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[Objective] To investigate the dermoscopic, skin confocal laser scanning microscopic (CLSM) and histopathological features of Fox-Fordyce disease and to deepen the understanding of this disease. [Methods] Clinical, dermoscopic, skin CLSM and histopathological data of 3 patients with FFD were retrospectively analysed. [Results] All 3 patients were females, with mean age of 37 years and mean disease duration of 8.3 years (2 years to 20 years). Skin lesions were isolated firm pruritic follicular papules, sized 1~4 mm in diameter, in skin color, brown or yellowish, accompanied by hair thinning, on the large sweat gland-rich sites, including armpits in 2 cases, and both armpits and periumbilical area in one case. Dermoscopic features included flesh- to light brown-colored follicle-centered amorphous area with loss of dermatoglyphics and some hyperkeratotic plugs. Skin CLSM showed hyperkeratosis, parakeratosis, irregular thickening of the epidermis, dilated follicular orifices, follicular plugs, intercellular spongiotic edema in the follicular infundibulum, and scattered perivascular infiltration of inflammatory cells in the dermis. Histopathological changes included irregular thickening of the epidermis, mild hyperkeratosis and parakeratosis, follicular plugs, intercellular edema in the follicular infundibulum, infiltration of inflammatory cells and foam cells around the follicular infundibulum, mild dilatation of the sweat ducts, and sweat retention. All patients did not respond well to oral antihistamines, topical retinoic acid cream, and topical medium-strength glucocorticoid cream. [Conclusions] FFD is rare. Although a diagnosis can be made based on the special involved sites and characteristics of skin lesions in combination with dermoscopic, skin CLSM, and histopathological features, the treatment is still a challenge.

This article discusses the dermoscopic findings of pseudomyogenic hemangioendothelioma (PHE), a rarely metastasizing vascular tumor. The case report describes a 45-year-old man with PHE on his back, presenting as two painful lesions with unclear borders and ulcerated surfaces. Dermoscopic features included a red background, bright yellow structureless areas, scattered scales, white radial streaks, brown streaks in a "polygonal" shape, thick arborizing vessels, and clusters of small serpentine vessels. The article also provides information on the clinical features, histopathological characteristics, and treatment options for PHE. This study is the first to report on the dermoscopic features of PHE. [Extracted from the article]

Abstract Background The utilization of dermoscopic analysis is becoming increasingly critical for diagnosing skin diseases by physicians and even artificial intelligence. With the expansion of dermoscopy, its vocabulary has proliferated, but the rapid evolution of the vocabulary of dermoscopy without standardized control is counterproductive. We aimed to develop a domain-specific ontology to formally represent knowledge for certain dermoscopic features. Methods The first phase involved creating a fundamental-level ontology that covers the fundamental aspects and elements in describing visualizations, such as shapes and colors. The second phase involved creating a domain ontology that harnesses the fundamental-level ontology to formalize the definitions of dermoscopic metaphorical terms. Results The Dermoscopy Elements of Visuals Ontology (DEVO) contains 1047 classes, 47 object properties, and 16 data properties. It has a better semiotic score compared to similar ontologies of the same domain. Three human annotators also examined the consistency, complexity, and future application of the ontology. Conclusions The proposed ontology was able to harness the definitions of metaphoric terms by decomposing them into their visual elements. Future applications include providing education for trainees and diagnostic support for dermatologists, with the goal of generating responses to queries about dermoscopic features and integrating these features to diagnose skin diseases.

Background: Dermoscopy is a useful, noninvasive technique also used to assess sebaceous lesions in humans. Sebaceous hyperplasia, sebaceous adenoma and sebaceous epithelioma are common cutaneous lesions in dogs; however, their dermoscopic features have not been investigated. Hypothesis/Objectives: The objectives of this study are to describe the dermoscopic features of canine sebaceous lesions and to assess the interobserver agreement on dermoscopic parameters. Animals: Thirty‐four lesions excised from 17 client‐owned dogs, histologically confirmed as sebaceous proliferations, were included in this study. Materials and Methods: Sebaceous lesions were evaluated in vivo at ×10 magnification with a handheld dermoscope. Each dermoscopic image was assessed independently by two ECVD board‐certified veterinary referral clinicians and an ECVD resident. Results: Thirty sebaceous hyperplasias, two sebaceous adenomas and two sebaceous epitheliomas were included. Dermoscopically, most lesions (91%) had single or multiple, well‐defined, white‐yellowish structures composed of grouped ovoid areas (clods). Irregular linear and, less commonly, arborising vessels were detected at the periphery of the yellow lobular‐like structures in 93% of sebaceous hyperplasias and in 50% of neoplastic lesions. Erosions were seen in 6% of sebaceous hyperplasias and 50% of neoplastic lesions. Good interobserver agreement was found for white/yellowish clods (k = 0.75), yellow scales (k = 0.83), brown/grey dots (k = 0.80), erosions (k = 0.82) and red/brownish scales/crusts (k = 0.75). There was moderate agreement for fissures (k = 0.48) and vascular pattern (k = 0.51–0.53). Conclusions and Clinical Relevance: Dermoscopy represents a useful technique to assess sebaceous gland proliferations in dogs, as it is in humans. [ABSTRACT FROM AUTHOR]

