Beyond regulation of male sexual function, the increasing evidence shows that androgens and androgen receptor (AR) have a variety of physiological and pathological effects on the skin. Skin cells express all androgen ...Beyond regulation of male sexual function, the increasing evidence shows that androgens and androgen receptor (AR) have a variety of physiological and pathological effects on the skin. Skin cells express all androgen metabolizing enzymes that are required for independent skin androgen synthesis and the development of hyperandrogenic related disorders such as acne, hirsutism and androgenetic alopecia. Targeting various elements of androgen function and metabolism is the major goal of medication design for the treatment of androgen-related diseases. Antiandrogen drugs such as clascoterone, flutamide could improve conditions. Even though the involvement of androgens and AR in skin diseases has been investigated for a long time, their molecular mechanisms in skin disorders remain largely insufficient. In this review, recent studies and advances on the role of androgens/AR in several skin-related diseases and their therapeutics are systematically summarized.展开更多
Biomedical image analysis has been exploited considerably by recent technology involvements,carrying about a pattern shift towards‘automation’and‘error free diagnosis’classification methods with markedly improved ...Biomedical image analysis has been exploited considerably by recent technology involvements,carrying about a pattern shift towards‘automation’and‘error free diagnosis’classification methods with markedly improved accurate diagnosis productivity and cost effectiveness.This paper proposes an automated deep learning model to diagnose skin disease at an early stage by using Dermoscopy images.The proposed model has four convolutional layers,two maxpool layers,one fully connected layer and three dense layers.All the convolutional layers are using the kernel size of 3∗3 whereas the maxpool layer is using the kernel size of 2∗2.The dermoscopy images are taken from the HAM10000 dataset.The proposed model is compared with the three different models of ResNet that are ResNet18,ResNet50 and ResNet101.The models are simulated with 32 batch size and Adadelta optimizer.The proposed model has obtained the best accuracy value of 0.96 whereas the ResNet101 model has obtained 0.90,the ResNet50 has obtained 0.89 and the ResNet18 model has obtained value as 0.86.Therefore,features obtained from the proposed model are more capable for improving the classification performance of multiple skin disease classes.This model can be used for early diagnosis of skin disease and can also act as a second opinion tool for dermatologists.展开更多
The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor ...The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.展开更多
Autoimmune-related skin diseases are a group of disorders with diverse etiology and pathophysiology involved in autoimmunity.Genetics and environmental factors may contribute to the development of these autoimmune dis...Autoimmune-related skin diseases are a group of disorders with diverse etiology and pathophysiology involved in autoimmunity.Genetics and environmental factors may contribute to the development of these autoimmune disorders.Although the etiology and pathogenesis of these disorders are poorly understood,environmental variables that induce aberrant epigenetic regulations may provide some insights.Epigenetics is the study of heritable mechanisms that regulate gene expression without changing DNA sequences.The most important epigenetic mechanisms are DNA methylation,histone modification,and noncoding RNAs.In this review,we discuss the most recent findings regarding the function of epigenetic mechanisms in autoimmune-related skin disorders,including systemic lupus erythematosus,bullous skin diseases,psoriasis,and systemic sclerosis.These findings will expand our understanding and highlight the possible clinical applications of precision epigenetics approaches.展开更多
Background:The prevalence of skin diseases and diabetes mellitus(DM)are prominent around the world.The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM(T2DM)is limi...Background:The prevalence of skin diseases and diabetes mellitus(DM)are prominent around the world.The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM(T2DM)is limited,leading to limited recognition of the correlations between skin diseases and T2DM.Methods:We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st,2016.The subjects were categorized into three groups:Normal glucose tolerance(NGT),impaired glucose tolerance(IGT),and T2DM.The prevalence and clinical characteristics of skin diseases were recorded and investigated.Results:In this cross-sectional study,383 individuals with ages ranging from 53 to 89-year-old were recruited.The overall prevalence of skin diseases was 93.5%,and 75.7%of individuals had two or more kinds of skin diseases.Additionally,there were 47 kinds of comorbid skin diseases in patients with T2DM,of which eight kinds of skin diseases had a prevalence>10%.The prevalence of skin diseases in NGT,IGT,and T2DM groups were 93.3%,91.5%,and 96.6%,respectively;stratified analysis by categories showed a statistically significant difference in"disturbances of pigmentation"and"neurological and psychogenic dermatoses".The duration of T2DM also significantly associated with the prevalence of"disturbances of pigmentation"and"neurological and psychogenic dermatoses".Subsequently,the prevalence of"disturbances of pigmentation"was higher in males than females in NGT(P<0.01)and T2DM(P<0.01)groups.In addition,the difference in the prevalence of"disturbances of pigmentation"was also significant in NGT and T2DM groups(P<0.01).Conclusions:There was a high prevalence of skin diseases in the Da Qing Diabetes Study.To address the skin diseases in the Da Qing Diabetes Study,increased awareness and intervention measures should be implemented.展开更多
