Browsing by Author "Peirano, Dominga"
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- ItemA systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis(2024) Salinas, María Paz; Sepúlveda, Javiera; Hidalgo, Leonel; Peirano, Dominga; Morel, Macarena; Uribe, Pablo; Rotemberg, Verónica; Briones, Juan; Mery, Domingo; Navarrete-Dechent, CristianScientific research of artificial intelligence (AI) in dermatology has increased exponentially. The objective of this study was to perform a systematic review and meta-analysis to evaluate the performance of AI algorithms for skin cancer classification in comparison to clinicians with different levels of expertise. Based on PRISMA guidelines, 3 electronic databases (PubMed, Embase, and Cochrane Library) were screened for relevant articles up to August 2022. The quality of the studies was assessed using QUADAS-2. A meta-analysis of sensitivity and specificity was performed for the accuracy of AI and clinicians. Fifty-three studies were included in the systematic review, and 19 met the inclusion criteria for the meta-analysis. Considering all studies and all subgroups of clinicians, we found a sensitivity (Sn) and specificity (Sp) of 87.0% and 77.1% for AI algorithms, respectively, and a Sn of 79.78% and Sp of 73.6% for all clinicians (overall); differences were statistically significant for both Sn and Sp. The difference between AI performance (Sn 92.5%, Sp 66.5%) vs. generalists (Sn 64.6%, Sp 72.8%), was greater, when compared with expert clinicians. Performance between AI algorithms (Sn 86.3%, Sp 78.4%) vs expert dermatologists (Sn 84.2%, Sp 74.4%) was clinically comparable. Limitations of AI algorithms in clinical practice should be considered, and future studies should focus on real-world settings, and towards AI-assistance.
- ItemAuthor Correction: A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis(2024) Salinas Espinoza, María Paz; Sepúlveda, Javiera; Hidalgo, Leonel; Peirano, Dominga; Morel, Macarena; Uribe, Pablo; Rotemberg, Verónica; Briones, Juan; Mery, Domingo; Navarrete Dechent, Cristian Patricio
- ItemDermoscopic Features of Pigmented Bowen Disease: A Multicenter Study on Behalf of the Ibero-Latin American College of Dermatology (CILAD)(2024) Cabo, Horacio; Salerni, Gabriel; Sabban, Emilia Cohen; Garlatti, Agustin Bollea; Orendain, Nicole; Rodriguez-Saa, Sonia; Bakos, Renato Marchiori; Pozzobon, Flavia Carolina; Gonzalez, Virginia M.; Peralta, Rosario; Navarrete-Dechent, Cristian; Peirano, Dominga; Perez-Fernandez, Elia; Puig, SusanaIntroduction: Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series. Objectives: To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population. Methods: We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology. Results: The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively. Conclusions: We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.
- ItemManagement of periocular keratinocyte carcinomas with Mohs micrographic surgery and predictors of complex reconstruction: a retrospective study(2023) Peirano, Dominga; Vargas Mancilla, Sebastián Enrique; Hidalgo Acuña, Leonel Esteban; Donoso Mendieta, Francisca; Abusleme, Eugenia; Sanhueza Zamora, Felipe Alberto; Cárdenas de la Torre, Consuelo Paz; Droppelmann, Katherine; Castro Ayala, Juan Camilo; Uribe González, Pablo Francisco; Zoroquiain Velez, José Pablo; Navarrete Dechent, Cristián PatricioBackground: Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision. Objective: To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile. Methods: A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017---2022. MMS details were recorded. Results: One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2were more likely to require complex reconstruction. Study limitations: Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly.
