Search Results (408)

Skin cancer is the most common cancer worldwide, for which early detection is crucial to improve survival rates. Visual inspection and biopsies have limitations, including being error-prone, costly, and time-consuming. Although several deep learning models have been developed, they demonstrate significant limitations. An interpretable and improved transfer learning model for binary skin cancer classification is proposed in this research, which uses the last convolutional block of VGG16 as the feature extractor. The methodology focuses on addressing the existing limitations in skin cancer classification, to support dermatologists and potentially saving lives through advanced, reliable, and accessible AI-driven diagnostic tools. Explainable AI is incorporated for the visualization and explanation of classifications. Multiple optimization techniques are applied to avoid overfitting, ensure stable training, and enhance the classification accuracy of dermoscopic images into benign and malignant classes. The proposed model shows 90.91% classification accuracy, which is better than state-of-the-art models and established approaches in skin cancer classification. An interactive desktop application integrating the model is developed, enabling real-time preliminary screening with offline access. Full article

Secukinumab (SEC) is a recombinant, fully human monoclonal antibody that is selective for interleukin-17A (IL-17A). SEC may increase the risk of developing infections such as oral herpes and oral candidiasis. The aim of this case report and literature review was to describe chronic hyperplastic candidiasis (CHC) in a patient with psoriasis (PsO) and psoriatic arthritis (PsA) treated with SEC. CHC is a rare and atypical clinical entity. A definitive diagnosis requires biopsy of the oral mucosa for histopathological diagnosis (PHD). The differential diagnosis includes hairy tongue, hairy leukoplakia, oral lichen planus (OLP), oral lichenoid reaction (OLR), leukoplakia, frictional keratosis, morsication, oral psoriasis, syphilis, and oral lesions associated with coronavirus disease (COVID-19). In addition to the usual factors (xerostomia, smoking, antibiotics, vitamin deficiency, immunosuppression, comorbidities), the new biological therapies/immunotherapies are a predisposing factor for oral candidiasis. The therapeutic approach must be multidisciplinary and in consultation with a clinical immunologist. Dentists and specialists (oral medicine, dermatologists, rheumatologists) must be familiar with the oral adverse events of the new biological therapies. Simultaneous monitoring of patients by clinical immunology and oral medicine specialists is crucial for timely diagnosis and therapeutic intervention to avoid possible adverse events and improve quality of life (QoL). Full article

Background/Objectives: Melanoma is an aggressive type of skin cancer that poses serious health risks if not detected in its early stages. Although early diagnosis enables effective treatment, delays can result in life-threatening consequences. Traditional diagnostic processes predominantly rely on the subjective expertise of dermatologists, which can lead to variability and time inefficiencies. Consequently, there is an increasing demand for automated systems that can accurately classify melanoma lesions and retrieve visually similar cases to support clinical decision-making. Methods: This study proposes a transfer learning (TL)-based deep learning (DL) framework for the classification of melanoma images and the enhancement of content-based image retrieval (CBIR) systems. Pre-trained models including DenseNet121, InceptionV3, Vision Transformer (ViT), and Xception were employed to extract deep feature representations. These features were integrated using a weighted fusion strategy and classified through an Ensemble learning approach designed to capitalize on the complementary strengths of the individual models. The performance of the proposed system was evaluated using classification accuracy and mean Average Precision (mAP) metrics. Results: Experimental evaluations demonstrated that the proposed Ensemble model significantly outperformed each standalone model in both classification and retrieval tasks. The Ensemble approach achieved a classification accuracy of 95.25%. In the CBIR task, the system attained a mean Average Precision (mAP) score of 0.9538, indicating high retrieval effectiveness. The performance gains were attributed to the synergistic integration of features from diverse model architectures through the ensemble and fusion strategies. Conclusions: The findings underscore the effectiveness of TL-based DL models in automating melanoma image classification and enhancing CBIR systems. The integration of deep features from multiple pre-trained models using an Ensemble approach not only improved accuracy but also demonstrated robustness in feature generalization. This approach holds promise for integration into clinical workflows, offering improved diagnostic accuracy and efficiency in the early detection of melanoma. Full article

