Search Results (37)

We present a case of a 72-year-old woman with four amelanotic tumors on the left arm, without a history of skin cancer or sun exposure. Dermoscopy showed polymorphic and arborizing vessels, with some lesions displaying non-specific malignant features. Histopathology confirmed basal cell carcinoma (BCC) in all lesions. No signs of recurrence were observed during 3-year follow-up. Segmental/agminated basal cell carcinoma is a rare differential diagnosis of multiple clustered, painless pink tumors. To the best of our knowledge, this is the first report describing their dermoscopic features. Full article

Background/Objectives: This proof-of-concept study evaluated whether optical coherence tomography angiography (OCTA) can non-invasively capture micro-vascular alterations in non-melanoma skin cancer (NMSC) lesions during and after superficial orthovoltage radiotherapy (RT) using radiomics and vascular features analysis. Methods: Eight patients (13 NMSC lesions) received 36–50 Gy in 6–20 fractions. High-resolution swept-source OCTA volumes (1.1 × 10 × 10 mm³) were acquired from each lesion at three time points: pre-RT, immediately post-RT, and three months post-RT. Additionally, healthy skin baseline was scanned. After artifact suppression and region-of-interest cropping, (i) first-order and texture radiomics and (ii) skeleton-based vascular features were extracted. Selected features after LASSO (least absolute shrinkage and selection operator) were explored with principal-component analysis. An XGBoost model was trained to classify time points with 100 bootstrap out-of-bag validations. Kruskal–Wallis tests with Benjamini–Hochberg correction assessed longitudinal changes in the 20 most influential features. Results: Sixty-one OCTA volumes were analyzable. LASSO retained 47 of 103 features. The first two principal components explained 63% of the variance, revealing a visible drift of lesions from pre- to three-month post-RT clusters. XGBoost achieved a macro-averaged AUC of 0.68 ± 0.07. Six features (3 texture, 2 first order, 1 vascular) changed significantly across time points (adjusted p < 0.05), indicating dose-dependent reductions in signal heterogeneity and micro-vascular complexity as early as treatment completion, which deepened by three months. Conclusions: OCTA-derived radiomic and vascular signatures tracked RT-induced micro-vascular remodeling in NMSC. The approach is entirely non-invasive, label-free, and feasible at the point of care. As an exploratory proof-of-concept, this study helps to refine scanning and analysis protocols and generates knowledge to support future integration of OCTA into adaptive skin-cancer radiotherapy workflows. Full article

Ovine gammaherpesvirus 2 (OvGHV2) is a Macavirus and the cause of sheep-associated malignant catarrhal fever (SA-MCF) in susceptible mammalian hosts worldwide. OvGHV2 may produce typical clinical manifestations of SA-MCF or subclinical infections. Additionally, OvGHV2 is associated with cutaneous lesions in ruminants, with few documented reports of this unusual manifestation worldwide. This paper presents the pathological, immunohistochemical (IHC), and molecular findings observed in outbreaks of OvGHV2-related skin infections in dairy cattle from Southern Brazil. Cutaneous scrapings (n = 35) and biopsies (n = 6) were obtained from dairy cows derived from three farms. All cows (n = 35) developed widespread, ulcerative to scaly and erythematous skin lesions, and had no contact with sheep or goats. The biopsies were evaluated for histopathological diagnosis and then used in IHC analyses designed to detect malignant catarrhal fever virus (MCFV) antigens and to evaluate the inflammatory response. All scrapings and biopsies were used in PCR assays to amplify OvGHV2. Additionally, all biopsies were used in PCR assays to detect bovine gammaherpesvirus 6 (BoGHV6), bovine alphaherpesvirus 1 (BoAHV1), and poxvirus. Histopathology revealed chronic folliculitis in all biopsies. IHC detected intralesional, intracytoplasmic MCFV antigens in most (83.3%; 5/6) of the cutaneous lesions with folliculitis. These skin lesions showed a strong T-cell response, macrophage clusters, and caspase-positive follicular keratinocytes. OvGHV2 DNA was detected in 66.7% (4/6) of the cutaneous biopsies that contained MCFV antigens and in 8.6% (3/35) of the cutaneous scrapings. The DNA of BoGHV6, BoAHV1, and Poxvirus was not amplified from any of the cutaneous biopsies. These findings demonstrated that OvGHV2 was associated with the cutaneous lesions in dairy cows at these farms and represent the first description of OvGHV2-related skin disease in ruminants from Brazil and the entire Latin America. A review of previous cases of skin lesions associated with infections by OvGHV2 revealed that most cases had a histological diagnosis of folliculitis, suggesting that folliculitis may be associated with OvGHV2-related skin infections. Additionally, this investigation contrasts all previous reports of OvGHV2-related skin disease in ruminants, since the infected cows herein identified were not reared concomitantly or within proximity of the asymptomatic reservoir host. Furthermore, the possible form of OvGHV2 dissemination to the susceptible cows during this study is discussed. Full article

