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Seminars in Cutaneous Medicine and Surgery

Kelly Fitzgerald, Katy K Tsai
The incidence of advanced cutaneous squamous cell carcinoma (cSCC) is increasing; of the 1.3 million nonmelanoma skin cancers that arise each year, approximately 20% are cSCC, and between 2-5% of these cases ultimately metastasize. However, there is no established consensus on first-line systemic treatment for those patients who have locally advanced or metastatic disease. Major classes of systemic agents include chemotherapy, epidermal growth factor receptor (EGFR)-targeted therapy, and immunotherapy; each is associated with a distinct set of adverse effects, and availability of data from randomized controlled trials (RCTs) to definitively guide treatment are limited...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Lance W Chapman, Siegrid S Yu, Sarah T Arron
Atypical fibroxanthoma (AFX) is a dermal spindle-cell sarcoma that is considered a superficial and clinically benign presentation of pleomorphic dermal sarcoma, malignant fibrous histiocytoma, and undifferentiated pleomorphic sarcoma. AFX appears clinically as a discrete red or pink nodule or papule, most commonly on the head and neck region of sun-damaged elderly patients. Histologic findings on routine hematoxylin and eosin staining reveal spindle-shaped, large, and pleomorphic tumor cells throughout the dermis...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Siegrid S Yu
No abstract text is available yet for this article.
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Justin L Jia, Danielle J Polin, Kavita Y Sarin
Emerging technology is fundamentally changing how individuals interact with the health care system. Web-based searches, mobile applications, social media, and directto- consumer genetic testing companies are facilitating information exchange at a higher rate than ever before, creating a macroscopic shift in the mechanisms by which individuals seek health information. The visual nature of skin disease enables individuals to browse, share, and search based on images, adding another dimension to how dermatological information is transferred...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Tracy Petrie, Ravikant Samatham, Shaun M Goodyear, Dan E Webster, Sancy A Leachman
Advancements in smartphone technologies and the use of specialized health care applications offer an exciting new era to promote melanoma awareness to the public and improve education and prevention strategies. These applications also afford an opportunity to power meaningful research aimed at improving image diagnostics and early melanoma detection. Here, we summarize our experience associated with developing and managing the implementation of MoleMapperâ„¢, a research-based application that not only provides an efficient way for users to digitally track images of moles and facilitate skin self-examinations but also provides a platform to crowdsource research participants and the curation of mole images in efforts to advance melanoma research...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Felipe Giuste, Juan Carlos Vizcarra, David A Gutman
In this chapter, we present the use of whole slide imaging (WSI) and dermoscopy in the field of dermatology. Image digitization has allowed for increasing computer-assisted clinical decision-making. An introduction to common digital imaging data sources such as WSI and dermoscopy is provided. We also review some commonly used image quantification methods and their potential applications in dermatology. Finally, we review how machine learning approaches utilize novel large dermatology image datasets.
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Veronica Rotemberg, Allan Halpern, Steven Dusza, Noel Cf Codella
In the past decade, machine learning and artificial intelligence have made significant advancements in pattern analysis, including speech and natural language processing, image recognition, object detection, facial recognition, and action categorization. Indeed, in many of these applications, accuracy has reached or exceeded human levels of performance. Subsequently, a multitude of studies have begun to examine the application of these technologies to health care, and in particular, medical image analysis. Perhaps the most difficult subdomain involves skin imaging because of the lack of standards around imaging hardware, technique, color, and lighting conditions...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Daniel I Schlessinger, Guillaume Chhor, Olivier Gevaert, Susan M Swetter, Justin Ko, Roberto A Novoa
The application of artificial intelligence (AI) to medicine has considerable potential within dermatology, where the majority of diagnoses are based on visual pattern recognition. Opportunities for AI in dermatology include the potential to automate repetitive tasks; optimize time-consuming tasks; extend limited medical resources; improve interobserver reliability issues; and expand the diagnostic toolbox of dermatologists. To achieve the full potential of AI, however, developers must aim to create algorithms representing diverse patient populations; ensure algorithm output is ultimately interpretable; validate algorithm performance prospectively; preserve human-patient interaction when necessary; and demonstrate validity in the eyes of regulatory bodies...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Andrew J Park, Mario K Maruther, Robert A Swerlick
The influences of information technology have touched almost all aspects of our lives, and health care delivery has been no exception. Law, policy, and regulation have driven the adoption of electronic medical records, particularly over the past decade, driving fundamental changes to the practice of medicine in general and dermatology in particular. This article reviews the history of these changes, the regulations that drove these changes, the intended and unintended consequences of these initiatives, and our insights into the appropriate roles for policy and regulation to drive positive change...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Roxana Daneshjou, Rachel Huddart, Teri E Klein, Russ B Altman