Background: Huriez syndrome is a rare hereditary skin disorder marked by early-onset sclerodactyly, hyperkeratosis of the palms and soles, and nail dysplasia. A key concern is the early and aggressive development of cutaneous squamous cell carcinoma (SCC), typically affecting the dorsal aspects of the hands. Methods: This narrative review summarizes clinical features, genetic aspects, and oncologic implications of Huriez syndrome. A systematic search was conducted in PubMed and Scopus, including English-language articles published up to May 2025. Relevant case reports and small case series were analyzed. Results: Seven patients (58.3%) underwent multiple surgeries due to recurrent or bilateral disease. Six patients (50%) required amputations, including finger, hand, and arm amputations, with no foot amputations reported. Reconstruction after oncological resection was performed in six patients (50%) using skin grafts (3), pedicled flaps (2), or free flaps (1). Amputation was mainly for advanced disease, with radial forearm flaps used for reconstruction. All flaps remained disease-free. Five cases (41.6%) had a history of local recurrence. Conclusions: The early diagnosis of Huriez syndrome is crucial to enable the surveillance and timely treatment of SCC. A multidisciplinary team including dermatologists, oncologists, plastic surgeons, and geneticists is recommended. Further research is needed to clarify genetic mechanisms and develop early detection strategies to improve outcomes. Full article

Localised cutaneous leishmaniasis (LCL) is a common neglected tropical disease in Ethiopia, which is mainly treated with intralesional (IL) pentavalent antimonial such as sodium stibogluconate (SSG) and/or cryotherapy. Both treatments are painful, and studies are lacking on the pain associated with these or affected individuals’ experiences of them. A cross-sectional, observational study was conducted at ALERT Comprehensive Specialized Hospital, Addis Ababa/Ethiopia. The socio-demographic and clinical data of individuals affected by LCL receiving IL SSG and/or cryotherapy was gathered, and their treatment was observed. Participants quantified their treatment-associated pain using the Wong–Baker Pain Scale. Health-related quality of life was measured using the (Children’s) Dermatology Life Quality Index. Adverse effects, participant experiences with local therapies, and dermatologists’ experiences and opinions of local LCL treatment were assessed using structured questionnaires. Of the thirty-six individuals with LCL included (64% male, 14% children), 52% reported a treatment-associated pain score ≥ 8. Cryotherapy administered with a cotton bud was associated with lower pain scores ≤ 6 (odds ratio: 0.15, 95% confidence interval: 0.03–0.89) compared to a cryotherapy spray device. There was wide variation in treatment administration. Local LCL treatment is painful, and most individuals experience significant pain. This study highlights the need for less painful but effective treatments, structured training, and clear standard operating procedures. Full article

Nowadays, a significant portion of the population uses eye cosmetics, a trend that is not limited to women, as men increasingly adopt stylish makeup techniques. Eye cosmetics, often termed eye makeup, include a diverse array of products such as eyelash enhancers (mascara, false eyelashes, growth serums, and dyes), eyelid products (eyeliner, kohl, eye contour cream, and eyeshadow), and eye makeup removers. There is a persistent interest among dermatologists in the influence of eye cosmetics on the skin surrounding the eye. The formulation of these cosmetics typically consists of various ingredients, some of which may present potential health risks to users. The application of eye cosmetics is linked to a range of adverse effects on the ocular surface, which may manifest as mechanical injury, tear film instability, toxicity, inflammation, and infections. Therefore, the use of cosmetics in this sensitive area is of paramount importance, necessitating a cooperative approach among eyecare professionals, dermatologists, and beauty experts. Despite the widespread use of eye makeup, its possible ocular side effects have not been sufficiently addressed. This report aims to elucidate how the use of eye cosmetics represents a lifestyle challenge that may exacerbate or initiate ocular surface and adnexal disorders. Full article

The use of artificial intelligence (AI) in dermatology is skyrocketing, but a comprehensive overview integrating regulatory, ethical, validation, and clinical issues is lacking. This work aims to review current research, map applicable legal regulations, identify ethical challenges and methods of verifying AI models in dermatology, assess publication trends, compare the most popular neural network architectures and datasets, and identify good practices in creating AI-based applications for dermatological use. A systematic literature review is conducted in accordance with the PRISMA guidelines, utilising Google Scholar, PubMed, Scopus, and Web of Science and employing bibliometric analysis. Since 2016, there has been exponential growth in deep learning research in dermatology, revealing gaps in EU and US regulations and significant differences in model performance across different datasets. The decision-making process in clinical dermatology is analysed, focusing on how AI is augmenting skin imaging techniques such as dermatoscopy and histology. Further demonstration is provided regarding how AI is a valuable tool that supports dermatologists by automatically analysing skin images, enabling faster diagnosis and the more accurate identification of skin lesions. These advances enhance the precision and efficiency of dermatological care, showcasing the potential of AI to revolutionise the speed of diagnosis in modern dermatology, sparking excitement and curiosity. Then, we discuss the regulatory framework for AI in medicine, as well as the ethical issues that may arise. Additionally, this article addresses the critical challenge of ensuring the safety and trustworthiness of AI in dermatology, presenting classic examples of safety issues that can arise during its implementation. The review provides recommendations for regulatory harmonisation, the standardisation of validation metrics, and further research on data explainability and representativeness, which can accelerate the safe implementation of AI in dermatological practice. Full article

