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clinical study. Onkologie 2013;36(12):738-44. doi: 10.1159/000356834. Epub 2013 Nov 20.

PMID: 24356565 [PubMed] [Scopus]

Abstract: BACKGROUND: Delayed diagnosis of squamous cell carcinoma (SCC) increases
recurrence, metastatic potential, and management costs. This study aims to identify risk
factors of patient-related delayed presentation in cutaneous SCC.

PATIENTS AND METHODS: A total of 513 patients, who first sought care for cutaneous

lesions that were subsequently removed and histologically confirmed as SCCs, were included.

Attitude to symptoms, psychosocial profile, and reasons for delayed presentation were
obtained via a structured questionnaire-based interview. First presentation > 3 months from
the onset of symptoms was considered as delayed.

RESULTS: Mean presentation time was 3.90 ± 2.05 months, while 186 patients delayed

presentation. Multivariate logistic regression analysis revealed that serious co-morbidity (p =
0.003), low education level (p < 0.001), non-recognition of the seriousness of symptoms (p <

0.001), a 'wait and see' attitude (p < 0.001), and fatalism (p = 0.005) were independent
determinants of significantly higher risk for delayed presentation. In contrast, female sex (p =

0.006), new lesion (p = 0.012), accessible topography (p = 0.019), size increase (p = 0.002),
color change (p = 0.017), non-healing wound (p = 0.048), and presence of social

support/advice (p < 0.001) were independent determinants significantly associated with early
presentation.

CONCLUSION: Recognition of symptom seriousness and elimination of factors hindering self-

referral may increase awareness and promote early patient presentation and diagnosis of
cutaneous SCC.

28. Panagopoulos P, Terzi I, Karanikas M, Galanopoulos N, Maltezos E. Myocarditis, pancreatitis,

polyarthritis, mononeuritis multiplex and vasculitis with symmetrical peripheral gangrene of
the lower extremities as a rare presentation of leptospirosis: a case report and review of the

literature. J Med Case Rep. 2014 May 14;8:150. doi: 10.1186/1752-1947-8-150. PMID:
24885926 [PubMed] [Scopus]

Abstract: Introduction: Leptospirosis is a zoonosis caused by the spirochete, Leptospira

interrogans. While most cases of leptospirosis are mild to moderate, the course may be
complicated by multiorgan dysfunction. We present a rare case of leptospirosis with acute
myocarditis, pancreatitis, polyarthritis, mononeuritis multiplex and severe vasculitis with

necrosis of the extremities.

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