skin

皮肤
  • 文章类型: Journal Article
    白细胞介素-17A治疗性抑制剂是中度至重度斑块型银屑病(PP)最有效的治疗方法之一。反射共聚焦显微镜是一种非侵入性成像技术,已被证明有益于评估局部活性物质和光疗治疗下PP的随访。本研究旨在评估与银屑病相关的表皮和真皮变化及其在全身苏金单抗治疗中重度PP患者中的RCM治疗。进行了一项初步研究,以评估RCM作为监测PP患者苏金单抗治疗的非侵入性工具。对于接受苏金单抗治疗的患者,选择病变皮肤进行RCM成像,记录在所有预定时间。基于银屑病的组织病理学诊断标准建立RCM评价标准。使用银屑病面积严重程度指数评估银屑病的临床严重程度。共有23名PP患者被纳入研究。每位患者在基线和第1-4周接受300mg皮下苏金单抗作为诱导治疗,随后每四周进行维持治疗。在治疗期间观察到显微共聚焦变化。结果确定了苏金单抗抗炎活性的早期微观证据,在临床检查中未检测到。与PASI相关的RCM结果用于观察患者对治疗的反应,并确定如下:棘皮病和角化不全,表皮和真皮炎症细胞的存在,存在非边缘真皮乳头,和乳头状真皮中的血管形成。这项研究是第一个证明RCM作为在临床或研究环境中在细胞水平上非侵入性监测苏金单抗治疗反应的有效工具。与苏金单抗活性相关的RCM参数的早期检测可以促进早期治疗反应的鉴定。RCM似乎能够提供有关接受苏金单抗治疗的PP患者随访的实用和有用的信息。RCM还可以为PP对生物治疗的反应的亚临床评估提供新的观点。
    Interleukin-17A therapeutic inhibitors are among the most effective treatment methods for moderate-to-severe plaque psoriasis (PP). Reflectance confocal microscopy is a non-invasive imaging technique already documented to be beneficial in evaluating the follow-up of PP under treatment with topical actives and phototherapy. This study aimed to assess the epidermal and dermal changes associated with psoriasis and its treatment with RCM during systemic secukinumab treatment in patients with moderate-to-severe PP. A pilot study was conducted to evaluate RCM as a non-invasive tool for monitoring secukinumab treatment in patients with PP. For patients receiving secukinumab treatment, lesional skin was selected for RCM imaging, which were recorded at all scheduled times. The RCM evaluation criteria were established based on the histopathological diagnostic criteria for psoriasis. The clinical severity of psoriasis was assessed utilizing the psoriasis area severity index. A total of 23 patients with PP were included in the study. Each patient received 300 mg of subcutaneous secukinumab as induction therapy at baseline and weeks 1-4, followed by maintenance therapy every four weeks. Microscopic confocal changes were observed during the treatment. The results identified early microscopic evidence of the anti-inflammatory activity of secukinumab, which was not detected during the clinical examination. RCM findings correlating with the PASI were used to observe the patient\'s response to treatment and were identified as follows: acanthosis and parakeratosis, presence of epidermal and dermal inflammatory cells, presence of non-edge dermal papillae, and vascularization in the papillary dermis. This study is the first to demonstrate the use of RCM as an effective tool for non-invasive monitoring of secukinumab therapeutic response at a cellular level in a clinical or research setting. Early detection of RCM parameters associated with secukinumab activity may facilitate the identification of an early treatment response. RCM appears to be capable of providing practical and helpful information regarding follow-up in patients with PP undergoing secukinumab treatment. RCM may also provide novel perspectives on the subclinical evaluation of PP\'s response to biological therapy.