Objective: The classification of skin cancer is very helpful in its early diagnosis and treatment, considering the complexity involved in differentiating AK from BCC and SK. These conditions are generally not easily detectable due to their comparable clinical presentations. Method: This paper presents a new approach to hyperspectral imaging for enhancing the visualization of skin lesions called the Spectrum-Aided Vision Enhancer (SAVE), which has the ability to convert any RGB image into a narrow-band image (NBI) by combining hyperspectral imaging (HSI) to increase the contrast of the area of the cancerous lesions when compared with the normal tissue, thereby increasing the accuracy of classification. The current study investigates the use of ten different machine learning algorithms for the purpose of classification of AK, BCC, and SK, including convolutional neural network (CNN), random forest (RF), you only look once (YOLO) version 8, support vector machine (SVM), ResNet50, MobileNetV2, Logistic Regression, SVM with stochastic gradient descent (SGD) Classifier, SVM with logarithmic (LOG) Classifier and SVM- Polynomial Classifier, in assessing the capability of the system to differentiate AK from BCC and SK with heightened accuracy. Results: The results demonstrated that SAVE enhanced classification performance and increased its accuracy, sensitivity, and specificity compared to a traditional RGB imaging approach. Conclusions: This advanced method offers dermatologists a tool for early and accurate diagnosis, reducing the likelihood of misclassification and improving patient outcomes. Full article

Background: Medical photography is widely used in dermatology referrals to secondary healthcare, yet concerns exist regarding image quality and data security. This study aimed to evaluate the quality of clinical photographs used in dermatology referrals, to identify discrepancies between specialties’ perceptions, and to determine the general awareness of proper storage and security of clinical photographs. Methods: A 43-question survey, based on previously validated questionnaires, was administered to general and family medicine (GFM) doctors and to dermatologists at an academic referral hospital in Porto, Portugal. The survey assessed demographics, photo-taking habits, perceived photo quality, adequacy of clinical information, and opinions on the role of photography in the referral process. Quantitative statistical methods were used to analyze questionnaire responses. Results: A total of 65 physicians participated (18 dermatologists and 47 GFM doctors). Significant differences were observed between the two groups. While 36.2% of GFMs rated their submitted photos as high- or very-high-quality, none of the dermatologists rated the received photos as high-quality, with 83.3% rating them as average (p = 0.012). Regarding clinical information, 46.8% of GFMs reported consistently sending enough information, while no dermatologists reported always receiving sufficient information (p < 0.001). Most respondents (76.9%) agreed that the quality of photographs is important in diagnosis and treatment. Conclusions: The findings reveal a discrepancy between GFM doctors’ and dermatologists’ perceptions of photograph quality and information sufficiency in dermatology referrals. Standardized guidelines and educational interventions are necessary to improve the quality and consistency of clinical photographs, thereby enhancing communication between healthcare providers and ensuring patient data privacy and security. Full article

