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1.
Int J Dermatol ; 61(1): 7-19, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34235719

RESUMO

Dermoscopy has traditionally been used for the diagnosis of neoplasms and more recently in the evaluation of inflammatory conditions. Recent observational studies have suggested a role for dermoscopy in identifying and differentiating acquired pigmentary disorders. This comprehensive review will summarize the growing literature on the use of dermoscopy for pigmentary disorders. A literature review was performed on PubMed dating from inception to October 2020. The following pigmentary disorders were included in this study: melasma, solar lentigines, poikiloderma of Civatte, exogenous ochronosis, lichen planus pigmentosus, erythromelanosis follicularis faciei et colli, pigmented contact dermatitis, Riehl's melanosis, postinflammatory hyperpigmentation, erythema dyschromicum perstans, ashy dermatosis, confluent and reticulated papillomatosis, acanthosis nigricans, pityriasis versicolor, tinea versicolor, idiopathic guttate hypomelanosis, and vitiligo. Search terms used included each pigmentary disorder along with the terms "dermoscopy" or "dermatoscopy." Relevant case reports and case series were included. Many pigmentary disorders have unique and distinguishable features on dermoscopy. Given that these disorders can be clinically challenging for clinicians and emotionally distressing for patients, dermoscopy provides an additional, useful tool in the evaluation and assessment process.


Assuntos
Hiperpigmentação , Líquen Plano , Melanose , Dermoscopia , Eritema , Humanos , Líquen Plano/diagnóstico
3.
Comput Intell Neurosci ; 2021: 9528664, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777495

RESUMO

Melanoma is defined as a disease that has been incurable in advanced stages, which shows the vital importance of timely diagnosis and treatment. To diagnose this type of cancer early, various methods and equipment have been used, almost all of which required a visit to the doctor and were not available to the public. In this study, an automated and accurate process to differentiate between benign skin pigmented lesions and malignant melanoma is presented, so that it can be used by the general public, and it does not require special equipment and special conditions in imaging. In this study, after preprocessing of the input images, the region of interest is segmented based on the Otsu method. Then, a new feature extraction is implemented on the segmented image to mine the beneficial characteristics. The process is then finalized by using an optimized Deep Believe Network (DBN) for categorization into 2 classes of normal and melanoma cases. The optimization process in DBN has been performed by a developed version of the newly introduced Thermal Exchange Optimization (dTEO) algorithm to obtain higher efficacy in different terms. To show the method's superiority, its performance is compared with 7 different techniques from the literature.


Assuntos
Melanoma , Neoplasias Cutâneas , Algoritmos , Dermoscopia , Humanos , Melanoma/diagnóstico , Pele , Neoplasias Cutâneas/diagnóstico
4.
Clin Dermatol ; 39(4): 643-656, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809769

RESUMO

Reflectance confocal microscopy (RCM) is a noninvasive imaging tool that has the potential to revolutionize dermatology. Extensive research in this area in conjunction with the recent assignment of reimbursement codes has made the clinical use of this technology a practical reality. Though there is awareness and use of this technology at large academic centers, a knowledge gap still remains in interpreting RCM images among the dermatology community. We review the key RCM features of melanocytic and nonmelanocytic lesions to provide guidance in distinguishing benign entities from malignant dermatologic neoplasms.


Assuntos
Melanócitos , Neoplasias Cutâneas , Dermoscopia , Humanos , Microscopia Confocal , Neoplasias Cutâneas/diagnóstico por imagem
5.
Clin Dermatol ; 39(4): 635-642, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809768

