Unlocking the potential of artificial intelligence in dermatology
Today’s report also covers research into laser and light-based therapies for hirsutism, systemic therapies for vulvar lichen sclerosus and vulvovaginal lichen planus, and more (1,500 words, 7 minutes)
The Women in Dermatology e-newsletter is supported without restriction by Galderma Canada
Good morning, and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the dermatologists who treat them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
Dr. Juthika Thakur (pictured below), a Toronto dermatologist, believes that artificial intelligence (AI) has the potential to revolutionize healthcare, particularly dermatology. During her speech at the Canadian Dermatology Association’s fourth biennial Women in Dermatology Leadership Conference on April 6th in Toronto, Dr. Thakur highlighted AI’s transformative power in reducing workloads and assisting physicians in optimizing their practices.
The presentation highlighted the exponential growth of AI utilization in recent years, emphasizing the importance of three key pillars: large language models, generative AI, and computer vision.
Dr. Thakur said large language models such as Chat GPT or Perplexity AI could have multiple applications in dermatology, from patient communication to research assistance. “You can use Chat GPT or any other language model to craft quick responses to patients about side effects or treatment clarifications,” she said. Despite their potential, Dr. Thakur acknowledged the need for personalized integration strategies such as fine-tuning language model parameters and refining response templates to tailor responses to each practitioner’s unique practice setting.
She further explained that generative AI, known for its capacity to produce images and narratives from text prompts, can simplify content creation, aiding in developing presentation slides and the composition of social media updates. She mentioned that generative AI could assist in creating charts and summarizing clinical histories with platforms such as Epic and lesion tracking. “AI is being incorporated into mole mapping applications such as FotoFinder,” Dr. Thakur noted. “You can track changes within a mole using AI to see which part of the mole has changed.”
Dr. Thakur said computer vision facilitates rapid and accurate diagnosis through image analysis. She highlighted existing applications such as Google Lens and Visual DX, which boast impressive diagnostic capabilities across various skin conditions. “They can confidently diagnose more than 117 skin conditions and show you representations of a disease with other photos,” she said.
While Dr. Thakur acknowledged the potential advantages of AI technologies, she stressed the need for skepticism and critical thinking in their application. She urged the audience to challenge AI models by scrutinizing their outputs, which would help ensure their accuracy and dependability. She suggested that the boundaries of AI models can be explored by posing questions in different ways, having them assume various personas such as ‘good cop’ or ‘bad cop,’ and trying different methods to elicit responses, like employing colloquial language or altering the complexity of the queries. Moreover, she highlighted the importance of ongoing exploration and experimentation to truly understand the extent of AI’s capabilities and discover innovative solutions and problem-solving techniques.
Bottom Line: Dr. Thakur’s presentation underscores the transformative potential of AI in healthcare and dermatology. There are three pillars of AI models: large language models, generative AI, and computer vision, and each can help doctors enhance productivity, streamline workflows, and ultimately improve outcomes in their practices. Despite the potential of AI, skepticism and critical thinking are essential.
From the literature on women in dermatology,
Anti-skin aging effects and bioavailability of collagen tripeptide and elastin peptide formulations in women
A study published in the Journal of Dermatologic Science and Cosmetic Technology evaluated the effects of an orally administered collagen drink combining collagen peptides and elastin peptides on the skin health of young and middle-aged women. The researchers found that the collagen drink improved skin hydration, skin elasticity, and dermal collagen content and also reduced transepidermal water loss, pore size, wrinkle length, skin roughness, and overall pore volume.
For this single-centre, randomized, double-blind, parallel-controlled trial, 70 participants drank either a fish collagen tripeptide beverage or a placebo for eight weeks. The results showed significant nourishing and anti-aging effects on the skin of volunteers who consumed the collagen drink. The authors concluded that the collagen drink improves several skin parameters and shows good bioavailability of collagen peptides.
A questionnaire-based study on genital hygiene practices in women with and without chronic vulvar dermatoses
Research in the International Journal of Life Sciences, Biotechnology and Pharma Research assessed public awareness regarding hygiene practices related to vulvar dermatosis among female patients. The researchers found that women without vulvar dermatoses washed the external vaginal area more frequently than women with vulvar dermatoses. Additionally, vaginal douching was more common among women with vulvar dermatoses, and the use of wet wipes was more prevalent among women without vulvar dermatoses.
