Clinical and Experimental Dermatology最新文献

Cutaneous lupus erythematosus is a complex autoimmune disease often characterized by a multitude of skin findings. Cutaneous lupus erythematosus (CLE) is generally classified into three main categories: acute cutaneous lupus (ACLE), subacute cutaneous lupus (SCLE), and chronic cutaneous lupus (CCLE). The current therapeutic guidelines for CLE include counseling patients on general measures and medication regimens. Treatment options include optimized photoprotection, avoidance of environmental triggers, corticosteroids, topical and systemic immunomodulators, and antimalarials. To date, no biologic medications (i.e., monoclonal antibodies [mAbs]) are approved for CLE. The first monoclonal antibody, belimumab, a B-lymphocyte stimulator (BLyS)-specific inhibitor, for the treatment of both systemic lupus erythematosus (SLE) and active lupus nephritis, was approved in 2011 and 2020, respectively. Anifrolumab, a type I interferon (IFN) receptor antagonist, was approved in 2021 for SLE. Other mAbs with different targets, including a novel biologic that inhibits blood dendritic cell antigen 2 (BDCA2), are currently under investigation for CLE. This review will describe the general treatment landscape for CLE. Select studies related to these various mAbs, as well as their safety profiles and efficacies demonstrated in clinical trials, will be discussed. Biologic medications can potentially augment the number of treatment options for patients living with CLE.

Background: Medical research, driven by advancing technologies like Artificial Intelligence (AI), is transforming healthcare. Dermatology, known for its visual nature, benefits from AI, especially in dermatopathology with digitized slides. This review explores into AI's role, challenges, opportunities, and future potential in enhancing dermatopathological diagnosis and care.

Materials and methodology: Adhering to PRISMA and Cochrane Handbook standards, this systematic review explored AI's function in dermatopathology. It employed an interdisciplinary method, encompassing diverse study types and comprehensive database searches. Inclusion criteria encompassed peer-reviewed articles from 2000 to 2023, with a focus on practical AI use in dermatopathology.

Results: Numerous studies have investigated AI's potential in dermatopathology. We reviewed 112 papers. Notable applications include AI classifying histopathological images of nevi and melanomas, although challenges exist regarding subtype differentiation and generalizability. AI achieved high accuracy in melanoma recognition from formalin-fixed paraffin-embedded samples but faced limitations due to small datasets. Deep learning algorithms showed diagnostic accuracy for specific skin conditions, but challenges persisted, such as small sample sizes and the need for prospective validation.

Conclusion: This systematic review underscores AI's potential in enhancing dermatopathology for better diagnosis and patient care. Addressing challenges like limited datasets and potential biases is essential. Future directions involve expanding datasets, conducting validation studies, promoting interdisciplinary collaboration, and creating patient-centred AI tools to enhance dermatopathology's accuracy, accessibility, and patient-focused care.

The fatal outcomes in DIHS/DRESS are reported to be associated with CMV reactivation. However, CMV reactivation is also observed not only in DIHS/DRESS but also in other diseases when high doses of corticosteroids are administered. Currently, it is difficult to distinguish whether CMV reactivation in DIHS/DRESS is caused by steroid-induced immunosuppression or the pathology of DIHS/DRESS. In this study, we describe the characteristic of CMV reactivation in patients with DIHS/DRESS (n=22) by comparing the frequency of reactivation and its complication with those with pemphigus vulgaris (PV) (n=21) treated with high dose of corticosteroids. The frequency of CMV reactivation showed no difference between DIHS/DRESS and PV. On the other hand, the frequency of CMV complication was higher in DIHS than PV. Our data shows the importance of monitoring the CMV complication while CMV reactivation is not unique consequence of DIHS/DRESS compared to diseases treated with high dose of corticosteroids.