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Journal of Cancer 2024This study has used machine learning algorithms to develop a predictive model for differentiating between dermoscopic images of basal cell carcinoma (BCC) and actinic...
Dermoscopy-based Radiomics Help Distinguish Basal Cell Carcinoma and Actinic Keratosis: A Large-scale Real-world Study Based on a 207-combination Machine Learning Computational Framework.
This study has used machine learning algorithms to develop a predictive model for differentiating between dermoscopic images of basal cell carcinoma (BCC) and actinic keratosis (AK). We compiled a total of 904 dermoscopic images from two sources - the public dataset (HAM10000) and our proprietary dataset from the First Affiliated Hospital of Dalian Medical University (DAYISET 1) - and subsequently categorised these images into four distinct cohorts. The study developed a deep learning model for quantitative analysis of image features and integrated 15 machine learning algorithms, generating 207 algorithmic combinations through random combinations and cross-validation. The final predictive model, formed by integrating XGBoost with Lasso regression, exhibited effective performance in the differential diagnosis of BCC and AK. The model demonstrated high sensitivity in the training set and maintained stable performance in three validation sets. The area under the curve (AUC) value reached 1.000 in the training set and an average of 0.695 in the validation sets. The study concludes that the constructed discriminative diagnostic model based on machine learning algorithms has excellent predictive capabilities that could enhance clinical decision-making efficiency, reduce unnecessary biopsies, and provide valuable guidance for further treatment.
PubMed: 38817855
DOI: 10.7150/jca.94759 -
Cureus Apr 2024Dermatological conditions often present diagnostic challenges due to their diverse manifestations and overlapping clinical features. In such cases, dermoscopy, a...
Dermatological conditions often present diagnostic challenges due to their diverse manifestations and overlapping clinical features. In such cases, dermoscopy, a non-invasive imaging technique, has emerged as a valuable tool to enhance diagnostic accuracy and guide clinicians in reaching an appropriate differential diagnosis. By visualizing subsurface skin structures and microvascular patterns, dermoscopy provides additional information that complements clinical examination, aiding in the recognition of specific dermatoses and the differentiation between benign and malignant skin lesions. Herein, we present a case that demonstrates the utility of dermoscopy in distinguishing between an initial broad list of differential diagnoses, namely, basal cell carcinoma, squamous cell carcinoma in situ, and other inflammatory dermatitides, such as psoriasis and atopic dermatitis, and narrowing down the differential diagnosis to just one likely diagnosis, which was basal cell carcinoma in our case.
PubMed: 38813281
DOI: 10.7759/cureus.59274 -
Dermatology Practical & Conceptual Apr 2024Scientific evidence supports dermoscopy as an essential tool in dermatological diagnosis.
INTRODUCTION
Scientific evidence supports dermoscopy as an essential tool in dermatological diagnosis.
OBJECTIVES
The objective is to know the factors that influence its use in Chilean dermatologists.
METHODS
Analytical cross-sectional study. An adapted version of the survey was submitted from the pan-European study by Forsea et al to members of the Chilean Society of Dermatology, between September and December 2020. Analysis using descriptive statistics and multivariate analysis with ordinal logistic regression looking for factors associated with greater use of.
RESULTS
One hundred and ninety-eight responses, mean age 46.3 years and 14.6 years on average practicing as dermatologists. 61.6% trained in dermoscopy during their residency. 98% use a dermatoscope. More than 80% consider dermoscopy useful for the diagnosis of melanomas, follow-up of melanocytic lesions, and diagnosis of pigmented and non-pigmented tumors. Between 50% and 70% consider it useful for monitoring non-melanocytic lesions, nail and hair pathologies. Greater confidence when evaluating pigmented and non-pigmented tumors and capillary pathology. Adjusting for age, sex, confidence, and education, participation in teaching was associated with greater use of dermoscopy in non-pigmented and pigmented tumors, and capillary pathology.