Background and Objectives: Chronic wounds pose a significant challenge to healthcare systems, requiring long-term management and multidisciplinary approaches. The absence of a standardized national therapeutic protocol in Romania has resulted in inconsistent clinical practices, which in turn affect treatment efficacy and patient outcomes. The implementation of structured guidelines and the integration of regenerative therapies could enhance the management of chronic wounds. Materials and Methods: This study employs a cross-sectional observational design to assess the current management strategies among physicians treating chronic wounds and to identify variations in treatment approaches. A 37-question questionnaire was distributed among plastic surgeons, general surgeons, vascular surgeons, and dermatologists via Google Forms. The data collection period spanned one month, resulting in a total of 240 responses from medical centers in Bucharest, Romania. Results: The study found that most physicians treated several cases per week (40.8%) of delayed healing wounds, with the most frequent types being bedsores (57.5%) and diabetic (58.3%) or venous ulcers (55%). Challenges in wound care included patient reluctance, financial constraints, and the psychological burden on caregivers. The most relevant decision factor for surgical treatment was wound stage (86.7%). Most physicians used an initial conservative approach in wound care (52.5%) or did not have a standard approach (44.2%). Around a quarter of respondents (25.8%) used PRP as a treatment method, considering it to have moderate effectiveness (51.6%). The most important factor for encouraging PRP usage was having the necessary equipment for the procedure (72.5%). The most frequently considered benefit in the case of implementing a treatment protocol was increased treatment efficacy (62.5%). Physicians were also highly interested in the use of a standardized treatment protocol (40%). Approximately 41.7% of the physicians expressed a very high interest in having a standardized diagnostic system for chronic wounds. Conclusions: This study highlights that wound care practices remain variable and that the decision-making process is often challenging. There is a moderate belief in the effectiveness of PRP, suggesting that logistical barriers need to be addressed to facilitate access to it. Therapeutic protocols were seen as key to improving care efficacy and consistency, therefore pressing the need for national strategies that support protocol development. Full article

Background: Fluoroquinolones, available in topical and oral formulations, are used to manage bacterial skin and soft tissue infections, including Pseudomonas aeruginosa, atypical mycobacteria, and select multidrug-resistant Gram-negative organisms. Their excellent tissue penetration, bactericidal activity, and convenient dosing make them effective for certain skin and soft tissue infections. However, their use is limited by potential safety concerns, including tendinopathy (odds ratio up to 9.1 in corticosteroid users), QT interval prolongation with risk of torsades de pointes, phototoxicity, and rising antimicrobial resistance. Methods: A literature search of PubMed, Scopus, and Web of Science was conducted for articles from January 1985 to April 2025 with the search terms (quinolone OR fluoroquinolone) AND (dermatology OR “skin and soft tissue infection” OR “skin structure infection”). Abstracts and presentations were excluded. A Google search used the same terms for articles from government regulatory agencies. Results: This review provides practical guidance on the clinical use of topical and oral fluoroquinolones in dermatology. Delafloxacin demonstrated over 90% cure rates in trials for complicated skin infections. However, serious safety concerns remain, including a ninefold increase in tendinopathy risk among older adults on corticosteroids and corrected QT intervals exceeding 500 milliseconds in high-risk patients. Phototoxicity varies, with agents like sparfloxacin linked to heightened ultraviolet sensitivity. Resistance to ciprofloxacin exceeds 20 percent in Escherichia coli and P. aeruginosa in some populations. Culture-based prescribing, shorter treatment courses, and preference for topical treatments can reduce risk and preserve efficacy. Conclusions: Fluoroquinolones remain clinically useful in dermatology when prescribed selectively. Their appropriate use requires careful attention to patient risk factors along with their evolving resistance patterns and ongoing stewardship efforts. Full article

Skin diseases represent a major worldwide health hazard affecting millions of people yearly and substantially compromising healthcare systems. Particularly in areas where dermatologists are scarce, standard diagnostic techniques, which mostly rely on visual inspection and clinical experience, are frequently subjective, time-consuming, and prone to mistakes. This investigation undertakes a comparative analysis of four state-of-the-art deep learning architectures, YOLO11, YOLOv8, VGG16, and ResNet50, in the context of skin disease identification. This study evaluates the performance of these models using pivotal metrics, building upon the foundation of the YOLO paradigm, which revolutionized spatial attention and multi-scale representation. A properly selected collection of 900 high-quality dermatological images with nine disease categories was used for investigation. Robustness and generalizability were guaranteed by using data augmentation and hyperparameter adjustment. By varying benchmark models in balancing accuracy and recall while limiting false positives and false negatives, YOLO11 obtained a test accuracy of 80.72%, precision of 88.7%, recall of 86.7%, and an F1 score of 87.0%. The expedition performance of YOLO11 signifies a promising trajectory in the development of highly accurate skin disease detection models. Our analysis not only highlights the strengths and weaknesses of the model but also underscores the rapid development of deep learning techniques in medical imaging. Full article

