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Shiu J, Lentsch G, Polleys CM, Mobasher P, Ericson M, Georgakoudi I, Ganesan AK, Balu M. Noninvasive Imaging Techniques for Monitoring Cellular Response to Treatment in Stable Vitiligo. J Invest Dermatol 2024; 144:912-915.e2. [PMID: 37952609 DOI: 10.1016/j.jid.2023.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Jessica Shiu
- Department of Dermatology, University of California, Irvine, Irvine, California, USA.
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | | | - Pezhman Mobasher
- Department of Dermatology, University of California, Irvine, Irvine, California, USA
| | - Marissa Ericson
- Biostatistics, Epidemiology and Research Design, University of California, Irvine, Irvine, California, USA
| | - Irene Georgakoudi
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, Irvine, California, USA; Department of Biological Chemistry, University of California, Irvine, Irvine, California, USA; Skin Biology Resource Center, University of California, Irvine, Irvine, California, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Skin Biology Resource Center, University of California, Irvine, Irvine, California, USA
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Li Y, Thng STG, Kong AWK. Bridging the Gap Between Vitiligo Segmentation and Clinical Scores. IEEE J Biomed Health Inform 2024; 28:1623-1634. [PMID: 38100337 DOI: 10.1109/jbhi.2023.3342069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Quantitative evaluation of vitiligo is crucial for assessing treatment response. Dermatologists evaluate vitiligo regularly to adjust their treatment plans, which requires extra work. Furthermore, the evaluations may not be objective due to inter- and intra-assessor variability. Though automatic vitiligo segmentation methods provide an objective evaluation, previous methods mainly focus on patch-wise images, and their results cannot be translated into clinical scores for treatment adjustment. Thus, full-body vitiligo segmentation needs to be developed for recording vitiligo changes in different body parts of a patient and for calculating the clinical scores. To bridge this gap, the first full-body vitiligo dataset with 1740 images, following the international vitiligo photo standard, was established. Compared with patch-wise images, full-body images have more complicated ambient light conditions and larger variances in lesion size and distribution. Additionally, in some hand and foot images, skin can be fully covered by either vitiligo or healthy skin. Previous patch-wise segmentation studies completely ignore these cases, as they assume that the contrast between vitiligo and healthy skin is available in each image for segmentation. To address the aforementioned challenges, the proposed algorithm in this study exploits a tailor-made contrast enhancement scheme and long-range comparison. Furthermore, a novel confidence score refinement module is proposed to manage images fully covered by vitiligo or healthy skin. Our results can be converted to clinical scores and used by clinicians. Compared to the state-of-the-art method, the proposed algorithm reduces the average per-image vitiligo involvement percentage error from 3.69% to 1.81%, and the top 10% per-image errors from 23.17% to 8.29%. Our algorithm achieves 1.17% and 3.11% for the mean and max error for the per-patient vitiligo involvement percentage, which is better than an experienced dermatologist's naked-eye evaluation.
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Wang Y, Chen L, Qin B, Ren M, Li Q. Reflectance confocal microscopy as a complementary diagnostic tool for vulvar lichen sclerosus and vulvar vitiligo in juvenile Chinese girls. Exp Dermatol 2024; 33:e15033. [PMID: 38414178 DOI: 10.1111/exd.15033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Ying Wang
- Department of Dermatology, Tianjin Children's Hospital/Children's Hospital, Tianjin University, Tianjin, China
| | - Lixin Chen
- Department of Dermatology, Tianjin Children's Hospital/Children's Hospital, Tianjin University, Tianjin, China
| | - Bei Qin
- Department of Dermatology, Tianjin Children's Hospital/Children's Hospital, Tianjin University, Tianjin, China
| | - Min Ren
- Department of Dermatology, Tianjin Children's Hospital/Children's Hospital, Tianjin University, Tianjin, China
| | - Qinfeng Li
- Department of Dermatology, Tianjin Children's Hospital/Children's Hospital, Tianjin University, Tianjin, China
