Validity of facial skin analysis pore detection: A comparative analysis.

BACKGROUND: Reliable, objective measures to assess facial characteristics would aid in the assessment of many dermatological treatments. Previous work utilized an iOS application-based artificial intelligence (AI) tool compared to the "gold standard" computer-based and a physician assessment on five skin metrics (British Journal of Dermatology, 2013, 169, 474). The AI tool had superior agreement for all skin metrics except pores and subsequently underwent an algorithm update for its pore detection system. AIMS: This comparative analysis assessed the performance of the updated AI tool's pore scores across all Fitzpatrick skin phototypes to determine whether the AI tool more accurately represents a dermatologist's assessment of pores. PATIENTS/METHODS: Frontal facing photographs in uniform lighting conditions were taken of each participant. Percentile scores were generated by each of the four self-learning models of the updated AI tool. The pore percentile scores generated by the original and updated AI tool were used to rate "worse" pores among participant pairs. These ratings were compared to pore assessments performed by a "gold-standard" device and a board-certified dermatologist. RESULTS: Compared to the original pore detection tool and the computer-based program, models A and D had the highest concordance with the physician's pore assessments for Fitzpatrick skin phototypes III-IV and V-VI, respectively. CONCLUSIONS: The AI tool's pores detection update was successful in its ability to accurately detect pores on all Fitzpatrick skin types, improving on the performance of the AI prior to the update. Responsibly developed AI tools that can accurately and reliably detect skin metrics across diverse Fitzpatrick skin types can facilitate dermatologic evaluation, individualize treatment, and determine treatment response.

Dermatologists' Perspectives on Biosimilars.

BACKGROUND: Biosimilars are biologic agents the Food and Drug Administration (FDA) has deemed to have no clinical difference from their reference biologics. In dermatology,  biosimilars are approved for the treatment of psoriasis and hidradenitis suppurativa. Although dermatologists are high prescribers of biologics, they are more reluctant to prescribe biosimilars than other specialists. This survey-based study sought to characterize dermatologists’ current perspectives on biosimilars.  Methods: A 27-question survey was distributed via email to dermatologists between September and October of 2022.  Results: Twenty percent of respondents would not prescribe a biosimilar for an FDA-approved indication. When asked about the greatest barriers to biosimilar adoption, 61% had concerns about biosimilar safety and efficacy, 24% reported uncertainty about state laws for interchangeability and substitutions, and 20% had concerns about biosimilar safety without concerns about efficacy. Thirty-five percent of respondents felt moderately or extremely knowledgeable about biosimilar interchangeability.  Conclusion: Biosimilars are safe and effective for treating approved dermatological conditions and may lower patient costs compared to their reference products. Patients are not always offered biosimilar therapy as an option, which may be due to unfamiliarity among dermatologists.  This survey suggests a need for more research and educational initiatives, such as modules and workshops that focus on biosimilar safety, efficacy, and interchangeability guidelines. J Drugs Dermatol. 2024;23(4):doi:10.36849/JDD.7755.

A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis.

Topical corticosteroids (TCS) are a mainstay of treatment for atopic dermatitis (AD). There are shared physician and patient concerns that TCS use can result in skin atrophy and systemic absorption. The clinical use of topical calcineurin inhibitors (TCI) for AD is relatively limited despite evidence that TCI are safe and effective. Understanding the differences in efficacy and adverse effects between TCS and TCI can help shape prescription practices to the benefit of patients. The objective of this review is to characterize the difference in efficacy and adverse effects between TCS and TCI. A review of the literature between 2002 and 2022 was performed using the PubMed, EMBASE, and Cochrane Library databases. Ten studies comparing TCS of varying potencies with TCI approved for AD treatment were included in the review. Outcome measures were qualified using percent reductions on the modified Eczema Area and Severity Index score and decreases in physician's global evaluation of AD severity. Tacrolimus had statistically significant (P < .05) improvement in disease severity compared with TCS in 4 of the 5 studies that compared tacrolimus with weak TCS. The data suggest greater treatment efficacy of tacrolimus over weak TCS, and inferior efficacy of pimecrolimus (TCI) compared with both tacrolimus and weak TCS. It is difficult to draw conclusions between moderate, potent, and very potent TCS and TCI due to the small number of available studies. TCI can improve disease severity, especially on thin or intertriginous skin regions most vulnerable to adverse events with TCS treatment, and their use may help overcome adherence issues due to patient bias against TCS.