CONCLUSIONS
Percentage of participation in the survey and training in dermoscopy higher than in the reference study, recognizing the usefulness of dermoscopy for the diagnosis and follow-up of tumor pathologies. Participating in teaching is a strong independent factor that is associated with a greater use of dermoscopy in Chile. Dermoscopy is positioned as a tool widely used by Chilean dermatologists in their daily practice.
PubMed: 38810061
DOI: 10.5826/dpc.1402a71 -
Dermatology Practical & Conceptual Apr 2024Seborrheic keratoses (SK) are benign epidermal tumors with high sun exposure as a major risk factor. Vitamin D deficiency is also thought to play a role in its...
INTRODUCTION
Seborrheic keratoses (SK) are benign epidermal tumors with high sun exposure as a major risk factor. Vitamin D deficiency is also thought to play a role in its pathogenesis. There has been no data regarding SK, calcidiol level, vitamin D intake, and sun index (SI) among people living in coastal areas in Indonesia.
OBJECTIVES
To assess the correlation between 1) serum calcidiol levels with SI and vitamin D intake and 2) lesion size with SI and serum calcidiol level among SK patients living in a coastal area.
METHODS
This is a cross-sectional study. We performed interviews using the sun index questionnaire and semiquantitative food frequency questionnaire for vitamin D; physical examination; dermoscopy to determine the largest SK lesion size; and measurement of serum calcidiol levels in participants with SK living in Cilincing District, North Jakarta. Spearman correlation test was used to assess the relationship between variables.
RESULTS
Thirty-nine participants with SK aged 19-59 years were analyzed. The median of the SK largest diameter, SI, serum calcidiol, and vitamin D intake was 2 (1-10) mm, 3.95 (1.1-23.52), 14.3 (5.25-35.30) ng/ml, and 4.3 (0.1-30.1) mcg/day, respectively. SI and vitamin D intake were not significantly correlated with calcidiol levels. Similarly, SI and calcidiol levels were not significantly correlated with the largest SK lesion size.
CONCLUSIONS
We found low calcidiol levels and vitamin D intake in this coastal population. The SI and vitamin D intake had no correlations with calcidiol levels. Furthermore, calcidiol levels and SI had no correlations with the lesion largest diameter.
PubMed: 38810054
DOI: 10.5826/dpc.1402a37 -
Dermatology Practical & Conceptual Apr 2024
PubMed: 38810049
DOI: 10.5826/dpc.1402a122 -
Dermatology Practical & Conceptual Apr 2024Dermoscopy has evolved over the years beyond distinguishing benign pigmented lesions from melanoma to diagnosing virtually all diseases in dermatology. Overwhelming...
INTRODUCTION
Dermoscopy has evolved over the years beyond distinguishing benign pigmented lesions from melanoma to diagnosing virtually all diseases in dermatology. Overwhelming evidence demonstrates its utility in improving diagnostic accuracy, reducing unnecessary biopsies and lesion monitoring. Dermoscopy is widely used in Western nations, hence most descriptions of lesions in literature are predominantly on Fitzpatrick skin types I-III. Current evidence shows that there are unique dermoscopic features in the dark skin as a result of pigment and pathological reactions. Nationwide surveys and reports have been conducted across several continents to highlight prevalence and factors influencing dermoscopy use with the hope of maximizing its apparent benefits. There are currently no such reports from Africa.
OBJECTIVES
To evaluate dermoscopy use and its determinants among dermatologists in Africa.
METHODS
A cross-sectional study. Online forms were e-mailed to individual practicing dermatologists and members of the African Society of Dermatologists and Venereologists.
RESULTS
There were 196 respondents from 24 African countries. Half of them used dermoscopy. Training, practice settings and location, provision of dermatoscopes by institutions and knowledge of criteria were notable significant determinants. Multiple training exposures, knowledge of criteria, availability of dermatoscopes, use of both hand-held and videodermatoscopes, average number of patients seen per day, and a positive outlook towards dermoscopy were significant determinants of frequency of use. Leading impediments were lack of training and inadequate dermatoscopes in practice.
CONCLUSIONS
Dermoscopy use in Africa is relatively low. Incorporating dermoscopy training into the curriculum with provision of dermatoscopes by training institutions will promote wider usage.