Background: The utilization of dermoscopic analysis is becoming increasingly critical for diagnosing skin diseases by physicians and even artificial intelligence. With the expansion of dermoscopy, its vocabulary has proliferated, but the rapid evolution of the vocabulary of dermoscopy without standardized control is counterproductive. We aimed to develop a domain-specific ontology to formally represent knowledge for certain dermoscopic features. Methods: The first phase involved creating a fundamental-level ontology that covers the fundamental aspects and elements in describing visualizations, such as shapes and colors. The second phase involved creating a domain ontology that harnesses the fundamental-level ontology to formalize the definitions of dermoscopic metaphorical terms. Results: The Dermoscopy Elements of Visuals Ontology (DEVO) contains 1047 classes, 47 object properties, and 16 data properties. It has a better semiotic score compared to similar ontologies of the same domain. Three human annotators also examined the consistency, complexity, and future application of the ontology. Conclusions: The proposed ontology was able to harness the definitions of metaphoric terms by decomposing them into their visual elements. Future applications include providing education for trainees and diagnostic support for dermatologists, with the goal of generating responses to queries about dermoscopic features and integrating these features to diagnose skin diseases. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of nevoid melanoma (NeM) is often difficult because NeM closely resembles a common nevus clinically and histologically. Methods: A retrospective study was conducted on 110 patients diagnosed with and/or treated for primary nevoid melanoma at the Veneto Institute of Oncology and at the University Hospital of Padua from August 1999. Results: Mean Breslow thickness was of 1.4 mm. Sentinel lymph node biopsy was conducted in nearly half of the patients, and positivity was detected in 16.7% of them. Twenty-four clinical and 23 dermoscopic pictures were collected. Papular and macular lesions prevailed over nodular and plaque-type lesions. Different hues of brown, pink, and red color were most represented. Twenty nevus-like NeMs and four multicomponent-pattern NeMs were observed. The Most frequent dermoscopic patterns for nevus-like NeM were atypical pigmented reticulum, irregular globules and dots, and hyperpigmented blotches. Atypical vessels, asymmetric peripheric striae, blue-white veil, and areas of regression were less frequent and prevailed in multicomponent pattern NeM. A structureless pattern was also featured. Many patients in the series had multiple melanomas. However, none of them had numerous multiple nevoid melanomas. Conclusions: NeM should not be regarded as a separate biological entity from classical melanoma, and the same histological and clinical prognostic factors apply to NeM. Clinically and dermoscopically, it often resembles benign nevi, although some clues such as evolution and some dermoscopic patterns could suggest malignancy. Clinical suspicion might prove crucial to further pathological analysis and recognition.

To date, is yet to be elucidated whether the body location of cutaneous melanoma can significantly affect an early dermoscopic diagnosis and, consequently, if it can be regarded as a prognostic factor. To investigate the dermoscopic appearance of early melanomas (EMs) at different body sites; to test the ability of dermoscopists in recognizing specific dermoscopic features in EMs. A pool of 106 experienced dermoscopists evaluated the presence of 10 dermoscopic features assumed as suggestive of malignancy among 268 images of EMs with ambiguous appearance located at 16 body sites. According to 720 evaluations, EMs of the "upper extremities" showed a prevalence of early atypical lentiginous features. EMs of the "anterior trunk" exhibited the lower rate of recognition for all features. EMs of the "rear trunk" can be regarded as an intermediate area, showing high recognition rates of regression-related and chronic-traumatism-related features. [ABSTRACT FROM AUTHOR]

Acquired capillary malformation, also known as Fegeler syndrome, is a rare condition in adults, often linked to trauma. This report presents a 49-year-old male with a violaceous nodule on the fourth toe, clinically resembling Kaposi's sarcoma. Dermoscopic examination revealed surface scaling, thick intersecting white lines, and a rainbow pattern. Despite the clinical and dermoscopic similarities to Kaposi's sarcoma, histopathological evaluation confirmed a diagnosis of capillary malformation. The patient had no history of significant trauma or medication use, though minor trauma from foot placement may have contributed. This case emphasizes the importance of considering capillary malformation in the differential diagnosis of nodular vascular lesions on the foot., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Balan et al.)

