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Dermatology
INTRODUCTION TO THE USE OF DERMOSCOPY (DERMATOSCOPY)
Built from Dermatology, 5th Edition
What’s inside
5 sections · 187 slides
Overview
- What this topic covers
Skin Biopsy and Dermatopathologic Diagnosis
How the right sample, handled the right way, becomes a diagnosis
- Matching the biopsy to the disease
- Optimal biopsy technique for inflammatory dermatoses
- Optimal biopsy technique for inflammatory dermatoses (continued)
- Optimal biopsy technique for inflammatory dermatoses (continued)
- Optimal biopsy technique for inflammatory dermatoses (continued)
- Optimal biopsy technique for inflammatory dermatoses (continued)
- Optimal biopsy technique for neoplastic skin lesions
- Optimal biopsy technique for neoplastic skin lesions (continued)
- Optimal biopsy technique for neoplastic skin lesions (continued)
- Handling the specimen after removal
- Fixing and transporting the sample
- Clinical information the pathologist needs
- Pattern analysis: the logic of reading a biopsy
- Limits of pattern analysis
- Ten major histopathologic patterns of skin inflammation
- Perivascular dermatitis
- Interface dermatitis
- Lichenoid interface dermatitis
- Spongiotic dermatitis
- Psoriasiform dermatitis
- Intraepidermal blistering: acantholysis
- Intraepidermal pustules
- Subepidermal blistering
- Vasculitis on biopsy
- Leukocytoclastic (small-vessel) vasculitis
- Other vasculitis and pseudovasculitis patterns
- Nodular and diffuse dermatitis
- Giant cells within granulomas
- Three granuloma types: tuberculoid, sarcoidal, palisaded
- Four more granuloma types
- Seven major types of cutaneous granuloma
- Langerhans vs non-Langerhans histiocytoses
- Folliculitis and perifolliculitis
- Fibrosing and sclerosing patterns
- Panniculitis: inflammation of the fat layer
- Septal panniculitis
- Lobular panniculitis
- Invisible dermatoses: a diagnostic trap
- Invisible dermatoses
- Invisible dermatoses (continued)
- Working through a suspected invisible dermatosis
- Deposits of foreign material within the skin
- Finding deposited material on biopsy
- H&E: the standard stain of dermatopathology
- When H&E is not enough: special stains
- Commonly employed special stains in dermatopathology
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Commonly employed special stains in dermatopathology (continued)
- Examples of histochemical special stains
- Immunohistochemistry: seeing invisible proteins
- Using immunohistochemistry wisely
- Immunohistochemistry confirming a diagnosis
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- Most commonly employed immunohistochemical (IHC) stains in dermatopathology (continued)
- A quick differential for a sudden widespread rash
- Acute cutaneous eruptions in otherwise healthy individuals
- Acute cutaneous eruptions in otherwise healthy individuals (continued)
Introduction to the Use of Dermoscopy (Dermatoscopy)
Seeing sub-macroscopic structure with a lit magnifier
- What dermoscopy is
- How the dermoscopy exam is performed
- Dermoscopic colors of keratinizing, melanocytic, and vascular tumors
- Why the fluid or polarization step matters
- Dermoscopy beyond pigmented lesions
- Telling inflammatory rashes apart
- Dermoscopy of non-pigmented inflammatory and infectious lesions
- Evidence that dermoscopy improves melanoma detection
- The two-step pattern analysis approach
- Basic dermoscopic patterns: lines, dots, clods, circles
- Pattern analysis: first-step algorithm for differentiation between melanocytic and non-melanocytic lesions
- Pattern analysis: first-step algorithm for differentiation between melanocytic and non-melanocytic lesions (continued)
- Pattern analysis: first-step algorithm for differentiation between melanocytic and non-melanocytic lesions (continued)
- Pattern analysis: first-step algorithm for differentiation between melanocytic and non-melanocytic lesions (continued)
- Pattern analysis: first-step algorithm for differentiation between melanocytic and non-melanocytic lesions (continued)
- The most common melanocytic nevi and non-melanocytic pigmented tumors
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Pattern analysis: second-step algorithm for differentiation between melanocytic nevi and melanoma (continued)
- Superficial melanomas of increasing tumor thickness
- Vessel shape as a diagnostic clue
- Vascular structures seen with dermoscopy
- Vascular structures seen in various skin tumors
- Vascular structures seen in various skin tumors (continued)
- Vascular structures seen in various skin tumors (continued)
- Dermoscopy of non-pigmented skin tumors
- Simplified scoring systems for less-expert users
- ABCD rule for the dermoscopic differentiation between benign melanocytic lesions and melanoma
- Menzies scoring method for the dermoscopic differentiation between benign melanocytic lesions and melanoma
- Menzies scoring method for the dermoscopic differentiation between benign melanocytic lesions and melanoma (continued)
- Menzies scoring method for the dermoscopic differentiation between benign melanocytic lesions and melanoma (continued)
- Menzies scoring method for the dermoscopic differentiation between benign melanocytic lesions and melanoma (continued)
- 7-point checklist for the dermoscopic differentiation between benign melanocytic lesions and melanoma
- 7-point checklist for the dermoscopic differentiation between benign melanocytic lesions and melanoma (continued)
- How well do the simplified rules perform?
- A quick 3-point rule for general physicians
- Definitions of dermoscopic criteria for the 3-point checklist
- Melanocytic nevi and pigmented tumor examples
- Non-melanocytic pigmented tumor examples
- Additional melanoma examples by dermoscopy
- Superficial melanomas of increasing thickness, additional examples
- Non-pigmented skin tumor examples
- Where dermoscopy is heading
Introduction to Confocal Microscopy
A non-invasive, cell-level 'virtual biopsy' of living skin
- What reflectance confocal microscopy is
- What RCM adds to patient care
- The physics behind an RCM image
- How an RCM scan is captured
- Two RCM devices, two different jobs
- Where RCM examination struggles
- Limitations of reflectance confocal microscopy (RCM) and possible interventions
- RCM for pigmented lesions
- Reflectance confocal microscopy of relapsed lentigo maligna
- Reflectance confocal microscopy of a solar lentigo / seborrheic keratosis
- Cutaneous tumors – major reflectance confocal microscopy (RCM) features
- Cutaneous tumors – major reflectance confocal microscopy (RCM) features (continued)
- RCM for non-pigmented tumors
- Reflectance confocal microscopy of an actinic keratosis
- Reflectance confocal microscopy of recurrent basal cell carcinoma
- RCM for inflammatory skin disease and hair loss
- Reflectance confocal microscopy of plaque psoriasis
- Reflectance confocal microscopy of allergic contact dermatitis
- Reflectance confocal microscopy of discoid lupus erythematosus
Introduction to Artificial Intelligence
How machine learning models are trained, tested, and used in the clinic
- Why AI is entering dermatology
- Training a model: preparing the data
- Training a model: the train-validate-test cycle
- Workflow for training and testing a machine learning model
- Why the test set has to stay untouched
- Six image-based tasks AI can perform
- Common image-based tasks solved with neural networks
- What each task is used for
- Deep learning and other AI approaches
- Why AI models need good data
- How small or biased datasets mislead a model
- Why measuring AI performance is tricky
- Five ways AI can be used in the clinic
- Possible clinical implementations of AI in dermatology
- What each implementation has shown so far
- The road ahead for AI in dermatology
- Key takeaways
- From terminology to technology
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
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- References (continued)
- Dermatology, 5th Edition (2-Volume Set)