Background Computer-aided diagnosis of skin lesions is a growing area of research, but its application to nonmelanoma skin cancer (NMSC) is relatively under-studied. The purpose of this review is to synthesize the research that has been conducted on automated detection of NMSC using digital images and to assess the quality of evidence for the diagnostic accuracy of these technologies. Methods Eight databases (PubMed, Google Scholar, Embase, IEEE Xplore, Web of Science, SpringerLink, ScienceDirect, and the ACM Digital Library) were searched to identify diagnostic studies of NMSC using image-based machine learning models. Two reviewers independently screened eligible articles. The level of evidence of each study was evaluated using a five tier rating system, and the applicability and risk of bias of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Results Thirty-nine studies were reviewed. Twenty-four models were designed to detect basal cell carcinoma, two were designed to detect squamous cell carcinoma, and thirteen were designed to detect both. All studies were conducted in silico. The overall diagnostic accuracy of the classifiers, defined as concordance with histopathologic diagnosis, was high, with reported accuracies ranging from 72 to 100% and areas under the receiver operating characteristic curve ranging from 0.832 to 1. Most studies had substantial methodological limitations, but several were robustly designed and presented a high level of evidence. Conclusion Most studies of image-based NMSC classifiers report performance greater than or equal to the reported diagnostic accuracy of the average dermatologist, but relatively few studies have presented a high level of evidence. Clinical studies are needed to assess whether these technologies can feasibly be implemented as a real-time aid for clinical diagnosis of NMSC. Electronic supplementary material The online version of this article (10.1186/s12880-019-0307-7) contains supplementary material, which is available to authorized users.

Testicular choriocarcinoma needs to be considered in the differential diagnosis of cutaneous metastases in young adult men because of its propensity for early hematogenous dissemination. Furthermore, the diagnosis may not be suspected in many cases in which there is clinically no testicular enlargement. This highly aggressive germ cell tumor typically metastasizes to the liver, lungs, and brain. Skin metastasis is exceedingly rare with only 22 cases previously reported in the world literature. We herein report 2 additional cases: a 25-year-old man and a 32-year-old man, both of whom were treated for mixed germ cell tumors and developed multiple cutaneous metastases to the head.

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A relationship between Kimura disease (KD) and angiolymphoid hyperplasia with eosinophilia (ALHE) has been debated. Given substantial clinical and histological overlap, these entities were once considered to represent a disease spectrum; however, they are now widely considered to be nosologically distinct. A diagnosis of either condition is further complicated by resemblance to various malignancies, which must be carefully excluded. Coexistence of ALHE and KD in a patient is extremely rare, with only four cases reported in the English literature. We report what is to our knowledge the first case of ALHE and KD overlap with evidence of diffuse visceral involvement.

Objective: To assess the attitudes and beliefs of faculty dermatologists regarding perceived characteristics of millennial trainees and colleagues. Participants and Methods: We conducted a cross-sectional survey of dermatology physician-educators listed in the Fellowship and Residency Electronic Interactive Database from August 1, 2019, to October 31, 2019. This survey consisted of 26 items (5-point Likert scales) representing positive, negative, and neutral millennial stereotypes relevant to graduate medical education. Participants' responses were analyzed using the chi-squared goodness of fit test with dichotomized data. Results: Seventy-six dermatology physician-educators participated in the national survey. A statistically significant response pattern was seen in 18 of 26 (69%) tested stereotypes. Positive judgments included denial of hesitations about working with millennials (P ¼ .038) and agreement with the notions that millennials are technologically savvy (P < .001), socially just (P < .001), equally capable dermatologists as other generations (P < .001), enjoyable to work with (P < .001), easy to connect with interpersonally (P < .001), and promising future leaders of medicine (P ¼ .039). Negative judgments included perceptions of the word millennial as a pejorative (P < .001) and of millennials being relatively entitled (P < .001), overly sensitive to feedback (P < .001), less polite (P < .001), and less hard-working (P < .001) compared with prior generations. Conclusion: This study represents the first national survey of the attitudes and perspectives of dermatology physician-educators regarding perceived characteristics of millennial trainees and colleagues. Our results suggest that dermatology faculty endorse various positive, negative, and neutral stereotypes regarding Generation Y. Early recognition of implicit biases can inform curricular design and prepare educators to address generational gaps in medical education.

Crospovidone is an insoluble pharmaceutical disintegrant that has been implicated in a rare foreign body reaction in injection drug users, classically associated with pulmonary angiothrombosis. We recently reported the first known cases of cutaneous crospovidone deposition. We herein report two additional cases with unique clinicopathologic manifestations, both in the setting of suspected injection drug abuse.Additionally, we provide a comprehensive overview of the distinct histomorphology and reproducible histochemistry of crospovidone.

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