Background: Dermoscopy is useful for the evaluation of juvenile xanthogranuloma (JXG). The classical "setting sun" pattern is characteristic of JXG, but its sensibility appears to be limited. An extensive description of other dermoscopic findings is not available in the literature. Objectives: The aim of this study was to valuate and describe the clinical and dermoscopic characteristics of a series of JXG cases. Methods: This is a retrospective descriptive study, including cases with histopathologic diagnosis of JXG, and the availability of clinical and dermoscopic images, assessed for the presence of dermoscopic features based on the available literature. Results: A total of 17 lesions were analyzed. 70.6% showed global symmetry, 35.3% presented the typical "setting sun" pattern. All lesions showed yellow-orange and/or pink-red structureless color. Other dermoscopic features were yellow globules (35.3%), shiny white streaks (23.5%), brown globules (17.6%), pale-brown network (11.8%), negative network (11.8%), erosion/ulceration (11.8%), rosettes (5.9%), and hemorrhage (5.9%). Scales were seen in 64.7% of patients. Vascular structures were observed in all the lesions, mostly in an irregular distribution (76.5%). The observed vessel types were dotted (52.9%), linear (52.9%), branching-arboriform (29.4%), comma-like (23.5%), hairpin-like (17.6%), globular (17.6%), coiled (11.8%), and milky-red globules (5.9%). Conclusions: Symmetry, yellow/orange-pink/red color, yellow globules, shiny white streaks, and irregularly distributed different types of vascular structures are the main dermoscopic features of JXG. This is the largest dermoscopic registry of JXG published to date. [ABSTRACT FROM AUTHOR]

Objective: To observe the dermoscopic features of psoriasis vulgaris in order to provide evidence basis for differential diagnosis of psoriasis. Methods: From January 2016 to February 2018, 86 cases of psoriasis, 11 of which confirmed by histopathology, were enrolled in this study. Common lesions included papule, erythema, plaque, scalp rash, palmoplantar rash, nail psoriasis and post-treatment lesions. The background color, scale color, scale distribution, vascular morphology, vascular arrangement and vascular orientation were observed using a dermoscope. Results: Typical dermoscopic features of psoriasis included bright red background, silver scales, scattered distribution of dotted vessels and small glomerular vessels arranged in a uniform pattern. These features varied with the types of lesions. Conclusions: Psoriasis displays typical dermoscopic features. Specific dermoscopic features of each type of lesion can facilitate clinical diagnosis of psoriasis.

Summary: Background: Few studies have evaluated facial photoaging by dermoscopy. Only one study has been performed among Egyptians. Objective: To study and compare the dermoscopic features of facial aging in males and females and to relate these features to clinical criteria. Methods: This study included 217 subjects divided into two groups; 117 males and 100 females. Each group was classified into three subgroups according to age. The dermoscopic features were reported according to dermoscopy photoaging scale (DPAS) criteria besides diffuse erythema and seborrheic keratosis and were related to significant clinical factors. Results: The most prominent DPAS features in males were yellowish discoloration, hypo‐hyperpigmented macules, superficial wrinkles, criss‐cross wrinkles, and deep wrinkles. The most prominent DPAS findings in females were yellow papules, hypo‐hyperpigmented macules, solar lentigo, and superficial wrinkles. A significant difference between males and females was detected regarding yellowish discoloration, white lines, hypo‐hyperpigmented macules, senile comedones, telangiectasia, all wrinkle types, and DPAS score besides diffuse erythema and seborrheic keratosis. The DPAS score and the dermoscopic features were more prominent with male gender, increase in age, sun exposure, Glogau's scale, and smoking and were detected early in skin phototypes II and III. Conclusion: We found a significant difference in various dermoscopic features in males compared to age‐matched females. Also, we detected increase in DPAS features and score with male gender, aging, sun exposure, Glogau's scale, and smoking. Therefore, dermoscopy is an objective technique that detects selectively photoaging in males and females that aids in proper choice of various targeted treatment modalities. [ABSTRACT FROM AUTHOR]