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  • 文章类型: Journal Article
    背景:年轻人的行为使他们有患皮肤癌的风险。通过社交媒体传播数字健康促进干预措施是一种潜在的有前途的策略,可以通过增加紫外线辐射(UVR)保护和皮肤癌检查来改变皮肤癌风险行为。
    目的:本研究旨在比较3种旨在改变紫外线照射的数字干预措施,防晒,和皮肤癌检测行为在中高危人群中。
    方法:本研究是2种积极干预措施的混合II型有效性实施随机对照试验,数字皮肤癌风险降低干预措施(UV4。我[基本])与增强版本(UV4。me2[增强]),和一本电子小册子(e-pamphlet)。在一年的时间里,对主要通过Facebook和Instagram招募的1369名美国年轻人进行了干预效果评估。鼓励干预参与和行为改变的增强措施包括更全面的目标设定活动,与先前建立的调解员相关的持续主动消息传递(例如,自我效能)的UVR暴露和保护,模块完成的嵌入式激励措施,以及正在进行的新闻和视频更新。通过线性回归评估的主要结果效果是UVR暴露和防晒和防护习惯。通过逻辑回归评估的次要结果效果是皮肤自我检查,医生皮肤检查,防晒霜的使用,室内鞣制,还有晒伤.
    结果:与电子小册子相比,积极干预措施增加了防晒(基本:P=.02;增强:P<.001)和习惯性防晒(基本:P=.04;增强P=.01)。增强的干预比基本的干预增加了更多的防晒。每次主动干预在3个月的随访中增加了防晒霜的使用(基本:P=.03;增强:P=.01),并在1年时进行皮肤自我检查(基本:P=.04;增强:P=.004),与电子小册子相比。其他干预效果以及基本干预效果和增强干预效果之间的差异不显着。
    结论:积极干预措施可有效改善多种皮肤癌风险和皮肤癌预防行为。与基础干预相比,加强干预增加了防晒的改善,但没有其他行为。未来的分析将探索干预参与(例如,审查内容的比例)。
    背景:ClinicalTrials.govNCT03313492;http://clinicaltrials.gov/ct2/show/NCT03313492。
    BACKGROUND: Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations.
    OBJECTIVE: This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer.
    METHODS: This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn.
    RESULTS: The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant.
    CONCLUSIONS: The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed).
    BACKGROUND: ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.
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  • 文章类型: Journal Article
    目的:寻常痤疮的几种治疗方案因其相关不良反应而受到限制。一种创新的方法涉及在使用选择性光热解破坏毛囊之前将光吸收纳米颗粒引入皮脂腺毛囊中。我们旨在研究将金和铂纳米颗粒引入皮脂腺毛囊的有效方法,并确定有效破坏这些毛囊的合适激光设备和参数。
    方法:我们使用猪皮肤作为实验模型。我们比较了thu激光的功效,超声,和手动按摩,并评估了在皮脂腺毛囊附近递送纳米颗粒的最佳方法。随后,使用1064nm波长的掺钕钇铝石榴石(Nd:YAG)激光诱导选择性光热解。我们比较了不同的参数,以确定Nd:YAG激光的最佳脉冲持续时间和通量。使用苏木精和伊红(H&E)染色评估皮脂腺毛囊的渗透和破坏程度,并进行了数值评估。
    结果:H&E染色显示,长脉冲Nd:YAG激光照射后,使用thu激光和超声电泳的组合有效地破坏了皮脂腺毛囊,破坏率超过50%。这些结果对于Nd:YAG激光的长脉冲持续时间和高通量是有效的。
    结论:这项研究表明,通过微通道和超声电泳的组合,可以通过金和铂纳米颗粒的混合物有效地破坏皮脂腺毛囊,随后是1064nm长脉冲高通量Nd:YAG激光引起的选择性热损伤。
    OBJECTIVE: Several treatment options for acne vulgaris are limited by their associated adverse effects. An innovative approach involves introducing light-absorbing nanoparticles into sebaceous follicles before destroying the follicles using selective photothermolysis. We aimed to investigate efficient methods for introducing gold and platinum nanoparticles into sebaceous follicles and to identify suitable laser equipment and parameters for the effective destruction of these follicles.
