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Dowdle TS, Tarbox MB. Optimizing clinical and dermatopathology images with the iPhone operating system (IOS) 16 background removal feature. J Am Acad Dermatol 2023; 89:e211-e212. [PMID: 36464084 DOI: 10.1016/j.jaad.2022.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Travis S Dowdle
- Texas Tech University Health Sciences Center - School of Medicine, Lubbock, Texas; Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas.
| | - Michelle B Tarbox
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
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2
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Synchronous and metachronous melanomas diagnosed at early stages in a patient with dysplastic nevus syndrome. An Bras Dermatol 2023:S0365-0596(23)00045-4. [PMID: 36922333 DOI: 10.1016/j.abd.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 03/14/2023] Open
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3
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Sadrolashrafi K, Cotter DG. Not Your Mother's Melanoma: Causes and Effects of Early Melanoma Diagnosis. Dermatopathology (Basel) 2022; 9:368-378. [PMID: 36547217 PMCID: PMC9777089 DOI: 10.3390/dermatopathology9040043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The year 2022 will herald approximately 100,000 new cases of cutaneous melanoma (CM), and over 7000 deaths from CM. Over the past 40 years, CM incidence has increased nearly six-fold; however, annual mortality has remained relatively constant. These trends encapsulate the phenomenon of overdiagnosis. Increased recognition of indolent lesions that appear histologically malignant may be leading to a melanoma epidemic. Enhanced melanoma awareness, screening efforts, physician uncertainty, medical-legal pressures, and diagnostic scrutiny using tools like immunohistochemical staining, mole mapping, dermoscopy, confocal microscopy, and molecular diagnostics contribute to increased CM diagnosis. As a result, current melanoma staging and treatment guidelines are being challenged. Existing standards fail to accurately identify histologically benign lesions that are lethal or, conversely, histologically malignant lesions that are innocuous. Healthcare systems and, more importantly, patients suffer from this diagnostic ambiguity that leads to the over-treatment of innocuous melanomas and under-treatment of aggressive melanomas. As dermatology continues to experience a shift towards earlier diagnosis of melanoma, management strategies must adapt. Herein, we review factors that may contribute to the increased incidence of melanoma, emphasize deficiencies in current staging systems, and provide insights into the future of melanoma management via precision medicine.
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Affiliation(s)
- Kaviyon Sadrolashrafi
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89106, USA
| | - David Graham Cotter
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89106, USA
- Las Vegas Dermatology, Las Vegas, NV 89144, USA
- Correspondence:
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4
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Li Z, Koban KC, Schenck TL, Giunta RE, Li Q, Sun Y. Artificial Intelligence in Dermatology Image Analysis: Current Developments and Future Trends. J Clin Med 2022; 11:jcm11226826. [PMID: 36431301 PMCID: PMC9693628 DOI: 10.3390/jcm11226826] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Thanks to the rapid development of computer-based systems and deep-learning-based algorithms, artificial intelligence (AI) has long been integrated into the healthcare field. AI is also particularly helpful in image recognition, surgical assistance and basic research. Due to the unique nature of dermatology, AI-aided dermatological diagnosis based on image recognition has become a modern focus and future trend. Key scientific concepts of review: The use of 3D imaging systems allows clinicians to screen and label skin pigmented lesions and distributed disorders, which can provide an objective assessment and image documentation of lesion sites. Dermatoscopes combined with intelligent software help the dermatologist to easily correlate each close-up image with the corresponding marked lesion in the 3D body map. In addition, AI in the field of prosthetics can assist in the rehabilitation of patients and help to restore limb function after amputation in patients with skin tumors. THE AIM OF THE STUDY For the benefit of patients, dermatologists have an obligation to explore the opportunities, risks and limitations of AI applications. This study focuses on the application of emerging AI in dermatology to aid clinical diagnosis and treatment, analyzes the current state of the field and summarizes its future trends and prospects so as to help dermatologists realize the impact of new technological innovations on traditional practices so that they can embrace and use AI-based medical approaches more quickly.
