Differential Diagnosis of

Erythemato-Exfoliative Skin Disorders

Wojciech Francuzik, Aleksandra Skłodowska

Tutor: Prof. Zygmunt Adamski

Student Scientific Working Group of Skin Diseases

The difficulties of diagnosing skin disorders

?

What is it? Definetly not this!

Materials Database form the UCI repository was used in this study, with retrospective diagnosis of six

diseases:

Database consisted of 366 Patients

PR Pityriasis rosea

P Psoriasis

LP Lichen planus

CD Chronic dermatitis

SD Seborrhoeic dermatitis

PRP Pityriasis rubra pilaris

Source: http://archive.ics.uci.edu/ml/datasets/Dermatology

METHOD Clinical Attributes: 1: erythema 2: scaling 3: definite borders 4: itching 5: koebner phenomenon 6: polygonal papules 7: follicular papules 8: oral mucosal involvement 9: knee and elbow involvement 10: scalp involvement 11: family history, (0 or 1) 34: Age (linear)

Histopathological Attributes: 12: melanin incontinence 13: eosinophils in the infiltrate 14: PNL infiltrate 15: fibrosis of the papillary dermis 16: exocytosis 17: acanthosis 18: hyperkeratosis 19: parakeratosis 20: clubbing of the rete ridges 21: elongation of the rete ridges 22: thinning of the suprapapillary epidermis

23: spongiform pustule 24: munro microabcess 25: focal hypergranulosis 26: disappearance of the granular layer 27: vacuolisation and damage of basal layer 28: spongiosis 29: saw-tooth appearance of retes 30: follicular horn plug 31: perifollicular parakeratosis 32: inflammatory monoluclear inflitrate 33: band-like infiltrate

METHOD

0, 1, 2, 3

0 & 1

Statistical analysis

PR

P

LP

CD

SD

PRP

All other vs & Odds Ratio

Algorithm preparation

PR

P

LP

CD

SD

PRP

Distinctive features

Algorithm design

Over 95% of correct diagnosis

Results

P

CD

PRP

Definite borders OR= ∞ (6,856 - ∞) Thinning of the suprapappilary epidermis OR= 3402 (527.161-30722.447) Elongation of the rete ridges OR= ∞ (79,848 - ∞)

follicular papules OR= ∞ (90- ∞) follicular horn plug OR= 2172,33 (185,951- 62594.677) follicular parakeratosis OR= ∞ (513.304- ∞)

fibrosis of the papillary dermis OR= ∞ (908.579 - ∞)

Results

LP

SD

PR

Polygonal papules OR= ∞ (900,336- ∞) Melanin incontinency OR= ∞ (∞ -1158,445) Oral mucosa involvement OR= ∞ (614,1 - ∞)

Polygonal papules OR= 0 Knee and elbow involvement OR= 0 (0- 0,1) Follicular papules OR= 0

Polygonal papules OR= 0 Clubbing of the rete ridges OR= 0 Saw tooth apparence OR= 0

Imperfections

•Unability to differentiate properly between Pityriasis rosea and Seborrhoeic dermatitis

Results

LP

SD

PR

Polygonal papules OR= ∞ (900,336- ∞) Melanin incontinency OR= ∞ (∞ -1158,445) Oral mucosa involvement OR= ∞ (614,1 - ∞)

Polygonal papules OR= 0 Knee and elbow involvement OR= 0 (0- 0,1) Follicular papules OR= 0

Polygonal papules OR= 0 Clubbing of the rete ridges OR= 0 Saw tooth apparence OR= 0

Results

LP

SD

PR

Polygonal papules OR= ∞ (900,336- ∞) Melanin incontinency OR= ∞ (∞ -1158,445) Oral mucosa involvement OR= ∞ (614,1 - ∞)

Polygonal papules OR= 0 Knee and elbow involvement OR= 0 (0- 0,1) Follicular papules OR= 0

Polygonal papules OR= 0 Clubbing of the rete ridges OR= 0 Saw tooth apparence OR= 0

+ Herald Patch !!!

SPECIAL THANKS TO DATA PROVIDERS:

Professor Nilsel Ilter, M.D, PhD. Grazi University

Professor Altalay Guvenir PhD.

Bilkent University

Collaboration and Open Data Sharing