The accurate segmentation of pigmented skin lesions is a critical prerequisite for reliable melanoma detection, yet approximately 30% of lesions exhibit fuzzy or poorly defined borders. This ambiguity makes the definition of a single contour unreliable and limits the effectiveness of computer-assisted diagnosis (CAD) systems. While clinical assessment based on the ABCDE criteria (asymmetry, border, color, diameter, and evolution), dermoscopic imaging, and scoring systems remains the standard, these methods are inherently subjective and vary with clinician experience. We address this challenge by reframing segmentation into three distinct regions: background, border, and lesion core. These regions are delineated using superpixels generated via the Simple Linear Iterative Clustering (SLIC) algorithm, which provides meaningful structural units for analysis. Our contributions are fourfold: (1) redefining lesion borders as regions, rather than sharp lines; (2) generating superpixel-level embeddings with a transformer-based autoencoder; (3) incorporating these embeddings as features for superpixel classification; and (4) integrating neighborhood information to construct enhanced feature vectors. Unlike pixel-level algorithms that often overlook boundary context, our pipeline fuses global class information with local spatial relationships, significantly improving precision and recall in challenging border regions. An evaluation on the HAM10000 melanoma dataset demonstrates that our superpixel–RAG–transformer (region adjacency graph) pipeline achieves exceptional performance (100% F1 score, accuracy, and precision) in classifying background, border, and lesion core superpixels. By transforming raw dermoscopic images into region-based structured representations, the proposed method generates more informative inputs for downstream deep learning models. This strategy not only advances melanoma analysis but also provides a generalizable framework for other medical image segmentation and classification tasks. Full article

The absence of skin color information in skin cancer datasets poses a significant challenge for accurate diagnosis using artificial intelligence models, particularly for non-white populations. In this paper, based on the Monk Skin Tone (MST) scale, which is less biased than the Fitzpatrick scale, we propose MST-AI, a novel method for detecting skin color in images of large datasets, such as the International Skin Imaging Collaboration (ISIC) archive. The approach includes automatic frame, lesion removal, and lesion segmentation using convolutional neural networks, and modeling normal skin tones with a Variational Bayesian Gaussian Mixture Model (VB-GMM). The distribution of skin color predictions was compared with MST scale probability distribution functions (PDFs) using the Kullback-Leibler Divergence (KLD) metric. Validation against manual annotations and comparison with K-means clustering of image and skin mean RGBs demonstrated the superior performance of the MST-AI, with Kendall’s Tau, Spearman’s Rho, and Normalized Discounted Cumulative Gain (NDGC) of 0.68, 0.69, and 1.00, respectively. This research lays the groundwork for developing unbiased AI models for early skin cancer diagnosis by addressing skin color imbalances in large datasets. Full article