    METHODS: We used porcine skin as the experimental model. We compared the efficacies of a thulium laser, ultrasound, and manual massage and evaluated the optimal method for delivering nanoparticles in close proximity to sebaceous follicles. Subsequently, a 1064-nm-wavelength neodymium-doped yttrium aluminum garnet (Nd: YAG) laser was employed to induce selective photothermolysis. We compared different parameters to identify the optimal pulse duration and fluence of the Nd: YAG laser. The extent of penetration and destruction of sebaceous follicles was assessed using hematoxylin and eosin (H&E) staining, and a numerical evaluation was conducted.
    RESULTS: H&E staining showed that irradiation with a long-pulsed Nd: YAG laser following a combination of thulium laser and sonophoresis effectively destroyed sebaceous follicles, with destruction rates exceeding 50%. These results were valid with a long pulse duration and a high fluence of the Nd: YAG laser.
    CONCLUSIONS: This study demonstrated that sebaceous follicles can be effectively destroyed through a mixture of gold and platinum nanoparticle delivery by a combination of microchanneling and sonophoresis, followed by selective thermal damage induced by a 1064-nm long-pulsed high-fluence Nd: YAG laser.
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  • 文章类型: Journal Article
    背景:消费品,例如电动剃须刀,以压力和剪切的形式在皮肤上施加动态载荷的组合。这种机械刺激可能导致不适和皮肤组织反应,其特征为“皮肤敏感性”。为了将剃须后的不适降至最低,需要使用光学相干断层扫描(OCT)等先进工具建立特定的刺激-反应关系.
    目的:探讨电剃刮刺激后皮肤形态和微血管功能的时空变化。
    方法:招募10名健康男性志愿者。这项研究包括对前臂进行60秒的电剃刺激,脸颊和脖子。在基线时记录皮肤参数,刺激后20分钟和刺激后24小时。使用OCT估计结构和动态皮肤参数,同时记录了经皮水分流失(TEWL),以提供皮肤屏障功能的参考值。
    结果:在基线时,八个参数中的六个显示了前臂和面部部位之间的统计学差异,而颊部和颈部之间仅表面粗糙度(Rq)和反射率有统计学差异(p<0.05)。剃须后20分钟,TEWL值显着增加,伴随着血液灌注的增加,变化幅度取决于解剖部位。刺激后24小时观察到恢复特征,大多数参数恢复到基础值,强调刺激的短暂影响。
    结论:OCT参数显示皮肤组织对电剃的反应在空间和时间上存在差异。这种方法可以告知剃须刀设计并防止皮肤敏感。
    BACKGROUND: Consumer products such as electrical shavers exert a combination of dynamic loading in the form of pressure and shear on the skin. This mechanical stimulus can lead to discomfort and skin tissue responses characterised as \"Skin Sensitivity\". To minimise discomfort following shaving, there is a need to establish specific stimulus-response relationships using advanced tools such as optical coherence tomography (OCT).
    OBJECTIVE: To explore the spatial and temporal changes in skin morphology and microvascular function following an electrical shaving stimulus.
    METHODS: Ten healthy male volunteers were recruited. The study included a 60-s electrical shaving stimulus on the forearm, cheek and neck. Skin parameters were recorded at baseline, 20 min post stimulus and 24 h post stimulus. Structural and dynamic skin parameters were estimated using OCT, while transepidermal water loss (TEWL) was recorded to provide reference values for skin barrier function.
    RESULTS: At baseline, six of the eight parameters revealed statistically significant differences between the forearm and the facial sites, while only surface roughness (Rq) and reflectivity were statistically different (p < 0.05) between the cheek and neck. At 20 min post shaving, there was a significant increase in the TEWL values accompanied by increased blood perfusion, with varying magnitude of change dependent on the anatomical site. Recovery characteristics were observed 24 h post stimulus with most parameters returning to basal values, highlighting the transient influence of the stimulus.
    CONCLUSIONS: OCT parameters revealed spatial and temporal differences in the skin tissue response to electrical shaving. This approach could inform shaver design and prevent skin sensitivity.
