention behaviors.

33790 Community bonding to break barriers to care: Improving skin cancer knowledge in the skin of color community

Background: The Skin of Color Community Event Series (SOCCES) hosts bimonthly events with an introductory presentation about skin of color concerns, followed by a question-and-answer session with an interdisciplinary rotating panel of dermatologists, psychologists, hair stylists, and estheticians. Here, we discuss the feasibility and effectiveness of our most recent 2021 virtual event on skin cancer. Methods: Paired T-test analyses were conducted to compare pre- and post-event mean knowledge and attitude scores. Results: Most participants (79.3%) were 18-34 year-old Black/African-American females. Although 63.2% of attendees reported a concerning spot, mole or skin growth, the majority (86.8%) had never visited a dermatologist for a full body skin examination. Top barriers to receiving care from a dermatologist included being unsure of where to go, lack of insurance coverage or cost concerns, and being unable to find a dermatologist they trusted. Approximately half (51.3%) of participants reported sunscreen use 75-100% of the time. Barriers to daily sunscreen application were forgetting to apply, the product’s white cast, and the belief that use is unnecessary. We observed significant increases in knowledge (t(16) = -6.57, P < .001) and positive attitudes (t(16) = -3.17, P < .003). Post-event questionnaires showed that 96% of attendees were more likely to wear sunscreen daily and 83% were likely to complete a self-skin examination at home. Conclusion: SOCCES uses unique virtual community spaces to promote knowledge and positive attitudes towards accessing dermatologic care to improve barriers to care for people of color.

35250 Real-time feedback during an interactive online skin cancer training game “Whack-a-Mole” is key to increasing confidence in performing skin self-examination at home.

Melanoma is the most lethal form of skin cancer (SK). Early melanoma detection has decreased mortality through skin self-examination (SSE) and dermatology full-body skin examinations. Although ABCD and UDS training increases melanoma identification skills, studies have shown that lacking self-confidence is the main barrier for performing SSE at home. This project compares the efficacy of various mole identification training strategies and explores the effect of real-time feedback on decision-making and self-confidence. We developed an online melanoma identification game that tests differences between training types and real-time feedback on mole identification. This online RCT tests a 4 (training: ABCD, UDS, both, control) by 3 (feedback: standard, motivational, control) factorial design on melanoma identification, self-efficacy, and SK prevention intentions. Real-time feedback was presented as standard and motivational. We recruited 1025 US adults. Our Whack-a-Mole gameplay integrates the same mechanics as Tinder (swipe left on safe moles and swipe right on malignant moles). Two-way ANCOVA was used for the analysis. ABCD training resulted in significantly higher melanoma identification than the control (P = .011). All training types resulted in significantly higher self-efficacy than the control (P = .007). All feedback elicited significantly higher levels of self-efficacy than the control (P = .001). Around 88% of participants intend to conduct SSE and wear sunscreen. Our data suggest that interactive ABCD and UDS training with real-time feedback may improve accuracy, ability, and self-confidence for melanoma identification and may lead to increase performing SSE at home. Overall, Whack-a-Mole is a novel efficacious tool for melanoma identification.

Discrepancies in Skin Cancer Screening Reporting Among Patients, Primary Care Physicians, and Patient Medical Records.

Skin cancer incidence in the United States has risen rapidly in recent decades, underscoring the need for accessible and effective prevention practices. The full-body skin examination (FBSE) is the quintessential tool for secondary skin cancer prevention, but the US Preventive Services Task Force (USPSTF) states there is insufficient evidence to recommend the examination for the general or at-risk population. Variable performance of FBSEs among primary care providers (PCPs) is a barrier to accurate studies, and variability in measurement of that performance can be a major impediment to assessment of FBSEs in practice. To better understand the degree of variability, we performed a multicenter, cross-sectional study of FBSEs reported among 53 PCPs and 3343 patients. The results highlight the need for standardization of FBSEs and more rigorous criteria for skin cancer screening.

212 Prevalence and risk factors of actinic keratosis: Results from the rotterdam study

Actinic keratoses (AKs) are pre-malignant skin lesions that occur secondary to extended ultraviolet radiation (UVR) exposure. Limited population-based studies are available to analyze the risk factors, severity and natural course of AK. The aim of this study was to calculate the prevalence of AK and investigate its risk factors and progression. Participants from the Rotterdam Study (RS), an ongoing prospective cohort study, who underwent full body skin examination (FBSE) were included. Univariable and multivariable multinomial logistic regression analyses were performed to study associations between selected risk factors and the number of clinically diagnosed AK lesions. A subset of participants underwent two FBSEs approximately 4 years apart for longitudinal assessment. Of the 8,239 included participants, 1,731 (21.1%) had at least one AK lesion, with the majority having 1-3 AKs (54.4 %). Male gender, older age, lighter hair color, Glogau scale, baldness, and a high tendency to develop sunburn were all significantly associated with AK, with the strongest associations detected for participants with ≥10 AKs. Light eye color was associated with severe AK, but not with mild to moderate AK. Current tobacco smokers had lower odds of mild and severe AK when compared to former and never smokers. 1,547 (18.8%) participants underwent two FBSEs. Of this group, 49% did not develop AK, 15.8% had an increase in AK number, 21.7% had a decrease in AK and 13.4% had approximately the same number. In this large-scale population-based study, we demonstrated that higher age, male gender, lighter hair color, baldness, and high Glogau scale score were associated with higher odds of AK. This effect was most prominent for subjects with severe AK. Conversely, smoking showed an inverse relationship with AK, which suggests there is a protective element that reduces the odds of cutaneous pre-malignancy. Over time, AK lesions are more likely to decrease in number rather than increase or remain unchanged.