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Wang J, Ding X, Xiao J. Poisson-based image editing for semi-supervised vitiligo lesion segmentation with limited annotations. Comput Biol Med 2023; 165:107320. [PMID: 37625258 DOI: 10.1016/j.compbiomed.2023.107320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/17/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Vitiligo lesion segmentation is crucial for the assessment and treatment of vitiligo. There are two significant challenges in this problem, namely, the availability of dense segmentation annotations and the collection of large amounts of vitiligo images, which are also major challenges in medical image analysis (MIA). However, most existing methods often heavily rely on the availability of large-scale labeled datasets and high-quality annotations. Consequently, the performance of these models may not be easily reproducible or transferable to those domains with limited data availability. As a result, there is a need to develop alternative approaches that can leverage unlabeled datasets for segmentation with a small-scale training set. In this paper, we propose a data augmentation strategy based on image editing, which can synthesize a large number of samples using a small number of annotated data. The synthesized examples are of high visual quality and enforce the segmentation performance without any cost. Besides, we also adapt the Mean-Teacher framework for reliable predictions mining from unlabeled samples to alleviate the demands of densely annotated segmentations. We obtain pseudo-labels for unlabeled samples by utilizing highly confident pixels. On the other hand, we proposed a new Bimodal Vitiligo Lesions Segmentation (BVLS) dataset containing fine-grain segmentation masks and bimodal images usually used for vitiligo diagnosis to mitigate the lack of a vitiligo segmentation dataset. Extensive experiments conducted on the BLVS dataset demonstrate that our approach can achieve significant improvements (+17.27%) compared with previous data augmentation methods on the UNet backbone. Furthermore, the semi-supervised framework can reach an IoU of 49.71% with only 10% annotated images. Our code and dataset are availabel at https://github.com/JcWang20/BLVS.
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Affiliation(s)
- Jiacong Wang
- School of Artificial Intelligence, University of Chinese Academy of Sciences, China
| | - Xiaolan Ding
- Department of Dermatology, Peking University People's Hospital, China
| | - Jun Xiao
- School of Artificial Intelligence, University of Chinese Academy of Sciences, China.
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Li Y, Kong AWK, Thng S. Segmenting Vitiligo on Clinical Face Images Using CNN Trained on Synthetic and Internet Images. IEEE J Biomed Health Inform 2021; 25:3082-3093. [PMID: 33513120 DOI: 10.1109/jbhi.2021.3055213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Accurately diagnosing and describing the severity of vitiligo is crucial for prognostication, treatment selection and comparison. Currently, disease severity scores require dermatologists to estimate percentage area of involvement, which is subjected to inter and intra-assessor variability. Previous studies focus on pure skin but vitiligo on the face, which has a more serious impact on patients' quality of life, was completely neglected. Convolutional neural networks (CNNs) have good performance on many segmentation tasks. However, due to data privacy, it is hard to have a large clinical vitiligo face image dataset to train a CNN. To address this challenge, images from two different sources, the Internet and the proposed vitiligo face synthesis algorithm, are employed in training. 843 vitiligo images taken from different viewpoints were collected from the Internet. These images are hugely different from the target clinical images collected according to a newly established international standard. To have more vitiligo face images similar to the target clinical images to enhance segmentation performance, an image synthesis algorithm is proposed. Both synthetic and Internet images are used to train a CNN which is modified from the fully convolutional network (FCN) to segment face vitiligo lesions. The results show that 1) the synthetic images effectively improve segmentation performance; 2) the proposed algorithm achieves 1.06 % error for the face vitiligo area estimation and 3) it is more accurate than two dermatologists and all the previous automated vitiligo segmentation methods, which were designed for segmentation vitiligo on pure skin.
