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Indian Dermatology Online Journal 2023Lasers have revolutionized the interventional dermatology field over the last two decades. Dermatologic conditions previously untreatable are now treated with lasers and... (Review)
Review
Lasers have revolutionized the interventional dermatology field over the last two decades. Dermatologic conditions previously untreatable are now treated with lasers and lights. A large number of laser systems with advances in technologies have expanded applications of lasers for conditions like birth marks, acne scars, wrinkles, pigmentation, etc. Newer avenues and protocols are now set to treat skin conditions with lasers. The applicability of laser for any indication is dependent on laser tissue interaction which is well documented. For a successful outcome with laser therapy, a right end point of treatment should be achieved. The laser physician often adjusts parameters for laser therapy depending on tissue response, the ultimate aim being achieving optimum outcome with minimum side effects. Gadget based skin evaluation techniques are now an integral part of dermatology and are extending to interventional dermatology too. Application of dermoscopy before, during, and after lasers in various indications has been documented and reviewed. The representative cases highlighted in article emphasize the added dimension to non-invasive diagnostic capabilities of a dermatologist by enabling subsurface microscopy and enhancing therapy outcomes, and incorporation of these into daily practice offers value addition to not only evaluation but also gauging response to therapies. Use of dermoscopy before, during, and after laser therapies is an invaluable non-invasive tool to assess the right indication, initiate appropriate priming, achieve good end point, gauge untoward side effects, achieve good results, and engage patient confidentiality. Comparison of high magnification digital images is also enabled by digital videodermoscopy. Structured studies and protocols are needed to standardize the use of dermoscopy integrated with laser procedures.
PubMed: 37727557
DOI: 10.4103/idoj.idoj_325_22 -
Cureus Oct 2023Our skin and nervous system are tightly connected. Numerous dermatomes on our skin provide sensory information to the brain. Because skin changes can occasionally be the... (Review)
Review
Our skin and nervous system are tightly connected. Numerous dermatomes on our skin provide sensory information to the brain. Because skin changes can occasionally be the first sign of a neurological problem, understanding skin alterations is crucial as it can indicate early about the underlying condition, which can affect the prognosis of the disease. In these cases, the dermatologists' and neurologists' skills are complementary to each other. In this article, we have categorized diseases with neuro-cutaneous manifestations under different headings, such as infections, metabolic diseases, connective tissue disorders, genodermatoses, nutritional deficiency, and the diagnostic criteria of some commonly encountered diseases. Through tabulation, it has been observed that this categorization can serve as a useful reference for managing day-to-day patients who are either diagnosed with the diseases mentioned above or suspected to have the conditions.
PubMed: 37965391
DOI: 10.7759/cureus.47024 -
Nature Communications Jan 2024Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance....
Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists' decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alongside its differential diagnoses of melanomas and nevi. Through a three-phase study, we assess its impact on dermatologists' diagnostic accuracy, diagnostic confidence, and trust in the XAI-support. Our results show strong alignment between XAI and dermatologist explanations. We also show that dermatologists' confidence in their diagnoses, and their trust in the support system significantly increase with XAI compared to conventional AI. This study highlights dermatologists' willingness to adopt such XAI systems, promoting future use in the clinic.
Topics: Humans; Trust; Artificial Intelligence; Dermatologists; Melanoma; Diagnosis, Differential
PubMed: 38225244
DOI: 10.1038/s41467-023-43095-4 -
Indian Dermatology Online Journal 2024
PubMed: 38550847
DOI: 10.4103/idoj.idoj_91_24 -
The Journal of Clinical and Aesthetic... Aug 2023It is not uncommon for dermatologists to utilize compounded drug formulations to address specific patient needs that cannot be met using commercially available drugs.... (Review)
Review
It is not uncommon for dermatologists to utilize compounded drug formulations to address specific patient needs that cannot be met using commercially available drugs. Some dermatology practices may derive certain economic benefits and convenience for their patients by compounding formulations in-house. Compounded drugs are considered off-label; thus, they are not approved by the United States Food and Drug Administration (FDA). Oversight of compounding pharmacies and in-clinic compounding varies by state, although the FDA has issued guidance on compounding pharmacies and regulates outsourcing and 503(B) pharmacies. Dermatologists should be aware of the legal and regulatory issues of pharmaceutical compounding, as well as safety issues and penalties associated with compounding violations. Some controversies in compounding include the use of drug moieties that have been recalled by the FDA, compounding commercially available drugs for economic reasons (cheaper than brand names), or compounding drugs when reasonable alternatives are available commercially. This article reviews the regulatory, legal, and clinical considerations of pharmaceutical compounding in the field of dermatology.
PubMed: 37636017
DOI: No ID Found -
Gland Surgery Jun 2023
PubMed: 37441018
DOI: 10.21037/gs-23-86 -
The Journal of Clinical and Aesthetic... Apr 2024
PubMed: 38638187
DOI: No ID Found -
BMJ Open Aug 2023To compare teledermatology and face-to-face (F2F) agreement in primary diagnoses of dermatological conditions. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To compare teledermatology and face-to-face (F2F) agreement in primary diagnoses of dermatological conditions.
DESIGN
Systematic review and meta-analysis METHODS: MEDLINE, Embase, Cochrane Library (Wiley), CINAHL and medRxiv were searched between January 2010 and May 2022. Observational studies and randomised clinical trials that reported percentage agreement or kappa concordance for primary diagnoses between teledermatology and F2F physicians were included. Titles, abstracts and full-text articles were screened in duplicate. From 7173 citations, 44 articles were included. A random-effects meta-analysis was conducted to estimate pooled estimates. Primary outcome measures were mean percentage and kappa concordance for assessing diagnostic matches between teledermatology and F2F physicians. Secondary outcome measures included the agreement between teledermatologists, F2F dermatologists, and teledermatology and histopathology results.
RESULTS
44 studies were extracted and reviewed. The pooled agreement rate was 68.9%, and kappa concordance was 0.67. When dermatologists conducted F2F and teledermatology consults, the overall diagnostic agreement was significantly higher at 71% compared with 44% for non-specialists. Kappa concordance was 0.69 for teledermatologist versus specialist and 0.52 for non-specialists. Higher diagnostic agreements were also noted with image acquisition training and digital photography. The agreement rate was 76.4% between teledermatologists, 82.4% between F2F physicians and 55.7% between teledermatology and histopathology.
CONCLUSIONS AND RELEVANCE
Teledermatology can be an attractive option particularly in resource-poor settings. Future efforts should be placed on incorporating image acquisition training and access to high-quality imaging technologies.
TRIAL REGISTRATION NUMBER
10.17605/OSF.IO/FJDVG.
Topics: Humans; Dermatology; Telemedicine; Reproducibility of Results; Referral and Consultation; Physicians; Skin Diseases
PubMed: 37567745
DOI: 10.1136/bmjopen-2022-068207 -
International Journal of Women's... Oct 2023
PubMed: 37680579
DOI: 10.1097/JW9.0000000000000107 -
JAAD International Sep 2023
PubMed: 37404249
DOI: 10.1016/j.jdin.2023.05.004