RESUMO

The dermatoscope has gained tremendous popularity among dermatologists as an adjunctive tool to better visualize subsurface structures and identify patterns that may improve the diagnosis of a wide range of skin diseases. Initially, the pigmented lesion experts who were the early adopters promoted the use of the dermatoscope to increase diagnostic accuracy of early melanomas and decrease the harvesting of benign lesions. With current near universal adoption of the diagnostic technique by dermatologists, the dermatoscope is now employed to help identify a wide variety of inflammatory, infectious, and vascular conditions of the skin, hair, and nails, resulting in the emergence of several branches of dermatoscopy-inflammoscopy, trichoscopy, onychoscopy, and entodermoscopy. The future of dermatoscopy will involve incorporation of artificial intelligence that will make the assessment process increasingly objective, more accurate, and universally available. Despite the wide acceptance and adoption of dermatoscopy, the overall impact of its widespread use still remains unclear, whether it has decreased biopsy rates of benign lesions, reduced health care costs, or improved patient outcomes.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Inteligência Artificial , Dermoscopia , Humanos , Melanoma/diagnóstico por imagem , Dermatopatias/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem
6.
Comput Methods Programs Biomed ; 212: 106447, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34678529

RESUMO

BACKGROUND AND OBJECTIVE: The skin lesion usually covers a small region of the dermoscopy image, and the lesions of different categories might own high similarities. Therefore, it is essential to design an elaborate network for accurate skin lesion classification, which can focus on semantically meaningful lesion parts. Although the Class Activation Mapping (CAM) shows good localization capability of highlighting the discriminative parts, it cannot be obtained in the forward propagation process. METHODS: We propose a Deep Attention Branch Network (DABN) model, which introduces the attention branches to expand the conventional Deep Convolutional Neural Networks (DCNN). The attention branch is designed to obtain the CAM in the training stage, which is then utilized as an attention map to make the network focus on discriminative parts of skin lesions. DABN is applicable to multiple DCNN structures and can be trained in an end-to-end manner. Moreover, a novel Entropy-guided Loss Weighting (ELW) strategy is designed to counter class imbalance influence in the skin lesion datasets. RESULTS: The proposed method achieves an Average Precision (AP) of 0.719 on the ISIC-2016 dataset and an average area under the ROC curve (AUC) of 0.922 on the ISIC-2017 dataset. Compared with other state-of-the-art methods, our method obtains better performance without external data and ensemble learning. Moreover, extensive experiments demonstrate that it can be applied to multi-class classification tasks and improves mean sensitivity by more than 2.6% in different DCNN structures. CONCLUSIONS: The proposed method can adaptively focus on the discriminative regions of dermoscopy images and allows for effective training when facing class imbalance, leading to the performance improvement of skin lesion classification, which could also be applied to other clinical applications.


Assuntos
Dermatopatias , Neoplasias Cutâneas , Dermoscopia , Humanos , Redes Neurais de Computação , Pesquisa , Dermatopatias/diagnóstico por imagem
7.
An Bras Dermatol ; 96(6): 735-745, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34620524

RESUMO

Dermoscopy is an essential in vivo diagnostic technique in the clinical evaluation of skin tumors. Currently, the same can also be said about its implications when approaching different clinical situations in Dermatology. A growing number of reports on dermatological scenarios and diseases have been published, in which dermoscopy has been of great diagnostic help. The term "entomodermoscopy" was coined to describe dermoscopic findings in skin infestations and also in dermatoses of infectious etiology. In part I of this article, the main dermoscopic descriptions of zoodermatoses and bacterial infections will be addressed. In many of them, such as scabies, pediculosis, myiasis, and tungiasis, it is possible to identify the pathogen and, consequently, attain the diagnosis more quickly and use the technique to follow-up therapeutic effectiveness. In other situations that will be described, dermoscopy can allow the observation of clinical findings with greater detail, rule out differential diagnoses, and increase the level of confidence in a clinical suspicion.


Assuntos
Infecções Bacterianas , Dermatopatias Parasitárias , Dermatopatias , Neoplasias Cutâneas , Dermoscopia , Humanos , Dermatopatias Parasitárias/diagnóstico
8.
An Bras Dermatol ; 96(6): 746-758, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34620527

RESUMO

In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.


