This survey represents the first endeavor to assess the clarity of the dermoscopic language by a chatbot, unveiling insights into the interplay between dermatologists and AI systems within the complexity of the dermoscopic language. Given the complex, descriptive, and metaphorical aspects of the dermoscopic language, subjective interpretations often emerge. The survey evaluated the completeness and diagnostic efficacy of chatbot-generated reports, focusing on their role in facilitating accurate diagnoses and educational opportunities for novice dermatologists. A total of 30 participants were presented with hypothetical dermoscopic descriptions of skin lesions, including dermoscopic descriptions of skin cancers such as BCC, SCC, and melanoma, skin cancer mimickers such as actinic and seborrheic keratosis, dermatofibroma, and atypical nevus, and inflammatory dermatosis such as psoriasis and alopecia areata. Each description was accompanied by specific clinical information, and the participants were tasked with assessing the differential diagnosis list generated by the AI chatbot in its initial response. In each scenario, the chatbot generated an extensive list of potential differential diagnoses, exhibiting lower performance in cases of SCC and inflammatory dermatoses, albeit without statistical significance, suggesting that the participants were equally satisfied with the responses provided. Scores decreased notably when practical descriptions of dermoscopic signs were provided. Answers to BCC scenario scores in the diagnosis category (2.9 ± 0.4) were higher than those with SCC (2.6 ± 0.66, p = 0.005) and inflammatory dermatoses (2.6 ± 0.67, p = 0). Similarly, in the teaching tool usefulness category, BCC-based chatbot differential diagnosis received higher scores (2.9 ± 0.4) compared to SCC (2.6 ± 0.67, p = 0.001) and inflammatory dermatoses (2.4 ± 0.81, p = 0). The abovementioned results underscore dermatologists’ familiarity with BCC dermoscopic images while highlighting the challenges associated with interpreting rigorous dermoscopic images. Moreover, by incorporating patient characteristics such as age, phototype, or immune state, the differential diagnosis list in each case was customized to include lesion types appropriate for each category, illustrating the AI’s flexibility in evaluating diagnoses and highlighting its value as a resource for dermatologists.

The emergence of systemic therapies and photoprotection against non-melanoma skin cancer (NMSC) raises questions on the broader systematic impact of the disease. Personalized medicine involves a holistic patient approach, through which the evaluation of systemic biomarkers can reveal the interconnected aspects of patient health and tailored therapies. Cumulative UV exposure disrupts redox equilibrium and triggers inflammation and cutaneous immunosuppression, processes that contribute independently or via their interplay to cutaneous carcinogenesis. This systemic impact can be further reinforced by biomolecules derived from the NMSC microenvironment, fueling a continuous cycle of oxidative stress and inflammation in the organism. Regarding investigation of the systemic burden of NMSC, we conducted a narrative review focusing on parameters related to redox status, inflammation, and immune suppression observed in the blood components (serum, plasma, and erythrocytes) of NMSC patients. Our findings revealed an association of NMSC patients with perturbations of redox homeostasis, as evidenced by the decreased antioxidant activity, lower levels of non-enzymatic antioxidants, and increased byproducts of lipid, protein, and DNA oxidative damage. Additionally, NMSC patients presented augmented levels of pro-inflammatory interleukins, reduced anti-tumor biomolecule levels, and enhanced immune response markers, as well as elevated vitamin D levels. These systemic changes may lead to the association of NMSC with a higher risk of secondary malignancies in other organs. Overall, the findings of the present study suggest that NMSC affects systemic health beyond the skin, underscoring the need for a comprehensive and individualized approach to the management and monitoring of the patient.

This literature review aims to comprehensively evaluate the clinical and dermoscopic presentations of common pediatric diseases among children with skin of color (SoC) while also addressing potential variations based on racial backgrounds. This review encompasses various conditions, such as nevi subtypes, viral infections, infestations, and inflammatory dermatoses, as well as hair diseases and abnormal vascular formations, occurring in pediatric populations. Overall, we identified 7 studies on nevi subtypes, 24 studies on skin infections, 6 on inflammatory dermatoses, 10 on hair diseases and disorders, and 14 on miscellaneous disorders that also satisfied our SoC- and race-specific criteria. In case of no results, we assumed that dermoscopic findings are similar between SoC adults and children, confirming the hypothesis with our cases of dark-skinned Indian child patients. Inflammatory dermatoses such as psoriasis, eczema, and cutaneous mastocytosis, as well as skin infections like cutaneous leishmaniasis, appear with brownish backgrounds or exhibit dark structures more frequently than the respective dermoscopy images of Caucasian populations. Dermoscopy traits such as erythema in tinea capitis are uncommon or even absent on a dark-colored scalp, while a dark skin tone often obscures many characteristic features, such as dark and yellow dots in alopecia areata and even parts of an intradermal parasite in the case of scabies. Race-specific traits were also observed, such as corkscrew hair in tinea capitis, primarily seen in patients of African origin. Many dermoscopic images are consistent between SoC and non-SoC in various skin lesions, including vascular anomalies, juvenile xanthogranuloma, mastocytoma, and viral skin lesions like molluscum contagiosum, as well as in various hair disorders such as trichotillomania, while tinea capitis displays the most diverse reported dermoscopic features across SoC- and race-specific studies.

