Background: Natural Language Processing (NLP) is a field of both computational linguistics and artificial intelligence (AI) dedicated to analysis and interpretation of human language.Objectives: This systematic review aims at exploring all the possible applications of NLP techniques in the dermatological setting.Methods: Extensive search on ‘natural language processing’ and ‘dermatology’ was performed on MEDLINE and Scopus electronic databases. Only journal articles with full text electronically available and English translation were considered. The PICO (Population, Intervention or exposure, Comparison, Outcome) algorithm was applied to our study protocol.Results: Natural Language Processing (NLP) techniques have been utilized across various dermatological domains, including atopic dermatitis, acne/rosacea, skin infections, non‐melanoma skin cancers (NMSCs), melanoma and skincare. There is versatility of NLP in data extraction from diverse sources such as electronic health records (EHRs), social media platforms and online forums. We found extensive utilization of NLP techniques across diverse dermatological domains, showcasing its potential in extracting valuable insights from various sources and informing diagnosis, treatment optimization, patient preferences and unmet needs in dermatological research and clinical practice.Conclusions: While NLP shows promise in enhancing dermatological research and clinical practice, challenges such as data quality, ambiguity, lack of standardization and privacy concerns necessitate careful consideration. Collaborative efforts between dermatologists, data scientists and ethicists are essential for addressing these challenges and maximizing the potential of NLP in dermatology.

Laser treatments have become popular in Dermatology. In parallel to technologic development enabling the availability of different laser wavelengths, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to explore morphologic and qualitative skin characteristics. Specifically, RCM can be applied to cosmetically sensitive skin areas such as the face, without the need for skin biopsies. For these reasons, apart from its current use in skin cancer diagnosis, our systematic review reveals how RCM can be employed in the field of laser treatment monitoring, being particularly suitable for the evaluation of variations in epidermis and dermis, and pigmentary and vascular characteristics of the skin. This systematic review article aims to provide an overview on current applications of RCM laser treatment monitoring, while describing RCM features identified for different applications. Studies on human subjects treated with laser treatments, monitored with RCM, were included in the current systematic review. Five groups of treatments were identified and described: skin rejuvenation, scar tissue, pigmentary disorders, vascular disorders and other. Interestingly, RCM can assist treatments with lasers targeting all chromophores in the skin and exploiting laser induced optical breakdown. Treatment monitoring encompasses assessment at baseline and examination of changes after treatment, therefore revealing details in morphologic alterations underlying different skin conditions and mechanisms of actions of laser therapy, as well as objectify results after treatment.

Background: Differential diagnosis of amelanotic/hypomelanotic melanoma among solitary flat pink lesions is challenging, due to limited clinical and dermoscopic clues. Dermoscopy and reflectance confocal microscopy assessments improve diagnostic accuracy, but their combined capacity among solitary flat pink lesions is yet to be defined.Objectives: To determine (i) whether diagnostic accuracy is improved with combined dermoscopy and reflectance confocal microscopy, (ii) a model to estimate probability of flat amelanotic/hypomelanotic melanoma among solitary flat pink lesions.Methods: A retrospective single‐centre study of solitary flat pink lesions, excised for suspected malignancy between 2011 and 2022 was performed. Images were independently evaluated by two dermatologists, blinded to histopathological diagnosis. Diagnostic performance was evaluated on the receiver operating characteristic curve and the area under the curve. Predictive features were identified by univariate and multivariate logistic regression analyses. A final predictive nomogram of independent risk factors was calculated by backward likelihood ratio. Hypothesis being tested was formulated before data collection.Results: A total of 184 patients (87 females, 47.3%) were included; mean age was 57.6 years (19–95). Combined dermoscopy and reflectance confocal microscopy was more sensitive (83%, CI 69.2–92.4 and 91.5%, CI 79.6–97.6) than dermoscopy alone (76.6%, CI 62.0–87.7 and 85.1%, CI 71.7–93.8). Predictive features defined the new model, including linear irregular vessels (4.26‐folds, CI 1.5–12.1), peripheral pigment network (6.07‐folds, CI 1.83–20.15), remnants of pigmentation (4.3‐folds, CI 1.27–14.55) at dermoscopy and atypical honeycomb (9.98‐folds, CI 1.91–51.96), disarranged epidermal pattern (15.22‐folds, CI 2.18–106.23), dendritic pagetoid cells in the epidermis (3.77‐folds, CI 1.25–11.26), hypopigmented pagetoid cells (27.05‐folds, CI 1.57–465.5), and dense and sparse nests (3.68‐folds, CI 1.24–10.96) in reflectance confocal microscopy. Diagnostic accuracy of the model was high (AUC 0.91).Conclusions: Adjunctive reflectance confocal microscopy increases diagnostic sensitivity of flat amelanotic/hypomelanotic melanoma differential diagnosis. The proposed model requires validation.

JAK inhibitors are used to treat various inflammatory skin diseases. However, systemic formulations are associated with an increased risk of major adverse events. Ruxolitinib 1.5% cream is a selective topical JAK1 and JAK2 inhibitor, which has recently been approved by EMA and MHRA for treating non‐segmental vitiligo, while being FDA‐approved for both vitiligo and atopic dermatitis. Recent literature has reported the off‐label use of topical Ruxolitinib for several skin conditions, but data are mostly limited to single case reports and series and few prospective studies, with mixed results. We conducted a systematic review of the literature to investigate the potential efficacy of topical Ruxolitinib in various skin diseases in an off‐label setting. The following keywords were used for searching the MEDLINE (Pubmed) and Scopus databases from inception to September 2024: “ruxolitinib cream and dermatology” and “topical ruxolitinib and dermatology”. Reviews, articles not focusing on the main topic, books and book chapters, and articles with no English text were excluded. A total of 170 studies were screened, of which 112 fell within exclusion criteria and 58 were assessed for eligibility. Of these, 28 studies, published between 2012 and 2024, were selected. Ruxolitinib cream resulted in being used off‐label mostly for treating lichenoid and granulomatous dermatoses, as well as alopecia areata. While for the former skin conditions, topical ruxolitinib proved to be effective and safe, results on efficacy in alopecia areata were controversial. Topical ruxolitinib might be a promising therapeutic option for lichenoid and granulomatous dermatoses. Noteworthily, despite the exciting results from the oral formulation, no consistent data were described for topical ruxolitinib in alopecia areata. Our review reported encouraging results for many inflammatory skin conditions that should be investigated in further studies.

Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer globally, accounting for 20% to 50% of all skin cancers