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Affiliation(s)
- Zhouxiao Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200023, China
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, 80339 Munich, Germany
| | | | - Thilo Ludwig Schenck
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, 80339 Munich, Germany
| | - Riccardo Enzo Giunta
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, 80339 Munich, Germany
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200023, China
- Correspondence: (Q.L.); (Y.S.)
| | - Yangbai Sun
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200023, China
- Correspondence: (Q.L.); (Y.S.)
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5
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Teague R, Wang M, Wen D, Sunderland M, Rolfe G, Oakley AMM, Rademaker M, Martin R. Virtual lesion clinic - Evaluation of a teledermatology triage system for referrals for suspected melanoma. Australas J Dermatol 2021; 63:e33-e40. [PMID: 34958127 DOI: 10.1111/ajd.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 11/12/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Virtual Lesion Clinic (VLC) of Waitematā District Health Board (WDHB) improves melanoma assessment and treatment using teledermatology. The VLC is reserved for pigmented lesions referred as suspected melanoma from primary care but indeterminate at the initial triage. OBJECTIVES To assess the efficacy of the VLC diagnosis of melanoma. METHODS A retrospective audit of suspected melanoma referrals (1 January 2012 to 31 December 2016) was conducted. Lesions were referred to the VLC if diagnostic uncertainty remained at the initial triage. VLC patients attended MoleMap imaging centres, a dermatologist reviewed history and images remotely and suggested a diagnosis and management plan. Post VLC provisional diagnosis of melanoma, all lesions subsequently excised were reviewed. A positive predictive value (PPV) was calculated using concordance between VLC diagnosis of melanoma and histopathological diagnosis of melanoma. Number needed to excise (NNE) for melanoma was derived, as well as an invasive to in-situ melanoma ratio (IM:MIS) and false negative rate (FNR). RESULTS The VLC received 1874 referrals for 3546 lesions during the 5-year study period. Six hundred and seventy-nine lesions were recommended excision/biopsy or specialist face-to-face assessment, and 504 lesions were subsequently excised. The PPV was 62%, NNE 1.62 and IM:MIS 0.76 for lesions suspected to be melanoma at VLC assessment. The VLC had a melanoma-specific FNR of 7%. CONCLUSIONS The VLC is effective in early diagnosis of melanoma with a high positive predictive value, low number needed to excise and low false negative rate amongst lesions referred as suspected melanoma.
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Affiliation(s)
- Rebecca Teague
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
| | - Mark Wang
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
| | - Daniel Wen
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
| | - Michael Sunderland
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
| | - Gill Rolfe
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
| | - Amanda M M Oakley
- Department of Dermatology, Waikato District Health Board, Takapuna, New Zealand.,Waikato Clinical Campus, University of Auckland, Auckland, New Zealand
| | - Marius Rademaker
- Department of Dermatology, Waikato District Health Board, Takapuna, New Zealand.,Waikato Clinical Campus, University of Auckland, Auckland, New Zealand
| | - Richard Martin
- Department of Cutaneous Oncology, North Shore Hospital, Waitematā District Health Board, Takapuna, New Zealand
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Jartarkar SR, Patil A, Wollina U, Gold MH, Stege H, Grabbe S, Goldust M. New diagnostic and imaging technologies in dermatology. J Cosmet Dermatol 2021; 20:3782-3787. [PMID: 34652880 DOI: 10.1111/jocd.14499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Diagnosis of dermatological disorders is primarily based on clinical examination in combination with histopathology. However, clinical findings alone may not be sufficient for accurate diagnosis and cutaneous biopsies are being associated with morbidity. OBJECTIVE The objective of this article is to review the newer technologies along with their applications, limitation and future prospectus. METHODOLOGY Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar". Articles published in English language were considered for the review. RESULTS In order to improve and/or widen the armamentarium in dermatologic disease diagnosis and therapy, newer emerging technologies are being made available which aid in diagnosis and management. New emerging technologies include confocal microscopy, digital photographic imaging, optical coherence tomography, high frequency ultrasonography, and artificial intelligence. There have been advancements in the dermoscopes. CONCLUSION Significant progress is seen in the diagnostic methods and imaging technologies in dermatology, each having its advantages and limitations. Artificial intelligence/machine-based learning software may have a great scope to influence the dermatological practice.