Background: Basal cell carcinoma of the skin (BCC, basalioma) is one of the most common malignant skin tumors. Dermoscopy is the most available today method of non-invasive diagnosis of skin tumors. Though, its usability is limited due to absence of prognostic dermoscopic criteria associated with different morphological variants of basalioma. Aim: To define dermoscopic features of different histological types of BCC. Materials and methods: 35 biopsy specimens from BCC lesions were evaluated. After clinical examination, superficial basalioma was diagnosed in 18 patients and nodular form in 17 patients. Results: Vascular structures were detected in 100% of cases. In patients with superficial multicentric type of basalioma, presence of all vascular types was a significant prognostic factor; predictive values of point- and spike-shaped vessels were 100 and 71.4%, respectively. Absence of point-shaped vessels and presence of other vascular types were associated with the prognosis of nodular basalioma. In patients with infiltrative type of basalioma, dendriform, tortuous and linear vessels in combination with short tiny teleangiectases and absence of spike-, comma-, point- or glome-like vessels had positive prognostic value. In patients with superficial multicentric and nodular types of basalioma, homogenous white and rose zones were most prevalent: in 53.8 and 57.1% of cases, respectively. In infiltrative type, this feature was typically absent (р

Although psoriatic nail lesions are small, they cause considerable discomfort for patients and adversely affect quality of life. Few studies have evaluated the dermoscopic features of psoriatic nails. The aim of this study was to clarify the dermoscopic features of nail psoriasis and identify those that reflect psoriatic activity. During biologic treatment of psoriasis, six patients with psoriatic nails twice underwent dermoscopic examination, with an interval of 17-42 weeks. We used the modified Nail Psoriasis Severity Index score and Psoriasis Area and Severity Index score to identify and assess dermoscopic features. We identified 10 dermoscopic findings, of which disappearance of diffuse scaling of the nail plate, transverse step-like notches and splinter hemorrhages of the nail bed, and appearance of erythematous borders of the onycholytic area were associated with improvement in Psoriasis Area and Severity Index score. Dermoscopy can detect nail changes during psoriasis treatment and should be used to evaluate treatment success. [ABSTRACT FROM AUTHOR]

Recently, convolutional neural networks have greatly outperformed previous systems based on handcrafted features once the size of public databases has increased. However, these algorithms learn feature representations that are difficult to interpret and analyse. On the other hand, experts require automatic systems to explain their decisions according to clinical criteria which, in the field of melanoma diagnosis, are related to the analysis of dermoscopic features found in the lesions. In recent years, the interpretability of deep networks has been explored using methods that obtain visual features highlighted by neurones or analyse activations to extract more useful information. Following the latter approach, this study proposes a system for melanoma diagnosis that explicitly incorporates dermoscopic feature segmentations into a diagnosis network through a channel modulation scheme. Modulation weights control the influence of the detected visual patterns based on the lesion content. As shown in the experimental section, our design not only improves the system performance on the ISIC 2016 (average AUC of 86.6% vs. 85.8%) and 2017 (average AUC of 94.0% vs. 93.8%) datasets, but also notably enhances the interpretability of the diagnosis, providing useful and intuitive cues to clinicians. [ABSTRACT FROM AUTHOR]