Background:Epidermal parasitic skin diseases(EPSD)occur in most countries and cause a considerable health and economic burden,particularly in the tropics and subtropics.The aim of this study was to assess and analyse ...Background:Epidermal parasitic skin diseases(EPSD)occur in most countries and cause a considerable health and economic burden,particularly in the tropics and subtropics.The aim of this study was to assess and analyse peerreviewed literature on EPSD in humans.The results of this study serve as an indicator of the extent the scientific community,health authorities,and international health agencies interact with EPSD as a health problem that is commonly associated with poverty and poor hygiene.Methods:A bibliometric analysis methodology was used.The Scopus database was used to retrieve documents about EPSD for the study period(1967-2017).The study focused on scabies,tungiasis,pediculosis,hookwormrelated cutaneous larva migrans(HrCLM),myiasis,and cutaneous strongyloidiasis.Documents that specifically and explicitly discuss EPSD in animals,aquatic organisms,and birds were excluded.Results:In total,4186 documents were retrieved.A fluctuated growth of publications on EPSD in the past five decades was found.The retrieved documents received 43301 citations,an average of 10.3 citations per article and an h-index of 74.The keywords“scabies”and was the most commonly encountered keyword followed by the keywords“head lice”and“pediculosis”.The most active journal involved in publishing articles on EPSD was the International Journal of Dermatology(164;3.9%).Researchers from 93 different countries published the retrieved articles.The USA led with 735(17.6%)documents,followed by the UK(274;6.5%),and Germany(259;6.2%).In terms of institutions,the Charite-Universitätsmedizin Berlin in Germany was the most active in this field with 78(1.9%)publications,followed by the Universidade Federal do Cearáin Brazil with 52(1.2%)publications.Conclusions:Research on scabies and pediculosis dominated the field of EPSD research to the expense of tungiasis,HrCLM,myiasis,and cutaneous strongyloidiasis.There was an underrepresentation of literature from the tropics and subtropics despite EPSD being common in these areas.This could possibly be explained by the presence of limited number of non-English journals in the Scopus database.International research collaborations and research networking should be strengthened to help advance and prioritize research on EPSD.展开更多
Skin lesions detection and classification is a prominent issue and difficult even for extremely skilled dermatologists and pathologists.Skin disease is the most common disorder triggered by fungus,viruses,bacteria,all...Skin lesions detection and classification is a prominent issue and difficult even for extremely skilled dermatologists and pathologists.Skin disease is the most common disorder triggered by fungus,viruses,bacteria,allergies,etc.Skin diseases are most dangerous and may be the cause of serious damage.Therefore,it requires to diagnose it at an earlier stage,but the diagnosis therapy itself is complex and needs advanced laser and photonic therapy.This advance therapy involvesfinancial burden and some other ill effects.Therefore,it must use artificial intelligence techniques to detect and diagnose it accurately at an earlier stage.Several techniques have been proposed to detect skin disease at an earlier stage but fail to get accuracy.Therefore,the primary goal of this paper is to classify,detect and provide accurate information about skin diseases.This paper deals with the same issue by proposing a high-performance Convolution neural network(CNN)to classify and detect skin disease at an earlier stage.The complete meth-odology is explained in different folds:firstly,the skin diseases images are pre-processed with processing techniques,and secondly,the important feature of the skin images are extracted.Thirdly,the pre-processed images are analyzed at different stages using a Deep Convolution Neural Network(DCNN).The approach proposed in this paper is simple,fast,and shows accurate results up to 98%and used to detect six different disease types.展开更多
