Artificial Intelligence in Dermatology: A Review of Literature and Application to Pediatric Dermatology

Main Article Content

Joshua Burshtein
Maria Gnarra Buethe

Keywords

pediatric, artificial intelligence, machine learning, deep learning, access, underserved

Abstract

Background: Artificial intelligence (AI) is increasingly investigated for use in dermatologic conditions. We review recent literature on AI, its potential application for pediatric dermatology, and its impact on the underserved community.


Objective: To evaluate the current state of AI in dermatology and its application to pediatric patients.


Methods: Literature search was performed in PubMed and Google Scholar using the following key terms in combination with "pediatric", and "dermatology": "artificial intelligence," "AI," "machine learning," "augmented intelligence," "neural network," and "deep learning".


Results: Current research is based on images from adult databases, with minimal delineation of patient age. Most literature on AI and dermatologic conditions pertains to melanoma and non-melanoma skin cancers, reporting accuracy from 67-99%. Other commonly studied diseases include psoriasis, acne vulgaris, onychomycosis, and atopic dermatitis, having varying accuracy, sensitivity, and specificity. A recently developed AI algorithm for diagnosis of infantile hemangioma found 91.7% accuracy. AI may be a means to increase access to pediatric dermatologic care, yet challenges remain for its use in underserved communities.


Conclusion: Literature on AI systems for dermatologic diseases continues to grow. Further research may tailor AI algorithms for pediatric patients and those of diverse skin color to decrease algorithm bias and increase diagnostic accuracy.

References

1. Cartron AM, Aldana PC , Khachemoune A. Pediatric teledermatology: A review of the literature. Pediatr Dermatol 2021;38:39-44.

2. Havele SA, Fathy R, McMahon P , Murthy AS. Pediatric teledermatology: A retrospective review of 1199 encounters during the COVID-19 pandemic. J Am Acad Dermatol 2022;87:678-80.

3. Du-Harpur X, Watt FM, Luscombe NM , Lynch MD. What is AI? Applications of artificial intelligence to dermatology. Br J Dermatol 2020;183:423-30.

4. Esteva A, Robicquet A, Ramsundar B, Kuleshov V, DePristo M, Chou K et al. A guide to deep learning in healthcare. Nat Med 2019;25:24-9.

5. Young AT, Xiong M, Pfau J, Keiser MJ , Wei ML. Artificial Intelligence in Dermatology: A Primer. J Invest Dermatol 2020;140:1504-12.

6. Li Z, Koban KC, Schenck TL, Giunta RE, Li Q , Sun Y. Artificial Intelligence in Dermatology Image Analysis: Current Developments and Future Trends. J Clin Med 2022;11.

7. Liu X, Faes L, Kale AU, Wagner SK, Fu DJ, Bruynseels A et al. A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis. Lancet Digit Health 2019;1:e271-e97.

8. Shrivastava VK, Londhe ND, Sonawane RS , Suri JS. A novel approach to multiclass psoriasis disease risk stratification: Machine learning paradigm. Biomedical Signal Processing and Control 2016;28:27-40.

9. Shen X, Zhang J, Yan C , Zhou H. An automatic diagnosis method of facial acne vulgaris based on convolutional neural network. Scientific Reports 2018;8:5839.

10. Han SS, Park GH, Lim W, Kim MS, Na JI, Park I et al. Deep neural networks show an equivalent and often superior performance to dermatologists in onychomycosis diagnosis: Automatic construction of onychomycosis datasets by region-based convolutional deep neural network. PLoS One 2018;13:e0191493.

11. Chan S, Reddy V, Myers B, Thibodeaux Q, Brownstone N , Liao W. Machine Learning in Dermatology: Current Applications, Opportunities, and Limitations. Dermatol Ther (Heidelb) 2020;10:365-86.

12. Takiddin A, Schneider J, Yang Y, Abd-Alrazaq A , Househ M. Artificial Intelligence for Skin Cancer Detection: Scoping Review. J Med Internet Res 2021;23:e22934.