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Khatibi T, Rezaei N, Ataei Fashtami L, Totonchi M. Proposing a novel unsupervised stack ensemble of deep and conventional image segmentation (SEDCIS) method for localizing vitiligo lesions in skin images. Skin Res Technol 2020; 27:126-137. [PMID: 32662570 DOI: 10.1111/srt.12920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/20/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vitiligo is an acquired pigmentary skin disorder characterized by depigmented macules and patches which brings many challenges for the patients suffering from. For vitiligo severity assessment, several scoring methods have been proposed based on morphometry and colorimetry. But, all methods suffer from much inter- and intra-observer variations for estimating the depigmented area. For all mentioned assessment methods of vitiligo disorder, accurate segmentation of the skin images for lesion detection and localization is required. The image segmentation for localizing vitiligo skin lesions has many challenges because of illumination variation, different shapes and sizes of vitiligo lesions, vague lesion boundaries and skin hairs and vignette effects. The manual image segmentation is a tedious and time-consuming task. Therefore, using automatic image segmentation methods for lesion detection is necessarily required. MATERIALS AND METHODS In this study, a novel unsupervised stack ensemble of deep and conventional image segmentation (SEDCIS) methods is proposed for localizing vitiligo lesions in skin images. Unsupervised segmentation methods do not require prior manual segmentation of vitiligo lesions which is a tedious and time-consuming task with intra- and inter-observer variations. RESULTS Our collected dataset includes 877 images taken from 21 patients with the resolution of 5760*3840 pixels suffering from vitiligo disorder. Experimental results show that SEDCIS outperforms the compared methods with accuracy of 97%, sensitivity of 98%, specificity of 96%, area overlapping of 94%, and Dice index of 97%. CONCLUSION The proposed method can segment vitiligo lesions with highly reasonable performance and can be used for assessing the vitiligo lesion surface.
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Affiliation(s)
- Toktam Khatibi
- School of Industrial and Systems Engineering, Tarbiat Modares University (TMU), Tehran, Iran
| | - Niloofar Rezaei
- School of Industrial and Systems Engineering, Tarbiat Modares University (TMU), Tehran, Iran
| | - Leila Ataei Fashtami
- Department of Regenerative Medicine, Royan Institute for Stem Cell Biology & Technology, Tehran, Iran
| | - Mehdi Totonchi
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Liao YH, Su YH, Shih YT, Chen WS, Jee SH, Sun CK. In vivo third-harmonic generation microscopy study on vitiligo patients. J Biomed Opt 2019; 25:1-13. [PMID: 31777224 PMCID: PMC7008507 DOI: 10.1117/1.jbo.25.1.014504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/11/2019] [Indexed: 05/25/2023]
Abstract
Melanin is known to provide strong third-harmonic generation (THG) contrast in human skin. With a high concentration in basal cell cytoplasm, THG contrast provided by melanin overshadows other THG sources in human skin studies. For better understanding of the THG signals in keratinocytes without the influence of melanin, an in vivo THG microscopy (THGM) study was first conducted on vitiliginous skin. As a result, the THG-brightness ratio between the melanin-lacking cytoplasm of basal cells and collagen fibers is about 1.106 at the dermal-epidermal junctions of vitiliginous skin, indicating high sensitivity of THGM for the presence of melanin. We further applied the in vivo THGM to assist evaluating the therapeutic outcome from the histopathological point of view for those showed no improvement under narrowband ultraviolet B therapy based on the seven-point Physician Global Assessment score. Our clinical study indicates the high potential of THGM to assist the histopathological assessment of the therapeutic efficacy of vitiligo treatments.
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Affiliation(s)
- Yi-Hua Liao
- National Taiwan University Hospital, National Taiwan University College of Medicine, Department of Dermatology, Taipei, Taiwan
| | - Yu-Hsiang Su
- National Taiwan University, Graduate Institute of Photonics and Optoelectronics, Department of Electrical Engineering, Taipei, Taiwan
| | - Yuan-Ta Shih
- National Taiwan University, Graduate Institute of Photonics and Optoelectronics, Department of Electrical Engineering, Taipei, Taiwan
| | - Wen-Shiang Chen
- National Taiwan University Hospital, National Taiwan University College of Medicine, Department of Physical Medicine and Rehabilitation, Taipei, Taiwan
| | - Shiou-Hwa Jee
- National Taiwan University Hospital, National Taiwan University College of Medicine, Department of Dermatology, Taipei, Taiwan
- Cathay General Hospital, Department of Dermatology, Taipei, Taiwan
| | - Chi-Kuang Sun
- National Taiwan University, Graduate Institute of Photonics and Optoelectronics, Department of Electrical Engineering, Taipei, Taiwan