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  • 文章类型: Journal Article
    胶原蛋白膳食补充剂作为减少皮肤老化迹象的手段正变得越来越受欢迎。这三方的目标,随机化,安慰剂对照,双盲研究旨在研究和对比日剂量5g水解胶原蛋白和80mg维生素C(CP产品)以及它们与30mg透明质酸(CPHA产品)联合使用16周的饮食补充效果.验证的方法用于皮肤参数的客观评估。总的来说,87个科目(妇女,40-65岁)完成了整个审判,各组分布如下:安慰剂组(n=29),CPHA组(n=28),CP组(n=30)。结果显示两种测试产品的有益效果,真皮密度显著增强,皮肤纹理,减少皱纹的严重程度。相比之下,两种产品的给药对皮肤弹性或水合作用均无明显影响.所研究的皮肤参数的观察未显示出将透明质酸(HA)添加到胶原蛋白中的优异效果。因此,除了单独补充胶原蛋白之外,补充HA改善对所研究皮肤参数的影响的能力无法得到证实。
    Collagen dietary supplements are becoming increasingly popular as a means to reduce signs of skin ageing. The objective of this three-way, randomised, placebo-controlled, double-blind study was to examine and contrast the effects of dietary supplementation with a daily dose of 5 g hydrolysed collagen with 80 mg of vitamin C (CP product) and their combination with 30 mg of hyaluronic acid (CPHA product) over 16 weeks. Validated methods were utilised for the objective evaluation of skin parameters. In total, 87 subjects (women, 40-65 years) completed the entire trial, distributed across the groups as follows: placebo group (n = 29), CPHA group (n = 28), and CP group (n = 30). The results showed beneficial effects of both test products, with notable enhancements in dermis density, skin texture, and a reduction in the severity of wrinkles. In contrast, the administration of either of the products did not yield any significant impacts on skin elasticity or hydration. Observation of the investigated skin parameters did not show superior effects of the addition of hyaluronic acid (HA) to collagen. Therefore, the ability of supplementation with HA to improve the effects on investigated skin parameters beyond the supplementation of collagen alone cannot be confirmed.
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  • 文章类型: Journal Article
    背景:迄今为止,没有公认的结果监测措施,关于硬伤的具体监测标准的共识仍然难以捉摸。一些研究已经评估了皮肤超声在角膜中的标准有效性。所以,在这项研究中,我们接近的超声检查结果在角膜病变。
    方法:这是一项在2021年12月至2023年5月之间进行的回顾性分析研究。在皮肤科门诊对患者进行临床评估,然后进行高频超声(HF-US)评估,并选择纳入本研究。病变也通过组织病理学证实。在病变部位和对称未受累的另一侧进行超声检查评估。记录真皮厚度和真皮回声。通过使用双尾学生t检验进行组差异的统计学分析。小于0.05的P值被认为是统计学上显著的。
    结果:研究中纳入了27例患者的41例炎症期的角膜病变。角膜病变的平均真皮厚度为1107.97±414.3,对照侧的平均真皮厚度为1094.65±331.06,这两个变量之间的差异无统计学意义。病变的平均真皮密度为49.13±18.97,对照侧的平均真皮密度为52.22±25.33。这两个变量之间的差异没有统计学意义。
    结论:这项研究表明,HF-US表明在组织病理学证实的炎症阶段,角膜病变的真皮厚度增加,真皮密度降低。
    BACKGROUND: To date, there are no accepted outcome measures to monitor morphea, and consensus on specific monitoring criteria for morphea remains elusive. A few studies have assessed the criterion validity of skin ultrasound in morphea. So, in this study, we approach ultrasound findings in morphea lesions.
    METHODS: This was a retrospective-analytical study conducted between December 2021 and May 2023. Patients were clinically evaluated at a dermatology outpatient clinic and then referred for high-frequency ultrasound (HF-US) evaluation and were selected to be included in this study. The lesions were confirmed by histopathology as well. Sonographic evaluations were performed on the lesion site and the symmetrical uninvolved other side. Dermal thickness and dermal echogenicities were recorded. Statistical analysis of group differences was performed by using the 2-tailed Student t-test. A p-value of less than 0.05 was considered statistically significant.