Assuntos
COVID-19 , Doenças do Pé , Dermoscopia , Humanos , Pandemias , SARS-CoV-2 , Tinha
9.
Acta Derm Venereol ; 101(11): adv00597, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34643739

RESUMO

BRAF/V600E mutation and other cell growth/growth-control mechanisms are involved in naevogenesis and melanomagenesis. Immunoexpression of BRAF/V600E and other molecules (p16, phosphatase and tensin homologue (PTEN), Ki67, hTERT and Cav3.1 and 3.2 calcium channels) were investigated in 80 histopatho-logically and dermoscopically classified acquired naevi. Regarding BRAF/V600E, dysplastic naevi showed lower immunostaining than common naevi, which was significant in comparison with intradermal naevi, which showed the highest BRAF/V600E histoscore. Junctional naevi showed the lowest BRAF/V600E levels. Globular/cobblestone and reticular dermoscopic patterns were consistently associated with high and low BRAF/V600E immunoexpression, respectively, but Zalaudek's peripheral globule pattern (CR/PG) showed the highest BRAF/V600E immunoexpression. Among global patterns, the previously not investigated multicomponent pattern showed the lowest BRAF/V600E immunoexpression. Regarding the remaining biomarkers, new immunohistochemical features were found, in particular p16 and PTEN low expression in multicomponent pattern; and Ki67, hTERT and Cav.3.1 high expression in CR/PG. In conclusion, histopathology and dermoscopy provide complementary information regarding the biology of melanocytic naevi.


Assuntos
Canais de Cálcio Tipo T , Nevo Pigmentado , Neoplasias Cutâneas , Biomarcadores , Dermoscopia , Humanos , PTEN Fosfo-Hidrolase , Proteínas Proto-Oncogênicas B-raf/genética
10.
Acta Derm Venereol ; 101(10): adv00570, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34596231

RESUMO

Several melanoma-specific dermoscopic features have been described, some of which have been reported as indicative of in situ or invasive melanomas. To assess the usefulness of these features to differentiate between these 2 categories, a retrospective, single-centre investigation was conducted. Dermoscopic images of melanomas were reviewed by 7 independent dermatologists. Fleiss' kappa (κ) was used to analyse interobserver agreement of predefined features. Logistic regression and odds ratios were used to assess whether specific features correlated with melanoma in situ or invasive melanoma. Overall, 182 melanomas (101 melanoma in situ and 81 invasive melanomas) were included. The interobserver agreement for melanoma-specific features ranged from slight to substantial. Atypical blue-white structures (κ=0.62, 95% confidence interval 0.59-0.65) and shiny white lines (κ=0.61, 95% confidence interval 0.58-0.64) had a substantial interobserver agreement. These 2 features were also indicative of invasive melanomas >1.0 mm in Breslow thickness. Furthermore, regression/peppering correlated with thin invasive melanomas. The overall agreement for classification of the lesions as invasive or melanoma in situ was moderate (κ=0.52, 95% confidence interval 0.49-0.56).


Assuntos
Melanoma , Neoplasias Cutâneas , Dermoscopia , Humanos , Melanoma/diagnóstico por imagem , Variações Dependentes do Observador , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagem
11.
Medicina (Kaunas) ; 57(10)2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34684064

RESUMO

Primary cutaneous amyloidosis (PCA) is characterized by the extracellular deposition of amyloid in the skin without systemic involvement. It comprises several clinical variants, the most common of which are macular amyloidosis (MA) and lichen amyloidosis (LA). PCA is frequently observed in Asians, while it is considered to be very rare in Caucasians. In the latter population, the condition often poses a diagnostic challenge. Dermoscopy has already been proved to be a useful, non-invasive diagnostic tool in various non-neoplastic skin diseases. In the paper, we present three Caucasian patients (skin phototypes I-II) with histologically confirmed LA. Under dermoscopy, central white hubs with grayish-brown dots and globules were observed in all three cases. Vascular structures were present in two cases and had the morphology of red globules and thick, unfocused branching lines intersecting the white hubs. A comprehensive review of the literature retrieved twelve papers presenting the dermoscopic features of PCA, including five articles on the dermoscopy of LA. The vast majority of these studies have been conducted on the Asian population, and there is a lack of data on the dermoscopic findings for patients with skin type I or II. The literature review revealed that MA and LA share several dermoscopic similarities (the presence of a white central hub and grayish dots), but also display distinct features. Compared to the dermoscopic features of LA in darker skin phototypes, our patients presented less pronounced pigmentation and more evident vascular structures. Nevertheless, further studies are needed in order to reliably evaluate the dermoscopic features of PCA in various ethnicities.


