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Artificial intelligence (AI), a field of computer science, aims at simulating human intelligence with computers. Though AI has surpassed dermatologists in skin cancer detection, it still lags behind various other specialties like radiologists in broader adoption. Newer AI applications are becoming increasingly accessible. AI plays a role in various areas, such as medical image recognition, auxiliary diagnosis, and drug research and development. Dermatology has a prime position in implementation of AI in medical research due to its larger clinical, dermoscopic, and histopathological image database. Hence, it is crucial to consider the potential and emerging role of AI in dermatology clinical practice. There are already studies focusing on various skin disorders like cancer, psoriasis, atopic dermatitis, etc. This article provides an overview of AI and its applications in hair and nail disorders at present and its future potential. J Drugs Dermatol. 2022;21(10):1049-1052. doi:10.36849/JDD.6519.

Erythrodermic variants of cutaneous T-cell lymphoma (CTLC) are one of the case of erythroderma. The aim of the study was to assess the value of scalp dermoscopy in differentiation between erythrodermic CTCL, psoriasis, and atopic dermatitis. A total of 76 patients were included into the study (16 patients with erythrodermic CTCL, 20 patients with psoriatic erythroderma, 20 with erythrodermic atopic dermatitis, and 20 healthy volunteers). The most common trichoscopic features of erythrodermic CTCL were: numerous pili torti, numerous broken hairs, white thick interfollicular bands, and patchy hyperpigmentation of the background. They were observed in 81% (13/16), 75% (12/16), 56% (9/16), and 37.5% (6/16) of patients with CTCL, respectively (p < 0.001). Other specific features of erythrodermic CTCL were 8-shaped hairs (19%; 3/16) and visible anagen bulbs (12.5%; 2/16) (p < 0.05 and p = 0.052, respectively). The most common vascular pattern of erythrodermic CTCL was perifollicular arrangement of glomerular (50%; 8/16; p < 0.001) or linear vessels (31%; 5/16; p < 0.05). Follicular spicules-like scaling was pathognomonic for erythrodermic CTCL (12%, 2/16) although its presence did not reach statistical significance (p = 0.052). In conclusion, the characteristic trichoscopic findings of erythrodermic CTCL are numerous pili torti, eight-shaped hairs, thick white interfollicular bands, color heterogeneity of the background and perifollicular arrangement of vessels.

Background: The diagnosis of a patient with erythroderma may be difficult and sometimes pose a challenge for both dermatologist and pathologist. The role of dermoscopy in this area seems to be poorly investigated. There are only a few reports, with limited number of patients, describing dermoscopic features in erythroderma of various origins. To the best of our knowledge, none of the previous studies had included trichoscopic examination., Objectives: Analysis of dermoscopic and trichoscopic patterns in series of patients with erythroderma., Methods: We retrospectively analysed 28 adult patients who presented with erythroderma between May 2016 and August 2020. Demographic data, disease course and duration, previous treatment, as well as dermoscopic and trichoscopic features were analysed., Results: There were 9 patients (32.1%) with the diagnosis of mycosis fungoides, 8 patients (28.5%) with atopic dermatitis, 3 patients (10.5%) with Sézary syndrome and 3 patients (10.5%) with pityriasis rubra pilaris. The others were diagnosed with allergic eczema (n = 1; 3.6%), dermatomyositis sine myositis (n = 1; 3.6%), psoriasis (n = 1; 3.6%), actinic reticuloid (n = 1; 3.6%) and crusted scabies (n = 1; 3.6%). Characteristic dermoscopic/trichoscopic patterns have been observed in erythroderma due to crusted scabies, psoriasis, dermatomyositis sine myositis, Sézary syndrome and pityriasis rubra pilaris. Differentiation of mycosis fungoides and long-standing atopic dermatitis based on dermoscopy is difficult, as the overlap of vessel morphology, background colour and scale colour exists. Similarly, differentiation between AD and AE based on dermoscopy/trichoscopy seems to be impossible, and clinical background is crucial., Conclusion: Dermoscopy and trichoscopy seem to provide additional clues in the assessment of erythrodermic patient. Depending on the underlying cause, trichoscopy or dermoscopy may be more useful., (© 2020 European Academy of Dermatology and Venereology.)

Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however, the early-stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries to comprehensively highlight the various diagnostic, therapeutic, and outcome aspects of scalp melanomas. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till May 2020 and reference lists of respective articles. Only articles published in English language were included., (© 2020 Wiley Periodicals LLC.)

Background: In-vivo reflectance confocal microscopy (RCM) plays an increasingly important role in differential diagnosis of melanoma. The aim of the study was to assess typical confocal features of thin (≤1 mm according to Breslow index) versus thick (>1mm) melanomas., Methods: Thirty patients with histopathologically confirmed cutaneous melanoma were included in the study. RCM was performed with Vivascope equipment prior to excision. Fifteen melanomas were thin (Breslow thickness ≤1 mm) and 15 were thick (Breslow thickness >1 mm)., Results: In the RCM examination, the following features were more frequently observed in thin compared to thick melanomas: edged papillae (26.7% vs. 0%, P=0.032) and areas with honeycomb or cobblestone pattern (33.3% vs. 6.7%, P=0.068). Both features are present in benign melanocytic lesions, so in melanoma are good prognostic factors. The group of thick melanomas compared to the group of thin melanomas in the RCM images presented with greater frequency of roundish cells (100% vs. 40%, P=0.001), non-edged papillae (100% vs. 60%, P=0.006), numerous pagetoid cells (73.3% vs. 33.3%, P=0.028), numerous atypical cells at dermal-epidermal junction (53.3% vs. 20%, P=0.058) and epidermal disarray (93.3% vs. 66.7%, P=0.068)., Conclusions: Non-invasive imaging methods helps in deepening of knowledge about the evolution and biology of melanoma. The most characteristic features for thin melanomas in confocal examination are: fragments of cobblestone or honeycomb pattern and edged papillae (as good prognostic factors). The features of thick melanomas in RCM examination are: roundish cells, non-edged papillae, numerous pagetoid cells at dermal-epidermal junction and epidermal disarray.

