Clinics in dermatology最新文献

{"title":"Desmoplastic Melanoma.","authors":"Klaus J Busam","doi":"10.1016/j.clindermatol.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.09.005","url":null,"abstract":"<p><p>Desmoplastic melanoma is a rare fibrosing variant of melanoma. It typically affects elderly patients but can occasionally affect young or middle-aged individuals. Desmoplastic melanoma is relevant as a diagnostic pitfall for pure tumor variants' distinct histopathologic and clinical features. The latter includes a lower regional lymph node involvement frequency and a more favorable prognosis among thick melanomas. Classic cases of desmoplastic melanoma tend to carry a high mutation burden. Patients with metastases from those tumors tend to respond favorably to novel immunotherapies.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MPATH-Dx Version 2.0 Schema for Melanocytic Lesions: A Robust Tool for Standardized Diagnostic Reporting.","authors":"Raymond L Barnhill, Michael W Piepkorn, Lyn M Duncan, Stevan Knezevich, Joann G Elmore, David E Elder","doi":"10.1016/j.clindermatol.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.09.007","url":null,"abstract":"<p><p>The new revised MPATH-Dx (Version 2.0) reporting schema for melanocytic lesions is presented herein. Principal changes include the simplification of the previous five-class Version 1.0 to a four-class hierarchy of melanocytic lesions to improve diagnostic agreement and to provide more explicit guidance in the management of patients. Version 2.0 also has clearly defined histopathological criteria for classification of Class I and II lesions now designated as low-grade (mild to moderate) atypia and high-grade (high-end moderate to severe) atypia, respectively. This new revised schema, also includes specific provisions for the less common WHO pathways to melanoma, provides guidance for classifying \"intermediate\" Class II tumors (melanocytomas), and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as a neoplasm falling short of fully-evolved melanoma.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Dermal Melanoma.","authors":"Jennifer Y Wang, Susan M Swetter","doi":"10.1016/j.clindermatol.2024.09.009","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.09.009","url":null,"abstract":"<p><p>Primary dermal melanoma (PDM) is a rare subtype of melanoma with an estimated incidence of less than 1%. PDM presents entirely in the dermis or subcutis and histopathologically mimics cutaneous metastases of melanoma due to its lack of connection to the overlying epidermis. A thorough history and examination, including imaging evaluation for metastatic disease, will reveal no prior history or concurrent lesion of primary cutaneous or metastatic melanoma. Despite its histopathologic similarities to melanoma metastasis, PDM is associated with an unexpectedly favorable prognosis. This review discusses the clinical and histopathologic features of PDM as a distinct subtype of melanoma, as well as the current approach to clinical staging and management.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Decedents by Restoring Mummified Fingerprints: Forensic Dermatology in the Investigation of Mummy Dermatoglyphics.","authors":"Philip R Cohen, Boraan Abdulkarim, Madison Wnuk, Lerah Sutton, Leonard J Hoenig","doi":"10.1016/j.clindermatol.2024.09.016","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.09.016","url":null,"abstract":"<p><p>Fingerprints are created by elevations and depressions on the fingertip pads. Each person has their own unique fingerprints which can be used in the identification of that individual when alive, during the immediate postmortem period, or even after the digits have become mummified. Mummification can occur naturally; it can be partial (such as localized to only the hands and feet, extensive, or complete. Obtaining fingerprints after the skin has become mummified can be attempted while the digits remaining intact with the hand; however, the digits may need to be removed from the hand and the finger pads may also need to be separated from the underlying bone to secure an adequate fingerprint. Frequently, the mummified tissue needs to be rehydrated; numerous solutions have been used that increase the turgor of the digits, provide softening and pliability of the tissue, and enhance the details of the finger pad ridges. An aqueous solution of sodium carbonate (either combined with acetic acid or combined with 95 percent ethanol and distilled water) was found to be most effective for rehydration. Thereafter, various techniques can be attempted to obtain the fingerprint. These include the traditional method of inking and rolling of the finger or photographing the finger. Powders (such as aluminum powder, black fingerprint powder, white cornstarch-based powder, or fluorescent powder) can be used to enhance the ridge features; adhesive tape can be pressed against the powdered digit and the print pattern preserved by applying the adhesive tape to a clear transparency sheet. In addition, molds (using modeling clay or silicone rubber) and casts (using plaster of Paris, dental casting materials, or putty) can be made of the digits; either the molds or the casts or both can be photographed with or without prior application of fingerprint powder. Transillumination, using a fiber optic light source to illuminate the epidermis and underlying remaining dermis of a scraped and defleshed finger pad can be used to demonstrate the finger ridge pattern when the photographing the tip of the digit. In summary, forensic dermatology can have an integral role in obtaining fingerprints from mummified digits, which can be successfully used for the identification of the decedent.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics of Residency Candidates Using Application Consulting Services.","authors":"Albert E Zhou, Elaine Flynn, Timothy Klufas, Shannon Hanggodo, Neelesh P Jain, Jane M Grant-Kels","doi":"10.1016/j.clindermatol.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.08.011","url":null,"abstract":"<p><p>While the prevalence is still being determined, more medical students are utilizing application consulting companies when applying to competitive residencies such as dermatology. We outline the structure of these companies, the scope of services provided, and the costs associated. We also discuss the ethical implications for the use in the residency application process of such firms and the impact of these practices on the candidate selection process. Finally, we offer possible solutions and measures that mitigate the impact of the use of consulting firms in residency applications. Application consulting services are meant to assist clients in maximizing their chances for a successful application cycle. Many companies cater to both prospective residency and pre-medical candidates, including \"Med School Insiders,\" \"BeMo Academic Consulting,\" and \"Elite Medical Prep.