Despite continued advancement in recent years, deep neural networks still rely on large amounts of training data to avoid overfitting. However, labeled training data for real-world applications such as healthcare is limited and difficult to access given longstanding privacy, and strict data sharing policies. By manipulating image datasets in the pixel or feature space, existing data augmentation techniques represent one of the effective ways to improve the quantity and diversity of training data.Here, we look to advance augmentation techniques by building upon the emerging success of text-to-image diffusion probabilistic models in augmenting the training samples of our macroscopic skin disease dataset. We do so by enabling fine-grained control of the image generation process via input text prompts. We demonstrate that this generative data augmentation approach successfully maintains a similar classification accuracy of the visual classifier even when trained on a fully synthetic skin disease dataset. Similar to recent applications of generative models, our study suggests that diffusion models are indeed effective in generating high-quality skin images that do not sacrifice the classifier performance, and can improve the augmentation of training datasets after curation.

Acrodermatitis continua of Hallopeau is a rare variant of localized pustular psoriasis characterized by the recurrent eruption of sterile pustules involving the distal portions of the fingers and toes that can lead to the destruction of the nail apparatus. Acrodermatitis continua of Hallopeau is a chronic, relapsing condition that is resistant to most topical and systemic psoriasis therapies, making it notoriously difficult to manage. Interleukin-36 and interleukin-17 are thought to play a pivotal role in the pathophysiology of pustular psoriasis, and evidence suggests that interleukin-17 inhibition can be an effective therapy for pustular psoriasis variants, including acrodermatitis continua of Hallopeau. Bimekizumab, a monoclonal antibody that inhibits the interleukin-17 pathway, may be a safe and effective treatment option for patients with acrodermatitis continua of Hallopeau. We present the first documented case of a patient with acrodermatitis continua of Hallopeau of the bilateral thumbnails who experienced an excellent response to bimekizumab treatment.

Context An increased risk of age-related eye disease has been observed in individuals lacking a balanced diet. Following a plant-based diet may result in nutritional insufficiencies and negatively affect health if an effort is not made to ensure the consumption of fortified foods or specific supplements. Objective The purpose of this article is to characterize the relationship between plant-based diets and age-related ocular outcomes among adults. Data Sources A comprehensive literature review was performed using the MEDLINE, Embase, Cochrane, and PubMed databases up until December 19, 2021. Study Selection Studies that focused on observed visual changes due to a reduced intake of animal products and that included a minimum of 50 eyes were eligible for inclusion. Data Extraction Two levels of screening, quality assessment, and data extraction were conducted by 2 reviewers independently. The 21 studies identified from 814 unique studies progressed to data extraction and 15 were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed on the basis of heterogeneity. Results The 15 (n = 51 695 participants) assessed the impact of fish consumption, 8 studies (n = 28 753 participants) analyzed the effect of red meat intake, and 3 studies (n = 7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development. Meta-analysis indicated regular consumption of fish (odds ratio [OR], 0.70; 95%CI, 0.62–0.79) and skim milk, poultry, and non-meat animal products (OR, 0.70; 95%CI, 0.61–0.79) reduced the risk of age-related eye disease development among adults. Consumption of red meat (OR, 1.41; 95%CI, 1.07–1.86) may increase the risk of age-related eye disease development. Conclusion A pescatarian diet is associated with the most favorable visual outcomes among adults, whereas consumption of red meat negatively affects ocular health. Results suggest a need for more initiatives promoting a healthy and balanced diet. Systematic Review Registration PROSPERO registration no. CRD42021269925

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Objectives The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Methods Data Sources: A comprehensive literature review was performed using the databases MEDLINE, EMBASE, Cochrane, and PubMed up until December 19, 2021. Study Selection: Studies that focused on observed visual changes due to a reduced intake of animal products with a minimum of 50 eyes were eligible for inclusion. Data Extraction: Two levels of screening, quality assessment, and data extraction were conducted by two reviewers independently. The twenty-one studies identified from 814 unique studies progressed to data extraction and fifteen were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed based on heterogeneity. Results Fifteen studies (51,695 participants) assessed the impact of fish consumption, eight studies (28,753 participants) analyzed the effect of red meat intake, and three studies (7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of visual deterioration as indicated by age-related macular degeneration, age-related maculopathy, or cataract development. Meta-analysis indicated regular consumption of fish (OR = 0.70; CI: [0.62–0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61–0.79]) reduced the risk of visual impairment among adults. Consumption of red meat [OR = 1.41; CI: [1.07–1.86]) may increase the risk of visual impairment. Conclusions A pescatarian diet is associated with the most favorable visual outcomes among adults while consumption of red meat negatively impacts vision. Results suggest a need for more initiatives promoting a healthy and balanced diet. Funding Sources Not applicable.

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Purpose: To identify and characterize the psychological impact of caregiving for children with eye disease. Awareness of the caregiving experience and insight into the factors related to caregiver burden is necessary to support high-quality ophthalmic care and develop supportive interventions. Methods: The databases MEDLINE (Ovid), CINAHL, EMBASE, Cochrane Library, PsychINFO, PubMed, and Google Scholar were queried up to June 25, 2021. Studies included assessed the psychological impact of providing care to children with eye diseases. A risk of bias assessment was performed according to the Modified Downs and Black Checklist. Demographic data and measures of burden were extracted and tabulated. Results: A total of 2,823 articles were screened, 28 underwent data extraction, and 7 were included in the meta-analysis. The meta-analysis indicated significant levels of burden (40% mild, 95% CI: [0.28 to 0.53]; 59% moderate, 95% CI: [0.36 to 0.82]; 7% severe, 95% CI: [0.02 to 0.11]) and depression (26% mild, 95% CI: [0.17 to 0.35]; 8% moderate, 95% CI: [0.03 to 0.14]); 11% severe, 95% CI:[0.03 to 0.10]). Interventions such as educational programs, life skills training programs, and other home-based early intervention programs were shown to improve psychological well-being of families. Conclusions: Caregivers experience significant levels of burden and depression, which may, in turn, affect the level of ophthalmic care they can provide for their children. Further studies investigating educational or psychological interventions for parents are needed, because the small number of studies that investigated these types of interventions have reported reduced parental stress and improved well-being. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XX–XX.]

A large number of autoimmune and fibrosing conditions associated with psoriasis and morphea have been reported in the literature. Currently, the relationship between psoriasis and morphea is unknown, and the coexistence of these conditions is quite rare. Due to the few patients affected by both conditions, and the lack of knowledge concerning their pathogenic mechanisms, the cause behind this co-occurrence is poorly understood. Here, we present a case of morphea under a plaque of psoriasis in a patient managed on ustekinumab.