The pathogenesis of psoriasis is complex and many specific immunopathogenic mechanisms still remain unclear. Our goal was to identify novel pathways involved in the pathogenesis of psoriasis by analyzing differentially expressed genes, and to conduct pathway and cluster analysis by comparing lesional and non-lesional skin with healthy controls. Accordingly, 2 mm punch biopsies were taken from lesional elbow skin and non-affected adjacent skin of 23 patients with plaque-type psoriasis and from the elbow skin of 25 healthy controls. Differentially expressed genes were analyzed through RNA sequencing, and gene set enrichment analysis was used to analyze biological pathways. Our results showed downregulation of the pathway clusters “Mitophagy” and “Respiratory Electron Transport” when comparing both lesional and non-lesional skin to control skin. The pathway “Signaling by ROBO receptors” was downregulated in all three comparisons. Conversely, pathways relating to SUMOylation were upregulated when comparing lesional skin to both non-lesional and control skin, and those relating to the synthesis of PIPs at the early endosome membrane were found to be upregulated in lesional skin compared to control skin. The dysregulation of pathways relating to mitophagy (involved in the removal of damaged mitochondria), complex I biogenesis (a component of the mitochondrial respiratory chain), signaling by ROBO receptors (important for cell migration), and the synthesis of PIPs at the early endosome membrane (with a pivotal role in endocytic pathways and autophagy) suggests their potential role in psoriasis. Further research into the mechanisms of these dysregulated pathways, along with confirmation of protein expression levels, is necessary to validate their roles in psoriasis pathogenesis. Full article

Domestic cats are currently recognized to be infected by 10 different Felis catus papillomavirus (FcaPV) types that are classified into three genera. Examination of a skin sample from a cat with presumptive allergic dermatitis revealed clusters of large amphophilic intracytoplasmic bodies within epidermal cells. A 312 bp section of DNA from a novel PV type was amplified from the sample, while the entire 7569 bp genome was amplified and sequenced from a skin swab. The novel PV, which was designated FcaPV11, was predicted to contain coding regions for five early proteins and two late ones. Phylogenetic analysis of the L1 gene sequence showed FcaPV11 clusters with members of the Treisetapapillomavirus genus and shares less than 64% similarity with any of the previously fully sequenced FcaPV types. FcaPV11 DNA was not detected in a series of neoplastic and non-neoplastic skin samples from an additional 30 cats. These results show, for the first time, that cats can be infected by members of the Treisetapapillomavirus genus and suggest PVs in this genus may have co-evolved with a common Carnivora ancestor. While FcaPV11 was considered unlikely to have caused skin lesions in this cat, the prominent PV-induced cell changes indicate the PV can influence cell regulation. This suggests FcaPV11 may have the potential to cause skin disease in cats. Full article

Avian pox is a globally spread viral disease affecting a wide spectrum of wild and domesticated bird species. The disease is caused by a diverse group of large DNA viruses, namely, avipoxviruses (genus Avipoxvirus, family Poxviridae). In this study, gross pathological examination and histopathological examination of skin lesions and several organs suggested acute poxvirus infection of a Eurasian crane (Grus grus, Linnaeus, 1758). Avipoxvirus infection was confirmed by testing wart-like lesions via gene-specific PCR assay and sequencing the obtained amplicon. Phylogenetic analysis of the gene encoding the DNA polymerase revealed that the crane poxvirus clustered in clade A, subclade A3. A large fragment of the poxvirus genome (306,477 bp in length) was assembled from the DNA of a skin specimen. Our study reaffirms previous findings that even complex virus genomes can be determined from a metagenomic assemblage generated directly from avian tissue samples without prior virus isolation, a promising approach for the epidemiologic surveillance of avipoxvirus infections in wild birds and domestic poultry. Full article