This questionnaire-based study included 2,792 women who attended the outpatient department of an Indian hospital between Jan. 2020 and Dec. 2021. The participants were divided into two subgroups: Group A comprised women with vulvar dermatoses, while Group B comprised those without vulvar dermatoses. The survey answers were analyzed according to the subgroups, showing significant differences.
Laser and light-based therapies for hirsutism management in women with PCOS
A study published in JAMA Dermatology reviewed the effectiveness of laser and light-based therapies for treating hirsutism in women with polycystic ovary syndrome (PCOS). The researchers found that the Alexandrite laser significantly improved hirsutism severity and psychological outcomes, especially at high-fluence application, and was more effective than intense pulsed light (IPL).
The authors conducted a systematic literature review for this study using the MEDLINE, Embase, EMCARE, and CINAHL databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The final review included six studies with data from 423 individual patients with PCOS who underwent laser or light-based hair reduction therapies. The findings showed combining a diode laser with metformin or an oral contraceptive produced better results than a diode laser alone, as did the addition of metformin to IPL compared to IPL treatment alone.
Use of systemic therapies for vulvar lichen sclerosus and vulvovaginal lichen planus
A research letter in the International Journal of Women’s Dermatology analyzed how clinicians use systemic agents for vulvar lichen sclerosus (VLS) and vulvovaginal lichen planus (VLP) treatment. The researchers found that approximately one-third of clinicians prescribed systemic therapies for VLS, and almost half prescribed them for VLP. Additionally, dermatologists are more likely to prescribe systemic therapies than gynecologists.
For this study, the authors distributed a 15-question survey to physicians worldwide. The survey was completed by 72 participants: 55 gynecologists, 15 dermatologists, and two urogynecologists. The results showed that 47% of dermatologists and 27% of gynecologists reported prescribing systemic therapies for VLS, and 93% of dermatologists and 33% of gynecologists reported prescribing systemic therapies for VLP. The most common systemic agents for both conditions were steroids, followed by methotrexate.
Atlanta-based dermatologist Dr. Anna Paré and entrepreneur Sarah Bentley Pearson discuss the value of women supporting and celebrating other women with their growth and success.
A case of vitiligo-like basal cell carcinoma
A case report in the Indian Journal of Dermatology, Venereology and Leprology described a 28-year-old woman presenting with a slowly expanding asymptomatic hypopigmented patch on her left cheek and nose. Despite topical treatment for suspected vitiligo, the lesion did not improve. Physicians considered several possible diagnoses, such as lichen sclerosus, mycosis fungoides and tinea versicolor. A punch biopsy revealed a micronodular subtype of basal cell carcinoma (BCC). The patient underwent Mohs micrographic surgery, followed by treatment with iridium brachytherapy. After three years of follow-up, the patient remained free of BCC recurrence.
On May 11, 2024, from 10 a.m. to 1 p.m. EDT, Drs. Marissa Joseph and Neil Shear will co-chair the Atopic Dermatitis Summit, a one-day virtual medical education event seeking the highest-quality AD education to help Canadian patients receive the best care possible. The session is developed by the organizers of Skin Spectrum Summit.
You can join your colleagues to learn more about the incidence of and the latest therapies for AD through live Q&As and lectures.
The Summit is a landmark opportunity to learn to:
Effectively communicate about AD with patient and their families
Diagnose AD across all skin phototypes
Prioritize sun protection in the management of AD
Address disparities among Indigenous communities
Understand the interplay between food allergies and AD
Registering for this compelling event is free, but space is limited. Reserve your (virtual) space now at https://tinyurl.com/ADSummit2024
L’Oréal, Procter & Gamble, Dermtek Pharma and other event supporters. Learn more at www.skinspectrum.ca/ad
Something to think about
“As women, we want to dominate the AI space. There’s not a lot of men in dermatology in the digital health space, so I think there’s a good opportunity here for us to take charge.”
— Dr. Juthika Thakur, a Toronto-based dermatologist, speaking at the Canadian Dermatology Association’s 4th biennial Women in Dermatology Leadership Conference.
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