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Dermatoses are highly intuitive, and disease information can be obtained from a large number of visual images. Artificial intelligence( Ai) has made progress by leaps and bounds in the field of visual image processing in recent years. The application of Ai has become a hot topic for dermatologists. The incidence rate of skin tumors is increasing, while the diagnosis of skin tumors is mainly through visual diagnosis, such as dermoscopy and pathological examination, which are difficult to make diagnosis in a timely manner. Based on skin imaging technology, Ai does not only reduce doctors' workload and improve the early detection rate, but also improves the diagnostic accuracy and sensitivity of skin diseases. This review summarizes the research status of Ai in the auxiliary diagnosis of skin tumors in skin imaging and pathology, to provide reference for clinical application and future research of Ai in dermatology. [ABSTRACT FROM AUTHOR]

Skin conditions associated with Tenacibaculum spp. constitute a significant threat to the health and welfare of sea‐farmed Atlantic salmon (Salmo salar L.) in Norway. Fifteen presumptive tenacibaculosis outbreaks distributed along the Norwegian coast during the late winter and spring of 2018 were investigated. Bacteriological culture confirmed the presence of Tenacibaculum spp. Seventy‐six isolates cultured from individual fish were selected and subjected to whole‐genome sequencing and MALDI‐TOF MS analysis. Average nucleotide identity and MALDI‐TOF analyses confirmed the presence of T. finnmarkense and T. dicentrarchi, with further division of T. finnmarkense into genomovars (gv.) finnmarkense and ulcerans. Core genome multilocus sequence typing (cgMLST) and single‐nucleotide polymorphism (SNP) analyses identified the presence of a genetically conserved cluster of gv. finnmarkense isolates against a background of relatively genetically diverse gv. finnmarkense and gv. ulcerans isolates in 13 of the 15 studied cases. This clustering strongly suggests a link between T. finnmarkense gv. finnmarkense and development of clinical tenacibaculosis in sea‐farmed Norwegian salmon in the late winter and spring. Analysis of 25 Tenacibaculum isolates collected during the spring of 2019 from similar cases identified a similar distribution of genotypes. Low water temperatures were common to all cases, and most incidences involved relatively small fish shortly after sea transfer, suggesting that these fish are particularly predisposed to Tenacibaculum infection. [ABSTRACT FROM AUTHOR]

Autoimmune skin diseases are a group of disorders that arise due to the dysregulated immune system attacking self-antigens, causing multiple tissue and organ lesions. With disease progression, the physical and psychological health of patients may be seriously damaged. High-frequency ultrasound is non-invasive, reproducible, and suitable for visualizing the fine structure of external organs. The usage of high-frequency ultrasound has increased in recent years in the auxiliary diagnosis and monitoring of various skin diseases; it serves as a promising tool for dermatological disease assessment. This review summarizes the characteristics of high-frequency ultrasound imaging in common autoimmune skin diseases, including systemic lupus erythematosus, scleroderma, psoriasis, dermatomyositis, and pemphigus/pemphigoid. The objective of this review is to provide new ideas and strategies for dermatologists to diagnose and track the prognosis of autoimmune skin diseases. [ABSTRACT FROM AUTHOR]

Necrobiosis lipoidica‐like lesions, in known cases of sarcoidosis, can be considered as a member of the broad spectrum of histologic changes in sarcoidosis. [ABSTRACT FROM AUTHOR]

Objectives: The impact of malpractice concerns on pathologists' use of defensive medicine and interpretations of melanocytic skin lesions (MSLs) is unknown.Methods: A total of 207 pathologists interpreting MSLs responded to a survey about past involvement in malpractice litigation, influence of malpractice concerns on diagnosis, and use of assurance behaviors (defensive medicine) to alleviate malpractice concerns. Assurance behaviors included requesting second opinions, additional slides, additional sampling, and ordering specialized tests.Results: Of the pathologists, 27.5% reported that malpractice concerns influenced them toward a more severe MSL diagnosis. Nearly all (95.2%) pathologists reported practicing at least one assurance behavior due to malpractice concerns, and this practice was associated with being influenced toward a more severe MSL diagnosis (odds ratio, 2.72; 95% confidence interval, 1.41-5.26).Conclusions: One of four US skin pathologists upgrade MSL diagnosis due to malpractice concerns, and nearly all practice assurance behaviors. Assurance behaviors are associated with rendering a more severe MSL diagnosis. [ABSTRACT FROM AUTHOR]

