Shiva Shankar Marri, Warood Albadri, Mohammed Salman Hyder, Ajit B Janagond, Arun C Inamadar
{"title":"Efficacy of an Artificial Intelligence App (Aysa) in Dermatological Diagnosis: Cross-Sectional Analysis.","authors":"Shiva Shankar Marri, Warood Albadri, Mohammed Salman Hyder, Ajit B Janagond, Arun C Inamadar","doi":"10.2196/48811","DOIUrl":"10.2196/48811","url":null,"abstract":"<p><strong>Background: </strong>Dermatology is an ideal specialty for artificial intelligence (AI)-driven image recognition to improve diagnostic accuracy and patient care. Lack of dermatologists in many parts of the world and the high frequency of cutaneous disorders and malignancies highlight the increasing need for AI-aided diagnosis. Although AI-based applications for the identification of dermatological conditions are widely available, research assessing their reliability and accuracy is lacking.</p><p><strong>Objective: </strong>The aim of this study was to analyze the efficacy of the Aysa AI app as a preliminary diagnostic tool for various dermatological conditions in a semiurban town in India.</p><p><strong>Methods: </strong>This observational cross-sectional study included patients over the age of 2 years who visited the dermatology clinic. Images of lesions from individuals with various skin disorders were uploaded to the app after obtaining informed consent. The app was used to make a patient profile, identify lesion morphology, plot the location on a human model, and answer questions regarding duration and symptoms. The app presented eight differential diagnoses, which were compared with the clinical diagnosis. The model's performance was evaluated using sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F<sub>1</sub>-score. Comparison of categorical variables was performed with the χ<sup>2</sup> test and statistical significance was considered at P<.05.</p><p><strong>Results: </strong>A total of 700 patients were part of the study. A wide variety of skin conditions were grouped into 12 categories. The AI model had a mean top-1 sensitivity of 71% (95% CI 61.5%-74.3%), top-3 sensitivity of 86.1% (95% CI 83.4%-88.6%), and all-8 sensitivity of 95.1% (95% CI 93.3%-96.6%). The top-1 sensitivities for diagnosis of skin infestations, disorders of keratinization, other inflammatory conditions, and bacterial infections were 85.7%, 85.7%, 82.7%, and 81.8%, respectively. In the case of photodermatoses and malignant tumors, the top-1 sensitivities were 33.3% and 10%, respectively. Each category had a strong correlation between the clinical diagnosis and the probable diagnoses (P<.001).</p><p><strong>Conclusions: </strong>The Aysa app showed promising results in identifying most dermatoses.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e48811"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mindy D Szeto, Michelle Hook Sobotka, Emily Woolhiser, Pritika Parmar, Jieying Wu, Lina Alhanshali, Robert P Dellavalle
{"title":"PatientsLikeMe and Online Patient Support Communities in Dermatology.","authors":"Mindy D Szeto, Michelle Hook Sobotka, Emily Woolhiser, Pritika Parmar, Jieying Wu, Lina Alhanshali, Robert P Dellavalle","doi":"10.2196/50453","DOIUrl":"10.2196/50453","url":null,"abstract":"<p><p>Online patient-oriented platforms such as PatientsLikeMe (PLM) offer a venue for individuals with various diagnoses to share experiences and build community, though they may not be representative of the larger patient population. This potentially limits generalizability and raises concerns about the spread of misinformation, emphasizing the need for informed use and health care provider engagement.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e50453"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mindy D Szeto, Torunn E Sivesind, Lori S Kim, Katie A O'Connell, Kathryn A Sprague, Yvonne Nong, Daniel M Strock, Annie L Cao, Jieying Wu, Lauren M Toledo, Sophia M Wolfe, Wyatt Boothby-Shoemaker, Robert P Dellavalle
{"title":"Gender Parity Analysis of the Editorial Boards of Influential Dermatology Journals: Cross-Sectional Study.","authors":"Mindy D Szeto, Torunn E Sivesind, Lori S Kim, Katie A O'Connell, Kathryn A Sprague, Yvonne Nong, Daniel M Strock, Annie L Cao, Jieying Wu, Lauren M Toledo, Sophia M Wolfe, Wyatt Boothby-Shoemaker, Robert P Dellavalle","doi":"10.2196/40819","DOIUrl":"10.2196/40819","url":null,"abstract":"<p><p>This study underscores the persistent underrepresentation of women in academic dermatology leadership positions by examining the gender composition of editorial boards across top dermatology journals, emphasizing the urgent need for proactive strategies to promote diversity, equity, and inclusion.