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, with an increasing number of targeted therapies available. While biologics to treat AD exclusively target the key cytokines of type 2 immunity, Janus kinase inhibitors target a broad variety of cytokines, including IFN-γ. To better stratify patients for optimal treatment outcomes, the identification and characterization of subgroups, especially with regard to their IFNG expression, is of great relevance, as the role of IFNG in AD has not yet been fully clarified. This study aims to define AD subgroups based on their lesional IFNG expression and to characterize them based on their gene expression, T cell secretome and clinical attributes. RNA from the lesional and non-lesional biopsies of 48 AD patients was analyzed by RNA sequencing. Based on IFNG gene expression and the release of IFN-γ by lesional T cells, this cohort was categorized into three IFNG groups (high, medium, and low) using unsupervised clustering. The low IFNG group showed features of extrinsic AD with a higher prevalence of atopic comorbidities and impaired epidermal lipid synthesis. In contrast, patients in the high IFNG group had a higher average age and an activation of additional pro-inflammatory pathways. On the cellular level, higher amounts of M1 macrophages and natural killer cell signaling were detected in the high IFNG group compared to the low IFNG group by a deconvolution algorithm. However, both groups shared a common dupilumab response gene signature, indicating that type 2 immunity is the dominant immune shift in both subgroups. In summary, high and low IFNG subgroups correspond to intrinsic and extrinsic AD classifications and might be considered in the future for evaluating therapeutic efficacy or non-responders. Full article

Folliculosebaceous cystic hamartoma (FSCH) is a rare and benign form of cutaneous hamartomas. These skin lesions often lead to clinical and histopathological misdiagnosis due to their similarities to cutaneous lesions with overproduction of clustered sebaceous glands. Clinically, the lesions often present as solitary, skin-colored, pedunculated warts to cauliflower-like, exophytic papules and nodules, usually with a diameter ranging 0.5–1.5 cm that rarely exceed 2 cm in size. Only a small number of giant variants are reported in the literature with a diameter in the range of 5–23 cm. The vast majority of the lesions appear in the central face and show a striking predilection for the nose, ears, and scalp, but also emerge on the nipples, extremities, and genitals. Histologically, the epithelial components of folliculosebaceous cystic hamartoma comprise dilated infundibular cystic proliferation with surrounding mesenchymal components, which commonly include fibroplasia and vascular and adipose tissue proliferation. These histological characteristics were coined by Kimura and colleagues (1991). To the best of our knowledge, our case represents the biggest variant of giant folliculosebaceous cystic hamartoma. Full article

Skin cancer poses a significant health risk, affecting multiple layers of the skin, including the dermis, epidermis, and hypodermis. Melanoma, a severe type of skin cancer, originates from the abnormal proliferation of melanocytes in the epidermis. Current methods for skin lesion segmentation heavily rely on large annotated datasets, which are costly, time-consuming, and demand specialized expertise from dermatologists. To address these limitations and improve logistics in dermatology practices, we present a self-supervised strategy for accurate skin lesion segmentation in dermatologist images, eliminating the need for manual annotations. Unlike the traditional appraoch, our proposed approach integrates a hybrid CNN/Transformer model, harnessing the complementary strengths of both architectures. The Transformer module captures long-range contextual dependencies, enabling a comprehensive understanding of image content, while the CNN encoder extracts local semantic information. To dynamically recalibrate the representation space, we introduce a contextual attention module that effectively combines hierarchical features and pixel-level information. By incorporating local and global dependencies among image pixels, we perform a clustering process that organizes the image content into a meaningful space. Furthermore, as another contribution, we incorporate a spatial consistency loss to promote the gradual merging of clusters with similar representations, thereby improving the segmentation quality. Experimental evaluations conducted on two publicly available skin lesion segmentation datasets demonstrate the superiority of our proposed method, outperforming both unsupervised and self-supervised strategies, and achieving state-of-the-art performance in this challenging task. Full article