Abstract: Background: Human skin is composed of the superimposition of tissue layers of various thicknesses and components. Histological staining of skin sections is the benchmark approach to analyse the organization and integrity of human skin biopsies; however, this approach does not allow 3D tissue visualization. Alternatively, confocal or two‐photon microscopy is an effective approach to perform fluorescent‐based 3D imaging. However, owing to light scattering, these methods display limited light penetration in depth. The objectives of this study were therefore to combine optical clearing and light‐sheet fluorescence microscopy (LSFM) to perform in‐depth optical sectioning of 5 mm‐thick human skin biopsies and generate 3D images of entire human skin biopsies. Materials and Methods: A benzyl alcohol and benzyl benzoate solution was used to successfully optically clear entire formalin fixed human skin biopsies, making them transparent. In‐depth optical sectioning was performed with LSFM on the basis of tissue‐autofluorescence observations. 3D image analysis of optical sections generated with LSFM was performed by using the Amira® software. Results: This new approach allowed us to observe in situ the different layers and compartments of human skin, such as the stratum corneum, the dermis and epidermal appendages. With this approach, we easily performed 3D reconstruction to visualise an entire human skin biopsy. Finally, we demonstrated that this method is useful to visualise and quantify histological anomalies, such as epidermal hyperplasia. Conclusion: The combination of optical clearing and LSFM has new applications in dermatology and dermatological research by allowing 3D visualization and analysis of whole human skin biopsies. [ABSTRACT FROM AUTHOR]

Background Skin is commonly affected by extraintestinal manifestations of inflammatory bowel disease ( IBD), but a controlled, systematic histopathologic analysis of cutaneous lesions is lacking. Methods A total of 4147 classified IBD [Crohn disease ( CD) or ulcerative colitis ( UC); 2000-2013] resections were cross referenced with skin biopsies. Associated non-neoplastic skin biopsies were categorized by basic reaction pattern and neutrophilic vs. granulomatous. Results Of 4147 patients, 133 had non-neoplastic skin biopsies (106/2772, 3.7% CD; 27/1375, 2% UC). Overall, miscellaneous > nodular and diffuse dermal > spongiotic dermatitides were most common (31.6, 21.8 and 15%, respectively). Spongiotic dermatitis, vasculitis, panniculitis and infections showed CD bias. Psoriasiform, perivascular, nodular/diffuse dermal and bullous categories, as well as neutrophilic processes, showed UC bias. Leukocytoclastic vasculitis, panniculitis and pyoderma gangrenosum were exclusive to CD and psoriasis vulgaris to UC. One CD patient had inverse psoriasis. Conclusions Our findings show the majority of dermatopathologic manifestations of IBD to have overlapping histology or pathophysiology to intestinal disease; with a wider spectrum of histologic patterns than typically discussed. Diseases 'classically' associated with IBD are relatively rare biopsy specimens. Cutaneous manifestations of IBD are more common in CD than UC and should be considered when reviewing an unexplained skin lesion in an IBD patient. [ABSTRACT FROM AUTHOR]

Objective. To determine how well skin symptoms considered specific to SSc are captured by patient reported outcomes currently used for assessing patients with SSc, the SHAQ, or skin disease, the Skindex-29; and how well these symptoms correlate with the extent of skin disease on physical exam and skin pathology. Methods. SSc patients completed the scleroderma modification of the Health Assessment Questionnaire (SHAQ), Skindex-29 and a Skin Symptom Assessment questionnaire developed for this study. Correlations were assessed between the Skin Symptom Assessment and SHAQ, Skindex-29, modified Rodnan skin score, and skin pathological features including myofibroblast staining completed on the same date. Results. Tight, hard and rigid/stiff skin symptoms correlated moderately highly with the modified Rodnan skin score (r =0.445, P = 0.0008; r = 0.486, P = 0.0002; and r = 0.488, P = 0.0002, respectively). Tight skin symptoms correlated moderately with myofibroblast infiltration (r = 0.544, P = 0.0023) and hyalinized collagen (r = 0.442, P = 0.0164), while both hard and rigid/stiff skin correlated moderately with inflammation (r = 0.401, P = 0.0310 and r=0.513, P = 0.0045), myofibroblast infiltration(r = 0.480, P = 0.0084 and r = 0.527, P = 0.0033) and hyalinized collagen (r = 0.453, P = 0.0137 and r= 0.478, P = 0.0087), while the SHAQ was not found to correlate with any of these pathological changes. In contrast, painful skin symptoms correlated moderately with the SHAQ (r = 0.413, P = 0.0073), and with the three domains of Skindex-29: Symptoms, Emotions and Functioning. Skindex-29 indicates that dcSSc patient skin symptoms are nearly as severe as those of patients with psoriasis or atopic dermatitis. Conclusion. Patient reported skin symptoms correlate with clinical and pathological measures in the skin. A validated patient reported skin symptom instrument might considerably improve evaluation of SSc skin disease. [ABSTRACT FROM AUTHOR]

Whereas our understanding of the skin immune system has increased exponentially in recent years, the role of B cells in cutaneous immunity remains poorly defined. Recent studies have revealed the presence of B cells within lymphocytic infiltrates in chronic inflammatory skin diseases and cutaneous malignancies including melanoma, and have examined their functional significance in these settings. We review these findings and discuss them in the context of the current understanding of the role of B cells in normal skin physiology, as well as in both animal and human models of skin pathology. We integrate these findings into a model of cutaneous immunity wherein crosstalk between B cells and other skin-resident immune cells plays a central role in skin immune homeostasis. [ABSTRACT FROM AUTHOR]