- ItemManejo de carcinomas queratinocíticos perioculares com cirurgia micrográfica de Mohs e preditores de reconstrução complexa: estudo retrospectivo(2024) Peirano, Dominga; Vargas, Sebastián; Hidalgo Acuña, Leonel Esteban; Donoso Mena, Francisca; Albuseme, Eugenia; Sanhueza Zamora, Felipe Alberto; Cardenas De La Torre, Consuelo Paz; Droppelmann Droppelmann, Katherine Ann; Castro, Juan Camilo; Uribe González, Pablo Francisco; Zoroquiain Vélez, José Pablo; Navarrete Dechent, Cristian PatricioFundamentos: O câncer de pele é o tipo mais frequente em todo o mundo e o mais frequente tumor periocular. Os carcinomas queratinocíticos (CQ) localizados em áreas perioculares são considerados tumores de alto risco. A cirurgia micrográfica de Mohs (CMM) é considerada a primeira linha para o tratamento do CQ de alto risco, com menor taxa de recorrência do que a excisão ampla convencional. Objetivo: Descrever as características clinico-patológicas do CQ periocular tratado com CMM em um centro universitário terciário no Chile. Métodos: Estudo retrospectivo unicêntrico de pacientes com CQ localizado na região periocular, submetidos à CMM entre 2017 e 2022. Detalhes da CMM foram registrados. Resultados: Foram incluídos 113 pacientes com carcinomas perioculares. A média de idade foi de 59 ± 13 anos; 52% eram mulheres. A localização mais frequente foi o canto medial do olho (53%), seguido da pálpebra inferior (30,1%). O tipo histológico mais frequente de carcinoma basocelular (CBC) foi o nodular (59,3%). Em relação à CMM, o número médio de estágios foi de 1,5 ± 0,7, e 54% dos casos necessitaram de apenas um estágio para atingir margens livres. Até o momento, nenhuma recorrência foi relatada. Tumores maiores que 8,5 mm em seu maior diâmetro ou 43,5 mm² foram mais propensos a necessitar de reconstrução complexa.
- ItemUse of game-based learning strategies for dermatology and dermoscopy education: a cross-sectional survey of members of the International Dermoscopy Society(2024) Donoso, Francisca; Peirano, Dominga; Aguero, Rosario; Longo, Caterina; Apalla, Zoe; Lallas, Aimilios; Jaimes, Natalia; Navarrete-Dechent, CristianBackground Dermoscopy is a valuable tool in the diagnosis of various skin conditions. It increases sensitivity and specificity in skin cancer diagnosis, as well as in infectious, inflammatory and hair diseases. However, mastering the intricacies of dermoscopy can be challenging. In this context, innovative educational methods are sought, including game-based learning (GBL) strategies. Objectives To describe current perceptions, knowledge and use of GBL strategies in dermoscopy education, and identify strengths and challenges to enhance their use. Methods A web-based cross-sectional survey with 25 questions was distributed to members of the International Dermoscopy Society between October 2022 and April 2023. Responses were collected and analysed using frequency analysis and graphical representation. Results In total, 801 responses were received. Of these, 46.6% of respondents were unfamiliar with gamification and serious games. Among those acquainted with these concepts, 56.3% reported using GBL strategies for education. Younger participants were more likely to use GBL strategies (P = 0.02). Participants familiar with GBL believed it enhanced medical education (78.5%) but should not entirely replace traditional teaching methods (96.0%). For dermoscopy education specifically, 22.1% of respondents had used GBL strategies, with Kahoot! (35.5%) and YOUdermoscopy (24.1%) being the most commonly used platforms. Respondents found gaming strategies to be fun (95.5%), motivating (91.0%) and valuable for e-learning (94.4%). Conclusions Results from this survey demonstrate a favourable perception of GBL strategies in dermatology education, including dermoscopy. While there are ongoing challenges in validation, GBL strategies are promising and valuable tools that can aid the learning and teaching experience. Addressing implementation barriers and validating existing games could optimize the impact of GBL on dermatology education.
- ItemVisualizing Touton Giant Cells Under Reflectance Confocal Microscopy in Two Cases of Juvenile Xanthogranuloma(2023) Peirano, Dominga; Donoso, Francisca; Hidalgo, Leonel; Feuerhake, Teo; Scope, Alon; Longo, Caterina; Navarrete-Dechent, Cristian