Artificial intelligence: Its role in dermatopathology.

Artificial intelligence (AI), a major frontier in the field of medical research, can potentially lead to a paradigm shift in clinical practice. A type of artificial intelligence system known as convolutional neural network points to the possible utility of deep learning in dermatopathology. Though pathology has been traditionally restricted to microscopes and glass slides, recent advancement in digital pathological imaging has led to a transition making it a potential branch for the implementation of artificial intelligence. The current application of artificial intelligence in dermatopathology is to complement the diagnosis and requires a well-trained dermatopathologist's guidance for better designing and development of deep learning algorithms. Here we review the recent advances of artificial intelligence in dermatopathology, its applications in disease diagnosis and in research, along with its limitations and future potential.

Artificial intelligence in Dermatopathology.

INTRODUCTION: Ever evolving research in medical field has reached an exciting stage with advent of newer technologies. With the introduction of digital microscopy, pathology has transitioned to become more digitally oriented speciality. The potential of artificial intelligence (AI) in dermatopathology is to aid the diagnosis, and it requires dermatopathologists' guidance for efficient functioning of artificial intelligence. METHOD: Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar." Articles published in English language were considered for the review. RESULTS: Convolutional neural network, a type of deep neural network, is considered as an ideal tool in image recognition, processing, classification, and segmentation. Implementation of AI in tumor pathology is involved in the diagnosis, grading, staging, and prognostic prediction as well as in identification of genetic or pathological features. In this review, we attempt to discuss the use of AI in dermatopathology, the attitude of patients and clinicians, its challenges, limitation, and potential opportunities in future implementation.

Artificial Intelligence in Hair and Nail Disorders.

Artificial intelligence (AI), a field of computer science, aims at simulating human intelligence with computers. Though AI has surpassed dermatologists in skin cancer detection, it still lags behind various other specialties like radiologists in broader adoption. Newer AI applications are becoming increasingly accessible. AI plays a role in various areas, such as medical image recognition, auxiliary diagnosis, and drug research and development. Dermatology has a prime position in implementation of AI in medical research due to its larger clinical, dermoscopic, and histopathological image database. Hence, it is crucial to consider the potential and emerging role of AI in dermatology clinical practice. There are already studies focusing on various skin disorders like cancer, psoriasis, atopic dermatitis, etc. This article provides an overview of AI and its applications in hair and nail disorders at present and its future potential. J Drugs Dermatol. 2022;21(10):1049-1052. doi:10.36849/JDD.6519.

Solitary Neurofibroma over Lower Lip: A Rare Manifestation.

Neurofibromas are common nerve sheath tumors, occurring either sporadically or associated with Von Recklinghausen's disease. Only 6.5% of solitary lesions are seen to involve the oral cavity without any features of neurofibromatosis type 1 (NF-1). It presents as a soft, skin-colored nodule with a characteristic buttonhole invagination. Histologically, it is an unencapsulated lesion consisting of proliferated neural elements, with a background of mucin and mast cells. Surgical excision is the treatment of choice. A 49-year-old female patient presented with a 35-year history of single, asymptomatic lesion over the lower lip, with no features of NF-1. On the basis of the history, histopathological findings, and dermoscopy, a diagnosis of neurofibroma was made and the lesion was excised, with no recurrence over a period of 1 year. The present case report has been reported for its interesting presentation and unusual site of involvement.

New diagnostic and imaging technologies in dermatology.

INTRODUCTION: Diagnosis of dermatological disorders is primarily based on clinical examination in combination with histopathology. However, clinical findings alone may not be sufficient for accurate diagnosis and cutaneous biopsies are being associated with morbidity. OBJECTIVE: The objective of this article is to review the newer technologies along with their applications, limitation and future prospectus. METHODOLOGY: Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar". Articles published in English language were considered for the review. RESULTS: In order to improve and/or widen the armamentarium in dermatologic disease diagnosis and therapy, newer emerging technologies are being made available which aid in diagnosis and management. New emerging technologies include confocal microscopy, digital photographic imaging, optical coherence tomography, high frequency ultrasonography, and artificial intelligence. There have been advancements in the dermoscopes. CONCLUSION: Significant progress is seen in the diagnostic methods and imaging technologies in dermatology, each having its advantages and limitations. Artificial intelligence/machine-based learning software may have a great scope to influence the dermatological practice.

Vitamina D intralesional em múltiplas verrugas plantares recorrentes - Um estudo cego, prospectivo e controlado por placebo / Intralesional vitamin D in multiple recurrent plantar warts - A single, blind, prospective, placebo-controlled study

Introdução: As verrugas, são proliferações epidérmicas benignas da pele. A maioria dos pacientes procura orientação médica, pois as verrugas são cosmeticamente inaceitáveis e podem ser dolorosas. As verrugas plantares, em particular, são tipicamente refratárias ao tratamento que requer várias sessões. As modalidades terapêuticas disponíveis são limitadas pela alta taxa de recorrência, dor e cicatrizes. Em contraste, as abordagens imunoterapêuticas estimulam o sistema imunológico do hospedeiro, aumentando a imunidade celular para eliminar o vírus. Objetivo: Avaliar a segurança e eficácia da injeção intralesional de vitamina D3 no tratamento de múltiplas verrugas plantares recorrentes. Métodos: Um total de 60 pacientes com verrugas plantares múltiplas recorrentes, foram divididos em dois grupos de 30. No grupo 1, 0,5ml de vitamina D intralesional foi injetado na base da maior verruga e no grupo 2, injetou-se 0,5ml de solução salina normal. As sessões foram repetidas a cada 2 semanas por no máximo 4 sessões e os pacientes foram acompanhados por um período de 12 meses. Resultados: No grupo de estudo, a eliminação completa foi observada em 73,3% (22) e nos controles, 70% dos pacientes não apresentaram resposta. Conclusão: A vitamina D3 intralesional é uma opção de tratamento segura e eficaz em verrugas plantares.

Introduction: Warts or verrucae, caused by the human papillomavirus (HPV), are a benign epidermal proliferation of the skin. Most patients seek medical advice as warts are cosmetically unacceptable and can be painful. Plantar warts, in particular, are typically refractory to treatment requiring multiple treatment sessions. High recurrence rates, pain, and scarring limit the available therapeutic modalities. In contrast, immunotherapeutic approaches stimulate the host immune system by enhancing cellular immunity to eliminate the virus. Objective: To assess the safety and efficacy of intralesional vitamin D3 injection to treat multiple recurrent plantar warts. Methods: 60 patients with multiple recurrent warts were divided into two groups of 30 each. Group 1 received 0.5 ml intralesional vitamin D in the base of the largest wart, and Group 2 received 0.5 ml of normal saline. The sessions were repeated every two weeks for a maximum of four sessions, and patients were followed up for 12 months to detect any recurrences. Results: The study group showed complete clearance in 73.3% (22) individuals, while most controls (70%) showed no response. Conclusion: Intralesional vitamin D3 is a safe and effective treatment option for multiple recurrent plantar warts.

Pathogenesis, Immunology and Management of Dermatophytosis.

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations.