Publications by authors named "Ashfaq A Marghoob"

Introduction: Speculatively, digital image post-processing (DIPP) enhances diagnostic accuracy in dermoscopy.

Objective: We aimed to investigate the advantages and limitations of DIPP, as well as its perceived reliability and safety.

Methods: In this study we investigated the perception and use of DIPP among members of the International Dermoscopy Society through a web-based survey with 17 questions focusing on: (i) demographics (sex, age, nationality, specialty, professional experience in dermoscopy), (ii) application of digital dermoscopy, (iii) imaging devices, (iv) DIPP software usage, (v) area of DIPP application (e.

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Background: There is lack of uniformity in reflectance confocal microscopy (RCM) terminology.

Objective: To establish expert consensus on a standardized set of RCM terms that describe non-melanocytic lesions (NMLs).

Methods: We invited RCM experts to participate in a Delphi-consensus study.

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Artificial intelligence (AI) is already impacting the way we diagnose skin diseases. Although there are many new AI tools promoted to be helpful to dermatologists and primary care physicians, especially in the recognition of melanoma and nonmelanoma skin cancers, there is a major obstacle that the sponsoring companies must overcome before it is possible to integrate any of these innovative AI-enabled technologies into clinical practice. The regulatory process of the Food and Drug Administration (FDA) is demanding and requires proof of safety and effectiveness for each of these devices before the FDA gives their approval.

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Background: When monitoring melanocytic neoplasms, the pattern of change may distinguish nevi from melanoma. Anticipating the growth dynamics of nevi based on their dermoscopic pattern is important to make this distinction.

Objectives: The primary aim was to examine the association between nevus dermoscopic pattern at baseline and diameter change during long-term monitoring.

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Background: Differentiating melanoma (MM) from seborrheic keratosis (SK) containing a blue-white veil (BWV) remains challenging.

Objective: Identify dermoscopic features that can improve upon the differentiation between MMs and SKs exhibiting BWV.

Methods: Images from 110 MMs and 121 SKs containing BWV were aggregated, and 91 MMs and 62 SKs from this data set had complete agreement on the presence of BWV according to 3 expert dermoscopists.

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Lentigo Maligna (LM) arises on chronically-sun damaged skin and can have extensive subclinical spread, often in functionally and cosmetically challenging areas. This two-part continuing medical education (CME) series reviews LM. Part I reviews epidemiology, risk factors, clinical presentation, diagnostic tools, biopsy technique, and histopathology of LM.

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Lentigo maligna (LM) is an increasingly common subtype of melanoma, presenting as a slow-growing tan-brown macule or patch with irregular borders arising on chronically solar-damaged skin. This two-part continuing medical education (CME) series provides an overview of LM. Part I reviews LM's epidemiology, risk factors, and clinical presentation.

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Article Synopsis
  • Congenital melanocytic nevi (CMN) are skin lesions present from birth, potentially causing cosmetic concerns and psychosocial effects, along with symptoms like itching and skin issues.
  • The main medical worry is their association with a higher risk of developing skin melanoma, other types of melanoma, and neurocutaneous melanocytosis (NCM), especially depending on the size and number of CMN.
  • Risk assessment for patients with CMN includes monitoring the size and number of nevi, with larger nevi having a significantly higher chance of melanoma and NCM, and the text discusses the importance of various clinical examinations and potential treatments.
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Incorporation of dermoscopy and artificial intelligence (AI) is improving healthcare professionals' ability to diagnose melanoma earlier, but these algorithms often suffer from a "black box" issue, where decision-making processes are not transparent, limiting their utility for training healthcare providers. To address this, an automated approach for generating melanoma imaging biomarker cues (IBCs), which mimics the screening cues used by expert dermoscopists, was developed. This study created a one-minute learning environment where dermatologists adopted a sensory cue integration algorithm to combine a single IBC with a risk score built on many IBCs, then immediately tested their performance in differentiating melanoma from benign nevi.