BACKGROUND There is indication that fecal microbiota transplant(FMT)has the potential to alter the course of chronic skin disease,but few studies have investigated this phenomenon beyond case reports.Research with lar...BACKGROUND There is indication that fecal microbiota transplant(FMT)has the potential to alter the course of chronic skin disease,but few studies have investigated this phenomenon beyond case reports.Research with larger sample sizes is needed to provide a more thorough assessment of possible associations and to establish a broader foundation upon which to base hypotheses.AIM To identify associations between FMT and skin conditions,particularly infectious and inflammatory etiologies,and the role of dermatology post-FMT.METHODS We conducted a retrospective cohort study involving a chart review of all patients whom received FMT between January 2013 and December 2019 at a single academic medical center.Dermatologic follow-up was assessed for the two years after FMT or through March 2020 for more recent procedures.Dermatologic diagnoses and visits within the study time frame were recorded and assessed for trends.This study was exploratory in nature.Descriptive statistics were calculated,and the t-test,Pearson’s chi-squared test,and Fisher’s exact test were used to calculate P values.RESULTS Median age was 38(range,17-90).In total,109 patients who underwent 111 fecal microbiota transplant events were included.Twenty-six events(23.4%)involved a dermatology office visit post-procedure,and of these events,20 out of the 26(76.9%)had an infectious or inflammatory skin condition.The mean time to first visit was 10.0(±7.0)mo.The most common diagnoses were dermatophyte,wart(s),and dermatitis,though no specific diagnoses predominated in a way indicating FMT had a significant impact.More patients with a post-FMT skin disease diagnosis had a history of Crohn’s disease compared to those without(P=0.022),but results could be affected by a small sample size.CONCLUSION Our study is limited by its retrospective nature,but the findings allow a glimpse at dermatologic conditions post-FMT.Few significant associations were found,but potential associations between FMT and skin disease should be further investigated,preferably in prospective studies,to identify how FMT might be of use for treating infectious and inflammatory skin diseases.展开更多
Deep learning has become an extremely popular method in recent years,and can be a powerful tool in complex,prior-knowledge-required areas,especially in the field of biomedicine,which is now facing the problem of inade...Deep learning has become an extremely popular method in recent years,and can be a powerful tool in complex,prior-knowledge-required areas,especially in the field of biomedicine,which is now facing the problem of inadequate medical resources.The application of deep learning in disease diagnosis has become a new research topic in derma-tology.This paper aims to provide a quick review of the classification of skin disease using deep learning to summa-rize the characteristics of skin lesions and the status of image technology.We study the characteristics of skin disease and review the research on skin disease classification using deep learning.We analyze these studies using datasets,data processing,classification models,and evaluation criteria.We summarize the development of this field,illustrate the key steps and influencing factors of dermatological diagnosis,and identify the challenges and opportunities at this stage.Our research confirms that a skin disease recognition method based on deep learning can be superior to professional dermatologists in specific scenarios and has broad research prospects.展开更多
Skin diseases effectively influence all parts of life.Early and accurate detection of skin cancer is necessary to avoid significant loss.The manual detection of skin diseases by dermatologists leads to misclassificati...Skin diseases effectively influence all parts of life.Early and accurate detection of skin cancer is necessary to avoid significant loss.The manual detection of skin diseases by dermatologists leads to misclassification due to the same intensity and color levels.Therefore,an automated system to identify these skin diseases is required.Few studies on skin disease classification using different techniques have been found.However,previous techniques failed to identify multi-class skin disease images due to their similar appearance.In the proposed study,a computer-aided framework for automatic skin disease detection is presented.In the proposed research,we collected and normalized the datasets from two databases(ISIC archive,Mendeley)based on six Basal Cell Carcinoma(BCC),Actinic Keratosis(AK),Seborrheic Keratosis(SK),Nevus(N),Squamous Cell Carcinoma(SCC),and Melanoma(M)common skin diseases.Besides,segmentation is performed using deep Convolutional Neural Networks(CNN).Furthermore,three types of features are extracted from segmented skin lesions:ABCD rule,GLCM,and in-depth features.AlexNet transfer learning is used for deep feature extraction,while a support vector machine(SVM)is used for classification.Experimental results show that SVM outperformed other studies in terms of accuracy,as AK disease achieved 100%accuracy,BCC 92.7%,M 95.1%,N 97.8%,SK 93.1%,SCC 91.4%with a global accuracy of 95.4%.展开更多
