Skin cancer is currently the most common type of cancer among Caucasians. The increase in life expectancy, along with new diagnostic tools and treatments for skin cancer, has resulted in unprecedented changes in patient care and has generated a great burden on healthcare systems. Early detection of skin tumors is expected to reduce this burden. Artificial intelligence (AI) algorithms that support skin cancer diagnoses have been shown to perform at least as well as dermatologists’ diagnoses. Recognizing the need for clinically and economically efficient means of diagnosing skin cancers at early stages in the primary care attention, we developed an efficient computer-aided diagnosis (CAD) system to be used by primary care physicians (PCP). Additionally, we developed a smartphone application with a protocol for data acquisition (i.e., photographs, demographic data and short clinical histories) and AI algorithms for clinical and dermoscopic image classification. For each lesion analyzed, a report is generated, showing the image of the suspected lesion and its respective Heat Map; the predicted probability of the suspected lesion being melanoma or malignant; the probable diagnosis based on that probability; and a suggestion on how the lesion should be managed. The accuracy of the dermoscopy model for melanoma was 89.3%, and for the clinical model, 84.7% with 0.91 and 0.89 sensitivity and 0.89 and 0.83 specificity, respectively. Both models achieved an area under the curve (AUC) above 0.9. Our CAD system can screen skin cancers to guide lesion management by PCPs, especially in the contexts where the access to the dermatologist can be difficult or time consuming. Its use can enable risk stratification of lesions and/or patients and dramatically improve timely access to specialist care for those requiring urgent attention.

Our study suggests that a smartphone-based teledermatology inpatient consultation model could be a reasonable option for hospitals lacking dermatological services. Also, it may be as or more effective than face-to-face consultations, if performed by a more experienced dermatologist. When feasible, photographing training should be performed.

<b><i>Background:</i></b> Androgenetic alopecia (AGA) affects up to 80% of men and 50% of women throughout their lifetime, causing significant discomfort. Minoxidil, finasteride, and low-level laser light therapy are the only Food and Drug Administration-approved treatments for AGA, and they have shown positive results in randomized controlled trials and meta-analyses. However, their efficacy is limited, and new therapies are needed. Injection of platelet-rich plasma (PRP), a minimally invasive technique, has been described by several authors as a promising treatment for AGA. Although many studies report beneficial effects of PRP on AGA, there is no standardized practice for PRP preparation and administration or a standard method to evaluate results. <b><i>Objective:</i></b> The aim of this study was to evaluate the efficacy of manually prepared PRP in the treatment of male AGA. <b><i>Materials and Methods:</i></b> We treated 20 male patients with AGA with 3 monthly injections of PRP and analyzed results by TrichoScan®. <b><i>Results:</i></b> In this study, there was no statistically significant improvement in hair count or proportion of anagen hairs. <b><i>Conclusions:</i></b> This lack of response could be related to any of the variables during PRP preparation described above and also to the limited number of patients in the study.

No abstract

Several guidelines recommend phototherapy, systemic agents, or biologic therapy for the treatment of moderate-to-severe psoriasis. Sequential use of more than 1 biologic has become more common due to primary or secondary failure with this type of treatment and an increase in the number of drugs available. However, the order of usage of these drugs is still speculative. We report about a patient with severe psoriasis with primary failure to respond after treatment with ustekinumab and adalimumab who achieved psoriasis area and severity index (PASI) 100 score with secukinumab in 8 weeks. Case PresentationA 47-year-old woman presented with a 30-year history of psoriasis vulgaris without psoriatic arthritis or other comorbidities. She was previously treated with methotrexate and PUVA but had hepatotoxicity and minimal response with UVB narrowband.At first visit, the patient revealed PASI 23.7, dermatology life quality index (DLQI) 30, body surface area (BSA) 30, and body weight 80 kg (Figure 1) and was subsequently