13. Jones OT, Matin RN, van der Schaar M, Prathivadi Bhayankaram K, Ranmuthu CKI, Islam MS et al. Artificial intelligence and machine learning algorithms for early detection of skin cancer in community and primary care settings: a systematic review. Lancet Digit Health 2022;4:e466-e76.

14. Thomsen K, Iversen L, Titlestad TL , Winther O. Systematic review of machine learning for diagnosis and prognosis in dermatology. J Dermatolog Treat 2020;31:496-510.

15. Wahba MA, Ashour AS, Guo Y, Napoleon SA , Elnaby MMA. A novel cumulative level difference mean based GLDM and modified ABCD features ranked using eigenvector centrality approach for four skin lesion types classification. Comput Methods Programs Biomed 2018;165:163-74.

16. Wahba MA, Ashour AS, Napoleon SA, Abd Elnaby MM , Guo Y. Combined empirical mode decomposition and texture features for skin lesion classification using quadratic support vector machine. Health Inf Sci Syst 2017;5:10.

17. Marka A, Carter JB, Toto E , Hassanpour S. Automated detection of nonmelanoma skin cancer using digital images: a systematic review. BMC Med Imaging 2019;19:21.

18. Shrivastava VK, Londhe ND, Sonawane RS , Suri JS. Exploring the color feature power for psoriasis risk stratification and classification: A data mining paradigm. Comput Biol Med 2015;65:54-68.

19. Shrivastava VK, Londhe ND, Sonawane RS , Suri JS. First review on psoriasis severity risk stratification: An engineering perspective. Comput Biol Med 2015;63:52-63.

20. Lu J, Kazmierczak E, Manton JH , Sinclair R. Automatic segmentation of scaling in 2-D psoriasis skin images. IEEE Trans Med Imaging 2013;32:719-30.

21. Huang ML, Hung YH, Lee WM, Li RK , Jiang BR. SVM-RFE based feature selection and Taguchi parameters optimization for multiclass SVM classifier. ScientificWorldJournal 2014;2014:795624.

22. Daliri MR. Feature selection using binary particle swarm optimization and support vector machines for medical diagnosis. Biomed Tech (Berl) 2012;57:395-402.

23. Dash M, Londhe ND, Ghosh S, Semwal A , Sonawaneb RS. PsLSNet: Automated psoriasis skin lesion segmentation using modified U-Net-based fully convolutional network. Biomedical Signal Processing and Control 2019;52:226-37.

24. Min S, Kong HJ, Yoon C, Kim HC , Suh DH. Development and evaluation of an automatic acne lesion detection program using digital image processing. Skin Res Technol 2013;19:e423-32.

25. Khan J, Malik AS, Kamel N, Dass SC , Affandi AM. Segmentation of acne lesion using fuzzy C-means technique with intelligent selection of the desired cluster. Annu Int Conf IEEE Eng Med Biol Soc 2015;2015:3077-80.

26. Khozeimeh F, Alizadehsani R, Roshanzamir M, Khosravi A, Layegh P , Nahavandi S. An expert system for selecting wart treatment method. Comput Biol Med 2017;81:167-75.

27. Haenssle HA, Fink C, Toberer F, Winkler J, Stolz W, Deinlein T et al. Man against machine reloaded: performance of a market-approved convolutional neural network in classifying a broad spectrum of skin lesions in comparison with 96 dermatologists working under less artificial conditions. Ann Oncol 2020;31:137-43.

28. Patel S, Wang JV, Motaparthi K , Lee JB. Artificial intelligence in dermatology for the clinician. Clin Dermatol 2021;39:667-72.

29. Zhang AJ, Lindberg N, Chamlin SL, Haggstrom AN, Mancini AJ, Siegel DH et al. Development of an artificial intelligence algorithm for the diagnosis of infantile hemangiomas. Pediatr Dermatol 2022;39:934-6.