Assuntos
Amiloidose Familiar , Amiloidose , Líquens , Dermatopatias Genéticas , Amiloidose Familiar/diagnóstico por imagem , Dermoscopia , Humanos
12.
An Bras Dermatol ; 96(6): 706-711, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34629194

RESUMO

BACKGROUND: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. OBJECTIVES: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. METHOD: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. RESULTS: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area​​ greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). STUDY LIMITATIONS: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. CONCLUSION: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.


Assuntos
Dermatite Alérgica de Contato , Dermoscopia , Eritema , Humanos , Testes do Emplastro , Estudos Prospectivos
13.
Comput Biol Med ; 137: 104812, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507158

RESUMO

In recent years, vast developments in Computer-Aided Diagnosis (CAD) for skin diseases have generated much interest from clinicians and other eventual end-users of this technology. Introducing clinical domain knowledge to these machine learning strategies can help dispel the black box nature of these tools, strengthening clinician trust. Clinical domain knowledge also provides new information channels which can improve CAD diagnostic performance. In this paper, we propose a novel framework for malignant melanoma (MM) detection by fusing clinical images and dermoscopic images. The proposed method combines a multi-labeled deep feature extractor and clinically constrained classifier chain (CC). This allows the 7-point checklist, a clinician diagnostic algorithm, to be included in the decision level while maintaining the clinical importance of the major and minor criteria in the checklist. Our proposed framework achieved an average accuracy of 81.3% for detecting all criteria and melanoma when testing on a publicly available 7-point checklist dataset. This is the highest reported results, outperforming state-of-the-art methods in the literature by 6.4% or more. Analyses also show that the proposed system surpasses the single modality system of using either clinical images or dermoscopic images alone and the systems without adopting the approach of multi-label and clinically constrained classifier chain. Our carefully designed system demonstrates a substantial improvement over melanoma detection. By keeping the familiar major and minor criteria of the 7-point checklist and their corresponding weights, the proposed system may be more accepted by physicians as a human-interpretable CAD tool for automated melanoma detection.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Dermoscopia , Diagnóstico por Computador , Humanos , Melanoma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem
14.
Eur J Cancer ; 156: 202-216, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34509059

RESUMO

BACKGROUND: Multiple studies have compared the performance of artificial intelligence (AI)-based models for automated skin cancer classification to human experts, thus setting the cornerstone for a successful translation of AI-based tools into clinicopathological practice. OBJECTIVE: The objective of the study was to systematically analyse the current state of research on reader studies involving melanoma and to assess their potential clinical relevance by evaluating three main aspects: test set characteristics (holdout/out-of-distribution data set, composition), test setting (experimental/clinical, inclusion of metadata) and representativeness of participating clinicians. METHODS: PubMed, Medline and ScienceDirect were screened for peer-reviewed studies published between 2017 and 2021 and dealing with AI-based skin cancer classification involving melanoma. The search terms skin cancer classification, deep learning, convolutional neural network (CNN), melanoma (detection), digital biomarkers, histopathology and whole slide imaging were combined. Based on the search results, only studies that considered direct comparison of AI results with clinicians and had a diagnostic classification as their main objective were included. RESULTS: A total of 19 reader studies fulfilled the inclusion criteria. Of these, 11 CNN-based approaches addressed the classification of dermoscopic images; 6 concentrated on the classification of clinical images, whereas 2 dermatopathological studies utilised digitised histopathological whole slide images. CONCLUSIONS: All 19 included studies demonstrated superior or at least equivalent performance of CNN-based classifiers compared with clinicians. However, almost all studies were conducted in highly artificial settings based exclusively on single images of the suspicious lesions. Moreover, test sets mainly consisted of holdout images and did not represent the full range of patient populations and melanoma subtypes encountered in clinical practice.