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e40819"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessing the Application of Large Language Models in Generating Dermatologic Patient Education Materials According to Reading Level: Qualitative Study.","authors":"Raphaella Lambert, Zi-Yi Choo, Kelsey Gradwohl, Liesl Schroedl, Arlene Ruiz De Luzuriaga","doi":"10.2196/55898","DOIUrl":"10.2196/55898","url":null,"abstract":"<p><strong>Background: </strong>Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels.</p><p><strong>Objective: </strong>This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees.</p><p><strong>Methods: </strong>The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to \"Create a patient education handout about [condition] at a [FKRL]\" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees.</p><p><strong>Results: </strong>The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%).</p><p><strong>Conclusions: </strong>GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the sevent","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e55898"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11140271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camille M Powers, Andrew K Yang, Hannah Verma, Jeremy Orloff, Austin J Piontkowski, Nicholas Gulati
{"title":"Online Patient Attitudes Toward Cutaneous Immune-Related Adverse Events Attributed to Nivolumab and Pembrolizumab: Sentiment Analysis.","authors":"Camille M Powers, Andrew K Yang, Hannah Verma, Jeremy Orloff, Austin J Piontkowski, Nicholas Gulati","doi":"10.2196/53792","DOIUrl":"10.2196/53792","url":null,"abstract":"","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e53792"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ross O'Hagan, Jessie Ngandjui, Benjamin Ungar, J. Ungar, N. Gulati
{"title":"A Survey of Demographics and Treatments in Melanoma Case Reports: Retrospective Bibliometric Analysis.","authors":"Ross O'Hagan, Jessie Ngandjui, Benjamin Ungar, J. Ungar, N. Gulati","doi":"10.2196/56684","DOIUrl":"https://doi.org/10.2196/56684","url":null,"abstract":"Melanoma case reports show variations in treatment by age and sex.","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"42 14","pages":"e56684"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ichthyosiform Lichen Planus Pigmentosus in a 19-Year-Old Male Patient: Case Report.","authors":"Audi Sugiharto, J. Gatmaitan, Johannes Dayrit","doi":"10.2196/50429","DOIUrl":"https://doi.org/10.2196/50429","url":null,"abstract":"Lichen planus pigmentosus (LPP) is a condition characterized by persistent and asymptomatic brownish-black-to-blue or purple-gray pigmentation, predominantly in the face and sun-exposed areas, commonly in dark-skinned individuals. Several clinical variants of LPP have been reported. However, the ichthyosiform type of LPP has not been reported. We present a 19-year-old male patient who presented with a 7-year history of asymptomatic grayish macules; patches with fine scales on the face, trunk, and upper extremities; and grayish plaques with thick \"ichthyosiform\" scales on the lower extremities. The diagnosis of LPP was proven by histopathological findings on both the macular and ichthyosiform plaques. Cluster differentiation (CD) 68 stain highlights the same density of pigment-laden macrophages in both the gray macule and the ichthyosiform plaque. The cause of LPP is unknown. Transcription factor anomalies may play a role in increased keratinization of lichen planus lesions. It can be assumed that the mechanism of the altered distribution of keratinization may occur on the ichthyosiform lesions in this patient. The terminology \"ichthyosiform lichen planus pigmentosus\" is hereby proposed to be added to the clinical variants of LPP.","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":" 2","pages":"e50429"},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140684272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Marie Toledo, Ramiro Rodriguez, Torunn E Sivesind, Efstratios Vakirlis, Reiji Kojima, Robert P Dellavalle
{"title":"From the Cochrane Library: Leukotriene Receptor Antagonists for Eczema.","authors":"Lauren Marie Toledo, Ramiro Rodriguez, Torunn E Sivesind, Efstratios Vakirlis, Reiji Kojima, Robert P Dellavalle","doi":"10.2196/50434","DOIUrl":"https://doi.org/10.2196/50434","url":null,"abstract":"","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e50434"},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11053388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priscilla L Haff, Alli Jacobson, Madison M Taylor, Hayden P Schandua, David P Farris, Hung Q Doan, Kelly C Nelson