One of the most critical steps in medical health is the proper diagnosis of the disease.Dermatology is one of the most volatile and challenging fields in terms of diagnosis.Dermatologists often require further testing...One of the most critical steps in medical health is the proper diagnosis of the disease.Dermatology is one of the most volatile and challenging fields in terms of diagnosis.Dermatologists often require further testing,review of the patient’s history,and other data to ensure a proper diagnosis.Therefore,finding a method that can guarantee a proper trusted diagnosis quickly is essential.Several approaches have been developed over the years to facilitate the diagnosis based on machine learning.However,the developed systems lack certain properties,such as high accuracy.This study proposes a system developed in MATLAB that can identify skin lesions and classify them as normal or benign.The classification process is effectuated by implementing the K-nearest neighbor(KNN)approach to differentiate between normal skin and malignant skin lesions that imply pathology.KNN is used because it is time efficient and promises highly accurate results.The accuracy of the system reached 98%in classifying skin lesions.展开更多
Skin lesion recognition is an important challenge in the medical field.In this paper,we have implemented an intelligent classification system based on convolutional neural network.First of all,this system can classify...Skin lesion recognition is an important challenge in the medical field.In this paper,we have implemented an intelligent classification system based on convolutional neural network.First of all,this system can classify whether the input image is a dermascopic image with an accuracy of 99%.And then diagnose the dermoscopic image and the non-skin mirror image separately.Due to the limitation of the data,we can only realize the recognition of vitiligo by non-skin mirror.We propose a vitiligo recognition based on the probability average of three structurally identical CNN models.The method is more efficient and robust than the traditional RGB color space-based image recognition method.For the dermoscopic classification model,we were able to classify 7 skin lesions,use weighted optimization to overcome the unbalanced data set,and greatly improve the sensitivity of the model by means of model fusion.The optimization and expansion of the system depend on the increase of database.展开更多
AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal ...AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtainedfrom our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of longterm immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series. CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.展开更多
Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated...Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated medicine.The existing skin health management in China is still based on the medical concept of"professional refinement and specialist differentiation",and still fails to solve many negative effects caused by the fragmentation of medical knowledge and the mechanization of clinical medical practice.Therefore,based on the concept of integrated medicine,this paper puts forward a new concept of skin health management integrated medicine.However,in order to establish this brand-new integrated medical view of skin health management,we should focus on the medicine for the diagnosis and treatment of skin diseases,the physical and mental health management of skin patients,the integration of traditional Chinese medicine and western medicine for the diagnosis and treatment of skin diseases,the combination of prevention and treatment of skin diseases,the cooperation of medical and nursing care for the health management of skin diseases,and the development of skin health care industry,speed up the skin disease health management integration of medical practice and other aspects.展开更多
By combing the mechanism and advantages of traditional Chinese medicine(TCM)soaking and washing and combining TCM syndrome differentiation with western medicine differentiation of diseases,guided by the view that"...By combing the mechanism and advantages of traditional Chinese medicine(TCM)soaking and washing and combining TCM syndrome differentiation with western medicine differentiation of diseases,guided by the view that"the principle of external treatment is that of internal treatment",this article discusses the differentiation and treatment ideas of palmoplantar keratosis by TCM soaking and washing,which will provide a reference for clinical treatment.展开更多
Cutaneous leishmaniasis is a neglected tropical skin endemic disease, with worldwide distribution. By 2020 in the Americas, Mexico was in 12th place with 11 states reporting new cases. Molecular biology with different...Cutaneous leishmaniasis is a neglected tropical skin endemic disease, with worldwide distribution. By 2020 in the Americas, Mexico was in 12th place with 11 states reporting new cases. Molecular biology with different targets for diagnosis and species identification has been used for decades, also dermoscopy, a non-invasive diagnostic tool has shown its usefulness. We present the first case of cutaneous leishmaniasis in non-endemic place (Guerrero, Mexico) identifying Leishmania mexicana with molecular biology, and treated with itraconazole.展开更多
Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reporte...Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reported improvements in inflammatory skin conditions in individuals treated with FMT,but larger studies are needed to clarify this possible relationship between the skin and the gut microbiome.We conducted a single-center,retrospective chart review to assess changes in acne,dermatitis herpetiformis and/or celiac disease,eczema,and psoriasis.Due to the retrospective nature of this study and the limitations of the current electronic medical record,we were unable to adequately assess cases of these diseases in relation to FMT.However,this study informs us that improvements in retrospective data are needed to formally evaluate this possible association.The better,but more cumbersome,study design would be a prospective,observational study.We encourage others to pursue further interdepartmental research on the influence of the gut microbiome on inflammatory skin diseases.展开更多
Fungal disease affects more than a billion people worldwide,resulting in different types of fungus diseases facing life-threatening infections.The outer layer of your body is called the integumentary system.Your skin,...Fungal disease affects more than a billion people worldwide,resulting in different types of fungus diseases facing life-threatening infections.The outer layer of your body is called the integumentary system.Your skin,hair,nails,and glands are all part of it.These organs and tissues serve as your first line of defence against bacteria while protecting you from harm and the sun.The It serves as a barrier between the outside world and the regulated environment inside our bodies and a regulating effect.Heat,light,damage,and illness are all protected by it.Fungi-caused infections are found in almost every part of the natural world.When an invasive fungus takes over a body region and overwhelms the immune system,it causes fungal infections in people.Another primary goal of this study was to create a Convolutional Neural Network(CNN)-based technique for detecting and classifying various types of fungal diseases.There are numerous fungal illnesses,but only two have been identified and classified using the proposed Innovative Fungal Disease Diagnosis(IFDD)system of Candidiasis and Tinea Infections.This paper aims to detect infected skin issues and provide treatment recommendations based on proposed system findings.To identify and categorize fungal infections,deep machine learning techniques are utilized.A CNN architecture was created,and it produced a promising outcome to improve the proposed system accuracy.The collected findings demonstrated that CNN might be used to identify and classify numerous species of fungal spores early and estimate all conceivable fungus hazards.Our CNN-Based can detect fungal diseases through medical images;earmarked IFDD system has a predictive performance of 99.6%accuracy.展开更多
BACKGROUND Chloracne is a rare skin condition that is caused by systemic exposure to halogenated aromatic compounds.The main characteristic of chloracne is blackhead,and in severe cases,it can be accompanied by system...BACKGROUND Chloracne is a rare skin condition that is caused by systemic exposure to halogenated aromatic compounds.The main characteristic of chloracne is blackhead,and in severe cases,it can be accompanied by systemic symptoms.Sodium 3,5,6-trichloropyridin-2-ol(STCP)is a necessary precursor compound for the production of chlorpyrifos and triclopyr,which are extensively used as a pesticide and herbicide,respectively.STCP is also a chlorophenol that has been associated with chloracne.STCP poisoning could induce mild myelin sheath damage.We herein report three cases with chloracne due to exposure to STCP.CASE SUMMARY Three young men,aged 29,33,and 26 years,respectively,in the same workplace had polymorphic skin lesions,characterized mainly by comedones and cysts,and one of them also had acne like lesions in the genital area.These clinical manifestations appeared when they were exposed to STCP for 3 d,1 wk,and 2 wk,respectively.Among them,polyneuropathy and liver damage occurred.We performed dermoscopy and clinical and laboratory tests on these patients.Additionally,histopathology was used for further diagnosis in the serious patient.These patients were diagnosed with chloracne and separated from STCP.The patients were prescribed oral viaminate capsules,topical adapalene gel,and regular hematologic follow-up for aspartate transaminase and lipids.They are still under follow-up.There was no new lesions and the laboratory tests returned to normal in two patients.Pigmentation and shallow scars remained in the original areas of papules.However,in the most serious patient,new papules still appeared intermittently.All these remind us that the treatment of chloracne caused by STCP is difficult,and we should attach great importance to this new compound related with the neuropathy and chloracne.CONCLUSION STCP is becoming a new chemical product to induce chloracne,which should attract the attention of all medical professionals,especially dermatologists.Due to the lack of knowledge on the new chemical,the diagnosis of chloracne cannot be made in time.Chloracne still deserves our attention.展开更多