Assuntos
Dermatologistas , Dermoscopia , Diagnóstico por Computador , Interpretação de Imagem Assistida por Computador , Melanoma/patologia , Microscopia , Redes Neurais de Computação , Patologistas , Neoplasias Cutâneas/patologia , Automação , Biópsia , Competência Clínica , Aprendizado Profundo , Humanos , Melanoma/classificação , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Neoplasias Cutâneas/classificação
15.
Pediatr Dermatol ; 38(5): 1264-1266, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34515369

RESUMO

The dermoscopic features of longitudinally aligned pigmentation on the hyponychium were previously described in pediatric patients with longitudinal melanonychia. We report four cases of biopsy-proven acral melanocytic nevi on the hyponychium with a longitudinal brush pigmentation (LBP) pattern in dermoscopy. This LBP pattern on the hyponychium may be a counterpart of the fibrillar pattern of acral melanocytic nevi. Therefore, the LBP pattern in dermoscopy may provide a useful clue for distinguishing benign melanocytic nevi from melanoma in pediatric patients.


Assuntos
Melanoma , Nevo Pigmentado , Neoplasias Cutâneas , Criança , Dermoscopia , Humanos , Nevo Pigmentado/diagnóstico , Pigmentação , Neoplasias Cutâneas/diagnóstico
16.
PLoS One ; 16(9): e0257006, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550970

RESUMO

Skin cancer is currently the most common type of cancer among Caucasians. The increase in life expectancy, along with new diagnostic tools and treatments for skin cancer, has resulted in unprecedented changes in patient care and has generated a great burden on healthcare systems. Early detection of skin tumors is expected to reduce this burden. Artificial intelligence (AI) algorithms that support skin cancer diagnoses have been shown to perform at least as well as dermatologists' diagnoses. Recognizing the need for clinically and economically efficient means of diagnosing skin cancers at early stages in the primary care attention, we developed an efficient computer-aided diagnosis (CAD) system to be used by primary care physicians (PCP). Additionally, we developed a smartphone application with a protocol for data acquisition (i.e., photographs, demographic data and short clinical histories) and AI algorithms for clinical and dermoscopic image classification. For each lesion analyzed, a report is generated, showing the image of the suspected lesion and its respective Heat Map; the predicted probability of the suspected lesion being melanoma or malignant; the probable diagnosis based on that probability; and a suggestion on how the lesion should be managed. The accuracy of the dermoscopy model for melanoma was 89.3%, and for the clinical model, 84.7% with 0.91 and 0.89 sensitivity and 0.89 and 0.83 specificity, respectively. Both models achieved an area under the curve (AUC) above 0.9. Our CAD system can screen skin cancers to guide lesion management by PCPs, especially in the contexts where the access to the dermatologist can be difficult or time consuming. Its use can enable risk stratification of lesions and/or patients and dramatically improve timely access to specialist care for those requiring urgent attention.


Assuntos
Inteligência Artificial , Dermoscopia/métodos , Diagnóstico por Computador/métodos , Detecção Precoce de Câncer/métodos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Área Sob a Curva , Dermoscopia/instrumentação , Diagnóstico por Computador/instrumentação , Feminino , Humanos , Masculino , Melanoma/patologia , Médicos de Atenção Primária/educação , Sensibilidade e Especificidade , Neoplasias Cutâneas/patologia , Smartphone , Inquéritos e Questionários
17.
Clin Podiatr Med Surg ; 38(4): 505-511, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34538427

RESUMO

Onychomycosis is one of the most frequent nail pathologies in podiatry practices. Differential diagnoses with the clinical presentation may delay an accurate diagnosis and timely treatment. This article discusses the technique and benefits of using a dermatoscope to improve patient care of this common disorder.


Assuntos
Onicomicose , Podiatria , Dermoscopia , Diagnóstico Diferencial , Humanos , Onicomicose/diagnóstico por imagem
18.
Clin Podiatr Med Surg ; 38(4): 513-520, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34538428

RESUMO

Traditionally, plantar warts or verrucae are often diagnosed by visual appearance and the lateral squeeze test. At times, these methods are not able to elucidate the difference between a plantar wart and a callus. The use of the dermatoscope can not only distinguish the difference between a wart and a callus, which ultimately helps to customize treatment plans to increase efficacy, but also be used to follow the therapeutic effects of treatment. The dermatoscope is a tool that can be used in the diagnosis of plantar verrucae and in assessment of the success of therapy.


