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Clinical Case Reports May 2024In extradigital glomus tumors, (1) noncontact and (2) contact dermoscopy show (1) a central purplish-white area corresponding to tumor nests surrounding enlarged...
In extradigital glomus tumors, (1) noncontact and (2) contact dermoscopy show (1) a central purplish-white area corresponding to tumor nests surrounding enlarged vessels, a peripheral yellow-white area corresponding to mucin deposition, melanin granules, and fibrous tissue, and (2) white reticular and linear cord areas corresponding to pseudocapsules and collagen fibers.
PubMed: 38770410
DOI: 10.1002/ccr3.8907 -
Boletin Medico Del Hospital Infantil de... 2024Pigmented fungiform papillae of the tongue is a benign condition frequent in dark skin patients. It usually appears in the second or third decade of life, and it has...
INTRODUCTION
Pigmented fungiform papillae of the tongue is a benign condition frequent in dark skin patients. It usually appears in the second or third decade of life, and it has been reported as autosomal dominant inheritance pattern. The diagnosis is clinical, but dermoscopy could be helpful: a classical rose petal pattern is observed. The pathogenesis is unknown, and no treatments are effective.
CASE REPORT
We report a case of a 15-year-old girl with a pigmented fungiform papillae and a compatible dermatoscopy pattern.
CONCLUSIONS
Knowing the existence of this entity and its characteristic dermoscopy, avoids additional invasive medical test. We have to know this entity because it is a variant of normality.
Topics: Humans; Female; Adolescent; Tongue Diseases; Dermoscopy; Tongue; Pigmentation Disorders
PubMed: 38768509
DOI: 10.24875/BMHIM.24000006 -
Cureus Apr 2024Kindler syndrome (KS) is a rare autosomal recessive skin condition. The FERMT1 gene mutates and causes symptoms such as blistering and epidermal atrophy, as well as an...
Kindler syndrome (KS) is a rare autosomal recessive skin condition. The FERMT1 gene mutates and causes symptoms such as blistering and epidermal atrophy, as well as an increased risk of cancer and poor wound healing. A male in his 20s sought treatment for his hyper-hypopigmentation over the body with poikiloderma of the face with thin wrinkled cigarette paper skin in association with photosensitivity. He gave a history of developing blisters all over the body during his childhood, which formed raw areas and eventually healed forming atrophic scars. The objective is to assess the correlation of clinical findings with dermoscopy in a case of KS. KS is a rare disorder with poikiloderma, photosensitivity, and acral bullae in infancy as predominant features. Dermoscopy proves to be a useful tool in the diagnosis of this rare disorder as it helps in the identification of poikiloderma, adermatoglyphia, and cigarette paper scarring.
PubMed: 38765347
DOI: 10.7759/cureus.58433 -
Emerging Microbes & Infections Dec 2024and , both of which are opportunistic pathogens, have been proved to be possible multidrug resistant. However, are all recurring symptoms in chronic infections related...
and , both of which are opportunistic pathogens, have been proved to be possible multidrug resistant. However, are all recurring symptoms in chronic infections related to decreasing susceptibility? Here we report a case of sporotrichosis secondary to infection. In addition, we find that the blackish-red spots under the dermoscopic view can be employed as a signal for the early identification and regression of subcutaneous fungal infection.
Topics: Sporothrix; Sporotrichosis; Humans; Mycobacterium chelonae; Mycobacterium Infections, Nontuberculous; Male; Coinfection
PubMed: 38764403
DOI: 10.1080/22221751.2024.2358073 -
Healthcare Informatics Research Apr 2024Skin cancer is a prevalent type of malignancy, necessitating efficient diagnostic tools. This study aimed to develop an automated skin lesion classification model using...
OBJECTIVES
Skin cancer is a prevalent type of malignancy, necessitating efficient diagnostic tools. This study aimed to develop an automated skin lesion classification model using the dynamically expandable representation (DER) incremental learning algorithm. This algorithm adapts to new data and expands its classification capabilities, with the goal of creating a scalable and efficient system for diagnosing skin cancer.
METHODS
The DER model with incremental learning was applied to the HAM10000 and ISIC 2019 datasets. Validation involved two steps: initially, training and evaluating the HAM10000 dataset against a fixed ResNet-50; subsequently, performing external validation of the trained model using the ISIC 2019 dataset. The model's performance was assessed using precision, recall, the F1-score, and area under the precision-recall curve.
RESULTS
The developed skin lesion classification model demonstrated high accuracy and reliability across various types of skin lesions, achieving a weighted-average precision, recall, and F1-score of 0.918, 0.808, and 0.847, respectively. The model's discrimination performance was reflected in an average area under the curve (AUC) value of 0.943. Further external validation with the ISIC 2019 dataset confirmed the model's effectiveness, as shown by an AUC of 0.911.