Lumpy skin disease(LSD)is a transboundary disease affecting cattle and has a detrimental effect on the cattle industries in numerous countries in Africa,Europe and Asia.In 2021,LSD outbreaks have been reported in almo...Lumpy skin disease(LSD)is a transboundary disease affecting cattle and has a detrimental effect on the cattle industries in numerous countries in Africa,Europe and Asia.In 2021,LSD outbreaks have been reported in almost all of Thailand's provinces.Indeed,fitting LSD occurrences using mathematical models provide important knowledge in the realm of animal disease modeling.Thus,the objective of this study is to fit the pattern of daily new LSD cases and daily cumulative LSD cases in Thailand using mathematical models.The first-and second-order models in the forms of Lorentzian,Gaussian and Pearson-type VII models are used to fit daily new LSD cases whereas Richard's growth,Boltzmann sigmoidal and Power-law growth models are utilized to fit the curve of cumulative LSD cases.Based on the root-mean-squared error(RMSE)and Akaike information criterion(AIC),results showed that both first and second orders of Pearson-type VII models and Richard's growth model(RGM)were fit to the data better than other models used in the present study.The obtained models and their parameters can be utilized to describe the LSD outbreak in Thailand.For disease preparedness purposes,we can use the first order of the Pearson-type VII model to estimate the time of maximum infected cases occurring when the growth rate of infected cases starts to slow down.Furthermore,the period when the growth rate changes at a slower rate,known as the inflection time,obtained from RGM allows us to anticipate when the pandemic has peaked and the situation has stabilized.This is the first study that utilizes mathematical methods to fit the LSD epidemics in Thailand.This study offers decision-makers and authorities with valuable information for establishing an effective disease control strategy.展开更多
文摘Beyond regulation of male sexual function, the increasing evidence shows that androgens and androgen receptor (AR) have a variety of physiological and pathological effects on the skin. Skin cells express all androgen metabolizing enzymes that are required for independent skin androgen synthesis and the development of hyperandrogenic related disorders such as acne, hirsutism and androgenetic alopecia. Targeting various elements of androgen function and metabolism is the major goal of medication design for the treatment of androgen-related diseases. Antiandrogen drugs such as clascoterone, flutamide could improve conditions. Even though the involvement of androgens and AR in skin diseases has been investigated for a long time, their molecular mechanisms in skin disorders remain largely insufficient. In this review, recent studies and advances on the role of androgens/AR in several skin-related diseases and their therapeutics are systematically summarized.
基金This work was supported by Taif university Researchers Supporting Project Number(TURPS-2020/114),Taif University,Taif,Saudi Arabia.
文摘Biomedical image analysis has been exploited considerably by recent technology involvements,carrying about a pattern shift towards‘automation’and‘error free diagnosis’classification methods with markedly improved accurate diagnosis productivity and cost effectiveness.This paper proposes an automated deep learning model to diagnose skin disease at an early stage by using Dermoscopy images.The proposed model has four convolutional layers,two maxpool layers,one fully connected layer and three dense layers.All the convolutional layers are using the kernel size of 3∗3 whereas the maxpool layer is using the kernel size of 2∗2.The dermoscopy images are taken from the HAM10000 dataset.The proposed model is compared with the three different models of ResNet that are ResNet18,ResNet50 and ResNet101.The models are simulated with 32 batch size and Adadelta optimizer.The proposed model has obtained the best accuracy value of 0.96 whereas the ResNet101 model has obtained 0.90,the ResNet50 has obtained 0.89 and the ResNet18 model has obtained value as 0.86.Therefore,features obtained from the proposed model are more capable for improving the classification performance of multiple skin disease classes.This model can be used for early diagnosis of skin disease and can also act as a second opinion tool for dermatologists.
文摘The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.
基金CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2021-I2M-1-059)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2020-RC320-003)+1 种基金the National Natural Science Foundation of China(No.81830097)Special Program of National Natural Science Foundation of China(No.32141004).
文摘Autoimmune-related skin diseases are a group of disorders with diverse etiology and pathophysiology involved in autoimmunity.Genetics and environmental factors may contribute to the development of these autoimmune disorders.Although the etiology and pathogenesis of these disorders are poorly understood,environmental variables that induce aberrant epigenetic regulations may provide some insights.Epigenetics is the study of heritable mechanisms that regulate gene expression without changing DNA sequences.The most important epigenetic mechanisms are DNA methylation,histone modification,and noncoding RNAs.In this review,we discuss the most recent findings regarding the function of epigenetic mechanisms in autoimmune-related skin disorders,including systemic lupus erythematosus,bullous skin diseases,psoriasis,and systemic sclerosis.These findings will expand our understanding and highlight the possible clinical applications of precision epigenetics approaches.
基金supported by grants from the Milstein Medical Asian American Partnership Foundation Research Project"Establishment and application of digital image database for skin diseases in the Chinese population"(No.MMAAP2016023)the Open Research Funding of China Skin Image Database(Nos.CSID-ORF-201711 and CSID-ORF-201918)+3 种基金the Fundamental Research Funds for the Central Universities(No.3332018182)Innovation Fund for Graduate Students(No.2018-1002-01-26)Peking Union Medical College,Chinaand the scholarship from China Scholarship Council(No.201806210430)。
文摘Background:The prevalence of skin diseases and diabetes mellitus(DM)are prominent around the world.The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM(T2DM)is limited,leading to limited recognition of the correlations between skin diseases and T2DM.Methods:We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st,2016.The subjects were categorized into three groups:Normal glucose tolerance(NGT),impaired glucose tolerance(IGT),and T2DM.The prevalence and clinical characteristics of skin diseases were recorded and investigated.Results:In this cross-sectional study,383 individuals with ages ranging from 53 to 89-year-old were recruited.The overall prevalence of skin diseases was 93.5%,and 75.7%of individuals had two or more kinds of skin diseases.Additionally,there were 47 kinds of comorbid skin diseases in patients with T2DM,of which eight kinds of skin diseases had a prevalence>10%.The prevalence of skin diseases in NGT,IGT,and T2DM groups were 93.3%,91.5%,and 96.6%,respectively;stratified analysis by categories showed a statistically significant difference in"disturbances of pigmentation"and"neurological and psychogenic dermatoses".The duration of T2DM also significantly associated with the prevalence of"disturbances of pigmentation"and"neurological and psychogenic dermatoses".Subsequently,the prevalence of"disturbances of pigmentation"was higher in males than females in NGT(P<0.01)and T2DM(P<0.01)groups.In addition,the difference in the prevalence of"disturbances of pigmentation"was also significant in NGT and T2DM groups(P<0.01).Conclusions:There was a high prevalence of skin diseases in the Da Qing Diabetes Study.To address the skin diseases in the Da Qing Diabetes Study,increased awareness and intervention measures should be implemented.
文摘Background:Epidermal parasitic skin diseases(EPSD)occur in most countries and cause a considerable health and economic burden,particularly in the tropics and subtropics.The aim of this study was to assess and analyse peerreviewed literature on EPSD in humans.The results of this study serve as an indicator of the extent the scientific community,health authorities,and international health agencies interact with EPSD as a health problem that is commonly associated with poverty and poor hygiene.Methods:A bibliometric analysis methodology was used.The Scopus database was used to retrieve documents about EPSD for the study period(1967-2017).The study focused on scabies,tungiasis,pediculosis,hookwormrelated cutaneous larva migrans(HrCLM),myiasis,and cutaneous strongyloidiasis.Documents that specifically and explicitly discuss EPSD in animals,aquatic organisms,and birds were excluded.Results:In total,4186 documents were retrieved.A fluctuated growth of publications on EPSD in the past five decades was found.The retrieved documents received 43301 citations,an average of 10.3 citations per article and an h-index of 74.The keywords“scabies”and was the most commonly encountered keyword followed by the keywords“head lice”and“pediculosis”.The most active journal involved in publishing articles on EPSD was the International Journal of Dermatology(164;3.9%).Researchers from 93 different countries published the retrieved articles.The USA led with 735(17.6%)documents,followed by the UK(274;6.5%),and Germany(259;6.2%).In terms of institutions,the Charite-Universitätsmedizin Berlin in Germany was the most active in this field with 78(1.9%)publications,followed by the Universidade Federal do Cearáin Brazil with 52(1.2%)publications.Conclusions:Research on scabies and pediculosis dominated the field of EPSD research to the expense of tungiasis,HrCLM,myiasis,and cutaneous strongyloidiasis.There was an underrepresentation of literature from the tropics and subtropics despite EPSD being common in these areas.This could possibly be explained by the presence of limited number of non-English journals in the Scopus database.International research collaborations and research networking should be strengthened to help advance and prioritize research on EPSD.
基金supported by Taif university Researchers Supporting Project Number(TURSP-2020/114),Taif University,Taif,Saudi Arabia.