PubMed: 38810048
DOI: 10.5826/dpc.1402a98 -
Dermatology Practical & Conceptual Apr 2024
PubMed: 38810040
DOI: 10.5826/dpc.1402a143 -
Dermatology Practical & Conceptual Apr 2024Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series.
INTRODUCTION
Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series.
OBJECTIVES
To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population.
METHODS
We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology.
RESULTS
The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively.
CONCLUSIONS
We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.
PubMed: 38810038
DOI: 10.5826/dpc.1402a86 -
Dermatology Practical & Conceptual Apr 2024Actinic Lichen Planus (ALP) is a rare photosensitive variant of lichen planus. Four subtypes can be distinguished: pigmented, annular (AALP), plaque-like and dyschromic...
INTRODUCTION
Actinic Lichen Planus (ALP) is a rare photosensitive variant of lichen planus. Four subtypes can be distinguished: pigmented, annular (AALP), plaque-like and dyschromic ALP.
METHODS
This is a retrospective; descriptive and analytical study investigating the dermoscopic patterns of different subtypes of ALP in skin of color.
RESULTS
Sixteen adult patients were included in this study; the majority of them were young females, while five patients with the pigmented subtype of ALP were more than 50 years old. This subtype was more prevalent in patients with phototype IV. AALP was described in men with a very dark phototype.In pigmented melasma-like ALP, dermoscopy showed an annular granular pattern, white reticular and circular Wickham striae (WS) with hypopigmentation lacking skin creases, dots inside circles and an eccentric pigmentation on circles. In ALP, annular, circular WS; and perifollicular white halos with follicular plugs were described. The black hole pattern with dotted vessels was seen in the dyschromic ALP. White-yellow-bluish WS were noticed in plaque-type ALP with circumferential radial lines at the periphery.
CONCLUSIONS
This descriptive study of dermoscopic patterns of various subtypes of ALP in skin of color highlighted new dermoscopic descriptions that vary according to the clinical variant or the morphology; lesions distribution; and phototype. Also, many epidemiological differences were found between our results and the literature concerning the older age of onset in melasma-like pigmented ALP, and the male predominance in annular ALP.
PubMed: 38810036
DOI: 10.5826/dpc.1402a101 -
Dermatology Practical & Conceptual Apr 2024Pilomatricoma is a benign adnexal dermal or subcutaneous tumor derived from immature hair matrix cells. (Review)
Review
INTRODUCTION
Pilomatricoma is a benign adnexal dermal or subcutaneous tumor derived from immature hair matrix cells.
OBJECTIVES
The aim of our study is to evaluate clinical and dermoscopic features of pilomatricomas, with a specific focus on pediatric lesions, and to provide a concise review of the existing literature.
METHODS
A single-center retrospective study was undertaken on 55 patients with a histopathological diagnosis of pilomatricoma referred to the Dermatology Unit, University of Bologna, Bologna, Italy, between 2005 and 2023. Pilomatricomas were retrospectively evaluated relying on clinical and dermoscopic images. A PubMed search was conducted. All the relevant research up to July 31, 2023, was reviewed. We classified the cases as "typical" or "atypical" based on whether they were suspected of being pilomatricomas or not.
RESULTS
A total of 55 children with pilomatricomas were observed and studied. Two patients presented with 2 pilomatricomas, leading to the identification of 58 pilomatricomas. 'Typical' pilomatricomas were observed in 79% of cases as nodular and pigmented lesions with one or more colors, ranging from blue-gray to red to yellow/white, evident on clinical examination and even better on dermoscopy. In 21% of cases, pilomatricomas presented in an 'atypical' form, which did not allow for a well-founded suspicion, placing them in differential diagnosis with other lesions and therefore requiring histological examination.
CONCLUSIONS
According to our case series and systematic review of the literature, clinical appearance and dermoscopy may be sufficient to diagnose or suspect pilomatricoma in around 80% of cases, while histological examination is necessary to confirm the diagnosis in the remaining 20% of cases.
PubMed: 38810027
DOI: 10.5826/dpc.1402a140