Diagnosing systemic lupus erythematosus (SLE) may be difficult in cases of negative results for antinuclear antibodies (ANAs) and anti-double stranded DNA (dsDNA) antibodies, which is known as seronegative SLE. Additionally, in patients with HIV infection, the diagnosis of SLE is made complicated by the overlap of symptoms and the possibility of false negative results on antibody tests. Herein, we report the case of a 24year-old female with HIV infection on anti-retroviral therapy who presented with vesicles and plaques over the malar area and ulcers over the roof of the mouth. Antibody tests for ANAs and dsDNA were negative. She was initially treated for herpes simplex with a secondary infection, but the symptoms did not improve. She ultimately died from acute myocardial infarction while awaiting results of direct immunofluorescence, which revealed the deposition of immunoglobulin (Ig) M, IgG, and C3 along the basement membrane, thus enabling a diagnosis of SLE. Therefore, SLE can be difficult to diagnose in patients with HIV, and other diagnostic criteria should be considered when suspecting SLE and treating these patients. Additionally, we also present our experience with ChatGPT (

Juvenile hyaline fibromatosis (JHF) and infantile systemic hyalinosis (ISF) are rare progressive, fatal autosomal recessive fibromatosis disorders that are characterized by the deposition of hyaline in various tissues. Mutations in capillary morphogenesis gene 2 are responsible for both of these conditions. These disorders usually present with fleshy, papular lesions, joint contractures, gingival hyperplasia, and persistent diarrhoea. An 18-month-old boy presented with multiple scalp abscesses, facial nodules, gingival hypertrophy, hypertrophic verrucous plaques and joint contractures with unique dermoscopic features and a history of recurrent diarrhoea and infections. Histopathological examination following skin biopsy revealed deposition of hyaline in the stroma and subcutaneous tissues. JHF is a differential diagnosis in children who present with multiple scalp nodules. Here, we report the case of overlapping features of JHF and ISH. The evolution of this case provides a special opportunity to further understand the pathogenesis and clinical characterization of hyaline fibromatosis syndrome.

Background Lichen sclerosus et atrophicus (LSEA) is a chronic inflammatory dermatosis of genital and extragenital sites with a prevalence ranging from 9% in prepubertal patients to 50% in postmenopausal patients. Chat generative pre-trained transformer (ChatGPT) is an artificial intelligence tool designed to assist humans based on supervised and reinforcement techniques. In this study, we aimed to evaluate the characteristics of patients with LSEA using ChatGPT. Methods In this retrospective study, we included all patients who presented to the outpatient dermatology department during 2017-2022 at a tertiary care teaching hospital in South India. Information regarding demographic data, characteristics of LSEA, comorbidities, and associated autoimmune disorders was gathered using a medical chart review. Following data analysis and drafting of the manuscript, the utility of ChatGPT-3 and ChatGPT-4 in finalizing the draft was assessed. Results Of 20 patients diagnosed with LSEA, 16 (80%) and four (20%) patients were females and males, respectively. Of them, 50% of female patients had attained menopause. While 65% of patients had genital LSEA, 30% of patients had extragenital LSEA only, and 5% of patients had both genital and extragenital LSEA. Furthermore, four (20%) patients were prepubertal children. Of four male patients, two (50%) were younger than 18 years of age, and one patient was diagnosed with balanitis xerotica obliterans. The commonest associated features in LSEA included joint involvement (30%), hypertension (25%), and anemia (15%). Rare concomitant disorders included psoriasis, asthma, and basal cell carcinoma over the nose. Conclusions LSEA may be confused with other various dermatoses, such as morphea, vitiligo, and lichen planus. A high index of suspicion is required, especially in children, to diagnose it early and intervene to prevent further complications. Its relationship with autoimmune disorders and comorbidities warrants further large-scale studies. ChatGPT was unreliable in the literature search due to the provision of non-existent citations. ChatGPT-4 was better than ChatGPT-3 since it provided few true publications. ChatGPT was used in this study to summarize the articles identified by the authors during the literature search and to correct grammatical errors in the final draft of the manuscript.

BACKGROUND ChatGPT, an artificial intelligence chatbot developed by OpenAI has ushered in a new era of possibilities, offering exciting opportunities for natural language processing in healthcare; it marks a clear paradigm shift in academic research, patient care, and clinical communication. However, a hurried and uninformed implementation of ChatGPT in healthcare settings can have unforeseen results. OBJECTIVE The objective of this study is to discuss and provide a comprehensive summary of the existing literature on ChatGPT based on insights derived from different research teams across diverse disciplines, focusing on the main applications in medicine as conceived by authors who have published on the subject. Furthermore, we seek to address potential concerns associated with the integration of ChatGPT in the medical field, while simultaneously opening up unexplored paths. METHODS The corresponding author selected a group of authors through an initial screening of papers published on ChatGPT from various databases. Based on the replies and their level of cooperation, a dozen authors were chosen for the study and included based on their cooperation and geographic representation. We conducted a comprehensive search across databases, including Web of Science, PubMed, and Scopus. The study followed the PRISMA guidelines for screening and selection. Analysis was performed on the selected articles (n=223), categorizing them based on article type, specialty, and specific role discussed. Descriptive statistics were calculated, and bibliometric analyses were conducted using VOSviewer. RESULTS We identified 223 peer-reviewed articles. Writing assistance emerged as the most widely discussed role of ChatGPT. The rest of the roles included: general use (16%, n=35), education tool (17%, n=37), solution and discussion of clinical vignettes (15%, n=34), valuing and predicting future impact (7%, n=15), information source (5%, n=12), and as a discussion forum about ethical issues (6%, n=14). To detect any difference in usage across continents, a chi-square test for distribution of categorical variables was carried out and yielded a p-value of P=0.56, in article type. Regarding specialty and the role of ChatGPT, the p-values were P=0.86 and P=0.87, respectively. We found no significant association between a specific geographic location and the distribution of any of the variables. CONCLUSIONS This study provides a comprehensive overview of the literature on ChatGPT, revealing its diverse range of applications as observed across different disciplines. By examining the concerns surrounding the integration of ChatGPT in medicine, we underscore the importance of responsible implementation and highlight the need for ongoing research and development in this area. Ultimately, this work opens new perspectives for the detection of unexplored paths and the realization of ChatGPT's potential in enhancing various domains, including medicine.