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Alnami A, AlJasser MI. Differentiating normal lip fluorescence from vitiligo under Wood's light. J Am Acad Dermatol 2019; 82:e1. [PMID: 31112728 DOI: 10.1016/j.jaad.2019.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/12/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Abdulaziz Alnami
- Division of Dermatology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Division of Dermatology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed I AlJasser
- Division of Dermatology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
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Cabrera R, Reculé F, Hojman L, Larrondo J. Follicular vitiligo: dermatoscopic features of a new subtype of vitiligo. An Bras Dermatol 2019; 94:120-121. [PMID: 30726484 PMCID: PMC6360965 DOI: 10.1590/abd1806-4841.20198086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/18/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Raúl Cabrera
- Department of Dermatology, Clínica Alemana, Universidad
del Desarrollo, Santiago, Chile
| | - Francisca Reculé
- Department of Dermatology, Clínica Alemana, Universidad
del Desarrollo, Santiago, Chile
| | - Lía Hojman
- Department of Dermatology, Clínica Alemana, Universidad
del Desarrollo, Santiago, Chile
| | - Jorge Larrondo
- Department of Dermatology, Clínica Alemana, Universidad
del Desarrollo, Santiago, Chile
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Nasca MR, Lacarrubba F, Ferraù F, Micali G. Vitiligo of the Face in a Patient Treated With Vemurafenib for Metastatic Melanoma. J Drugs Dermatol 2016; 15:766-768. [PMID: 27272087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Vemurafenib is a potent and selective BRAF inhibitor, which is effective on patients with BRAF V600E mutated late-stage melanoma. Common and less common adverse skin reactions include photosensitivity, maculo-papular exanthema, hand-foot skin reactions, hyperkeratotic follicular rash, pruritus, benign verrucous papillomas, plantar hyperkeratosis, keratoacanthomas, squamous cell carcinomas, infections, and melanoma. To our knowledge, vitiligo has been reported in 2 cases only. This paper reports the case of a 63-year-old man with metastatic melanoma, who developed sudden facial depigmentation after 4 weeks of treatment with vemurafenib 960 mg twice daily. Features consistent with vitiligo were evident at clinical and ultraviolet light examination, as well as at in vivo reflectance confocal microscopy. The latter examination showed lack of normal brightly refractile papillary rings at the dermo-epidermal junction in lesional skin, as well as decreased brightness and half-rings with "scalloped border-like" features in adjacent non-lesional skin. Vitiligo is an adverse reaction to be expected in patients treated with vemurafenib and whether its occurrence may be associated with a positive outcome, as suggested by previous investigations, is still a matter of debate. <br /><br /> <em>J Drugs Dermatol. </em>2016;15(6):766-768.
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Pietrzak A, Dybiec E, Urban J. The liver and its ultrasonographic picture in children suffering from vitiligo. Ann Univ Mariae Curie Sklodowska Med 2003; 57:419-25. [PMID: 12898873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The size and the structure of the liver in 38 children with vitiligo and 43 healthy children suffering from a mild form of pityriasis capitis were measured in an ultrasonographic examination and then compared. In the examined group there were found single cases beyond the norm. No changes in the structure of the liver parenchyma were stated in any of the vitiligo cases. For the liver measured in L1 there were stated 94.7% cases of vitiligo within the range from 2.5 to 97.5 percentile values in the control group. For the liver measured in L2--92.5% cases from 2.5 to 97.5 percentile values in the control group and for the liver measured in L3--92.1% cases of vitiligo were within the range 2.5 do 97.5 percentile values in the control group.
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Affiliation(s)
- Aldona Pietrzak
- Department of Dermatology, Department of Pediatric Radiology, Medical University of Lublin
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Pietrzak A, Dybiec E, Lecewicz-Toruń B. Ultrasonographic estimation of spleen size in children affected with vitiligo. Ann Univ Mariae Curie Sklodowska Med 2002; 55:111-7. [PMID: 11482060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- A Pietrzak
- Katedra i Klinika Dermatologii Akademii Medycznej w Lublinie
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Abstract
Vitiligo and thyroid disease are commonly associated disorders. Twenty-two clinically euthyroid vitiligo patients were studied for functional assessment of thyroid by radioactive iodine uptake assay. Half of them showed abnormal uptake values at 24 hours. Of these patients, 90% had lower values indicating a tendency towards developing hypothyroid state. Subclinical thyroid dysfunction in vitiligo appears to be an adaptive change.
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Affiliation(s)
- V Kumar
- Department of Dermatology, Medical College and Hospital, Rohtak, India
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