Pharmacogenomics aims to associate human genetic variability with differences in drug phenotypes in order to tailor drug treatment to individual patients. The massive amount of genetic data generated from large cohorts of patients with variable drug phenotypes have led to advances in this field. Understanding the application of pharmacogenomics in dermatology could inform clinical practice and provide insight for future research. The Pharmacogenomics Knowledge Base and the Clinical Pharmacogenetics Implementation Consortium are among the resources to help clinicians and researchers navigate the many gene-drug associations that have already been discovered...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Miroslav Blumenberg
Skinomics is a field of bioinformatics applied specifically to skin biology and, by extension, to dermatology. Skinomics has been expanding into extensive genome-wide association studies, eg, of psoriasis, proteomics, lipidomics, metabolomics, metagenomics, and the studies of the microbiome. Here, the current state of the field of transcriptomics is reviewed, including the studies of the gene expression in human skin under several healthy and disease conditions. Specifically, transcriptional studies of epidermal differentiation, skin aging, effects of cytokines, inflammation with emphases on psoriasis and atopic dermatitis, and wound healing are reviewed...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Jason E Parad, Wilson Liao
Bioinformatics uses computationally intensive approaches to make sense of complex biological data sets. Here we review the role of bioinformatics in 3 areas of biology: genetics, transcriptomics, and microbiomics. Examples of bioinformatics in each area are given with respect to psoriasis and psoriatic arthritis, related inflammatory disorders at the forefront of bioinformatic research in dermatology. While bioinformatic technologies and analyses have traditionally been developed and deployed in siloes, the field of integrative omics is on the horizon...
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Roberto Andres Novoa
No abstract text is available yet for this article.
March 1, 2019: Seminars in Cutaneous Medicine and Surgery
Eric W Baum, Sergio Schwartzman
Psoriasis is a chronic skin condition that is associated with several comorbidities and co-manifestations that reduce patient quality of life. Psoriatic arthritis (PsA) is a form of spondyloarthritis that is associated with psoriasis and typically involves peripheral disease, axial disease, enthesitis, dactylitis, and skin and nail lesions. Psoriatic arthritis is associated with a substantial psychosocial and functional burden and can lead to irreversible joint damage if left untreated. Early and accurate diagnosis of PsA is critical...
December 2018: Seminars in Cutaneous Medicine and Surgery
Amanda K Suggs, Selina S Hamill, Paul M Friedman
Melasma is a common, acquired, chronic cutaneous pigment disorder that is often difficult to treat and has a high recurrence rate. The goal of a melasma treatment regimen is to decrease pigment production and increase elimination. Topical tyrosinase inhibitors block melanin synthesis and thereby reduce pigment production. Peels and laserand light-based devices increase melanin elimination. A multimodality treatment approach targeting both pigment production and elimination is necessary to achieve equilibrium and disease remission...
December 2018: Seminars in Cutaneous Medicine and Surgery
Laura Schilling, Nazanin Saedi
Many medical conditions can cross over the territories of various specialties. These conditions may benefit from, or even require, a multidisciplinary approach. While ideally this leads to a collaborative and coveted patient-centered care model, it can also give rise to competitive turf wars. A popular topic that has entered the turf wars is vaginal rejuvenation. Vaginal rejuvenation through light- and energy-based devices is a rapidly expanding field, quickly gaining the attention of dermatologists and gynecologists alike...
December 2018: Seminars in Cutaneous Medicine and Surgery
Misha D Miller
No abstract text is available yet for this article.
December 2018: Seminars in Cutaneous Medicine and Surgery
Min-Wei Christine Lee
Dermatologists were the pioneers in the development of laser technology and have the most experience using these lasers to treat the external genitalia for many cutaneous disorders. Dermatologists who have experience and expertise using lasers and devices, are already using them to treat the external genitalia, and are comfortable performing female gynecologic exams may want to explore the wide range of options that are available to treat the functional and aesthetic needs of the female population. Dermatologists should work with obstetricians and gynecologists to ensure that patients are proper candidates for the procedures...
December 2018: Seminars in Cutaneous Medicine and Surgery
Lauren Meshkov Bonati, Mona Sadeghpour, Nicola A Quatrano
No abstract text is available yet for this article.
December 2018: Seminars in Cutaneous Medicine and Surgery
Sara Hogan, Mara Weinstein Velez, Michael S Kaminer
Cellulite is a common dermatologic condition and frequent cause of cosmetic concern among women. This paper aims to update what is known about the pathogenesis of cellulite and reviews targeted treatment modalities that address its underlying components of microvascular dysfunction, endocrine-mediated inflammation, and connective tissue fibrosclerosis.
December 2018: Seminars in Cutaneous Medicine and Surgery
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