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Anais Brasileiros de Dermatologia 2021Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests,...
BACKGROUND
Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions.
OBJECTIVES
To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions.
METHOD
Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy.
RESULTS
77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001).
STUDY LIMITATIONS
The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed.
CONCLUSION
Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.
Topics: Dermatitis, Allergic Contact; Dermoscopy; Erythema; Humans; Patch Tests; Prospective Studies
PubMed: 34629194
DOI: 10.1016/j.abd.2021.04.006 -
Journal of Cancer Education : the... Aug 2020In many countries, patients with concerning skin lesions will first consult a primary care physician (PCP). Dermoscopy has an evidence base supporting its use in primary... (Review)
Review
In many countries, patients with concerning skin lesions will first consult a primary care physician (PCP). Dermoscopy has an evidence base supporting its use in primary care for skin cancer detection, but need for training has been cited as a key barrier to its use. How PCPs train to use dermoscopy is unclear. A scoping literature review was carried out to examine what is known from the published literature about PCP training in dermoscopy. The methodological steps taken in this review followed those described by Arksey and O'Malley, as revised by Levac et al. Four electronic databases were searched for evidence published up to June 2018. Sixteen articles were identified for analysis, all published since 2000. Ten training programs were identified all of which addressed dermoscopy of pigmented skin lesions, among other topics. Ten articles reported on a range of outcomes measured after training and showed generally positive results in terms of improved diagnostic performance, although no meta-analysis was conducted. However, it was unclear whether trained PCPs continued to use dermoscopy after training. Observational questionnaire data revealed that many PCPs use dermoscopy in practice without any formal training. The literature generally supports the use of dermoscopy by PCPs, but it is unclear whether current training leads to long-term change in PCPs' use of dermoscopy in clinical practice. Understanding this problem, as well as exploring PCPs' training needs, is essential to develop training programs that will facilitate the uptake and use of dermoscopy in primary care.
Topics: Dermoscopy; Humans; Physicians, Primary Care; Referral and Consultation; Skin Neoplasms; Surveys and Questionnaires
PubMed: 31792723
DOI: 10.1007/s13187-019-01647-7 -
Anais Brasileiros de Dermatologia Jun 2018Tinea manuum is a dermatophytosis which is often mistaken for other keratodermas, especially palmar psoriasis and chronic hand eczema. We report the use of dermoscopy as...
Tinea manuum is a dermatophytosis which is often mistaken for other keratodermas, especially palmar psoriasis and chronic hand eczema. We report the use of dermoscopy as a diagnostic aid in a case of tinea manuum. The dermoscopic clue turned out to be the presence of whitish scaling located mainly in the furrows. This aspect has never been seen in other keratodermas and therefore can be considered as a useful finding to assist in the recognition of tinea manuum.
Topics: Dermoscopy; Diagnosis, Differential; Eczema; Female; Hand Dermatoses; Humans; Middle Aged; Psoriasis; Tinea
PubMed: 29924225
DOI: 10.1590/abd1806-4841.20186366 -
Skin Research and Technology : Official... Jan 2023Polarized dermoscopy, Wood's lamp, and reflectance confocal microscopy were currently commonly used auxiliary technology in vitiligo clinic diagnosis. To improve the...
BACKGROUND/OBJECTIVE
Polarized dermoscopy, Wood's lamp, and reflectance confocal microscopy were currently commonly used auxiliary technology in vitiligo clinic diagnosis. To improve the efficiency and accuracy of different periods of lesions of vitiligo, we used a novel ultraviolet (UV)-dermoscopy (Model CH-UVDS30, Ultraviolet wavelength range of 360<390nm, Chuanghong Science and Technology Company, China) in clinical observation.
MATERIALS AND METHODS
Three cases of different periods of vitiligo patients were included in this study. Polarised dermoscopy and novel UV-dermoscopy (UV wavelength range of 360 nm < λ < 390 nm) were performed at 20 × magnification in polarized and UV modes. Characteristic manifestations of different periods of vitiligo lesions were captured and compared.
RESULTS
The depigmented and pigmented junctional zone and perifollicular pigmentation areas could be easier and simultaneously identified via UV-dermoscopy. In a progressive vitiligo patient (woman, 42 years old, face) enhanced perifollicular pigmentation and blurred border were clearly observed. In a stable vitiligo patient (man, 27 years old, right foot) sharply demarcated border and perifollicular depigmentation could be found. In a re-pigmenting vitiligo patient (woman, 41 years old, neck) telangiectasias and pigmentation reservoirs were observed.
CONCLUSION
Novel UV-dermoscopy, as a miniature and portable device, might help early diagnosis, active/progress judgment, and treatment effect evaluation of vitiligo in the clinic.