CONCLUSIONS
This study presents an optimized skin lesion classification model based on the DER algorithm, which shows high performance in disease classification with the potential to expand its classification range. The model demonstrated robust results in external validation, indicating its adaptability to new disease classes.
PubMed: 38755104
DOI: 10.4258/hir.2024.30.2.140 -
Cureus Apr 2024Pigmented hairy epidermal nevus, also known as Becker's nevus, has a typical description as a unilateral, hairy in appearance, light to dark brown patch with an...
Pigmented hairy epidermal nevus, also known as Becker's nevus, has a typical description as a unilateral, hairy in appearance, light to dark brown patch with an irregular but clearly defined border. However, the exact aetiopathogenesis is still poorly comprehended. We report the case of a 19-year-old female who presented with asymptomatic brownish-pigmented macular lesions on the right breast that had slowly increased in size over the past three years. Upon cutaneous inspection, the right breast had 3-5 mm rounded and oval perifollicular macules that ranged from light to dark brown hue without increased hair growth. The macules were discrete and in no particular pattern. Dermoscopy of the lesions showed well-defined perifollicular hypopigmentation surrounded by a pigmented network-like pattern. Histopathology of a punch biopsy taken from one of the follicular lesions demonstrated an increase in basal layer pigmentation with elongation of rete ridges and acanthosis, consistent with Becker's nevus. The patient underwent three sittings of diode laser therapy, once in four weeks, with slight improvement in pigmentation.
PubMed: 38752066
DOI: 10.7759/cureus.58264 -
Wounds : a Compendium of Clinical... Apr 2024Leg ulcers have various etiologies, including malignancy, although vascular issues are the most frequent cause. Malignant wounds present diagnostic challenges, with a...
BACKGROUND
Leg ulcers have various etiologies, including malignancy, although vascular issues are the most frequent cause. Malignant wounds present diagnostic challenges, with a reported prevalence rate ranging from 0.4% to 23%. This significant variability in reported prevalence appears to be due to the different settings in which data are collected, which suggests potential influence by medical specialty. Consequently, the misdiagnosis of neoplastic ulcers (eg, ulcerated melanoma) as vascular wounds is relatively common, leading to delayed diagnosis, inadequate treatment, and a dramatic worsening of the patient's prognosis. Identifying malignancy in nonresponsive wounds involves recognizing signs such as hypertrophic granulation tissue, bleeding, unusual pigmentation, and raised edges. The appearance of the perilesional skin, together with dermoscopic observation, is also crucial to differentiation. Ultimately, a biopsy may provide valuable diagnostic clarification.
CASE REPORT
A case is presented of lower limb melanoma that for years was misdiagnosed as a vascular wound by multiple specialists, with delayed referral to a dermatologist and resulting recognition and diagnosis, at which time nodular satellite metastases were found. Dermoscopy and biopsy confirmed the diagnosis. The disease was already advanced, with in-transit and distant site metastases, and the prognosis was regrettably poor.
CONCLUSION
This case underscores the importance of early detection and accurate diagnosis of malignant wounds, emphasizing the need to refer patients with suspicious nonresponsive ulcers to a dermatologist.
Topics: Humans; Melanoma; Skin Neoplasms; Leg Ulcer; Diagnosis, Differential; Dermoscopy; Male; Female; Fatal Outcome; Biopsy; Aged
PubMed: 38743857
DOI: 10.25270/wnds/23111 -
Skin Research and Technology : Official... May 2024Timely diagnosis plays a critical role in determining melanoma prognosis, prompting the development of deep learning models to aid clinicians. Questions persist...
BACKGROUND
Timely diagnosis plays a critical role in determining melanoma prognosis, prompting the development of deep learning models to aid clinicians. Questions persist regarding the efficacy of clinical images alone or in conjunction with dermoscopy images for model training. This study aims to compare the classification performance for melanoma of three types of CNN models: those trained on clinical images, dermoscopy images, and a combination of paired clinical and dermoscopy images from the same lesion.
MATERIALS AND METHODS
We divided 914 image pairs into training, validation, and test sets. Models were built using pre-trained Inception-ResNetV2 convolutional layers for feature extraction, followed by binary classification. Training comprised 20 models per CNN type using sets of random hyperparameters. Best models were chosen based on validation AUC-ROC.
RESULTS
Significant AUC-ROC differences were found between clinical versus dermoscopy models (0.661 vs. 0.869, p < 0.001) and clinical versus clinical + dermoscopy models (0.661 vs. 0.822, p = 0.001). Significant sensitivity differences were found between clinical and dermoscopy models (0.513 vs. 0.799, p = 0.01), dermoscopy versus clinical + dermoscopy models (0.799 vs. 1.000, p = 0.02), and clinical versus clinical + dermoscopy models (0.513 vs. 1.000, p < 0.001). Significant specificity differences were found between dermoscopy versus clinical + dermoscopy models (0.800 vs. 0.288, p < 0.001) and clinical versus clinical + dermoscopy models (0.650 vs. 0.288, p < 0.001).