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Affiliation(s)
- Shishira R Jartarkar
- Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA
| | - Henner Stege
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Ji‐Xu A, Dinnes J, Matin R. Total body photography for the diagnosis of cutaneous melanoma in adults: a systematic review and meta‐analysis*. Br J Dermatol 2021; 185:302-312. [DOI: 10.1111/bjd.19759] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 01/10/2023]
Affiliation(s)
- A. Ji‐Xu
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford UK
| | - J. Dinnes
- Test Evaluation Research Group Institute of Applied Health Research University of Birmingham Birmingham UK
- NIHR Birmingham Biomedical Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham Birmingham UK
| | - R.N. Matin
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford UK
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Kirkdale CL, Archer Z, Thornley T, Wright D, Valeur M, Gourlay N, Ayerst K. Accessing Mole-Scanning through Community Pharmacy: A Pilot Service in Collaboration with Dermatology Specialists. PHARMACY 2020; 8:pharmacy8040231. [PMID: 33287210 PMCID: PMC7768496 DOI: 10.3390/pharmacy8040231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022] Open
Abstract
Early identification and treatment of malignant melanoma is crucial to prevent mortality. The aim of this work was to describe the uptake, profile of users and service outcomes of a mole scanning service in the community pharmacy setting in the UK. In addition, health care costs saved from the perspective of general practice were estimated. The service allowed patients to have concerning skin lesions scanned with a dermatoscopy device which were analyzed remotely by clinical dermatology specialists in order to provide recommendations for the patient. Patients were followed up to ascertain the clinical outcome. Data were analyzed for 6355 patients and 9881 scans across 50 community pharmacies. The majority of the scans required no further follow-up (n = 8763, 88.7%). Diagnosis was confirmed for 70.4% (n = 757/1118) of scans where patients were recommended to seek further medical attention. Of these, 44.3% were ultimately defined as normal (n = 335) and 6.2% as malignant melanoma (n = 47/757). An estimated 0.7% of scans taken as part of the service led to a confirmed diagnosis of malignant melanoma. This service evaluation has shown that a mole scanning service available within community pharmacies is effective at triaging patients and ultimately playing a part in identifying diagnoses of malignant melanoma.
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Affiliation(s)
| | - Zoe Archer
- ScreenCancer UK Ltd., Innovation Centre, Maidstone Road, Chatham, Kent ME5 9FD, UK; (Z.A.); (M.V.); (K.A.)
| | - Tracey Thornley
- Boots UK, Thane Road, Nottingham NG90 1BS, UK; (T.T.); (N.G.)
- School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - David Wright
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Mette Valeur
- ScreenCancer UK Ltd., Innovation Centre, Maidstone Road, Chatham, Kent ME5 9FD, UK; (Z.A.); (M.V.); (K.A.)
| | - Nicola Gourlay
- Boots UK, Thane Road, Nottingham NG90 1BS, UK; (T.T.); (N.G.)
| | - Kurt Ayerst
- ScreenCancer UK Ltd., Innovation Centre, Maidstone Road, Chatham, Kent ME5 9FD, UK; (Z.A.); (M.V.); (K.A.)