A 14-year-old West Highland White terrier dog developed multiple raised plaques that were confined to the concave surface of the right pinna. Histology allowed a diagnosis of viral plaque, although the lesions contained some unusual microscopic features. A papillomaviral (PV) DNA sequence was amplified from the plaque using consensus PCR primers. The amplified sequence was used as a template to design ‘outward facing’ PCR primers, which allowed amplification of the complete PV DNA sequence. The sequence was 7778 bp and was predicted to code for five early genes and two late genes. The ORF L1 showed the highest (83.9%) similarity to CPV15, and phylogenetic analysis revealed the novel PV clustered with the species 3 ChiPVs. The novel PV was designated as canine papillomavirus (CPV) type 25. As CPV25 was not previously detected in a canine viral plaque, this PV type may be a rare cause of skin disease in dogs. However, as plaques that remain confined to the pinna were not previously reported in dogs, it is possible that CPV25 could be more common in plaques from this area of skin. The findings from this case expand the number of PV types that cause disease in dogs. Evidence from this case suggests that, compared to the other canine ChiPV types, infection by CPV25 results in viral plaques in atypical locations with unusual histological features. Full article

Nevus sebaceous of Jadassohn (NSJ) is a rare congenital lesion that affects the adnexal structures of the skin. It is typically located on the scalp and face of females and presents as a well-defined, slightly elevated, yellow lesion. It is also linked to a high risk of secondary tumors, which are more frequently benign than malignant. In vivo reflectance confocal microscopy (RCM) is a non-invasive imaging technique that provides a horizontal image of the skin with a resolution similar to histology. We report a case of basal cell carcinoma (BCC) developed in an NSJ with its dermoscopic, confocal, and histopathological features. A 49-year-old female presented with a well-circumscribed, 1 cm-diameter verrucous, yellowish lesion surrounded by a poorly defined, slightly erythematous, translucent plaque, located on the scalp in the temporoparietal region, which had been present since birth, grew at puberty, and changed its appearance in the last three years. Dermoscopy of the central lesion revealed yellow globules grouped into clusters, with peripheral linear and arborescent thin vessels, surrounded by several translucent nodular lesions with fine, arborizing vessels. RCM examination showed large, monomorphic cells with a hyperreflective periphery and a hyperreflective center located on the central lesion, corresponding to sebocytes, surrounded by multiple dark silhouettes lined with hyperreflective bands of thickened collagen, corresponding to tumor islands. The histopathological findings confirmed the diagnosis of BCC developed on an NJS. RCM can be a useful technique for the non-invasive examination and monitoring of these lesions, taking into account their transformation risk and preventing unnecessary excisions that might have a detrimental aesthetic impact on patients. Full article

This paper describes the process of developing a classification model for the effective detection of malignant melanoma, an aggressive type of cancer in skin lesions. Primary focus is given on fine-tuning and improving a state-of-the-art convolutional neural network (CNN) to obtain the optimal ROC-AUC score. The study investigates a variety of artificial intelligence (AI) clustering techniques to train the developed models on a combined dataset of images across data from the 2019 and 2020 IIM-ISIC Melanoma Classification Challenges. The models were evaluated using varying cross-fold validations, with the highest ROC-AUC reaching a score of 99.48%. Full article

Staphylococcus aureus superantigens (SAgs) have been reported to aggravate atopic dermatitis. However, comprehensive analyses of these molecules in multiple microniches are lacking. The present study involved 50 adult patients with active atopic dermatitis. S. aureus was isolated from the lesional skin, nonlesional skin, and anterior nares. Multiplex-PCR was performed to identify genes encoding (1) selX (core genome); (2) seg, selI, selM, selN, selO, selU (enterotoxin gene cluster, EGC); and (3) sea, seb, sec, sed, see, tstH (classic SAgs encoded on other mobile genetic elements). The results were correlated to clinical parameters of the study group. selx and EGC were the most prevalent in all microniches. The number of SAg-encoding genes correlated between the anterior nares and nonlesional skin, and between the nonlesional and lesional skin. On lesional skin, the total number of SAg genes correlated with disease severity (total and objective SCORAD, intensity, erythema, edema/papulation, lichenification and dryness). Linear regression revealed that AD severity was predicted only by selx and EGC. This study revealed that selX and EGC are associated with atopic dermatitis severity. Anterior nares and nonlesional skin could be reservoirs of SAg-positive S. aureus. Restoring the physiological microbiome could reduce the SAg burden and alleviate syndromes of atopic dermatitis. Full article