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Introduction: Chronic ulcers significantly burden healthcare systems, requiring precise measurement and assessment for effective treatment. Traditional methods, such as manual segmentation, are time-consuming and error-prone. This review evaluates the potential of artificial intelligence AI-powered mobile apps for automated ulcer segmentation and their application in clinical settings. Methods: A comprehensive literature search was conducted across PubMed, CINAHL, Cochrane, and Google Scholar databases. The review focused on mobile apps that use fully automatic AI algorithms for wound segmentation. Apps requiring additional hardware or needing more technical documentation were excluded. Vital technological features, clinical validation, and usability were analysed. Results: Ten mobile apps were identified, showing varying levels of segmentation accuracy and clinical validation. However, many apps did not publish sufficient information on the segmentation methods or algorithms used, and most lacked details on the databases employed for training their AI models. Additionally, several apps were unavailable in public repositories, limiting their accessibility and independent evaluation. These factors challenge their integration into clinical practice despite promising preliminary results. Discussion: AI-powered mobile apps offer significant potential for improving wound care by enhancing diagnostic accuracy and reducing the burden on healthcare professionals. Nonetheless, the lack of transparency regarding segmentation techniques, unpublished databases, and the limited availability of many apps in public repositories remain substantial barriers to widespread clinical adoption. Conclusions: AI-driven mobile apps for ulcer segmentation could revolutionise chronic wound management. However, overcoming limitations related to transparency, data availability, and accessibility is essential for their successful integration into healthcare systems. [ABSTRACT FROM AUTHOR]

Appropriate wound management shortens the healing times and reduces the management costs, benefiting the patient in physical terms and potentially reducing the healthcare system's economic burden. Among the instrumental measurement methods, the image analysis of a wound area is becoming one of the cornerstones of chronic ulcer management. Our study aim is to develop a solid AI method based on a convolutional neural network to segment the wounds efficiently to make the work of the physician more efficient, and subsequently, to lay the foundations for the further development of more in-depth analyses of ulcer characteristics. In this work, we introduce a fully automated model for identifying and segmenting wound areas which can completely automatize the clinical wound severity assessment starting from images acquired from smartphones. This method is based on an active semi-supervised learning training of a convolutional neural network model. In our work, we tested the robustness of our method against a wide range of natural images acquired in different light conditions and image expositions. We collected the images using an ad hoc developed app and saved them in a database which we then used for AI training. We then tested different CNN architectures to develop a balanced model, which we finally validated with a public dataset. We used a dataset of images acquired during clinical practice and built an annotated wound image dataset consisting of 1564 ulcer images from 474 patients. Only a small part of this large amount of data was manually annotated by experts (ground truth). A multi-step, active, semi-supervised training procedure was applied to improve the segmentation performances of the model. The developed training strategy mimics a continuous learning approach and provides a viable alternative for further medical applications. We tested the efficiency of our model against other public datasets, proving its robustness. The efficiency of the transfer learning showed that after less than 50 epochs, the model achieved a stable DSC that was greater than 0.95. The proposed active semi-supervised learning strategy could allow us to obtain an efficient segmentation method, thereby facilitating the work of the clinician by reducing their working times to achieve the measurements. Finally, the robustness of our pipeline confirms its possible usage in clinical practice as a reliable decision support system for clinicians. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical efficacy of a hypericum and neem oil dressing, Primary Wound Dressing [ONE] (1PWD) (Kerecis AG, Switzerland), in a patient population with dehiscence of surgical wounds with critical colonisation/infection. Efficacy was defined as resolution of inflammatory/infective symptoms. Method: A randomised, controlled, single-blinded, parallel-arms phase III study was conducted comparing the experimental medication to silver-based dressings. All patients were evaluated at enrolment, on days 7, 14, 21 and 28. Improvement of inflammatory/infective symptoms was measured by detecting seven items of the Bates–Jensen Wound Assessment Tool (BWAT). Pain was assessed using the Numeric Rating Scale (NRS). Results: The study enrolled 99 patients. Follow-up was completed in 49 patients in the experimental group and 48 patients in the control group. Overall BWAT evaluation demonstrated similar outcomes between the groups: t=0.23, p-value=0.81, 95% confidence interval (CI): –13.3–10.8. Furthermore, when evaluating the seven items of the BWAT relating to inflammatory signs, there was not a significant difference between the groups: t=0.38, p=0.35, 95% CI: –2.8–2.7. However, when an analysis using the NRS pain scale was performed, a statistically significant pain reduction was demonstrated in favour of the experimental group: t=7.8, p<0.0001, 95% CI: 2.918–4.8819. Conclusion: This randomised controlled trial confirmed the efficacy of 1PWD, an investigational product, in the management of surgical dehiscence with critical colonisation or infection, with the added benefit of significant pain reduction when compared with a silver-based dressing. [ABSTRACT FROM AUTHOR]

This article presents the case of a non-HIV-positive patient who contemporaneously suffered from Kaposi's sarcoma and bullous pemphigoid. Kaposi's sarcoma is a rare low-grade vascular tumour associated with human herpes virus 8 infection, while bullous pemphigoid is the most common autoimmune subepidermal blistering disease in western countries. [ABSTRACT FROM AUTHOR]

Retronychia describes the proximal ingrowing of the nail plate. In the early stage, topical steroids are the gold standard therapy, while in the late stage surgical treatment is mandatory. We identified an intermediate severity stage of retronychia, where the topical treatment alone is ineffective and surgery is avoidable. Intralesional steroids turn the best treatment in these patients. A pilot study consisting of a 3‐month treatment period and 9‐month follow‐up time was designed to evaluate the treatment outcome to intralesional steroid injections in patients affected by the intermediate‐stage of toenail retronychia. The complete recovery of retronychia‐associated nail abnormalities was observed in 27/28 recruited patients at the end of the treatment phase. Paronychia, nail plate discoloration, proximal nail fold (PNF) elevation, and discharge were reduced (P <.01) after one steroid administration, while nail regrowth became significant after two sessions. No significant difference in terms of clinical outcome was found, while pain VAS score and intra‐operative pain evaluated with Wong‐Baker faces scale were higher in the female group (P <.01). Limitation Lack of control group of patients. Despite its temporary effect, the intralesional triamcinolone injection is an effective, cheap, and safe treatment especially for the intermediate stage of retronychia. [ABSTRACT FROM AUTHOR]

In this article, we report the sonographic features of vaccination granulomas in three children sensitized to aluminum. Although the recognition of the vaccination granuloma relies on the clinical examination, misdiagnosis is frequent, leading to distressful procedures or prolonged antibiotic administration. In all our cases, sonography revealed a teardrop‐shaped echogenic central structure, suggesting the deposition of aluminum crystals along the route of administration with consequent subcutaneous degenerative changes, and a surrounding hypoechoic cap, which reflects the changeable inflammatory reaction and the granuloma formation. [ABSTRACT FROM AUTHOR]

Although nodular vasculitis (NV) and erythema induratum (Bazin's disease) have historically been considered synonymous, the terms erythema induratum and Bazin's disease are mainly used for cases of NV that are associated with I M i . I tuberculosis i infection, but the usage of the terms NV and erythema induratum still varies worldwide.1 Possible causes of NV include infections and neoplastic and autoimmune disorders, while drug-induced has been rarely reported. [Extracted from the article]

The article presents a case study of a 82-year-old man showed up with a painful chronic ulcer located on the second toe of his left foot,. It notes diagnosis of Blue toe syndrome (BTS) caused by peripheral embolism from the abdominal aortic aneurysm; and also mentions that anamnestic data of trauma and foreign body retention could lead to a wrong diagnosis.