Australasian Journal of Dermatology最新文献

This case series outlines a proposed simplified and cost-effective alternative to expensive laboratory-based autologous non-cultured epidermal suspension (NCES). In all five adult participants, 75%-100% repigmentation was observed at 6 months, with one participant experiencing unsatisfactory colour mismatch and one participant experiencing hypertrophic scarring. Larger, randomised controlled trials with extended follow-up are needed to determine the long-term efficacy and safety profile of our clinical NCES protocol.

Background/objectives: Studies on factors that predict the number of stages in Mohs micrographic surgery (MMS) have been published previously. To date, no studies have analysed the predictors for the number of sections during MMS.

Methods: A retrospective case-control study of patients treated for keratinocyte cancer (KC) between 2013 and 2017 was conducted to identify predictive factors for 13 or more MMS sections. Patient, tumour, management and practitioner-related factors were analysed with univariate logistic regression and a multivariate predictive model. Surface area for tumours and defects was studied in cases and controls as a secondary outcome.

Results: Out of 10,132 tumours, a total of 195 cases representing 1.9% of all MMS procedures for the study period required more than 13 MMS sections. A control group with 213 tumours was also randomly selected. Largest preoperative tumour diameter, mixed histology, tumour recurrence and age were significant predictors for 13 or more MMS sections in a multivariate model (AUC 88.4%, sensitivity 77.2% and specificity 87.0%). Significantly larger defects were also found in our cases compared to the control group (median tumour to defect ratio 3.94 vs. 2.43; p < 0.0001).

Conclusion: Identifying factors that predict 13 or more sections prior to surgery could assist the Mohs practitioner in informing patients and allocating time and resources accordingly.

The gold standard for medical data extraction has traditionally been manual; however, this approach is very time consuming, labour intensive, expensive and prone to error. Many approaches to automated data extraction have been explored over the years; however, they have required significant technical knowledge and have not been reliably accurate. Large Language Models (LLMs) have been developed at an astronomical pace and have demonstrated incredible accuracy, and they are continuing to evolve and improve. The significant time and cost savings achieved with LLMs will allow for more efficient research and real-time monitoring of patient outcomes. This review explores how LLMs can be used in medical data collection, including the types of data collected and output given, types of LLMs used, amount of training required, the accuracy, speed, and cost of data extraction, types of errors commonly made, and any security concerns. There are still many challenges to overcome, particularly with reducing hallucinations/fictitious content and other common errors, ensuring patient privacy, handling complex tasks and producing output in clean and usable formats. Health professionals and researchers in the field of dermatology must be well trained and upskilled in the use of these new technologies and should continue to explore and build on what has already been achieved to optimise the use of LLMs in the automated data extraction process.

Background: Direct comparison of the adverse effect (AE) profiles of the hedgehog inhibitor (HIs) medications is limited to post hoc analyses of phase III clinical trials.

Objective: Compare the AE profiles between vismodegib and sonidegib in the FDA Adverse Event Reporting System (FAERS).

Methods: Case/non-case analyses were performed in FAERS and reporting odds ratios (ROR) were compared to determine unique and disproportionate AEs between HIs.

Results: Vismodegib had significantly higher ROR for taste symptoms and alopecia. Sonidegib was associated with neutropenia and elevated blood creatinine phosphokinase. Both vismodegib and sonidegib were associated with an increased ROR for cSCC (50.36 [42.36-59.86] vs. 50.28 [27.71-91.23]). This signal persisted despite comparison to an aggregate of other medications used to treat basal cell carcinoma (BCC) (11.56 [9.51-14.05] vs. 9.71 [1.25-75.43]).

Limitations: Retrospective nature predisposed to bias.

Conclusions: Vismodegib has a significantly higher ROR for alopecia and taste symptoms, while sonidegib was associated with neutropenia, which is a novel finding. Both HIs are associated with an increased ROR for cSCC, which persists despite stringent controls and does not parallel total cSCC cases reported to FAERS. These data suggest that HIs increase the risk of cSCC above the baseline expected in this patient population.

Male genital lichen sclerosis (mGLS) is a chronic progressive inflammatory disease with potential complications including urethral strictures and penile cancer. Despite its clinical significance, the molecular mechanisms underlying mGLS remain poorly understood, and male-specific data are limited. This systematic review consolidates current evidence on tissue-based gene and protein expression in mGLS, aiming to identify commonly investigated biomarkers and highlight gaps in the literature. Using the JBI Sumari interface, our research strategy identified a total of 24 studies with considerable variability in targets and methodologies. Only a small subset of 12 genes and proteins was assessed and only one gene, p16, was assessed across multiple studies, limiting the strength of conclusions. QIAGEN Ingenuity Pathway Analysis was used to explore canonical pathways and disease associations linked to reported biomarkers. While preliminary patterns suggest involvement of inflammatory and fibrotic pathways, further research is needed to validate these findings and assess their diagnostic, prognostic or therapeutic potential. This review provides a foundation for future studies focused on improving molecular understanding and clinical management of mGLS.

This study aimed to identify the proportion of patients with vitiligo reporting new-onset disease or changes in disease status following COVID-19 vaccination or infection using an online survey. Among 114 respondents, over half reported no new-onset vitiligo or a change in vitiligo status following COVID-19 vaccination or infection; however, a sizeable minority reported worsening of vitiligo, smaller numbers reported new-onset disease, and few reported improvement. Larger studies are needed to clarify whether these associations are coincidental or reflect underlying pathological processes.

Total Body Photography has undergone substantial technological advancement, now embracing high-resolution digital imaging, 3D reconstruction and the potential applications of artificial intelligence (AI), and mobile interoperability. However, its broader implementation is tempered by logistical hurdles as well as concerns regarding cost-effectiveness. This article traces its historical trajectory, evaluates its current clinical utility, and explores future applications.