CONCLUSION
CNN models trained on dermoscopy images outperformed those relying solely on clinical images under our study conditions. The potential advantages of incorporating paired clinical and dermoscopy images for CNN-based melanoma classification appear less clear based on our findings.
Topics: Humans; Melanoma; Dermoscopy; Skin Neoplasms; Neural Networks, Computer; Deep Learning; Sensitivity and Specificity; Female; ROC Curve; Image Interpretation, Computer-Assisted; Male
PubMed: 38742379
DOI: 10.1111/srt.13607 -
JMIR Formative Research May 2024Skin cancers are the most common group of cancers diagnosed worldwide. Aging and sun exposure increase their risk. The decline in the number of dermatologists is pushing...
BACKGROUND
Skin cancers are the most common group of cancers diagnosed worldwide. Aging and sun exposure increase their risk. The decline in the number of dermatologists is pushing the issue of dermatological screening back onto family doctors. Dermoscopy is an easy-to-use tool that increases the sensitivity of melanoma diagnosis by 60% to 90%, but its use is limited due to lack of training. The characteristics of "ideal" dermoscopy training have yet to be established. We created a Moodle (Moodle HQ)-based e-learning course to train family medicine residents in dermoscopy.
OBJECTIVE
This study aimed to evaluate the evolution of dermoscopy knowledge among family doctors immediately and 1 and 3 months after e-learning training.
METHODS
We conducted a prospective interventional study between April and November 2020 to evaluate an educational program intended for family medicine residents at the University of Montpellier-Nîmes, France. They were asked to complete an e-learning course consisting of 2 modules, with an assessment quiz repeated at 1 (M1) and 3 months (M3). The course was based on a 2-step algorithm, a method of dermoscopic analysis of pigmented skin lesions that is internationally accepted. The objectives of modules 1 and 2 were to differentiate melanocytic lesions from nonmelanocytic lesions and to precisely identify skin lesions by looking for dermoscopic morphological criteria specific to each lesion. Each module consisted of 15 questions with immediate feedback after each question.
RESULTS
In total, 134 residents were included, and 66.4% (n=89) and 47% (n=63) of trainees fully participated in the evaluation of module 1 and module 2, respectively. This study showed a significant score improvement 3 months after the training course in 92.1% (n=82) of participants for module 1 and 87.3% (n=55) of participants for module 2 (P<.001). The majority of the participants expressed satisfaction (n=48, 90.6%) with the training course, and 96.3% (n=51) planned to use a dermatoscope in their future practice. Regarding final scores, the only variable that was statistically significant was the resident's initial scores (P=.003) for module 1. No measured variable was found to be associated with retention (midtraining or final evaluation) for module 2. Residents who had completed at least 1 dermatology rotation during medical school had significantly higher initial scores in module 1 at M0 (P=.03). Residents who reported having completed at least 1 dermatology rotation during their family medicine training had a statistically significant higher score at M1 for module 1 and M3 for module 2 (P=.01 and P=.001).
CONCLUSIONS
The integration of an e-learning training course in dermoscopy into the curriculum of FM residents results in a significant improvement in their diagnosis skills and meets their expectations. Developing a program combining an e-learning course and face-to-face training for residents is likely to result in more frequent and effective dermoscopy use by family doctors.
PubMed: 38739910
DOI: 10.2196/56005 -
Frontiers in Medicine 2024Cutaneous squamous cell carcinoma, a type of non-melanoma skin cancer, is a form of keratinocyte carcinoma that stands as one of the most prevalent cancers, exhibiting a... (Review)
Review
Cutaneous squamous cell carcinoma, a type of non-melanoma skin cancer, is a form of keratinocyte carcinoma that stands as one of the most prevalent cancers, exhibiting a rising frequency. This review provides an overview of the latest literature on imaging methods for diagnosing squamous cell carcinoma (SCC) and actinic keratosis (AK). It discusses the diagnostic criteria, advantages, and disadvantages of various techniques such as dermatoscopy, skin ultrasound (US), and reflectance confocal microscopy (RCM), and line-field confocal optical coherence tomography (LC-OCT). These methods offer benefits including non-invasiveness, rapidity, comprehensive lesion imaging, and enhanced sensitivity, but face challenges like high costs and the need for specialized expertise. Despite obstacles, the use of these innovative techniques is expected to increase with ongoing technological advancements, improving diagnosis and treatment planning for keratinocyte carcinomas. Standardizing LC-OCT imaging algorithms for AK, Bowen's disease, and SCC remains an area for further research.
PubMed: 38737758
DOI: 10.3389/fmed.2024.1388835