Background: Basal cell carcinoma (BCC) of the ocular and periocular region is characterized by a painless progressive extension. An early diagnosis can limit the extent of facial tissue involvement and subsequent resection resulting in better cosmetic and functional results. Objectives: The aim is to provide the largest and most up-to-date overview of ocular and periocular BCCs. We also reported the first case of caruncle BCC investigated by dermoscopy and reflectance confocal microscopy (RCM). Methods: A systematic review and meta-analysis (Prospero ID CRD583032) were carried out by searching PUBMED–MEDLINE, including all articles with a full-text English version and with BCCs in eyelids, medial and lateral canthus, caruncle, conjunctiva, and orbit. The following data were collected: authors, year, title and type of publication, medical specialization, number, sex, age and comorbidities of the patients, anatomic localization of the disease, clinical and dermoscopic aspect, histological examination, and treatment. Results: We identified 731 articles through a database search, of which 236 articles matched our inclusion criteria. A total of 71.730 patients with ocular and periocular BCCs were included in the present study, and all data collected were reported in a dataset. Most of the articles included were described by ophthalmologists (67.5%), dermatologists (11.2%), or plastic surgeons (5.6%). The proportional meta-analysis revealed varying significance and heterogeneity for each type of study included. Conclusions: BCC more frequently affects the lower eyelid. The most common BCC subtype of ocular and periocular area is the nodular form. Limited data are available concerning the application of dermoscopy and RCM in this area. RCM may be particularly useful for early diagnosis, mapping, and treatment monitoring of ocular and periocular BCCs. Surgery still remains the first-choice treatment. Full article

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, debilitating skin disease primarily diagnosed through clinical examination. Despite its characteristic clinical features, HS remains under-recognized and frequently misclassified, especially by non-dermatologist clinicians. This study aims to evaluate the diagnostic accuracy of HS across various specialties, identify knowledge gaps, and inform targeted educational strategies to reduce diagnostic delays. Methods: A cross-sectional survey was conducted during multidisciplinary scientific conferences, enrolling 655 clinicians including dermatologists, gynecologists, urologists, general surgeons, and general practitioners. Participants were presented with clinical images representing HS lesions at Hurley stages I–III and responded to open-ended and closed-ended diagnostic questions. Data were analyzed to assess diagnostic accuracy and compare recognition patterns across specialties. Results: The recognition of HS varied significantly by specialty and disease stage. For Hurley stage III axillary disease, correct identification was highest among dermatologists (96.56%) compared to general practitioners (48.91%), gynecologists (31.25%), urologists (40%), and general surgeons (63.64%). In a Hurley II genital case in a male patient, only 34.5% diagnosed HS, while 25.65% suggested furunculosis and 16.18% venereal granuloma. For a Hurley I genital case in a female patient, 29.92% diagnosed HS, with furunculosis (23.36%) and steatocystoma multiplex (14.35%) as common misdiagnoses. A Hurley III buttock case was correctly identified by only 29.77% of participants. Conclusions: This large, first-of-its-kind global survey highlights substantial gaps in HS recognition, particularly among non-dermatologist clinicians. The findings underscore the urgent need for targeted, multidisciplinary educational interventions to improve diagnostic accuracy, reduce delays, and ultimately enhance patient outcomes in HS. Full article

Introduction: Acrodermatitis chronica atrophicans (ACA) is a late-stage cutaneous manifestation of Lyme borreliosis, primarily caused by Borrelia afzelii. It mainly affects the distal limbs and leads to progressive skin atrophy. Unlike other Lyme disease rashes, ACA does not resolve on its own and can worsen into severe atrophy and fibrosis if left untreated. Diagnosing ACA can be difficult due to its delayed onset and subtle symptoms, requiring clinical evaluation, multiple blood tests, and skin biopsy. Case presentation: We present the case of a 48-year-old female with a history of pulmonary sarcoidosis who presented to our clinic with multiple erythemato-violaceous patches over her left lower leg and was initially misdiagnosed with venous insufficiency. Histopathological and serological analyses confirmed ACA in its inflammatory phase. The patient responded well to a 30-day course of doxycycline, achieving complete resolution. This report underscores the importance of considering ACA in differential diagnoses and provides a comprehensive review of its pathogenesis, clinical progression, histopathological features, and epidemiology. Conclusions: This case emphasizes the need to consider acrodermatitis chronica atrophicans (ACA) in the differential diagnosis of chronic skin lesions. Clinicians should maintain a high index of suspicion for ACA, particularly in atypical presentations. When the diagnosis is uncertain but clinical suspicion persists, skin biopsy is recommended for histopathologic confirmation. Early diagnosis and appropriate antibiotic therapy are essential to prevent disease progression and irreversible cutaneous atrophy. Accurate diagnosis and effective management require a multidisciplinary approach, involving close collaboration between dermatologists, pathologists, and infectious disease specialists. Full article