    RESULTS: Forty-one morphea lesions in the inflammatory phase of 27 patients were included in the study. The mean dermal thickness of morphea lesions was 1107.97 ± 414.3 and the mean dermal thickness of the control side was 1094.65 ± 331.06, The difference between these two variables was not statistically significant. The mean dermal density of lesions was 49.13 ± 18.97 and the mean dermal density of the control side was 52.22 ± 25.33. The difference between these two variables was not statistically significant.
    CONCLUSIONS: This study shows that HF-US indicated increasing dermal thickness and reducing the dermal density of the morphea lesions in the inflammatory phase confirmed with the histopathology.
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  • 文章类型: Journal Article
    本研究旨在评估温和的洗发水和含有Adelmidrol的摩丝的效果,木薯淀粉和非处方抗菌复合物对脂溢和其他临床症状继发于犬特应性皮炎(cAD)。纳入46只在瘙痒视觉模拟评分(P-VAS)和/或细菌/马拉色菌过度生长上具有cAD相关脂溢和/或瘙痒>4cm的狗。慕斯每天涂两次,在第(D)0、7、14和28天通过皮肤脂溢性指数(SSI)评估狗,P-VAS,cAD病变指数(CADLI),和半定量细胞学评分。前两周平均SSI值改善(4.1±0.37至1.9±0.30;p<0.0001)。平均P-VAS评分(cm)从D0时的6.6±0.19降至D14时的3.8±0.31(p<0.0001)。平均CADLI评分在D14时从13.7±1.24降至8.5±1.14(p<0.001)。细菌和马拉色菌的细胞学评分分别从3.2±0.10和3.2±0.11下降,至1.2±0.19和1.2±0.24(p<0.0001)。所有研究的体征在D28进一步改善。总之,这些观察结果表明,所测试的方案可能有助于管理cAD相关症状.
    The present study aimed at evaluating the effect of a gentle shampoo and a mousse containing Adelmidrol, tapioca starch and a non-prescription antimicrobial complex on seborrhoea and other clinical signs secondary to canine atopic dermatitis (cAD). Forty-six dogs with cAD-associated seborrhoea and/or pruritus > 4 cm on the pruritus visual analogue scale (P-VAS) and/or bacterial/Malassezia overgrowth were enrolled. The mousse was applied twice daily, and dogs were evaluated at days (D)0, 7, 14 and optionally 28, by means of a skin seborrheic index (SSI), P-VAS, cAD lesion index (CADLI), and a semiquantitative cytological score. The mean SSI value improved during the first two weeks (4.1 ± 0.37 to 1.9 ± 0.30; p < 0.0001). The mean P-VAS score (cm) decreased from 6.6 ± 0.19 at D0 to 3.8 ± 0.31 at D14 (p < 0.0001). The mean CADLI score dropped from 13.7 ± 1.24 to 8.5 ± 1.14 at D14 (p < 0.001). The cytological score for bacteria and Malassezia decreased from 3.2 ± 0.10 and 3.2 ± 0.11, respectively, to 1.2 ± 0.19 and 1.2 ± 0.24 (p < 0.0001). All the investigated signs further improved at D28. Altogether, these observations suggest that the tested protocol might be useful in managing cAD-associated signs.