Abstract: The development of Photodynamic Therapy (PDT) predictive models has become a valuable tool for an optimal treatment planning, monitoring and dosimetry adjustment. A few attempts have achieved a quite complete characterization of the complex photochemical and photophysical processes involved, even taking into account superficial fluorescence in the target tissue. The present work is devoted to the application of a predictive PDT model to obtain fluorescence tomography information during PDT when applied to a skin disease. The model takes into account the optical radiation distribution, a non-homogeneous topical photosensitizer distribution, the time dependent photochemical interaction and the photosensitizer fluorescence emission. The results show the spatial evolution of the photosensitizer fluorescence emission and the amount of singlet oxygen produced during PDT. The depth dependent photosensitizer fluorescence emission obtained is essential to estimate the spatial photosensitizer concentration and its degradation due to photobleaching. As a consequence the proposed approach could be used to predict the photosensitizer fluorescence tomographic measurements during PDT. The singlet oxygen prediction could also be employed as a valuable tool to predict the short term treatment outcome. [Copyright &y& Elsevier]

Abstract: Polyurethanes (PU) are polymers made with diisocyanates such as MDI (4,4′-methylene diphenyl diisocyanate) and TDI (2,4-toluene diisocyanate and 2,6-toluene diisocyanate). Investigations have been undertaken with MDI and TDI to assess dermal uptake and resulting systemic exposure. Absorption, distribution and excretion of MDI was studied in rats using a single dermal administration of 14C-MDI dissolved in acetone at nominal 165mg/kg body weight and 15mg/kg bw (4.0 and 0.4mg/cm2) and intradermal injection of 14C-MDI dissolved in corn oil at nominal 1.4mg/kgbw. Dermal absorption of 14C-MDI (at both doses) was low; at or below 1% of the applied dose. Considerable amounts of the applied radioactivity were found at the application site which could not be washed off. By intradermal administration of 14C-MDI approximately 66% of applied radioactivity remained at the application site with approximately 26% recovered in excreta, cage wash, tissues and carcass. The absorption, distribution and excretion of 2,4-TDI was studied in rats following a single dermal administration of radiolabelled 14C-2,4-TDI at nominal 350mg/kg body weight (12mg/cm2). Dermal absorption of 14C-2,4-TDI was at or below 1% of the applied dose. Considerable amounts of the applied radioactivity were found at the application site which could not be washed off. In summary the results show that dermal uptake of MDI and TDI is very low. Due to the chemical reactivity of isocyanates it can be expected that small amounts which might be absorbed will react with tissue constituents directly at the exposed skin area, or will be converted to adducts with biomacromolecules or to biologically inactive oligoureas. Overall it is concluded that, following dermal exposure to MDI and TDI, systemic exposures and resulting toxicity, other than the known sensitization, can be expected to be very low. In addition studies were performed with dermal application of unlabelled 2,4 and 2,6 TDI to check the availability and fate of this chemical on rat skin surface and to assess possible tissue damage. These experiments showed that unchanged test material can be detected on rat skin for up to 8h if not washed off. Dermal treatment with 2,4 or 2,6 TDI was associated with irritation with increased severity over a 48h period after washing with a decontaminant solution. [Copyright &y& Elsevier]

A common observation by clinicians who surgically excise skin pathology is the discrepancy between the measured size of the surgical specimen and that of the measurements reported by the examining pathologist. This discrepancy can often be the difference between whether, in the case of skin malignancies, the patient requires further wider excision, follow-up and, in cases where relevant, discharge. Could it therefore mean that patients are needlessly undergoing further excisions that could be avoided with more careful attention to specimen measurements and specimen ‘shrinkage,’ both surgically and pathologically? We measured the length and width of skin lesions excised pre- and post-operatively and compared these measurements with the reported histopathological measurements. A significant difference in length ( p = 0.000) and width ( p = 0.001) exists between pre- and post-operative measurements. No significant difference exists between post-operative and pathological measurements of length ( p = 0.072) or width ( p = 0.157). Length of time preserved in 10% formalin did not make a significant difference to specimen size ( p = 0.47). The aim of clinicians is to excise fully all skin pathology relevant for excision, ensuring sufficient clear margins to prevent potential recurrence whilst trying to sacrifice as little ‘normal’ tissue as possible in the process. What this study helps to highlight is the fact that clinicians cannot take for granted the reported measurements on the histopathology reports, upon which subsequent clinical management on reported excision margins are often based, without taking into consideration documented excision margins and subsequent allowance for significant specimen shrinkage, often resulting, for malignancies, in further wider excisions that are potentially disfiguring, and in the authors opinion, in more cases than currently thought, unnecessary. If one also factors in the fact that malignant cells shrink less than both benign tumours and, most importantly, normal skin, then subsequent reported pathological margins may be increasingly inaccurate as the excision margins may indeed be greater. [ABSTRACT FROM AUTHOR]