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.

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.

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.

A flexural exanthem following postexposure prophylaxis.

We report a case of symmetrical drug-related intertriginous and flexural exanthema following antiretroviral postexposure prophylactic medications, tenofovir and emtricitabine, commencement of which preceded the onset of the rash. Tenofovir and emtricitabine are both nucleoside reverse transcriptase inhibitor medications, commonly used to prevent development of AIDS.

Nivolumab Induced Psoriasis Successfully Treated With Acitretin.

Immunotherapy is emerging as a promising alternative treatment for a variety of solid tumors. Its beneficial effects are mediated through hijacking the immune system to mount an anti-tumor response. One of the mechanisms of increasing anti-tumour immunity is through immune checkpoint blockade.

A case series of persistent lymphopaenia following treatment with fumaric acid esters for psoriasis.

WHAT IS KNOWN AND OBJECTIVE: Fumaric acid esters (FAEs) have been used for fifty years to treat moderate-to-severe psoriasis. However, recent case reports of progressive multifocal leukoencephalopathy, associated with FAE-induced lymphopaenia, have been a cause for concern (J Dtsch Dermatol Ges. 2009;7:603). CASE SERIES: We report six cases of persistent lymphopaenia following cessation of treatment with FAEs, with a mean duration of lymphopaenia of 33 months. WHAT IS NEW AND CONCLUSION: Given the lack of evidence regarding expected recovery of lymphocyte counts, further research is required to guide physicians in the risk stratification of patients prior to considering treatment with FAEs.

Psychological Distress, Alexithymia and Alcohol Misuse in Patients with Psoriasis: A Cross-Sectional Study.

This study investigates (a) the prevalence of psychological distress, alexithymia and alcohol misuse in psoriasis patients; and (b) the relationship between psoriasis severity, alexithymia, alcohol and psychological distress in patients with psoriasis. A cross-sectional study was conducted. Outpatients (n = 184) with moderate to severe psoriasis completed a psychological screening battery. Measures included the Hospital Anxiety and Depression Scale, the Penn State Worry Questionnaire, the twenty-item Toronto Alexithymia Scale, the Dermatology Life Quality Index, the Psoriasis Area and Severity Index, the Self-Administered Psoriasis Area and Severity Index, and the Alcohol Use Disorders Identification Test. Demographic, clinical details and information on knowledge of psychosocial issues, alcohol and confidence on coping with distress and talking to others about psoriasis was also gathered. Alexithymia was associated with anxiety, depression and worry; subjective psoriasis severity was associated with worry. Alcohol misuse was related to anxiety and worry, but not to depression. Appropriate identification and treatment of alcohol difficulties and psychological distress of patients with psoriasis is needed.