Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration

BackgroundThere is no internationally vetted set of anatomic terms to describe human surface anatomy.ObjectiveTo establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy.MethodsWe conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered - accepted- and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms.ResultsThe Delphi included 21 participants. We found consensus (- ¥75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases- Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method.ConclusionsWe have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.Linked Commentary: R.J.G. Chalmers. J Eur Acad Dermatol Venereol 2020; 34: 2456- 2457. https://doi.org/10.1111/jdv.16978.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163915/1/jdv16855_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163915/2/jdv16855-sup-0001-FigS1-S3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163915/3/jdv16855.pd

Human-computer collaboration for skin cancer recognition

The rapid increase in telemedicine coupled with recent advances in diagnostic artificial intelligence (AI) create the imperative to consider the opportunities and risks of inserting AI-based support into new paradigms of care. Here we build on recent achievements in the accuracy of image-based AI for skin cancer diagnosis to address the effects of varied representations of AI-based support across different levels of clinical expertise and multiple clinical workflows. We find that good quality AI-based support of clinical decision-making improves diagnostic accuracy over that of either AI or physicians alone, and that the least experienced clinicians gain the most from AI-based support. We further find that AI-based multiclass probabilities outperformed content-based image retrieval (CBIR) representations of AI in the mobile technology environment, and AI-based support had utility in simulations of second opinions and of telemedicine triage. In addition to demonstrating the potential benefits associated with good quality AI in the hands of non-expert clinicians, we find that faulty AI can mislead the entire spectrum of clinicians, including experts. Lastly, we show that insights derived from AI class-activation maps can inform improvements in human diagnosis. Together, our approach and findings offer a framework for future studies across the spectrum of image-based diagnostics to improve human-computer collaboration in clinical practice

Ultraviolet-induced fluorescent dermoscopy for biopsy site identification prior to dermatologic surgery: A retrospective study.

Supplementary material for JAAD-D-23-0028

Supplementary Table for Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: A prospective study

Supplementary Table 1. Sensitivity analysis of results. Agreement statistics for the overall sample and for the 4 lesion quadrants and lesion center. In this analysis, a random sample of ~25% of the lesion quadrants were shifted to counterclockwise to the quadrant prior and the agreement statistics were recalculated

The use of a sunscreen containing DNA-photolyase in the treatment of patients with field cancerization and multiple actinic keratoses: a case-series

Cutaneous field cancerization (CFC) is associated witha high-risk of developing cutaneous squamous cellcarcinoma (cSCC). It manifests as actinic keratoses(AK) as one of the few macroscopic alterations in CFCpatients. A prospective, single-arm, case-series wasperformed to evaluate the utility of a novel sunscreencontaining DNA-photolyase for treatment of CFCin nine subjects (mean age 70.6 years, male: femaleratio 5:4). The cream was applied topically twicedaily on CFC/AK areas and patients were followedup for three months, with no other treatments. Theprimary outcome was the overall response rate (ORR),categorized as complete response (CR, completeresolution of AKs), partial response (PR, reduction inthe number of AKs), and no-response (NR, similar/increase in number of AKs). A 100% PR was observed.All subjects displayed at minimum, a 50% reductionin their lesion number and most patients experiencedalmost CR. Evaluation of AK numbers revealed anabsolute count reduction of 76.6% in the number oflesions, with the mean number of lesions reducedfrom 13.4 to 3.1 (p &lt; 0.0001). No adverse events werereported. Patients with CFC may benefit from noveltopical applications containing DNA-photolyase,at minimum, as complementary therapy for themanagement of CFC disease. We propose a newconcept called “active photoprotection” because of itsdual mechanism involving therapy and protection

The use of a sunscreen containing DNA-photolyase in the treatment of patients with field cancerization and multiple actinic keratoses: a case-series

Cutaneous field cancerization (CFC) is associated witha high-risk of developing cutaneous squamous cellcarcinoma (cSCC). It manifests as actinic keratoses(AK) as one of the few macroscopic alterations in CFCpatients. A prospective, single-arm, case-series wasperformed to evaluate the utility of a novel sunscreencontaining DNA-photolyase for treatment of CFCin nine subjects (mean age 70.6 years, male: femaleratio 5:4). The cream was applied topically twicedaily on CFC/AK areas and patients were followedup for three months, with no other treatments. Theprimary outcome was the overall response rate (ORR),categorized as complete response (CR, completeresolution of AKs), partial response (PR, reduction inthe number of AKs), and no-response (NR, similar/increase in number of AKs). A 100% PR was observed.All subjects displayed at minimum, a 50% reductionin their lesion number and most patients experiencedalmost CR. Evaluation of AK numbers revealed anabsolute count reduction of 76.6% in the number oflesions, with the mean number of lesions reducedfrom 13.4 to 3.1 (p &lt; 0.0001). No adverse events werereported. Patients with CFC may benefit from noveltopical applications containing DNA-photolyase,at minimum, as complementary therapy for themanagement of CFC disease. We propose a newconcept called “active photoprotection” because of itsdual mechanism involving therapy and protection