Dermoscopy in China: current status and future prospective

Objective: Dermoscopy is a useful technique for improving the diagnostic accuracy of various types of skin disorders. In China, dermoscopy has been widely accepted, and domestic researchers have made tremendous progress in the field of dermoscopy. The main purpose of this review is to summarize the current status of dermoscopy in China and identify its future directions. Data sources: Articles included in this review were obtained by searching the following databases: Wanfang, China National Knowledge Infrastructure, PubMed, and the Web of Science. We focused on research published before 2019 with keywords including dermoscopy, dermoscopic, dermoscope and trichoscopy. Study selection: A total of 50 studies were selected. Of these studies, 20 studies were in Chinese and 30 in English, research samples of all the studies were collected from Chinese populations. Results: Since 2000, more than 380 articles about dermoscopy have been published in domestic or foreign journals. Dermoscopy can improve the diagnostic accuracy of neoplastic diseases, evaluating the therapeutic effect of treatment, and determining the treatment endpoint, and it can also assist in the differential diagnosis of inflammatory diseases and in the assessment of the severity of the disease. In addition, researches about the applications of dermoscopy during surgical treatment have been published. Training courses aiming to improve the diagnostic ability of dermatologists, either face-to-face or online, have been offered. The Chinese Skin Image Database, launched in 2017 as a work platform for dermatologists, has promoted the development of dermoscopy in China. Computer-aided diagnostic systems based on the Chinese population are ready for use. In the future, cooperation, resource sharing, talent development, image management, and computer-aided diagnosis will be important directions for the development of dermoscopy in China. Conclusion: Dermoscopy has been widely used and developed in China, however, it still needs to address more challenges in the future.

Artificial intelligence in dermatology: past, present, and future

Artificial intelligence (AI) had been first coined at a famous Dartmouth College conference in 1956. AI is gradually interrelated with all disciplines, and also permeates all aspects of the medical field. In the early 1970s, medical researchers discovered the applicability of AI in life sciences.[1] AI can play a role in many aspects, such as medical image recognition and auxiliary diagnosis,[2] biotechnology,[3] drug research and development,[4] etc. Currently, medical image recognition is the most widely used.

Diagnostic capacity of skin tumor artificial intelligence-assisted decision-making software in real-world clinical settings

Background:Youzhi artificial intelligence(AI)software is the AI-assisted decision-making system for diagnosing skin tumors.The high diagnostic accuracy of Youzhi AI software was previously validated in specific datasets.The objective of this study was to compare the performance of diagnostic capacity between Youzhi AI software and dermatologists in real-world clinical settings.Methods:A total of 106 patients who underwent skin tumor resection in the Dermatology Department of China-Japan Friendship Hospital from July 2017 to June 2019 and were confirmed as skin tumors by pathological biopsy were selected.Dermoscopy and clinical images of 106 patients were diagnosed by Youzhi AI software and dermatologists at different dermoscopy diagnostic levels.The primary outcome was to compare the diagnostic accuracy of the Youzhi AI software with that of dermatologists and that measured in the laboratory using specific data sets.The secondary results included the sensitivity,specificity,positive predictive value,negative predictive value,F-measure,and Matthews correlation coefficient of Youzhi AI software in the real-world.Results:The diagnostic accuracy of Youzhi AI software in real-world clinical settings was lower than that of the laboratory data(P<0.001).The output result of Youzhi AI software has good stability after several tests.Youzhi AI software diagnosed benign and malignant diseases by recognizing dermoscopic images and diagnosed disease types with higher diagnostic accuracy than by recognizing clinical images(P=0.008,P=0.016,respectively).Compared with dermatologists,Youzhi AI software was more accurate in the diagnosis of skin tumor types through the recognition of dermoscopic images(P=0.01).By evaluating the diagnostic performance of dermatologists under different modes,the diagnostic accuracy of dermatologists in diagnosing disease types by matching dermoscopic and clinical images was significantly higher than that by identifying dermoscopic and clinical images in random sequence(P=0.022).The diagnostic accuracy of dermatologists in the diagnosis of benign and malignant diseases by recognizing dermoscopic images was significantly higher than that by recognizing clinical images(P=0.010).Conclusion:The diagnostic accuracy of Youzhi AI software for skin tumors in real-world clinical settings was not as high as that of using special data sets in the laboratory.However,there was no significant difference between the diagnostic capacity of Youzhi AI software and the average diagnostic capacity of dermatologists.It can provide assistant diagnostic decisions for dermatologists in the current state.