{"title":"The New Media Landscape and Its Effects on Skin Cancer Diagnostics, Prognostics, and Prevention: Scoping Review.","authors":"Priscilla L Haff, Alli Jacobson, Madison M Taylor, Hayden P Schandua, David P Farris, Hung Q Doan, Kelly C Nelson","doi":"10.2196/53373","DOIUrl":"10.2196/53373","url":null,"abstract":"<p><strong>Background: </strong>The wide availability of web-based sources, including social media (SM), has supported rapid, widespread dissemination of health information. This dissemination can be an asset during public health emergencies; however, it can also present challenges when the information is inaccurate or ill-informed. Of interest, many SM sources discuss cancer, specifically cutaneous melanoma and keratinocyte cancers (basal cell and squamous cell carcinoma).</p><p><strong>Objective: </strong>Through a comprehensive and scoping review of the literature, this study aims to gain an actionable perspective of the state of SM information regarding skin cancer diagnostics, prognostics, and prevention.</p><p><strong>Methods: </strong>We performed a scoping literature review to establish the relationship between SM and skin cancer. A literature search was conducted across MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus from January 2000 to June 2023. The included studies discussed SM and its relationship to and effect on skin cancer.</p><p><strong>Results: </strong>Through the search, 1009 abstracts were initially identified, 188 received full-text review, and 112 met inclusion criteria. The included studies were divided into 7 groupings based on a publication's primary objective: misinformation (n=40, 36%), prevention campaign (n=19, 17%), engagement (n=16, 14%), research (n=12, 11%), education (n=11, 10%), demographics (n=10, 9%), and patient support (n=4, 3%), which were the most common identified themes.</p><p><strong>Conclusions: </strong>Through this review, we gained a better understanding of the SM environment addressing skin cancer information, and we gained insight into the best practices by which SM could be used to positively influence the health care information ecosystem.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e53373"},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shaikha Salah Alhaj, Fatma Abdulghaffar Qaderi, Tarek Ibrahim, Maha Almohammad
{"title":"Merkel Cell Carcinoma on the Face: Case Report.","authors":"Shaikha Salah Alhaj, Fatma Abdulghaffar Qaderi, Tarek Ibrahim, Maha Almohammad","doi":"10.2196/56658","DOIUrl":"10.2196/56658","url":null,"abstract":"<p><p>Merkel cell carcinoma (MCC) is a rare primary neuroendocrine skin tumor that presents as a flesh-colored or bluish-red nodule on the face, neck, or head. Long-term ultraviolet radiation exposure and Merkel cell polyomavirus are associated with MCC pathogenesis. We present a case of MCC on the right cheek in a male patient aged 87 years. Our primary goal in presenting the case is to bring MCC, which is a diagnostic challenge, to the notice of dermatologists and oncologists, as early detection and prompt treatment are important. The patient had a significant past medical history, including diabetes mellitus, hypertension, dyslipidemia, stage 3 chronic kidney disease, benign prostatic hyperplasia, chronic hyponatremia, acute pancreatitis, essential thrombocytosis on hydroxyurea, and ischemic heart disease. The patient presented with a mildly swollen right upper lip showing a poorly defined, relatively homogeneous subcutaneous lesion with a history of persistence for 1.5 months. The clinical examination revealed a 5 × 3-cm nodular lesion on the right side of the cheek with swelling of the right upper lip. Immunohistochemistry markers and histopathological features confirmed the diagnosis of MCC. The patient was referred to the oncology department for further management. MCC of the skin is an aggressive lesion with a high risk of metastasis and recurrence, which is more common in immunocompromised people. Prompt management and treatment of MCC is essential because if left untreated, it can spread to other parts of the body and can also metastasize to lymph nodes and other organs. The patient is 87 years old and has a significant past medical history of diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease stage 3, benign prostatic hyperplasia, chronic hyponatremia, acute pancreatitis, essential thrombocytosis on hydroxyurea, and ischemic heart disease. Currently, the patient presented with a mildly swollen right upper lip showing a poorly defined, relatively homogenous subcutaneous lesion with a history of persistence for 1.5 months. The clinical examination revealed a 5x3 cm nodular lesion on the right side of the cheek with swelling of the right upper lip. Immunohistochemistry markers results and histopathological features confirmed the diagnosis of Merkel cell carcinoma. The patient was referred to the oncology department for further management. Merkel cell carcinoma of the skin is an aggressive lesion with a high risk of metastasis and recurrence, which is more common in immunocompromised people. Prompt management and treatment of Merkel cell carcinoma is essential because if left untreated, it can spread to other parts of the body and can also metastasize to lymph nodes and other organs.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":" ","pages":"e56658"},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}