Natural language processing in dermatology: A systematic literature review and state of the art

BackgroundNatural Language Processing (NLP) is a field of both computational linguistics and artificial intelligence (AI) dedicated to analysis and interpretation of human language.ObjectivesThis systematic review aims at exploring all the possible applications of NLP techniques in the dermatological setting.MethodsExtensive search on 'natural language processing' and 'dermatology' was performed on MEDLINE and Scopus electronic databases. Only journal articles with full text electronically available and English translation were considered. The PICO (Population, Intervention or exposure, Comparison, Outcome) algorithm was applied to our study protocol.ResultsNatural Language Processing (NLP) techniques have been utilized across various dermatological domains, including atopic dermatitis, acne/rosacea, skin infections, non-melanoma skin cancers (NMSCs), melanoma and skincare. There is versatility of NLP in data extraction from diverse sources such as electronic health records (EHRs), social media platforms and online forums. We found extensive utilization of NLP techniques across diverse dermatological domains, showcasing its potential in extracting valuable insights from various sources and informing diagnosis, treatment optimization, patient preferences and unmet needs in dermatological research and clinical practice.ConclusionsWhile NLP shows promise in enhancing dermatological research and clinical practice, challenges such as data quality, ambiguity, lack of standardization and privacy concerns necessitate careful consideration. Collaborative efforts between dermatologists, data scientists and ethicists are essential for addressing these challenges and maximizing the potential of NLP in dermatology.Natural language processing (NLP) is efficiently used in dermatological research, with potential applications in the setting of different dermatological settings, including skin and soft tissue infections (SSTIs), acne/rosacea, melanoma and non-melanoma skin cancer (NMSC), atopic dermatitis (AD) and other immune-mediated dermatoses, skincare. Created with .imag

Topical photodynamic therapy with 5-aminolevulinate for the treatment of tumor-stage mycosis fungoides: a case report

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Ultraviolet-Induced Fluorescence Dermoscopy Reveals Fluorescent Clues in Pitted Keratolysis

Ultraviolet-Induced Fluorescence Dermatoscopy Reveals Fluorescent Clues in Pitted Keratolysi

Importance of Both Clinical and Dermoscopic Findings in Predicting High-Risk Histopathological Subtype in Facial Basal Cell Carcinomas

Introduction: Being able to recognize high-risk facial basal cell carcinoma (BCC) may lead to fewer incomplete excisions and inappropriate treatments. Objectives: We sought to investigate clinical and dermoscopic criteria for predicting facial BCC subtypes, analyze the interobserver agreement between readers, and develop a diagnostic algorithm to predict high-risk histopathological subtype. Methods: In this single-center, retrospective investigation, 6 independent readers evaluated predefined clinical and dermoscopic criteria in images of histopathologically verified primary facial BCCs including: topography, border demarcation, vessels, ulceration, white porcelain areas, shiny white blotches and strands, and pigmented structures and vessels within ulceration. Results: Overall, 297 clinical and dermoscopic image pairs were analyzed. The strongest associations with high-risk subtype were: “bumpy” topography (OR 3.8, 95% CI, 3.1-4.7), ill-defined borders (OR 3.4, 95% CI 3.1-4.7), white porcelain area (OR 3.5, 95% CI 2.8-4.5), and vessels within ulceration (OR 3.1, 95% CI 2.4-4.1). Predominantly focused vessels were a positive diagnostic criterium for either nodular (OR 1.7, 95% CI 1.3-2.2) or high-risk (OR 2.0, 95% CI 1.6-2.5) subtypes and a strong negative diagnostic criterium for superficial BCC (OR 14.0, 95% CI 9.6-20.8). Interobserver agreement ranged from fair to substantial (κ=0.36 to 0.72). A diagnostic algorithm based on these findings demonstrated a sensitivity of 81.4% (95% CI, 78.9-83.7%) and a specificity of 53.3% (95% CI, 49.7-56.9%) for predicting high-risk BCC subtype. Conclusions: Integration of both clinical and dermoscopic features (including novel features such as topography and vessels within ulceration) are essential to improve subtype prediction of facial BCCs and management decisions

Patterns of Recurrence of Cutaneous Melanoma: A Literature Review

The incidence of melanoma has been dramatically increasing over the last decades. Melanoma is considered to have a high metastatic potential and it can progress due to hematogenous metastasis or via lymphatic vessels. Different patterns of recurrence have been described, namely, local, satellite, and in transit metastasis (LCIT), lymphatic, and systemic metastasis. With a more advanced melanoma stage at diagnosis, there is a higher risk for systemic metastasis in comparison to LCIT; in contrast, early-stage melanoma tends to recur more frequently as LCIT and less commonly as systematic metastasis. The aim of this review was to summarize the patterns of recurrence of cutaneous melanoma, giving the clinician a practical summary for diagnosis, prognosis, and surveillance. There is a knowledge gap of the common patterns of recurrence that needs to be addressed to better identify patients at high risk of disease recurrence and personalize surveillance strategies as well as patient counseling

Assessment of the Safety Risk of Dermatoscope Magnets in Patients With Cardiovascular Implanted Electronic Devices

Importance Cardiovascular implanted electronic devices (CIEDs) are susceptible to electromagnetic interference. Dermatologists regularly use devices containing magnets, including dermatoscopes and their attachments, which could pose a hazard to patients with CIEDs. Objective To investigate the safety risk of magnets in dermatoscopes to patients with CIEDs. Design, Setting, and Participants This cross-sectional observational study was conducted between January 1, 2018, and March 31, 2018, in a controlled laboratory setting. Two experiments were performed. In the first experiment (performed in the Dermatology Service at Memorial Sloan Kettering Cancer Center, New York), dermatoscopes that contain magnets were obtained from 3 manufacturers. Using a magnometer, the magnetic field strength of the dermatoscopes was measured over the magnet; at the faceplate; and at a distance of 0.5 cm, 1 cm and 15 cm away from the faceplate. In the second experiment (performed in the University Heart Center Zurich, Zurich, Switzerland), ex vivo measurements were conducted to determine how the dermatoscopes affected old-generation and new generation CIEDs (pacemakers and implantable defibrillators). Main Outcomes and Measures Magnetic field strength as measured directly over the dermatoscope magnet; at the faceplate; and at distances of 0.5 cm, 1 cm, and 15 cm from the faceplate. Pacemaker and defibrillator operation when exposed to dermatoscopes. Results After conducting 24 measurements, the magnetic field (measured in gauss [G]) strength varied between 24.26 G and 163.04 G over the dermatoscope magnet, between 2.22 G and 9.98 G at the dermatoscope faceplate, between 0.82 G and 2.4 G at a distance of 0.5 cm, and between 0.5 G and 1.04 G at a distance of 1 cm; it was 0 for all devices at a 15 cm distance. The field strength at the faceplate was found to be generally below the CIED industry standard safety threshold. None of the dermatoscopes in the ex vivo experiment exerted any demonstrable disruptions or changes to the CIEDs. Conclusions and Relevance In real life, dermatoscope magnets likely present no measurable safety risk to patients with CIEDs. Using the polarized noncontact mode permits dermoscopy to be performed at least 0.5 cm from the skin surface, where the magnetic field strength was well below the 5-G safety threshold

In vivo identification of amyloid and mucin in basal cell carcinoma with combined reflectance confocal microscopy-optical coherence tomography device and direct histopathologic correlation.

VoRSUNY DownstatePathologyN/