Background and Objectives: Artificial intelligence (AI) has transitioned to an integral part of dermatology in only few years, yet perceptions of its use vary widely, reflecting diverse hopes, concerns, and perceived clinical utility. Materials and Methods: In this study, 300 dermatologists from 13 countries, representing a range of experience levels and AI usage statuses, were surveyed regarding the characteristics and applications of AI in dermatology. Results: Among respondents, 61.33% reported having used AI tools in clinical practice. Adoption of AI was observed across all age groups, countries, and experience levels. Analysis of the types of AI tools used revealed a strong reliance on general-purpose large language models (LLMs), with chatbots being the most frequently cited category, utilized by 58.15% of users. Younger clinicians demonstrated a significant preference for chatbots (p < 0.05). Country-specific patterns in AI adoption were also noted. The most highly rated expected benefit of AI in dermatology was improved diagnostic accuracy, while the primary concern centered on regulatory and ethical limitations, suggesting that the “AI revolution” in dermatology is currently constrained less by technical barriers and more by regulation considerations. Use of consent forms when AI use takes place was more frequently reported as mandatory by dermatologists who had never used AI, reflecting heightened caution among non-users (p = 0.03). Additionally, 75% of respondents agreed that formal training in AI is necessary, highlighting a significant gap in traditional medical education regarding emerging technologies.

The dermoscopic rainbow pattern (RP), also known as polychromatic pattern, is characterized by a multicolored appearance, resulting from the dispersion of polarized light as it penetrates various tissue components. Its separation into different wavelengths occurs according to the physics principles of scattering, absorption, and interference of light, creating the optical effect of RP. Even though the RP is regarded as a highly specific dermoscopic indicator of Kaposi’s sarcoma, in the medical literature, it has also been documented as an atypical dermoscopic finding of other non-Kaposi skin entities. We aim to present two distinct cases—a pigmented basal cell carcinoma (pBCC) and an aneurysmatic dermatofibroma—that exhibited RP in dermoscopy and to conduct a thorough review of skin conditions that display RP, revealing any predisposing factors that could increase the likelihood of its occurrence in certain lesions. We identified 33 case reports and large-scale studies with diverse entities characterized by the presence of RP, including skin cancers (Merkel cell carcinoma, BCC, melanoma, etc.), adnexal tumors, special types of nevi (blue, deep penetrating), vascular lesions (acroangiodermatitis, strawberry angioma, angiokeratoma, aneurismatic dermatofibromas, etc.), granulation tissue, hypertrophic scars and fibrous lesions, skin infections (sporotrichosis and cutaneous leishmaniasis), and inflammatory dermatoses (lichen simplex and stasis dermatitis). According to our results, the majority of the lesions exhibiting the RP were located on the extremities. Identified precipitating factors included the nodular shape, lesion composition and vascularization, skin pigmentation, and lesions’ depth and thickness. These parameters lead to increased scattering and interference of light, producing a spectrum of colors that resemble a rainbow.

Keratoacanthoma (KA) is a fast-growing skin tumor subtype that can be observed as a solitary lesion or rarely as multiple lesions in the context of rare genetic syndromes. Syndromes with multiple keratoacanthoma-like lesions have been documented as multiple self-healing squamous epithelioma (Ferguson–Smith syndrome), eruptive keratoacanthoma of Grzybowski, multiple familial keratoacanthoma of Witten and Zak Muir–Torre syndrome, and incontinentia pigmenti. The treatment approach of those entities is challenging due to the numerous lesions, the lesions’ undefined nature, and the co-existence of other malignant skin tumors. Herein, we report a case of a 40-year-old woman who developed multiple treatment-resistant Ferguson–Smith-like keratoacanthomas with a co-existing large and ulcerated invasive squamous cell carcinoma and microcystic adnexal carcinoma on the scalp. Multiple keratoacanthomas on her extremities were successfully treated with oral acitretin (0.5 mg/kg/day) in combination with topical Fluorouracil (5-FU) 5%, while excision and plastic surgery restoration were performed to treat the ulcerated cancer lesion on her scalp. Due to the interesting nature of this rare syndrome, we performed a literature review including case reports and case series on multiple-KA-like lesions syndromes and focusing on diagnosis and therapy approaches. We also conducted a comparison of patient reports, which included assessing the clinical appearance of the lesions and evaluating the success and progress or the failure of various treatment approaches that were implemented.