ABSTRACT
BACKGROUND: With advances in medical imaging systems, digital dermoscopy has become one of the major imaging modalities in the analysis of skin lesions. Thus, automated segmentation or border detection has a great impact on the subsequent steps of skin cancer computer-aided diagnosis using demoscopy images. Since dermoscopy images suffer from artifacts such as shading and hair, there is a need for automated and robust artifact attenuation removal and lesion border detection. METHODS: method for segmentation of dermoscopy images is proposed based on active contour. To this end, at first, a simple method for hair pixels is restored and a new scheme for shading detection is proposed. Then, particle swarm optimization (PSO) algorithm is applied to select the best coefficients for converting RGB to gray level. The obtained gray level image is then used as input for multi Otsu method which provides initial contour for border detection using active contour. Finally, Chan and Vese active contour is used for final lesion border detection. RESULTS: The method is tested on a total of 145 dermoscopic images: 79 cases with benign lesion and 75 cases with melanoma lesion. Mean accuracy, sensitivity and specificity were obtained 94%, 78.5% and 99%, respectively. CONCLUSION: Results reveal that the proposed method segments the lesion from dermoscopy images accurately.
ABSTRACT
BACKGROUND: Psoriasis is a common chronic inflammatory disease with unpredictable prognosis. Given the immunomodulatory effects of statins, the present study was conducted to determine whether the addition of orally administered simvastatin to the topical betamethasone, a standard antipsoriatic treatment, can produce a more powerful therapeutic response against this clinical conundrum. METHOD: In a double-blind study, 30 patients with plaque type psoriasis were randomly divided into two equal treatment groups. Group 1 received oral simvastatin (40 mg/d) plus topical steroid (50% betamethasone in petrolatum) for 8 weeks and group 2 received oral placebo plus the same topical steroid for the same time period. Psoriasis Area and Severity Index (PASI) score was checked before and at the end of the treatment period. RESULTS: PASI score decreased significantly in both groups, but the decline of PASI score was more significant in patients who received simvastatin (Mann-Whitney test; P-value = 0.001). No side effect or any laboratory abnormality was detected in patients. CONCLUSION: Our work, which is the first double-blind, randomized, placebo-controlled study on this subject, shows that oral simvastatin enhances the therapeutic effect of topical steroids against psoriasis. The increased risk of cardiovascular accidents in psoriatic patients and the protective effect of statins against cardiovascular disease further encourages their use in the treatment of this clinical conundrum.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Betamethasone/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Psoriasis/drug therapy , Simvastatin/administration & dosage , Administration, Oral , Administration, Topical , Adolescent , Adult , Aged , Double-Blind Method , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Psoriasis/pathology , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
Psoriasis is a common chronic inflammatory disease with unpredictable prognosis. Given the immunomodulatory effects of statins; the present study was conducted to determine whether the addition of orally administered simvastatin to the topical betamethasone; a standard antipsoriatic treatment; can produce a more powerful therapeutic response against this clinical conundrum. In a double-blind study; 30 patients with plaque type psoriasis were randomly divided into two equal treatment groups. Group 1 received oral simvastatin (40 mg/d) plus topical steroid (50betamethasone in petrolatum) for 8 weeks and group 2 received oral placebo plus the same topical steroid for the same time period. Psoriasis Area and Severity Index (PASI) score was checked before and at the end of the treatment period. PASI score decreased significantly in both groups; but the decline of PASI score was more significant in patients who received simvastatin (Mann-Whitney test; P-value=0.001). No side effect or any laboratory abnormality was detected in patients. Our work; which is the first doubleblind; randomized; placebo-controlled study on this subject; shows that oral simvastatin enhances the therapeutic effect of topical steroids against psoriasis. The increased risk of cardiovascular accidents in psoriatic patients and the protective effect of statins against cardiovascular disease further encourages their use in the treatment of this clinical conundrum
