Detection of acne by deep learning object detection

ImportanceState-of-the art performance is achieved with a deep learning object detection model for acne detection. There is little current research on object detection in dermatology and acne in particular. As such, this work is early in this field and achieves state of the art performance.ObjectiveTrain an object detection model on a publicly available data set of acne photos.Design, Setting, and ParticipantsA deep learning model is trained with cross validation on a data set of facial acne photos.Main Outcomes and MeasuresObject detection models for detecting acne for single-class (acne) and multi-class (four severity levels). We train and evaluate the models using standard metrics such as mean average precision (mAP). Then we manually evaluate the model predictions on the test set, and calculate accuracy in terms of precision, recall, F1, true and false positive and negative detections.ResultsWe achieve state-of-the art mean average precision [email protected] value of 37.97 for the single class acne detection task, and 26.50 for the 4-class acne detection task. Moreover, our manual evaluation shows that the single class detection model performs well on the validation set, achieving true positive 93.59 %, precision 96.45 % and recall 94.73 %.Conclusions and RelevanceWe are able to train a high-accuracy acne detection model using only a small publicly available data set of facial acne. Transfer learning on the pre-trained deep learning model yields good accuracy and high degree of transferability to patient submitted photographs. We also note that the training of standard architecture object detection models has given significantly better accuracy than more intricate and bespoke neural network architectures in the existing research literature.Key PointsQuestionCan deep learning-based acne detection models trained on a small data set of publicly available photos of patients with acne achieve high prediction accuracy?FindingsWe find that it is possible to train a reasonably good object detection model on a small, annotated data set of acne photos using standard deep learning architectures.MeaningDeep learning-based object detection models for acne detection can be a useful decision support tools for dermatologists treating acne patients in a digital clinical practice. It can prove a particularly useful tool for monitoring the time evolution of the acne disease state over prolonged time during follow-ups, as the model predictions give a quantifiable and comparable output for photographs over time. This is particularly helpful in teledermatological consultations, as a prediction model can be integrated in the patient-doctor remote communication.

Efficacy and safety comparison between 1927 nm thulium laser and 2940 nm Er:YAG laser in the treatment of facial atrophic acne scarring: a prospective, simultaneous spilt-face clinical trial

Acne scarring is a common disfiguring complication of acne, and fractional lasers are widely applied in improving it. This study is to compare the efficacy and safety of fractional non-ablative 1927 nm thulium laser (FTL) and fractional ablative 2940 nm Er:YAG laser (FEL) in the treatment of acne scarring. Subjects with moderate or severe atrophic facial acne scarring received 3 sessions of FTL on the left side of face and FEL on the right side of face at an average interval of 4–6 weeks. Major assessments included Goodman&Baron quantitative global scarring grading system (GBS), self-rated improvement and satisfaction score. Twenty-seven subjects completed the study; for FTL side, average GBS decreased from 11.15 ± 5.04 at baseline to 7.07 ± 4.87 with an improvement percent of 36.54%; for FEL side, average GBS decreased from 10.81 ± 4.46 to 7.00 ± 4.07 with an improvement percent of 35.27%. Adverse effects include transient pain, erythema, edema, and increase of acne. No significant difference was found between two lasers. Both FTL and FEL improved atrophic acne scarring and were well-tolerated. Increase of acne during laser treatment may have a negative impact on efficacy. Trial registration number was NCT04813419 and date of registration was 19th, March, 2021, retrospectively registered.

Acne exacerbation after tofacitinib treatment for alopecia areata

The major discovery of the novel therapeutic Janus kinase (JAK) inhibitors has been implicated in several dermatological diseases. Recently, studies have shown the efficacy and encouraging results of oral JAK inhibitors as a treatment for alopecia areata (AA). Due to the novelty of this treatment, potential side effects are not fully explored. In this paper, we present a case of a 28-year-old male with a 10-year history of alopecia totalis (AT) treated successfully with tofacitinib with encouraging effects on hair regrowth; however, a significant worsening of the patient’s facial acne was observed four months after AT treatment initiation. JAK inhibitors have promising results in the management of different dermatological conditions including moderate-severe forms of AA with few reported adverse events. Acne exacerbation is a unique observed adverse effect of this therapy. More thorough larger sized studies are needed to further characterize the association between acne exacerbation and the use of JAK inhibitors.

Isotretinoin in Acne Vulgaris Complicated by Underlying Major Depression: A Case Report and Review of Literature

We relay the case of a teenage female with severe facial acne vulgaris and a past psychiatric history of major depressive disorder who presented to the emergency department with a primary complaint of ongoing suicidal ideation. Defining features of this case stem from the patient endorsing that her suicidal ideation was a result of her severe acne and the coinciding social perturbation it caused. Additionally, the patient reported that just four months prior to the current presentation, her dermatologist started her on isotretinoin therapy for the management of acne vulgaris. To the best of the authors’ knowledge, there have been no reported cases which describe a teenage female presenting with active suicidal ideation secondary to severe acne vulgaris while concurrently undergoing treatment with isotretinoin. Given the controversial but reported association between isotretinoin and increased suicidality, we considered the appropriateness of continuing this medication for our patient. We then conducted a literature search evaluating the evidence concerning this association. In what follows, we present a unique case report and provide a thorough review of the evidence—or lack thereof—surrounding the relationship between isotretinoin and suicidality. Additionally, the authors aim to provide recommendations for the management of future patients who may present under similar circumstances.