Background: The dermoscopic features of congenital melanocytic nevi (CMN) have recently been described, and some structures have been proposed as distinctive of these moles. Objective: The aim of our study was to evaluate the agreement between observers, i.e. the reproducibility, in the identification of these features. Method: Fifty-two CMN, randomly selected from 127 male subjects carrying at least 1 CMN, were examined by a 1st medium-experienced observer. The image recording was performed according to the dermoscopic patterns of the Consensus Net Meeting on Dermoscopy and to the features proposed for CMN by Seidenari et al. The presence/absence of these features was recorded in a specifically developed patient’s card, and the most typical dermoscopic features of the lesions were also photographed and observed again in this form by the same investigator and by a 2nd basic-experienced observer. The reproducibility of the dermoscopic features assessed directly and on photographs by the 1st observer (intraobserver agreement) and the agreement between the 1st and the 2nd observers judging nevi on photographs (interobserver agreement) were estimated by Cohen’s kappa statistics. Results: Intraobserver agreement was highly satisfactory for all the dermoscopic features, with the exception of focal thickening of network lines and follicles (satisfactory), and hyperpigmented areas and target vessels (fairly satisfactory), which were more frequently identified on Dermaphot pictures. Interobserver agreementwas highly satisfactory for network, globules/dots, blotches, focal hypopigmentation, skin furrow hypopigmentation and follicles; it was satisfactoryfor perifollicular hypopigmentation, vessels and target vessels, and barely satisfactory for focal thickening of network lines, target globules and hyperpigmented areas; finally, it was fairly satisfactory for target network. Conclusion: The identification of dermoscopic features of CMN seems to show a good reproducibility, with a satisfactory intra- and interobserver agreement. Other studies involving a higher number of experienced and less experienced observers are requested to confirm these results. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Dermoscopic features of congenital melanocytic nevi (CMN) have been mostly assessed by high-resolution videodermoscopy. However, optical dermoscopy with the 10-fold magnification is largely available. In some instances, the differential diagnosis between large CMN and Becker nevus (BN) may be difficult. Objective: The aims of this work were: (1) to assess by dermoscopy with the 10-fold magnification the morphological features which have been previously suggested as useful for the identification of CMN in high-resolution videodermoscopy; (2) to search and point out the dermoscopic features of BN; (3) to explore dermoscopic differences between CMN and BN. Methods: The subjects were observed among about 23,000 consecutive young men assessed at the Draft Council’s Medical Unit of the Italian Navy in Taranto for compulsory recruitment and referred to the Department of Dermatology of the Italian Navy Hospital for dermatological examination. Lesions were examined by the same observer using a dermatoscope with a 10-fold magnification, and both the dermoscopic criteria stated by the international Consensus Net Meeting on Dermoscopy and dermoscopic features previously suggested as useful for the identification of CMN by videodermoscopy were recorded in a predisposed patient’s card. Results: There were 127 male subjects, median age 19 years, with 127 CMN, measuring ≥1.5 to ≤19.9 cm in 78% and ≥20 cm in 22% of cases, and 64 male subjects, median age 19 years, with 64 BN. In the sample of medium-sized and large CMN, dermoscopic features previously identified as characteristic of congenital lesions (i.e. target network, focal thickening of network lines, target globules, skin furrow hypopigmentation, focal hypopigmentation, hair follicles, perifollicular hypopigmentation, vessels and target vessels) were observed in sufficiently high rates. In the BN group, network, focal hypopigmentation, skin furrow hypopigmentation, hair follicles, perifollicular hypopigmentation and vessels were the main dermoscopic features. Focal thickening of network lines, globules, target globules, homogeneous diffuse pigmentation, hyperpigmented areas, blotches and target vessels were more frequently observed in CMN than in BN. Conclusions: (1) The same dermoscopic features observed in small and medium-sized CMN by videodermoscopy with high magnifications are also detectable in medium-sized and large CMN, employing the dermoscopy with the 10-fold magnification. (2) Network, focal, skin furrow and perifollicular hypopigmentation, hair follicles and vessels could be considered as peculiar dermoscopic features of BN. (3) Major differences in the frequency of dermoscopic characteristics were detected between CMN and BN, and dermoscopy seems to provide some diagnostic aid in differentiating CMN from BN in equivocal cases. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Tinea barbae is a rare form of dermatophytosis that affects hair follicles of the beard and moustache. Dermoscopy could prove useful to identify parasitism of hair of the beard, just as it has proven useful in the diagnosis of Tinea capitis. We present the first fully documented case series of T. barbae with clinical, dermoscopic and mycological features. [ABSTRACT FROM AUTHOR]

• An automatic skin lesion segmentation based on deep convolution network designed. • Image representations from transform domain used to improve the performance. • Despite of small dataset, pre-processing and excessive data augmentation not applied. • The analysis proved the efficiency of the proposed method on tested images. Automated diagnosis systems provide a huge improvement in early detection of skin cancer, and consequently, contribute to successful treatment. Recent research on convolutional neural network has achieved enormous success in segmentation and object detection tasks. However, these networks require large amount of data that is a big challenge in medical domain where often have insufficient data and even a pretrained model on medical images can be hardly found. Lesion segmentation as the initial step of skin cancer analysis remains a challenging issue since datasets are small and include a variety of images in terms of light, color, scale, and marks which have led researchers to use extensive augmentation and preprocessing techniques or fine tuning the network with a pretrained model on irrelevant images. A segmentation model based on convolutional neural networks is proposed in this study for the tasks of skin lesion segmentation and dermoscopic feature segmentation. The network is trained from scratch and despite the small size of datasets neither excessive data augmentation nor any preprocessing to remove artifacts or enhance the images are applied. Alternatively, we investigated incorporating image representations of the transform domain to the convolutional neural network and compared to a model with more convolutional layers that resulted in 6% higher Jaccard index and has shorter training time. The model improved by applying CIELAB color space and the performance of the final proposed architecture is evaluated on publicly available datasets from ISBI challenges in 2016 and 2017. The proposed model has resulted in an improvement of as much as 7% for the segmentation metrics and 17% for the feature segmentation, which demonstrates the robustness of this unique hybrid framework and its future applications as well as further improvement. [ABSTRACT FROM AUTHOR]