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Fried L, Tan A, Bajaj S, Liebman TN, Polsky D, Stein JA. Technological advances for the detection of melanoma. J Am Acad Dermatol 2020; 83:983-992. [DOI: 10.1016/j.jaad.2020.03.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 03/02/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022]
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10
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Eapen BR, Archer N, Sartipi K. LesionMap: A Method and Tool for the Semantic Annotation of Dermatological Lesions for Documentation and Machine Learning. JMIR DERMATOLOGY 2020. [DOI: 10.2196/18149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diagnosis and follow-up of patients in dermatology rely on visual cues. Documentation of skin lesions in dermatology is time-consuming and inaccurate. Digital photography is resource-intensive, difficult to standardize, and has privacy concerns. We propose a simple method—LesionMap—and an electronic health software tool—LesionMapper—for semantically annotating dermatological lesions on a body wireframe. We discuss how the type, distribution, and progression of lesions can be represented in a standardized way. The tool is an open-source JavaScript package that can be integrated into web-based electronic medical records. We believe that LesionMapper will facilitate documentation in dermatology that can be used for machine learning in a privacy-preserving manner.
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11
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[Artificial intelligence in plastic surgery : Current developments and perspectives]. Chirurg 2019; 91:211-215. [PMID: 31650203 DOI: 10.1007/s00104-019-01052-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Artificial intelligence (AI) has long been established in various parts of everyday life due to the instrumentalization of machines and robotics in industry, autonomous vehicles and the rapid development of computer-based systems. OBJECTIVE Demonstration of current developments and perspectives of AI in plastic surgery. MATERIAL AND METHODS Evaluation of statistics, press releases and original articles from journals and discussion of reviews. RESULTS In the healthcare system and in plastic surgery AI is particularly useful in the context of data analysis from digital patient files and big data from central registers. The use of 3D imaging systems provides objective feedback on surgical results in terms of volume and aesthetics. Intelligent robots assist plastic surgeons in microsurgical anastomoses of increasingly smaller vessels and the implementation of AI in the field of prosthetics enables patients to regain hand function following amputation injuries. CONCLUSION For the benefit of the patients, it is the responsibility of experimental surgery to explore the opportunities, risks and limitations of applications with AI.
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12
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Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part II: Applications and limitations. J Am Acad Dermatol 2018; 80:1121-1131. [PMID: 30528310 DOI: 10.1016/j.jaad.2018.11.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022]
Abstract
Clinical examination is critical for the diagnosis and identification of response to treatment. It is fortunate that technologies are continuing to evolve, enabling augmentation of classical clinical examination with noninvasive imaging modalities. This article discusses emerging technologies with a focus on digital photographic imaging, confocal microscopy, optical coherence tomography, and high-frequency ultrasound, as well as several additional developing modalities. The most readily adopted technologies to date include total-body digital photography and dermoscopy, with some practitioners beginning to use confocal microscopy. In this article, applications and limitations are addressed. For a detailed discussion of the principles involved in these technologies, please refer to the first part of this review article.
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Affiliation(s)
| | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - M Laurin Council
- Division of Dermatology, Washington University, St. Louis, Missouri
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part I: Basic principles. J Am Acad Dermatol 2018; 80:1114-1120. [PMID: 30528311 DOI: 10.1016/j.jaad.2018.11.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/27/2022]
Abstract
Dermatologists rely primarily on clinical examination in combination with histopathology to diagnose conditions; however, clinical examination alone might not be sufficient for accurate diagnosis and skin biopsies have associated morbidity. With continued technological advancement, there are emerging ancillary imaging technologies available to dermatologists to aid in diagnosis and management. This 2-part review article will discuss these emerging technologies including: digital photographic imaging, confocal microscopy, optical coherence tomography, and high-frequency ultrasound, as well as several additional modalities in development. In this first installment, the authors describe the breadth of technologies available and the science behind them. Then, in the second article, the authors discuss the applications and limitations of these technologies and future directions.
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Affiliation(s)
| | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - M Laurin Council
- Division of Dermatology, Washington University, St. Louis, Missouri
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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