Topics: Adult; Female; Humans; Male; Dermoscopy; Early Diagnosis; Vitiligo; Ultraviolet Rays
PubMed: 36464842
DOI: 10.1111/srt.13249 -
Computational Intelligence and... 2022Skin cancer is the uncontrolled growth of irregular cancer cells in the human-skin's outer layer. Skin cells commonly grow in an uneven pattern on exposed skin surfaces.... (Review)
Review
Skin cancer is the uncontrolled growth of irregular cancer cells in the human-skin's outer layer. Skin cells commonly grow in an uneven pattern on exposed skin surfaces. The majority of melanomas, aside from this variety, form in areas that are rarely exposed to sunlight. Harmful sunlight, which results in a mutation in the DNA and irreparable DNA damage, is the primary cause of skin cancer. This demonstrates a close connection between skin cancer and molecular biology and genetics. Males and females both experience the same incidence rate. Avoiding revelation to ultraviolet (UV) emissions can lower the risk rate. This needed to be known about in order to be prevented from happening. To identify skin cancer, an improved image analysis technique was put forth in this work. The skin alterations are routinely monitored by this proposed skin cancer categorization approach. Therefore, early detection of suspicious skin changes can aid in the early discovery of skin cancer, increasing the likelihood of a favourable outcome. Due to the blessing of diagnostic technology and recent advancements in cancer treatment, the survival rate of patients with skin cancer has grown. The strategy for detecting skin cancer using image processing technologies is presented in this paper. The system receives the image of the skin lesion as an input and analyses it using cutting-edge image processing methods to determine whether skin cancer is present. The Lesion Image Analysis Tools use texture, size, and shape assessment for image segmentation and feature phases to check for various cancer criteria including asymmetries, borders, pigment, and diameter. The image is classified as Normal skin and a lesion caused by skin cancer using the derived feature parameters.
Topics: Algorithms; Data Mining; Delivery of Health Care; Dermoscopy; Female; Humans; Male; Skin Neoplasms
PubMed: 36199959
DOI: 10.1155/2022/2250275 -
Dermatology (Basel, Switzerland) 2022Seborrheic keratoses (SKs) are ubiquitous, generally benign skin tumors that exhibit high clinical variability. While age is a known risk factor, the precise roles of UV... (Review)
Review
Seborrheic keratoses (SKs) are ubiquitous, generally benign skin tumors that exhibit high clinical variability. While age is a known risk factor, the precise roles of UV exposure and immune abnormalities are currently unclear. The underlying mechanisms of this benign disorder are paradoxically driven by oncogenic mutations and may have profound implications for our understanding of the malignant state. Advances in molecular pathogenesis suggest that inhibition of Akt and APP, as well as existing treatments for skin cancer, may have therapeutic potential in SK. Dermoscopic criteria have also become increasingly important to the accurate detection of SK, and other noninvasive diagnostic methods, such as reflectance confocal microscopy and optical coherence tomography, are rapidly developing. Given their ability to mimic malignant tumors, SK cases are often used to train artificial intelligence-based algorithms in the computerized detection of skin disease. These technologies are becoming increasingly accurate and have the potential to significantly augment clinical practice. Current treatment options for SK cause discomfort and can lead to adverse post-treatment effects, especially in skin of color. In light of the discontinuation of ESKATA in late 2019, promising alternatives, such as nitric-zinc and trichloroacetic acid topicals, should be further developed. There is also a need for larger, head-to-head trials of emerging laser therapies to ensure that future treatment standards address diverse patient needs.
Topics: Artificial Intelligence; Dermoscopy; Humans; Keratosis, Seborrheic; Microscopy, Confocal; Skin Neoplasms
PubMed: 34311463
DOI: 10.1159/000517070 -
Anais Brasileiros de Dermatologia 2023
Topics: Humans; Histiocytoma, Benign Fibrous; Dermoscopy; Skin Neoplasms
PubMed: 36803559
DOI: 10.1016/j.abd.2021.12.010 -
Indian Journal of Dermatology,... 2021
Topics: Dermoscopy; Equipment Design; Humans
PubMed: 33666054
DOI: 10.25259/IJDVL_992_19 -
JAMA Dermatology Jun 2023Studies suggest that convolutional neural networks (CNNs) perform equally to trained dermatologists in skin lesion classification tasks. Despite the approval of the...
IMPORTANCE
Studies suggest that convolutional neural networks (CNNs) perform equally to trained dermatologists in skin lesion classification tasks. Despite the approval of the first neural networks for clinical use, prospective studies demonstrating benefits of human with machine cooperation are lacking.
OBJECTIVE
To assess whether dermatologists benefit from cooperation with a market-approved CNN in classifying melanocytic lesions.
