-
Journal of the American Academy of... Dec 2022Because of a convergence of the availability of large data sets, graphics-specific computer hardware, and important theoretical advancements, artificial intelligence has... (Review)
Review
Because of a convergence of the availability of large data sets, graphics-specific computer hardware, and important theoretical advancements, artificial intelligence has recently contributed to dramatic progress in medicine. One type of artificial intelligence known as deep learning has been particularly impactful for medical image analysis. Deep learning applications have shown promising results in dermatology and other specialties, including radiology, cardiology, and ophthalmology. The modern clinician will benefit from an understanding of the basic features of deep learning to effectively use new applications and to better gauge their utility and limitations. In this second article of a 2-part series, we review the existing and emerging clinical applications of deep learning in dermatology and discuss future opportunities and limitations. Part 1 of this series offered an introduction to the basic concepts of deep learning to facilitate effective communication between clinicians and technical experts.
Topics: Humans; Artificial Intelligence; Deep Learning; Dermatologists; Radiology; Radiography
PubMed: 32428608
DOI: 10.1016/j.jaad.2020.05.053 -
Clinical Rheumatology May 2022Telemedicine encompasses a variety of modalities that allow for the remote assessment and treatment of patients. The technologies, services, and tools available for... (Review)
Review
Telemedicine encompasses a variety of modalities that allow for the remote assessment and treatment of patients. The technologies, services, and tools available for telemedicine in the USA are increasingly becoming an integral part of the healthcare system to bridge the gaps in care that can arise from geographic and/or socioeconomic obstacles and provider shortages. Telemedicine can be applied to a spectrum of clinical areas, including rheumatic diseases. Psoriatic arthritis (PsA) is a chronic, inflammatory, multisystem disease with predominately skin and joint manifestations. PsA is often misdiagnosed and/or undiagnosed, which can lead to worse patient outcomes, including irreversible joint erosion and damage. The difficulties in diagnosing and managing PsA are confounded by the emergence and increased use of telemedicine because of the COVID-19 pandemic. Telemedicine presents the opportunity to increase access to healthcare by rheumatologists and dermatologists to improve training and education regarding PsA and to decrease time attributed to office visits associated with PsA. However, challenges in diagnosing PsA without a thorough in-person physical examination by a trained rheumatologist or dermatologist exist. We provide an overview of the ways telemedicine can be incorporated into clinical care and optimized for patients with PsA; characteristic clinical features of PsA, with a focus on skin and joint signs and symptoms; screening tools to be used in routine clinical care; assessments that can be used to evaluate quality of life, functional ability, and disease activity in PsA; and resources and recommendations for the development of future telemedicine use in rheumatology and dermatology. Key Points • Patients with psoriatic arthritis (PsA) are often misdiagnosed and/or undiagnosed. • Telemedicine can improve access to healthcare by rheumatologists and dermatologists. • Telemedicine can be incorporated into clinical care and optimized for managing PsA.
Topics: Arthritis, Psoriatic; COVID-19; Dermatologists; Dermatology; Humans; Pandemics; Psoriasis; Quality of Life; Rheumatologists; Rheumatology; Telemedicine
PubMed: 35083564
DOI: 10.1007/s10067-022-06077-3 -
Dermatology Practical & Conceptual Sep 2021We are currently in the midst of an international epidemic of diabetes mellitus (DM) and prediabetes. The prevalence of DM in the United States is estimated at 9.4% of... (Review)
Review
We are currently in the midst of an international epidemic of diabetes mellitus (DM) and prediabetes. The prevalence of DM in the United States is estimated at 9.4% of the population across all ages, while an estimated 1 in 3 Americans (33.9%) has prediabetes. According to the WHO, about 60 million people suffer from diabetes in the European Region. Dermatologists may play an important role in tackling this epidemic via efforts to improve early detection of both diabetes and prediabetes. Dermatologists often treat patients with, or at risk of, diabetes. This includes patients who present with cutaneous manifestations such as acanthosis nigricans, as well as patient populations at increased risk, including those with psoriasis, hidradenitis suppurativa, and polycystic ovarian syndrome. Simple screening guidelines can be used to identify patients at risk, and screening can be performed via a single non-fasting blood test. The diagnosis of prediabetes is a key feature in diabetes prevention, as interventions in this group can markedly reduce progression towards diabetes. In addition to referral to a primary care physician, dermatologists may refer these patients directly to structured behavioral lifestyle intervention programs known as diabetes prevention programs. A significant portion of the population lacks routine care by a primary care physician, and current data indicates need for improvement in diabetes screening and prevention among patient groups such as those with psoriasis. These factors highlight the importance of the dermatologist's role in the detection and prevention of diabetes.