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Importance: Somatic variants in the RAS/MAPK pathway genes are commonly associated with melanocytic nevi and melanoma, whereas germline variants in these genes are associated with RASopathies, syndromes involving multiple organs, including the skin. Nevi counts may be higher in some RASopathies, but studies on features observed through dermoscopy are limited.

Objective: To determine the distinguishing dermoscopic features of melanocytic nevi and how the RAS pathway influences them by comparing nevi in patients with cardiofaciocutaneous syndrome (CFC) and Costello syndrome (CS).

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Dermatological conditions often present diagnostic challenges due to their diverse manifestations and overlapping clinical features. In such cases, dermoscopy, a non-invasive imaging technique, has emerged as a valuable tool to enhance diagnostic accuracy and guide clinicians in reaching an appropriate differential diagnosis. By visualizing subsurface skin structures and microvascular patterns, dermoscopy provides additional information that complements clinical examination, aiding in the recognition of specific dermatoses and the differentiation between benign and malignant skin lesions.

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Background: A common terminology for diagnosis is critically important for clinical communication, education, research and artificial intelligence. Prevailing lexicons are limited in fully representing skin neoplasms.

Objectives: To achieve expert consensus on diagnostic terms for skin neoplasms and their hierarchical mapping.

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Article Synopsis
  • Dermatoscopy is a non-invasive technique that improves skin examination for both cancerous and non-cancerous skin conditions, with new methods involving UV imaging emerging recently.
  • A systematic review analyzed the principles and categorizations of these new UV techniques, examining their clinical applications, safety measures, and limitations.
  • While UV dermatoscopy can enhance early detection and visualization of various skin issues, it also faces challenges like distinguishing between pigments and issues with uneven surfaces, necessitating careful use by clinicians.
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Background: Pediatric melanoma presents with distinct clinical features compared to adult disease.

Objective: Characterize risk factors and negative outcomes in pediatric melanoma.

Methods: Multicenter retrospective study of patients under 20 years diagnosed with melanoma between January 1, 1995 and June 30, 2015 from 11 academic medical centers.

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Reflectance confocal microscopy (RCM) images skin lesions noninvasively at quasi-histological resolution. RCM has improved the diagnosis of skin neoplasms, and recently acquired billing codes in the USA. However, reading RCM images requires training, imposing a major barrier to its widespread adoption.

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Background: Full-body skin examination (FSE) is a vital practice in the diagnosis of cutaneous malignancy. Precisely how FSE should be conducted with respect to concealed site inclusion remains poorly elucidated.

Objective: To establish the approach of Australian dermatologists to concealed site examination (CSE).

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Article Synopsis
  • Dermoscopy is valuable for detecting melanoma, but experts often disagree on important features.
  • This study examined the agreement among 25 expert dermatologists on 248 dermoscopic images, focusing on specific melanocytic features and their locations.
  • Results showed good-to-excellent agreement for 14 out of 31 features, especially for melanoma-specific characteristics, and all images are publicly available for educational and research purposes.
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Background: Lentigo maligna (LM) can mimic benign, flat, pigmented lesions and can be challenging to diagnose.

Objective: To describe a new dermatoscopic feature termed "perifollicular linear projections (PLP)" as a diagnostic criterion for LM on the face.

Methods: Retrospective study on reflectance confocal microscopy and dermatoscopy images of flat facial pigmented lesions originating from 2 databases.

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Article Synopsis
  • The study validated the accuracy of an open-source AI algorithm for diagnosing melanoma, assessing its sensitivity and specificity based on skin lesion images from 435 participants.
  • The AI showed a sensitivity of 96.8% at a threshold of 95%, while dermatologists' accuracy in assessing melanoma risk improved after reviewing the AI's findings.
  • The results indicate the AI's potential to enhance decision-making in dermatology, though further larger trials are necessary to integrate it into clinical practice.
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