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  • 文章类型: Journal Article
    视觉评估,而在临床实践中,色素沉着和红斑的主要评估方法,是主观的,耗时,并可能导致临床医生之间的观察差异。需要客观和定量技术来精确评估疾病的严重程度和治疗效果。这项研究检查了新开发的皮肤成像系统在评估色素沉着和红斑方面的准确性和实用性。招募了60名参与者,他们的面部图像用新的OBSERV520x皮肤成像系统分析,与DERMACATCH进行区域分析和VISIA进行全面检查相比。使用皮肤科医生评估的MASI评分对皮肤色素沉着的程度进行临床分级。数据显示,新型皮肤成像系统与两种常规仪器在定量色素沉着和红斑方面呈正相关。无论是区域分析还是全面分析。此外,新的皮肤成像系统与临床MASI评分呈正相关(r=0.4314,P<0.01)。相比之下,我们的研究发现传统系统和临床评估之间没有显着相关性,表明在新系统中更有能力评估色素沉着过度。我们的研究验证了创新的皮肤成像系统在评估色素沉着和红斑方面的准确性,证明其在临床和研究目的的定量评估的可行性。
    Visual assessment, while the primary method for pigmentation and erythema evaluation in clinical practice, is subjective, time-consuming, and may lead to variability in observations among clinicians. Objective and quantitative techniques are required for a precise evaluation of the disease\'s severity and the treatment\'s efficacy. This research examines the precision and utility of a newly developed skin imaging system in assessing pigmentation and erythema. Sixty participants were recruited, and their facial images were analyzed with the new OBSERV 520 x skin imaging system, compared to DERMACATCH for regional analysis and VISIA for full-face examination. The degree of skin pigmentation was clinically graded using the MASI scores evaluated by dermatologists. The data revealed positive correlations between the novel skin imaging system and the two conventional instruments in quantifying pigmentation and erythema, whether in regional or full-face analysis. Furthermore, the new skin imaging system positively correlated with the clinical MASI scores (r = 0.4314, P < 0.01). In contrast, our study found no significant correlation between the traditional system and clinical assessment, indicating a more substantial capacity for hyperpigmentation assessment in the new system. Our study validates the innovative skin imaging system\'s accuracy in evaluating pigmentation and erythema, demonstrating its feasibility for quantitative evaluation in both clinical and research purposes.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:皮肤镜检查是一个不断发展的领域,它使用显微镜使皮肤科医生和初级保健医生能够识别皮肤病变。对于给定的皮肤损伤,存在各种各样的鉴别诊断,这对于没有经验的用户来说,命名和理解可能是具有挑战性的。
    目的:在本研究中,我们描述了皮肤镜鉴别诊断浏览器(D3X)的创建,将皮肤观察模式与鉴别诊断联系起来的本体论。
    方法:合并到D3X中的现有本体包括视觉本体的元素和视觉本体的皮肤镜元素,将视觉特征与皮肤观察模式联系起来。根据文献并与领域专家协商,生成了每种模式的鉴别诊断列表。开源图像来自DermNet,皮肤科,和开放获取的研究论文。
    结果:D3X采用OWL2Web本体语言编码,包括3041个逻辑公理,1519班,103个对象属性,和20个数据属性。我们使用符号学理论驱动的度量标准将D3X与皮肤病学领域中的公开可用本体进行了比较,以测量D3X与其他人的先天素质。结果表明,D3X与皮肤病学领域的其他本体具有足够的可比性。
    结论:D3X本体是一种资源,可以将皮肤镜鉴别诊断和补充信息与现有的基于本体的资源链接并集成。未来的方向包括开发基于D3X的Web应用程序,用于皮肤镜检查教育和临床实践。
    BACKGROUND: Dermoscopy is a growing field that uses microscopy to allow dermatologists and primary care physicians to identify skin lesions. For a given skin lesion, a wide variety of differential diagnoses exist, which may be challenging for inexperienced users to name and understand.
    OBJECTIVE: In this study, we describe the creation of the dermoscopy differential diagnosis explorer (D3X), an ontology linking dermoscopic patterns to differential diagnoses.
    METHODS: Existing ontologies that were incorporated into D3X include the elements of visuals ontology and dermoscopy elements of visuals ontology, which connect visual features to dermoscopic patterns. A list of differential diagnoses for each pattern was generated from the literature and in consultation with domain experts. Open-source images were incorporated from DermNet, Dermoscopedia, and open-access research papers.
    RESULTS: D3X was encoded in the OWL 2 web ontology language and includes 3041 logical axioms, 1519 classes, 103 object properties, and 20 data properties. We compared D3X with publicly available ontologies in the dermatology domain using a semiotic theory-driven metric to measure the innate qualities of D3X with others. The results indicate that D3X is adequately comparable with other ontologies of the dermatology domain.
    CONCLUSIONS: The D3X ontology is a resource that can link and integrate dermoscopic differential diagnoses and supplementary information with existing ontology-based resources. Future directions include developing a web application based on D3X for dermoscopy education and clinical practice.
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