Assuntos
Doenças do Pé , Verrugas , Dermoscopia , Doenças do Pé/diagnóstico por imagem , Humanos , Papillomaviridae , Verrugas/diagnóstico por imagem , Verrugas/terapia
19.
J Med Internet Res ; 23(9): e26025, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34546174

RESUMO

BACKGROUND: Skin and subcutaneous disease is the fourth-leading cause of the nonfatal disease burden worldwide and constitutes one of the most common burdens in primary care. However, there is a severe lack of dermatologists, particularly in rural Chinese areas. Furthermore, although artificial intelligence (AI) tools can assist in diagnosing skin disorders from images, the database for the Chinese population is limited. OBJECTIVE: This study aims to establish a database for AI based on the Chinese population and presents an initial study on six common skin diseases. METHODS: Each image was captured with either a digital camera or a smartphone, verified by at least three experienced dermatologists and corresponding pathology information, and finally added to the Xiangya-Derm database. Based on this database, we conducted AI-assisted classification research on six common skin diseases and then proposed a network called Xy-SkinNet. Xy-SkinNet applies a two-step strategy to identify skin diseases. First, given an input image, we segmented the regions of the skin lesion. Second, we introduced an information fusion block to combine the output of all segmented regions. We compared the performance with 31 dermatologists of varied experiences. RESULTS: Xiangya-Derm, as a new database that consists of over 150,000 clinical images of 571 different skin diseases in the Chinese population, is the largest and most diverse dermatological data set of the Chinese population. The AI-based six-category classification achieved a top 3 accuracy of 84.77%, which exceeded the average accuracy of dermatologists (78.15%). CONCLUSIONS: Xiangya-Derm, the largest database for the Chinese population, was created. The classification of six common skin conditions was conducted based on Xiangya-Derm to lay a foundation for product research.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Inteligência Artificial , China , Dermoscopia , Humanos , Dermatopatias/diagnóstico
20.
Acta Dermatovenerol Croat ; 291(1): 62-63, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34477070

RESUMO

Dear Editor, We present a case of proximal pyogenic granuloma in 4-year-old child. The patient presented to our Department due to a fast-growing lesion on the proximal part of the nail unit. The lesion had appeared over several weeks, and it was extremely painful for the child. On the day of the 1st visit, the lesion was not bleeding but was very painful during examination and photo-documentation. Clinically, it presented as an exogenous tumoral lesion of the proximal 1/3 of the nail, partially exulcerated with one part exhibiting coagulated hemorrhage and with uneven coloration (Figure 1). The lesion was not sharply demarcated. Dermoscopically, the majority of the lesion presented an unspecific dermoscopic structure, orange background color, and matched the criteria for a vascular lesion: few unspecific vessels and hemorrhage. The "sticky fiber" sign was also present (Figure 2). Since the lesion was fast-growing and due to the unspecific dermoscopic appearance, the child was referred to a pediatric surgeon and a complete excisional biopsy of the lesion was performed. The dermoscopy of pyogenic granuloma has been already described (1). The histology report confirmed pyogenic granuloma. Pyogenic granulomas of the nail unit are not a common finding, but our case confirms that even this location can be site of this type of benign lesion. It more commonly found in the periungual region and can be expected due to adverse effects of different kinds of systemic therapies. However, due to differential diagnosis that includes different types of tumors occurring at the nail unit, most importantly amelanotic melanoma and SCC, it is suggested to excise or take a biopsy of this type of lesion to be able to exclude aggressive tumor types, which are very rare but not impossible the in pediatric population (2). In cases of unquestionable diagnosis, several local treatments are available. Since the lesion presented a destructive nature in our case, we decided to perform excisional biopsy followed by histology, which in our case was both a diagnostic and therapeutic procedure.


Assuntos
Granuloma Piogênico , Melanoma , Neoplasias Cutâneas , Criança , Pré-Escolar , Dermoscopia , Diagnóstico Diferencial , Granuloma Piogênico/diagnóstico , Granuloma Piogênico/cirurgia , Humanos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
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