Cutaneous manifestations of obesity in Turkish children: A comparative study.

Cutaneous changes in obese adults have been investigated in numerous studies, but this issue has not been adequately investigated in children. We aimed to determine the prevalence of skin manifestations in children with obesity by comparing them to normal-weight children. A cross-sectional study was conducted between June 2017 and January 2019 in which 82 children with obesity and 86 normal-weight healthy control children were enrolled. Study participants had detailed full-body skin examinations performed by the same dermatologist; mycological and Wood's lamp examinations were performed when necessary. Sociodemographic and anthropometric measurements of the participants were recorded. Striae distensae were the most common skin manifestation in children with obesity; striae were significantly higher in the obese than in the control group (72% vs. 26.7%, p<.001). The anatomical distribution of the striae distensae in the groups differed significantly. Striae distensae were most commonly observed on the buttocks in the control group, while the thighs were the most common site in the obese group. Acanthosis nigricans (63.4% vs. 3.5%, p<.001), acrochordons (17.1% vs. 1.2%, p<.001), keratosis pilaris (32.9% vs. 17.4%, p=.021), intertrigo (11% vs. 0%, p=.001), folliculitis (31.7% vs. 5.8%, p<.001), seborrheic dermatitis (12.2% vs. 3.5%, p=.035) and facial erythema (7.3% vs. 0%, p=.012) were found to be statistically significantly more common in the obese group compared to the control group. Obesity in children is associated with numerous cutaneous manifestations. Further study is needed to identify whether weight loss can reduce skin manifestations in obese children.

P164 Assessment of awareness and compliance with the recommendations of primary and secondary prevention of cancer in patients with Inflammatory Bowel Disease

Abstract Background Patients with Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are at risk of developing malignancies, so prevention and adherence to cancer screening may improve its detection. The aim of this study was to asses the compliance with medical recommendations, especially primary and secondary prevention of cancer. Methods This prospective, one-center study was carried out between June and October 2021r. amongst patients from Department of Internal Medicine and Gastroenterology with IBD Division, Central Clinical Hospital of Ministry of Interior Affairs and Administrations, Warsaw, Poland. Patients were asked to complete anonymous questionnaire which included 42 questions concerning lifestyle, cancer risk factors, cancer history, and checkups in patients with IBD. Results A total of 190 patients with IBD were included in survey. 117 (61.6%) had CD, 67 (35.3%) UC and 6 (3.2%) unclassified disease. 43.7% were women and more than a half of them had &amp;gt;8 years of the length of the disease. In total 84.2% were taking mesalazine, 48.4% immunosupresive medication and 77.9% biological treatment. Statistically significantly (p=0.034) more patients with CD than those with UC practiced regular physical activity (respectively 65.8% and 48.5%). Patients with UC more often were non-smokers (76.7% vs 92.5% for CD and UC respectively; p=0.007). 39.7% of patients with CD and 27.3% with UC declared alcohol consumption (p=0.128). Only 6% of patients responded not to use sun protection measures when sun-bathing but 24.8% with CD and 34.4% with UC didn’t have regular full-body skin examinations. 78.7% of patients had abdominal ultrasound scan performed in the last year. Out of 52.7% who had colonoscopy recommended, 49.3% of patients declared that the examination was carried out (36.8% of CD and 65.5% of UC; p= 0.038) and another endoscopy was scheduled (18.6% of CD and 48.4% of UC; p&amp;lt;0.001). According to respondents cholangio-MRI was recommended to 14.3% patients with CD and 6.2% with UC (p=0.219). Only 1 patient in both groups did not perform this examination. Most of the examinations were recommended by gastroenterologists. Moreover, in the last 12 months 59.6% of female answerer declared to have ultrasound imagining of the breast and 98.7% gynecological examination performed (65.4% had regular Pap-test screening). 82.3% of respondents knew about HPV vaccination but only 25% were vaccinated. Conclusion Our study reveals that many of IBD patients are exposed on risk factors of malignancies. Screening for cancer and regular checkups should be regularly performed. Primary prevention, such as HPV vaccinations, should be reminded to all patients.

Cervical, oral and anal Human papillomavirus infection in women attending the Dermatology Unit of a regional reference hospital in Genoa, Italy: a prevalence study.

Between January 2016 and December 2018, the female patients attending the STI center (cases) and those requiring a full body skin examination for skin cancer screening ("supposed" healthy population: controls) were recruited. Cervical/anal/oral samples were collected with ThinPrep liquid based cytology preparation system: polymerase chain reaction for HPV and cytological evaluation were performed. Overall, 85 cases and 31 controls were recruited. Cervical HPV infection was detected in 60% of the cases and 48% of the controls; anal HPV infection in 44% of the cases and 26% of the controls. Cervical and anal HPV infection resulted associated, especially in the control group. Moreover, 32% of the cases and 29% of the controls proved HPV positive in the oral cavity. In the cases of our series, prevalence of cervical, anal and oral HPV infection was higher compared with the controls. The high prevalence of anal-oral infections and the frequent association between anal and cervical infections, provide reason to suggest HPV screening also in the anal and oral regions, which may represent HPV reservoirs and grounds for cancer development.