30. Krowchuk DP, Frieden IJ, Mancini AJ, Darrow DH, Blei F, Greene AK et al. Clinical Practice Guideline for the Management of Infantile Hemangiomas. Pediatrics 2019;143.

31. Yu K, Syed MN, Bernardis E , Gelfand JM. Machine Learning Applications in the Evaluation and Management of Psoriasis: A Systematic Review. J Psoriasis Psoriatic Arthritis 2020;5:147-59.

32. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK , Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017;137:26-30.

33. Guimaraes P, Batista A, Zieger M, Kaatz M , Koenig K. Artificial Intelligence in Multiphoton Tomography: Atopic Dermatitis Diagnosis. Sci Rep 2020;10:7968.

34. Prosperi MC, Belgrave D, Buchan I, Simpson A , Custovic A. Challenges in interpreting allergen microarrays in relation to clinical symptoms: a machine learning approach. Pediatr Allergy Immunol 2014;25:71-9.

35. De Guzman LC, Maglaque RPC, Torres VMB, Zapido SPA , Cordel MO. Design and Evaluation of a Multi-model, Multi-level Artificial Neural Network for Eczema Skin Lesion Detection. 3rd International Conference on Artificial Intelligence, Modelling and Simulation (AIMS)2015. p. 42-7.

36. Toy J, Gregory A , Rehmus W. Barriers to healthcare access in pediatric dermatology: A systematic review. Pediatr Dermatol 2021;38 Suppl 2:13-9.

37. Cline A, Gao JC, Berk-Krauss J, Kaplan L, Bienenfeld A, Desai A et al. Sustained reduction in no-show rate with the integration of teledermatology in a Federally Qualified Health Center. J Am Acad Dermatol 2021;85:e299-e301.

38. Cline A, Jacobs AK, Fonseca M , Marmon S. The impact of telemedicine on no-show rates in pediatric dermatology: A multicenter retrospective analysis of safety-net clinics. J Am Acad Dermatol 2022;86:e235-e7.

39. Kim YH, Kobic A , Vidal NY. Distribution of race and Fitzpatrick skin types in data sets for deep learning in dermatology: A systematic review. J Am Acad Dermatol 2022;87:460-1.

40. Buolamwini J , T G. Gender shades: intersectional accuracy disparities in commercial gender classification. Proceedings of the 1st Conference on Fairness, Accountability and Transparency. New York, NY2018. p. 77-91.

41. Tsetsi E , Rains SA. Smartphone Internet access and use: Extending the digital divide and usage gap. Mobile Media & Communication 2017;5:239-55.

42. Tong ST , Sopory P. Does integral affect influence intentions to use artificial intelligence for skin cancer screening? A test of the affect heuristic. Psychol Health 2019;34:828-49.

43. Han SS, Kim MS, Lim W, Park GH, Park I , Chang SE. Classification of the Clinical Images for Benign and Malignant Cutaneous Tumors Using a Deep Learning Algorithm. J Invest Dermatol 2018;138:1529-38.

44. Navarrete-Dechent C, Dusza SW, Liopyris K, Marghoob AA, Halpern AC , Marchetti MA. Automated Dermatological Diagnosis: Hype or Reality? J Invest Dermatol 2018;138:2277-9.

45. Oliveira R, Mercedes E, Ma Z, Papa J, Pereira A , Tavares J. Computational methods for the image segmentation of pigmented skin lesions: a review. Computer Methods and Programs in Biomedicine 2016:127-41.

46. Haggenmuller S, Maron RC, Hekler A, Utikal JS, Barata C, Barnhill RL et al. Skin cancer classification via convolutional neural networks: systematic review of studies involving human experts. Eur J Cancer 2021;156:202-16.

47. Han SS, Moon IJ, Kim SH, Na JI, Kim MS, Park GH et al. Assessment of deep neural networks for the diagnosis of benign and malignant skin neoplasms in comparison with dermatologists: A retrospective validation study. PLoS Med 2020;17:e1003381.

Most read articles by the same author(s)