PubMed: 34631273
DOI: 10.5826/dpc.1104a131 -
Italian Journal of Dermatology and... Feb 2023Monkeypox (MPX) is a human zoonotic disease due to Monkeypox virus. Morbidity and mortality are lower than in other Orthopox virus diseases, in particular smallpox. MPX...
Monkeypox (MPX) is a human zoonotic disease due to Monkeypox virus. Morbidity and mortality are lower than in other Orthopox virus diseases, in particular smallpox. MPX is an endemic disease of Western and Central Africa. However, a multi-country outbreak is currently taking place in many non-endemic countries. The clinical and epidemiological characteristics of this epidemic appear peculiar, with significant differences compared to those of the endemic areas. In particular, it predominantly affects males having sex with males, and the route of sexual transmission appears to be particularly frequent. This has led to considerable media interest and concern among the population. Dermatologists are likely to be consulted frequently during the outbreak, especially for the differential diagnosis. Indeed, although MPX can affect various organs, the skin is constantly involved. Since the skin rash have different stages of development, MPX should be differentiate from several, common skin diseases, also because the systemic symptoms can be variable and of different severity. Therefore, dermatologists must be aware of the clinical characteristics of the disease and its management.
Topics: Humans; Male; Mpox (monkeypox); Dermatologists; Monkeypox virus; Skin; Awareness
PubMed: 36939499
DOI: 10.23736/S2784-8671.23.07448-0 -
Indian Journal of Dermatology,... 2016
Review
Topics: Dermatologists; Dermatology; Humans; Skin Diseases; Therapies, Investigational
PubMed: 27647356
DOI: 10.4103/0378-6323.190871 -
International Journal of Women's... Oct 2022Delusions of parasitosis (DOP), which is also called Morgellons disease or delusional infestation, can be one of the most challenging clinical encounters in a... (Review)
Review
Delusions of parasitosis (DOP), which is also called Morgellons disease or delusional infestation, can be one of the most challenging clinical encounters in a dermatologist's practice. One reason for this is lack of education during dermatology residency and a paucity of resources for the practicing dermatologist such as specialized psychodermatology clinics for these patients. To help close this knowledge gap, an interview was conducted with 3 experts in the field of psychodermatology and their responses were recorded and edited with goal of improving care for patients suffering from DOP by educating the busy, practicing dermatologist. The experts discussed many topics regarding DOP including the difference between primary and secondary DOP, how to build a good rapport with DOP patients, why the condition is seen mostly in older woman, and which medications are effective for treatment. The interview ends with a few high-yield practical treatment tips.
PubMed: 35822193
DOI: 10.1097/JW9.0000000000000035 -
Italian Journal of Dermatology and... Aug 2022Atopic dermatitis (AD) is a chronic disease of the skin with significant pruritus and phases of exacerbation and remission. The hallmarks of AD are changes in the... (Review)
Review
Atopic dermatitis (AD) is a chronic disease of the skin with significant pruritus and phases of exacerbation and remission. The hallmarks of AD are changes in the epithelial barrier and chronic inflammation. This condition is associated with an increased risk of developing mental disorders such as depression, anxiety, and suicidal ideation. It has been proposed that psychological stress may impact on immunological factors with an up-regulation of mediating neuropeptides at the level of central nervous system and secondary involvement of endocrine glands, peripheral nervous system, and immune resident skin cells. This article provides a concise review for dermatologists on the psychodermatology of AD, in order to highlight the putative common pathways between the dermatologic and mental health issues in this illness.