Skin diseases in the Da Qing Diabetes Study:a cross-sectional study

Background:The prevalence of skin diseases and diabetes mellitus(DM)are prominent around the world.The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM(T2DM)is limited,leading to limited recognition of the correlations between skin diseases and T2DM.Methods:We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st,2016.The subjects were categorized into three groups:Normal glucose tolerance(NGT),impaired glucose tolerance(IGT),and T2DM.The prevalence and clinical characteristics of skin diseases were recorded and investigated.Results:In this cross-sectional study,383 individuals with ages ranging from 53 to 89-year-old were recruited.The overall prevalence of skin diseases was 93.5%,and 75.7%of individuals had two or more kinds of skin diseases.Additionally,there were 47 kinds of comorbid skin diseases in patients with T2DM,of which eight kinds of skin diseases had a prevalence>10%.The prevalence of skin diseases in NGT,IGT,and T2DM groups were 93.3%,91.5%,and 96.6%,respectively;stratified analysis by categories showed a statistically significant difference in"disturbances of pigmentation"and"neurological and psychogenic dermatoses".The duration of T2DM also significantly associated with the prevalence of"disturbances of pigmentation"and"neurological and psychogenic dermatoses".Subsequently,the prevalence of"disturbances of pigmentation"was higher in males than females in NGT(P<0.01)and T2DM(P<0.01)groups.In addition,the difference in the prevalence of"disturbances of pigmentation"was also significant in NGT and T2DM groups(P<0.01).Conclusions:There was a high prevalence of skin diseases in the Da Qing Diabetes Study.To address the skin diseases in the Da Qing Diabetes Study,increased awareness and intervention measures should be implemented.

Accuracy of dermoscopic and reflectance confocal microscopic criteria for diagnosis of psoriasis

To the Editor:Psoriasis is a chronic inflammatory disease that is usually diagnosed on the basis of typical clinical features.However,ambiguous cases can exist at times and are sometimes mistaken for other erythematosquamous diseases.Although histopathologic diagnosis remains the gold standard in such cases,it is frequently bypassed to avoid damage to the lesion areas and reduce discomfort for patients.Because a biopsy cannot provide real-time monitoring,non-invasive techniques that are cost-effective,such as dermoscopy and reflectance confocal microscopy(RCM),have increasingly been used in clinical practice during the past few years.

Assessment of imaging diagnosis ability of skin tumors in Chinese dermatologists

Skin tumors begin from normal skin cells, and some parts of them may transform with the potential to reproduce in an out-of-control manner.[1] Skin tumors are exceedingly common and the incidence is increasing at an alarming rate across the globe.

Reflectance confocal microscopy characteristics for melanocytic nevi

To the Editor: Melanocytic nevi are a common benign tumor disease in dermatology and can occur in all ages and parts of the skin surface. There are different clinical manifestations in pigmented nevus skin lesions. It is difficult to distinguish other diseases which have similar clinical manifestations of pigmented nevus if medical diagnosis is based solely on the color, shape, or clinical experience of the lesion. Nevi are mainly divided into three categories: junctional (melanocytes confined to the epidermis only), intra-dermal (confined to the dermis only), and compound (both an epidermal and a dermal component). The relationships between these three different types of nevi and what factors contribute to the formation of one type vs. another are still unclear.[1]