Bowen's disease, named after John Templeton Bowen, also known as squamous cell carcinoma in situ is a type of non-melanocytic intraepidermal malignancy. It is estimated that in general population around 3% to 5% of Bowen's disease transform into invasive squamous cell cancer. Dermoscopy aims in the identification of the Bowen's disease. The most typical dermoscopic features of Bowen's disease include glomerular vessels and scaly surface. Although dermoscopy of Bowen's disease has been well established other skin lesions may present similar or identical structures in dermoscpic images leading to differential diagnosis dilemmas. Histopathological confirmation should be obtained prior the treatment of suspected cases of Bowen's disease in order to avoid a misdiagnosis.

Dermoscopy is widely used in dermatological practice. The method increases the accuracy of basal cell carcinoma (BCC) detection. Pigmented and nonpigmented variants of basal cell carcinoma present different dermoscopic features. Specific dermoscopy criteria have been recognized in different subtypes of BCC. Differentiation of superficial BCC from other subtypes is the most important issue, as it may determine further management decisions., (© 2018 British Association of Dermatologists.)

Squamous cell carcinoma of the skin is the second most common cutaneous malignancy. Despite various available treatment methods and advances in noninvasive diagnostic techniques, the incidence of metastatic cutaneous squamous cell carcinoma is rising. Deficiency in effective preventive or treatment methods of transformed keratinocytes leads to necessity of searching for new anticancer agents. The present study aims to evaluate the possibility of using wool hydrolysates as such agents. Commercially available compounds such as 5-fluorouracil, ingenol mebutate, diclofenac sodium salt were also used in this study. The process of wool degradation was based on chemical pre-activation and enzymatic digestion of wool. The effect of mentioned compounds on cell viability of squamous carcinoma cell line and healthy keratinocytes was evaluated. The obtained data show a significantly stronger effect of selected wool hydrolysates compared to commercial compounds (p<0.05) on viability of cells. The wool hydrolysates decreased squamous cell carcinoma cells viability by up to 67% comparing to untreated cells. These results indicate bioactive properties of wool hydrolysates, which affect the viability of squamous carcinoma cells and decrease their number. We hypothesize that these agents may be used topically for treatment of transformed keratinocytes in actinic keratosis and invasive squamous skin cancer in humans.

Aim: The aim of our study was to assess the usefulness of high frequency ultrasonography in the diagnosis of melanoma., Methods: We examined 84 patients with suspicious melanocytic skin lesions, including 19 cases of melanoma. In vivo high-resolution ultrasonography (30 MHz) was performed prior to excision., Results: In ultrasound scans early melanomas presented as flat oval or fusiform shaped structures and were clearly demarcated, while advanced melanomas were characterized by a roundish shape with less distinct borders. The ultrasonographic thickness of in situ melanomas ranged from 0.02 to 0.85 mm. In the case of invasive tumors, the mean thickness evaluated by high frequency ultrasonography was 10.7% higher compared to the Breslow Score (1.44±0.8 mm and 1.3±0.88 mm, respectively). In all melanomas of Breslow Score of 1 mm or more ultrasound also indicated a Breslow Score of 1 mm or more., Conclusion: High frequency ultrasound examination has limited value in differential diagnosis of melanoma, but it gives a clear picture of the size and depth of the tumor. The method should be used as a complementary method (after dermoscopy and, where applicable, reflectance confocal microscopy) in preoperative evaluation of the tumor. In some cases of locally advanced melanoma, ultrasound examination may allow to reduce the number of surgical procedures and favor the decision of a one-time surgical treatment (removal of primary tumor and sentinel lymph node biopsy at the same time).

Importance: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical., Objective: To determine the dermoscopy features of NM., Design: Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes., Setting: Predominantly hospital-based clinics from 5 continents., Main Outcome Measures: Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma., Results: Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM., Conclusions and Relevance: When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.

Beta-carotene, administered orally to mice, caused a decrease in angiogenesis evoked by HPV-transformed tumorigenic cell lines (SKv-t, HeLa). It did not affect angiogenesis induced by the non-tumorigenic SKv (not-t) cell line, and increased lymphocyte-induced immune angiogenesis. We suggest that the anti-cancerogenic effect of beta-carotene may be due, at least in part, to its inhibitory effect on formation of new blood vessels within the tumour mass.

The production of interleukin-1 (IL-1) and interleukin-1 inhibitor by keratinocytes isolated from the skin of epidermodysplasia verruciformis patients was studied. Keratinocytes from uninvolved skin of patients with most pronounced neoplastic lesions produced large amounts of an IL-1 inhibitor (20-40 kD). Keratinocytes from preneoplastic lesions showed no significant differences compared to cells from healthy donors but their production of IL-1 after UVB irradiation was increased.