Large Language and Vision Assistant in Dermatology: A Game Changer or Just Hype?

The integration of artificial intelligence (AI) in healthcare, particularly in the field of dermatology, has experienced significant progress through the creation of advanced tools such as the Large Language and Vision Assistant (LLaVA). This comprehensive review examines whether LLaVA represents a significant breakthrough or merely a passing trend in dermatological practice. By incorporating both language and visual analysis capabilities, LLaVA aims to support enhanced diagnostic accuracy, patient engagement, and customized treatment planning, as evidenced by current research and case studies. However, its practical utility in a clinical setting remains a subject of debate. We explore the visual assistant chatbot's potential in improving diagnostic precision, especially in analyzing skin lesions and conditions that are visually complex. The tool's capacity to process and interpret dermatological images using advanced algorithms could aid clinicians in early detection and management of skin diseases. Furthermore, LLaVA's interactive nature potentially improves patient education and adherence to treatment protocols. Despite these advantages, there are noteworthy limitations and risks. The accuracy of LLaVA in handling atypical or rare dermatological cases is an area of concern. The tool's reliance on existing medical data raises questions about bias and the generalizability of its findings. Additionally, ethical considerations, such as patient data privacy and the potential for overreliance on AI in clinical decision-making, are critical issues that need addressing. This article aims to provide dermatologists with a comprehensive understanding of large language and visual assistant's capabilities and limitations. We discuss practical guidelines for its integration into research and clinical educational augmentation, ensuring that dermatologists can make informed decisions about employing this technology for the enhancement of patient care and treatment outcomes. The question remains: is LLaVA a game changer in dermatology, or is it just hype? This review endeavours to answer this, establishing a foundation for knowledgeable and efficient application of visual AI chatbots in dermatology practices.

An analysis of direct and indirect costs in Hidradenitis Suppurativa.

Background: Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition with recurrent nodules and abscesses that culminate in purulent discharge and scarring. It has significant physical, psychological and financial impact. Objectives: This study plans to analyse patient costs associated with HS. Direct costs include prescription items. Indirect or out-of-pocket costs include dressings, analgesia, and healthcare-related travel costs. This study will also assess disease impact on quality-of-life (QOL). Methods: Patients with HS diagnosis attending dermatology OPD at our public tertiary centre were invited to participate. Ethical approval was secured, and informed consent was obtained. Participants completed an anonymous survey which was analysed to identify costs associated with HS as well as demographics and QOL impact. Results: A total of 25 patients completed the survey; median age was 29% and 80% were female. Median time from HS onset to diagnosis was 2 years, with 24% waiting >10 years to be diagnosed. In the past 3 months, 20% spent >€200 in both categories; prescription and non-prescription items. In the non-prescription category, 36% of patients reported expenditure >€100 in the past 3 months. Dressings were the most common out-of-pocket expense (in 15/25 patients), followed by analgesia and protective clothing. Attendance at medical appointments cost 24% of patients €50-€200. Four participants reported difficulty accessing HS treatments due to associated costs. Mean number of absence days from work/education as result of HS was 8.7 in the past 3 months. Two patients reported being on disability allowance, and two on unemployment benefit as result of their skin disorder. In the QOL question; 96% reported disease impact on QOL, and 11 participants reported that it affected their life 'very much'. Conclusions: HS is a chronic inflammatory skin condition with significant financial burden alongside the well-analysed biopsychosocial disease impact. Financial burden can be divided into direct prescription costs and indirect costs such as non-prescription items, protective clothing and travel costs which we have explored in this study. Further research is needed in this area to identify and optimise both the financial and QOL implications of HS in acute flares and chronic disease management.

Response to, 'Letter to the Editor on "Comparison of Social Media Content on Hidradenitis Suppurativa: A Cross-Sectional Study'.

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Melanoma-related costs by disease stage and phase of management in Ireland.

BACKGROUND: Management options for the treatment of melanoma have expanded in recent years. In an era of promising, but expensive novel pharmacological treatments, robust stage-specific melanoma-related cost estimates are necessary to support budgetary planning, evaluation of cost-effectiveness and to contribute to the investment case for prevention. METHODS: A detailed decision model, describing the melanoma care pathway (by disease stage) from diagnosis, through treatment and follow-up was developed over a 5-year time frame from the perspective of the Irish healthcare system. The model was populated with real-world data from the National Cancer Registry Ireland. Uncertainty was explored using one-way and probabilistic sensitivity analysis. RESULTS: The cost of managing a case of melanoma diagnosed at Stage IV (€122 985) was more than 25 times more expensive than managing a case diagnosed at Stage IA (€4269). Total costs were sensitive to the choice of immunotherapeutic and targeted drug, duration of treatment and proportion of patients receiving immunotherapy agents. CONCLUSIONS: The rising incidence of melanoma and high cost of new novel therapies presents an immediate challenge to cancer control and public health globally. This study highlights the cost differential between early and late detection and the potential return on investment for prevention versus high-cost treatment.

Comparison of Social Media Content on Hidradenitis Suppurativa: A Cross-Sectional Study.

BACKGROUND: Research has shown that patients may turn to social media seeking information regarding diagnosis and treatment. This study aimed to analyze and compare content related to hidradenitis suppurativa (HS) using the "hashtag" tool across three of the most popular social media platforms to determine the information that patients are exposed to online. METHODS: We identified hashtags across Instagram, TikTok, and Facebook for "#hidradenitissuppurativa." The top 50 videos returned by the algorithm across each site were selected for analysis. Data extracted for comparison included content creator demographics, number of followers, type of content (educational vs. noneducational), and associated hashtags. RESULTS: Sixty-seven percent of posts were created by females (n = 101/150), 10% by males (n = 16/150), and 22% other (n = 33/150). Distribution was similar across all platforms. User accounts on TikTok have a significantly higher number of followers (median = 38,700, range = 902-17,600,000 followers) compared to Facebook (median = 1,375, range = 58-777,000 followers) and Instagram (median = 2,818, range = 57-9,800 followers). CONCLUSION: This study suggests that there is a disproportionate number of patients creating content to raise awareness on HS on social media compared to patient support groups or medical professionals. We propose that social media is a useful platform that dermatologists and official institutional bodies can utilize as an alternative method of health promotion and patient education. Further research to explore social media trends across a range of dermatological conditions can help guide targeted education campaigns in the future.