Topics: Anxiety; Dermatitis, Atopic; Dermatologists; Humans; Pruritus; Suicidal Ideation
PubMed: 34761667
DOI: 10.23736/S2784-8671.21.07139-5 -
Maedica Sep 2019Psoriasis is an inflammatory, chronic disorder that affects mainly the skin, always expecting systemic manifestations and distribution. The prevalence of psoriasis is...
Psoriasis is an inflammatory, chronic disorder that affects mainly the skin, always expecting systemic manifestations and distribution. The prevalence of psoriasis is estimated to be near 3% in adult population and industrialized countries. Also considering day to day consultations, it is one of the most frequently presented skin disorders, in which psychological stress and depression represent the key factors regarding the onset, flare or therapeutic resistance of psoriatic disease. We are going to present a review of the scientific literature about the psychological impact in individuals' well-being and further correlation with the severity of this disease. Prevention and further research of skin-psychology connection can guide to a multidisciplinary approach and a more effective treatment of psoriasis patients by treating the individual.
PubMed: 31798747
DOI: 10.26574/maedica.2019.14.3.287 -
Actas Dermo-sifiliograficas May 2014Many dermatologists are largely unfamiliar with arteriovenous malformations (AVMs). This is partly due to the low prevalence of these lesions and to the fact that they... (Review)
Review
Many dermatologists are largely unfamiliar with arteriovenous malformations (AVMs). This is partly due to the low prevalence of these lesions and to the fact that they are generally managed by other specialists, in particular, interventional radiologists and pediatric, maxillofacial, and plastic surgeons. In this article, we review the recommended nomenclature for AVMs and look at their clinical manifestations and diagnosis, as well as the ideal type and time of treatment. AVMs should be managed from a multidisciplinary approach, and the dermatologist's primary goal should be to make a proper diagnosis and thereby avoid unnecessary treatments.
Topics: Algorithms; Arteriovenous Malformations; Humans
PubMed: 23856611
DOI: 10.1016/j.ad.2013.04.013 -
Journal of Cutaneous and Aesthetic... 2019The incidence of melanoma and nonmelanoma skin cancers is increasing in the United Kingdom. Surgical excision carries the highest cure rates for all skin cancers and is... (Review)
Review
BACKGROUND
The incidence of melanoma and nonmelanoma skin cancers is increasing in the United Kingdom. Surgical excision carries the highest cure rates for all skin cancers and is the first-line treatment for melanomas and high-risk nonmelanoma cancers. This is most commonly performed by general practitioners (GPs), dermatologists, and plastic surgeons.
OBJECTIVE
The aim of this study was to identify which health-care professionals achieve the best outcomes following surgical excision of skin cancer lesions.
MATERIALS AND METHODS
A comprehensive search of the Cochrane Library and PubMed databases was conducted. PRISMA guidelines were adhered to throughout.
RESULTS
Six studies were identified and reviewed. Dermatologists were most likely to excise lesions adequately, and GPs were the least likely. Dermatologists displayed the greatest diagnostic accuracy, and excisions led by them had the highest overall and disease-free survival rates. Plastic surgeons were most likely to excise complex lesions on difficult-to-treat areas.
CONCLUSION
Dermatologists can excise many skin lesions adequately, but plastic surgeons should continue to take an active role in complex or anatomically challenging lesions. There is a need for more validated training for GPs in the management of skin cancers. Further studies incorporating a randomized control protocol are needed to definitely assess who is best placed to surgically excise these lesions.
PubMed: 31619886
DOI: 10.4103/JCAS.JCAS_174_18