\" The scope of application consulting services is vast. Clients can request services such as personalized school selection, application advising, document preparation review [e.g., curriculum vitae (CV), personal statements, and essays), electronic residency application service (ERAS)], and interview coaching. Another service offered is residency match advising, which details specific requirements programs desire. Prospective clients would gain a significant advantage, mainly when used at the outset of medical school training when planning a trajectory for competitive specialties. We review the ethical issues associated with using these consulting services.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jewish Women in Dermatology.","authors":"Tristi M Edwards, Nicolas Andre, Leonard J Hoenig, Eve J Lowenstein","doi":"10.1016/j.clindermatol.2024.08.009","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2024.08.009","url":null,"abstract":"<p><p>We highlight the contribution of notable Jewish women in American Dermatology. While not intended to be a thorough listing, we selected nine representatives as examples of early pioneering women in American dermatology, research, political leaders, authors and journal editors, and teachers and role models. All struggled to overcome professional barriers to women in medicine: many experienced antisemitism, especially those forced to flee Nazi Germany. Despite persecution and upending their lives, they rebuilt their careers and made outstanding contributions to dermatology.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic features of nonvascular complications of hyaluronic acid fillers: a retrospective study at a reference center for dermatologic ultrasonography","authors":"","doi":"10.1016/j.clindermatol.2024.05.006","DOIUrl":"10.1016/j.clindermatol.2024.05.006","url":null,"abstract":"<div><div><span>Hyaluronic acid filler injections have been associated with early, temporary, and delayed-onset complications. High-resolution ultrasound with Doppler analysis has been increasingly used to detect and identify such complications. We comprehensively describe the most common ultrasonographic findings of nonvascular complications associated with hyaluronic acid filler injections. This retrospective, cross-sectional, observational study was conducted at a reference center for </span>dermatologic<span> ultrasound in Bogotá, Colombia. Ultrasound reports documented the ultrasonographic findings of nonvascular complications of hyaluronic acid filler injections. Fifty-two complications were documented in a cohort of 50 patients (women, 88%). The infraorbital region was the most common site affected (23%), followed by the nasolabial region (22%). The Tyndall effect was the most common complication (25% of all), followed by changes in rheology (21%) and pseudosarcoidal (foreign body granuloma) reaction (15%). The Tyndall effect stood out for its distinctive ultrasonographic characteristics. We discuss the ultrasonographic findings and pathogenesis of other complications, including filler migration, early hypersensitivity, aseptic abscess, overcorrection, and filler material interaction. The clinical presentation of hyaluronic acid filler complications can be confusing, delaying timely diagnosis and treatment. High-resolution ultrasound with Doppler analysis is a valuable tool for avoiding unnecessary treatments and ensuring timely diagnosis and treatment.</span></div></div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher detection of melanoma on the back in married men","authors":"","doi":"10.1016/j.clindermatol.2024.06.001","DOIUrl":"10.1016/j.clindermatol.2024.06.001","url":null,"abstract":"","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for nonmelanoma skin cancer","authors":"","doi":"10.1016/j.clindermatol.2024.06.016","DOIUrl":"10.1016/j.clindermatol.2024.06.016","url":null,"abstract":"<div><div>Nonmelanoma skin cancers (NMSCs) are among the top five most common cancers globally. NMSC is an area with great potential for novel application of diagnostic tools including artificial intelligence (AI). In this scoping review, we aimed to describe the applications of AI in the diagnosis and treatment of NMSC. Twenty-nine publications described AI applications to dermatopathology including lesion classification and margin assessment. Twenty-five publications discussed AI use in clinical image analysis, showing that algorithms are not superior to dermatologists and may rely on unbalanced, nonrepresentative, and nontransparent training data sets. Sixteen publications described the use of AI in cutaneous surgery for NMSC including use in margin assessment during excisions and Mohs surgery, as well as predicting procedural complexity. Eleven publications discussed spectroscopy, confocal microscopy, thermography, and the AI algorithms that analyze and interpret their data. Ten publications pertained to AI applications for the discovery and use of NMSC biomarkers. Eight publications discussed the use of smartphones and AI, specifically how they enable clinicians and patients to have increased access to instant dermatologic assessments but with varying accuracies. Five publications discussed large language models and NMSC, including how they may facilitate or hinder patient education and medical decision-making. Three publications pertaining to the skin of color and AI for NMSC discussed concerns regarding limited diverse data sets for the training of convolutional neural networks. AI demonstrates tremendous potential to improve diagnosis, patient and clinician education, and management of NMSC. Despite excitement regarding AI, data sets are often not transparently reported, may include low-quality images, and may not include diverse skin types, limiting generalizability. AI may serve as a tool to increase access to dermatology services for patients in rural areas and save health care dollars. These benefits can only be achieved, however, with consideration of potential ethical costs.</div></div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legal implications of artificial intelligence in health care","authors":"","doi":"10.1016/j.clindermatol.2024.06.014","DOIUrl":"10.1016/j.clindermatol.2024.06.014","url":null,"abstract":"<div><div>The last few years have seen a boom in the popularity of artificial intelligence (AI) around the world, and the health care sector has not been immune from what has been perceived by some as a revolutionary technology. Although AI has been around for many years, including in the field of health care, the recent introduction of consumer-facing generative AI tools has put a spotlight on the technology that has drawn attention from governments, corporations, consumers and more. Health care systems, physician groups, health insurance companies, and others in the space have shown an eagerness to explore AI's potential to improve various aspects of health care, but new legal risks and challenges are unfolding every day. This contribution looks at the latest health care-related measures in the United States and international legal and regulatory landscapes, as well as data privacy implications and discrimination concerns coming out of AI-enabled solutions. It also discusses concerns that health care systems and physicians alike are monitoring, including the potential for medical errors resulting from AI, liability considerations, and malpractice insurance trends.</div></div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}