Dermatoscope for the diagnosis of erythema with purpura induced by lidocaine/prilocaine cream:A case report

BACKGROUND Lidocaine/prilocaine(EMLA)cream is a local anesthetic that is applied to the skin or mucosa during painful therapeutic procedures with few reported side effects.CASE SUMMARY Here,we report the use of dermatoscopy to identify a case of erythema with purpura,a rare side effect,after the application of 5%EMLA cream.CONCLUSION We conclude that erythema with purpura is caused by irritation and toxicity associated with EMLA,but the specific mechanism by which the toxic substance affects skin blood vessels is unclear.In response to this situation and for cosmetic needs,we recommend tranexamic acid,in addition to routine therapy,to prevent changes in pigmentation in patients with dermatitis.

Purpura annularis telangiectodes of Majocchi:A case report

BACKGROUND Purpura annularis telangiectodes of Majocchi(PATM),also known as Majocchi,is a rare subclass of pigmented purpuric dermatoses.The etiology of PATM is unknown,but it seems more common in children and young women.The skin lesions are mostly symmetrical ring-shaped reddish-brown macules on the lower limbs.CASE SUMMARY A 9-year-old girl,who has received treated in our department,presented with reddish-brown ring-shaped rash on both lower limbs that had been present for 6 mo.These lesions,red brownish annular or petaloid patches,were mostly found on ankles and lower limber,which do not fade when adding pressure and no feel of infiltration and no atrophy when touching those lesions.Pathological examination showed deposition of hemosiderin in papillary dermis.However,dermoscopy showed the pigmentation in the center as well as the lavender patches on the edge of lesion.The child was thus diagnosed with PATM.After diagnosis,we suggested the patient avoid strenuous exercise.she was given vitamin C tablets for oral and mometasone furoate cream for external use.Followup examinations and treatment continue to support the clinical diagnosis to date.CONCLUSION This is the first report of investigating PATM using dermoscopy,which can differentiate PATM from other diseases due to its unique microscopic feature under dermoscopy.Although PATM is harmless,it still requires long-term follow-up.Moreover,dermoscopy technique can be applied for observation of multi-site lesions and correlated with histopathology.Thus,we believe this approach could be generalized for future diagnosis of PATM.

Diagnosis of Various Skin Cancer Lesions Based on Fine-Tuned ResNet50 Deep Network

With the massive success of deep networks,there have been signi-cant efforts to analyze cancer diseases,especially skin cancer.For this purpose,this work investigates the capability of deep networks in diagnosing a variety of dermoscopic lesion images.This paper aims to develop and ne-tune a deep learning architecture to diagnose different skin cancer grades based on dermatoscopic images.Fine-tuning is a powerful method to obtain enhanced classication results by the customized pre-trained network.Regularization,batch normalization,and hyperparameter optimization are performed for ne-tuning the proposed deep network.The proposed ne-tuned ResNet50 model successfully classied 7-respective classes of dermoscopic lesions using the publicly available HAM10000 dataset.The developed deep model was compared against two powerful models,i.e.,InceptionV3 and VGG16,using the Dice similarity coefcient(DSC)and the area under the curve(AUC).The evaluation results show that the proposed model achieved higher results than some recent and robust models.