Exploring the Potential of DALL-E 2 in Pediatric Dermatology: A Critical Analysis.

INTRODUCTION: Artificial intelligence (AI) is becoming increasingly explored for its potential applications in dermatology. Among various AI models, DALL-E 2 (San Francisco, CA: OpenAI), which generates de novoimages from textual inputs, has garnered significant attention for its remarkable photorealism. In our study, we aimed to analyze the performance of DALL-E 2 in the context of dermatology. METHODS: The following 12 pediatric dermatological conditions common to ages <15 years were selected as tests: acne, atopic dermatitis, contact dermatitis, vitiligo, congenital melanocytic nevus, warts, molluscum contagiosum, seborrheic dermatitis, alopecia areata, infantile hemangioma, impetigo, and dermatophytosis, specifically tinea corporis. Representative morphological descriptions of each diagnosis, along with their corresponding names, were inputted into DALL-E 2 as textual prompts and subsequently compared. The accuracy of the generated images and their alignment with the intended descriptions were assessed. RESULTS: Among the total of 24 images reported, 18 were photorealistic and six were cartoons. More cartoons were generated when providing the model with morphological descriptions as textual inputs compared to when diagnoses were inputted. While not entirely accurate, acne stood out as the only diagnosis that was the most consistent and closest to the actual diagnosis. Both images of acne portrayed erythematous papules scattered across the face. However, DALL-E 2 resulted in poor performance for the remaining eleven diagnoses. They did not accurately represent the intended diagnoses nor align with their counterpart image. Moreover, most of the generated images featured lighter skin tones. CONCLUSION: In assessing DALL-E 2's applications in dermatology, our study highlights the need for more domain-specific and demographically inclusive training data in its algorithms to improve performance.

Google search trends about systemic psoriasis treatment: what do people want to know about biologics and JAK inhibitors?

UNSTRUCTURED: This study investigates the most frequently asked questions regarding systemic treatments for psoriasis vulgaris using Google Trends and People Also Asked (PAA) tools, focusing on traditional DMARDs, biologics, and small-molecule inhibitors. Analyzing data from January 31, 2019, to January 31, 2024, Adalimumab was found to have the highest search volume, followed by Apremilast and Methotrexate in their respective categories. Based on Rothwell's Question Classification Criteria, questions about Adalimumab predominantly centered around their technical, factual details and cost of the medication. The study highlights significant public interest in these factors over their safety profile and it is likely influenced by Adalimumab's high direct-to-consumer marketing. Moreover, evaluation of 782 websites showed that potential patients were seeking commercial and government-based websites to learn more about systemic psoriasis treatment. According to the JAMA benchmark criteria, these source types also scored the highest in terms of information quality, while medical practice websites scored the lowest. The findings suggest the need for dermatologists to address factual details such as medication administration scheduling, dietary restrictions, and cost during patient consultations, and to guide patients towards high-quality online resources. Limitations include potential comprehensiveness of questions and evolving medication concerns.

Successful Treatment of Keloids and Hypertrophic Scars With Systemic and Intralesional Dupilumab.

Keloids and hypertrophic scars negatively impact the quality of life for millions of people in the world. Unfortunately, though many thera-peutic approaches are used to treat scars, they are often limited in efficacy with high rates of recurrence. Lately, a better understanding of the immune dysregulation of several dermatologic conditions has led to the emergence of multiple cytokine-targeted therapies for numerous conditions. Several studies have implicated T helper 2 (Th2) immune dysregulation in the development of scars and keloids, with interleukins (IL)-4 and -13 identified as pro-fibrotic mediators. Dupilumab is an IL-4 receptor alpha antagonist that inhibits the ex-pression of both IL-4 and -13. Herein, we describe a 44-year-old woman who developed numerous disfiguring hypertrophic scars and keloids after suffering from a severe herpes zoster infection. Given the number of scars, intralesional corticosteroid injections were not feasible. Therefore, treatment with systemic dupilumab was initiated. Many scars flattened, several even developing a cigarette-paper-like texture due to rapid involution. The largest and most recalcitrant keloid was further treated with intralesional dupliumab injec-tions every 2 weeks with an even more dramatic improvement noted in 2 months. To our knowledge, this is the first report of treating multiple keloids and hypertrophic scars with both systemic and intralesional dupilumab. Dermatologists may want to consider treating keloids that cover a large area with systemic dupilumab, a therapy with an established, reassuring safety profile. The most recalcitrant areas may further benefit from concentrating dupilumab by intralesional delivery. J Drugs Dermatol. 2023;22(12):1220-1222.  doi:10.36849/JDD.6385.

OnabotulinumtoxinA for Systemic Sclerosis-associated Raynaud's Phenomenon: A Multi-Institutional Study on Accessibility and Effectiveness.

Raynaud’s phenomenon (RP), a common presenting symptom of systemic sclerosis (SSc), is a painful and debilitating condition of the digits caused by increased vascular reactivity.1,2.

Dermatomyositis: An Update on Diagnosis and Treatment.

Dermatomyositis is a rare inflammatory disease with characteristic cutaneous findings and varying amounts of systemic involvement. Patients may present with skin disease alone, have concomitant muscle disease, or have extracutaneous manifestations such as pulmonary disease or an associated malignancy. Given such diverse presentations, dermatomyositis is both a diagnostic and therapeutic challenge. However, a prompt diagnosis is of utmost importance to institute adequate therapy and screen patients for an associated malignancy. Dermatologists should play a crucial role in the diagnosis and management of patients with dermatomyositis as cutaneous disease tends to be chronic, negatively impact quality of life, and be more recalcitrant to therapy. In this review, we discuss diagnosis, with a focus on myositis-specific antibodies and their associated phenotypes. We also review therapies available for this often refractory skin disease.