DESIGN, SETTING, AND PARTICIPANTS
In this prospective diagnostic 2-center study, dermatologists performed skin cancer screenings using naked-eye examination and dermoscopy. Dermatologists graded suspect melanocytic lesions by the probability of malignancy (range 0-1, threshold for malignancy ≥0.5) and indicated management decisions (no action, follow-up, excision). Next, dermoscopic images of suspect lesions were assessed by a market-approved CNN, Moleanalyzer Pro (FotoFinder Systems). The CNN malignancy scores (range 0-1, threshold for malignancy ≥0.5) were transferred to dermatologists with the request to re-evaluate lesions and revise initial decisions in consideration of CNN results. Reference diagnoses were based on histopathologic examination in 125 (54.8%) lesions or, in the case of nonexcised lesions, on clinical follow-up data and expert consensus. Data were collected from October 2020 to October 2021.
MAIN OUTCOMES AND MEASURES
Primary outcome measures were diagnostic sensitivity and specificity of dermatologists alone and dermatologists cooperating with the CNN. Accuracy and receiver operator characteristic area under the curve (ROC AUC) were considered as additional measures.
RESULTS
A total of 22 dermatologists detected 228 suspect melanocytic lesions (190 nevi, 38 melanomas) in 188 patients (mean [range] age, 53.4 [19-91] years; 97 [51.6%] male patients). Diagnostic sensitivity and specificity significantly improved when dermatologists additionally integrated CNN results into decision-making (mean sensitivity from 84.2% [95% CI, 69.6%-92.6%] to 100.0% [95% CI, 90.8%-100.0%]; P = .03; mean specificity from 72.1% [95% CI, 65.3%-78.0%] to 83.7% [95% CI, 77.8%-88.3%]; P < .001; mean accuracy from 74.1% [95% CI, 68.1%-79.4%] to 86.4% [95% CI, 81.3%-90.3%]; P < .001; and mean ROC AUC from 0.895 [95% CI, 0.836-0.954] to 0.968 [95% CI, 0.948-0.988]; P = .005). In addition, the CNN alone achieved a comparable sensitivity, higher specificity, and higher diagnostic accuracy compared with dermatologists alone in classifying melanocytic lesions. Moreover, unnecessary excisions of benign nevi were reduced by 19.2%, from 104 (54.7%) of 190 benign nevi to 84 nevi when dermatologists cooperated with the CNN (P < .001). Most lesions were examined by dermatologists with 2 to 5 years (96, 42.1%) or less than 2 years of experience (78, 34.2%); others (54, 23.7%) were evaluated by dermatologists with more than 5 years of experience. Dermatologists with less dermoscopy experience cooperating with the CNN had the most diagnostic improvement compared with more experienced dermatologists.
CONCLUSIONS AND RELEVANCE
In this prospective diagnostic study, these findings suggest that dermatologists may improve their performance when they cooperate with the market-approved CNN and that a broader application of this human with machine approach could be beneficial for dermatologists and patients.
Topics: Humans; Male; Middle Aged; Female; Prospective Studies; Dermatologists; Skin Neoplasms; Neural Networks, Computer; Nevus; Dermoscopy
PubMed: 37133847
DOI: 10.1001/jamadermatol.2023.0905 -
Italian Journal of Dermatology and... Apr 2024Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being... (Review)
Review
INTRODUCTION
Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being employed for both tumors and inflammatory diseases. Whereas distinction between neoplastic and inflammatory lesions is often straightforward based on clinical data, there are some scenarios that may be troublesome, e.g., solitary inflammatory lesions or tumors superimposed to a widespread inflammatory condition that may share macroscopic morphological findings.
EVIDENCE ACQUISITION
We reviewed the literature to identify dermoscopic clues to support the differential diagnosis of clinically similar inflammatory and neoplastic skin lesions, also providing the histological background of such dermoscopic points of differentiation.
EVIDENCE SYNTHESIS
Dermoscopic differentiating features were identified for 12 relatively common challenging scenarios, including Bowen's disease and basal cell carcinoma vs. psoriasis and dermatitis, erythroplasia of Queyrat vs. inflammatory balanitis, mammary and extramammary Paget's disease vs. inflammatory mimickers, actinic keratoses vs. discoid lupus erythematosus, squamous cell carcinoma vs. hypertrophic lichen planus and lichen simplex chronicus, actinic cheilitis vs. inflammatory cheilitis, keratoacanthomas vs. prurigo nodularis, nodular lymphomas vs. pseudolymphomas and inflammatory mimickers, mycosis fungoides vs. parapsoriasis and inflammatory mimickers, angiosarcoma vs granuloma faciale, and Kaposi sarcoma vs pseudo-Kaposi.
CONCLUSIONS
Dermoscopy may be of aid in differentiating clinically similar inflammatory and neoplastic skin lesions.
Topics: Dermoscopy; Humans; Diagnosis, Differential; Skin Neoplasms; Dermatitis; Skin Diseases; Psoriasis
PubMed: 38650495
DOI: 10.23736/S2784-8671.24.07825-3