文摘Skin lesions detection and classification is a prominent issue and difficult even for extremely skilled dermatologists and pathologists.Skin disease is the most common disorder triggered by fungus,viruses,bacteria,allergies,etc.Skin diseases are most dangerous and may be the cause of serious damage.Therefore,it requires to diagnose it at an earlier stage,but the diagnosis therapy itself is complex and needs advanced laser and photonic therapy.This advance therapy involvesfinancial burden and some other ill effects.Therefore,it must use artificial intelligence techniques to detect and diagnose it accurately at an earlier stage.Several techniques have been proposed to detect skin disease at an earlier stage but fail to get accuracy.Therefore,the primary goal of this paper is to classify,detect and provide accurate information about skin diseases.This paper deals with the same issue by proposing a high-performance Convolution neural network(CNN)to classify and detect skin disease at an earlier stage.The complete meth-odology is explained in different folds:firstly,the skin diseases images are pre-processed with processing techniques,and secondly,the important feature of the skin images are extracted.Thirdly,the pre-processed images are analyzed at different stages using a Deep Convolution Neural Network(DCNN).The approach proposed in this paper is simple,fast,and shows accurate results up to 98%and used to detect six different disease types.
文摘BACKGROUND There is indication that fecal microbiota transplant(FMT)has the potential to alter the course of chronic skin disease,but few studies have investigated this phenomenon beyond case reports.Research with larger sample sizes is needed to provide a more thorough assessment of possible associations and to establish a broader foundation upon which to base hypotheses.AIM To identify associations between FMT and skin conditions,particularly infectious and inflammatory etiologies,and the role of dermatology post-FMT.METHODS We conducted a retrospective cohort study involving a chart review of all patients whom received FMT between January 2013 and December 2019 at a single academic medical center.Dermatologic follow-up was assessed for the two years after FMT or through March 2020 for more recent procedures.Dermatologic diagnoses and visits within the study time frame were recorded and assessed for trends.This study was exploratory in nature.Descriptive statistics were calculated,and the t-test,Pearson’s chi-squared test,and Fisher’s exact test were used to calculate P values.RESULTS Median age was 38(range,17-90).In total,109 patients who underwent 111 fecal microbiota transplant events were included.Twenty-six events(23.4%)involved a dermatology office visit post-procedure,and of these events,20 out of the 26(76.9%)had an infectious or inflammatory skin condition.The mean time to first visit was 10.0(±7.0)mo.The most common diagnoses were dermatophyte,wart(s),and dermatitis,though no specific diagnoses predominated in a way indicating FMT had a significant impact.More patients with a post-FMT skin disease diagnosis had a history of Crohn’s disease compared to those without(P=0.022),but results could be affected by a small sample size.CONCLUSION Our study is limited by its retrospective nature,but the findings allow a glimpse at dermatologic conditions post-FMT.Few significant associations were found,but potential associations between FMT and skin disease should be further investigated,preferably in prospective studies,to identify how FMT might be of use for treating infectious and inflammatory skin diseases.
基金Supported by Key Research and Development Projects of Zhejiang Province of China(Grant No.2017C01054)National Key Research and Development Program of China(Grant No.2018YFA0703000)+1 种基金National Natural Science Foundation of China(Grant No.51875518)Fundamental Research Funds for the Central Universities of China(Grant Nos.2019XZZX003-02,2019FZA4002).
文摘Deep learning has become an extremely popular method in recent years,and can be a powerful tool in complex,prior-knowledge-required areas,especially in the field of biomedicine,which is now facing the problem of inadequate medical resources.The application of deep learning in disease diagnosis has become a new research topic in derma-tology.This paper aims to provide a quick review of the classification of skin disease using deep learning to summa-rize the characteristics of skin lesions and the status of image technology.We study the characteristics of skin disease and review the research on skin disease classification using deep learning.We analyze these studies using datasets,data processing,classification models,and evaluation criteria.We summarize the development of this field,illustrate the key steps and influencing factors of dermatological diagnosis,and identify the challenges and opportunities at this stage.Our research confirms that a skin disease recognition method based on deep learning can be superior to professional dermatologists in specific scenarios and has broad research prospects.
基金The authors extend their appreciation to the Deanship of Scientific Research at King Saud University for funding this work through research group number RG-1440-048.
文摘Skin diseases effectively influence all parts of life.Early and accurate detection of skin cancer is necessary to avoid significant loss.The manual detection of skin diseases by dermatologists leads to misclassification due to the same intensity and color levels.Therefore,an automated system to identify these skin diseases is required.Few studies on skin disease classification using different techniques have been found.However,previous techniques failed to identify multi-class skin disease images due to their similar appearance.In the proposed study,a computer-aided framework for automatic skin disease detection is presented.In the proposed research,we collected and normalized the datasets from two databases(ISIC archive,Mendeley)based on six Basal Cell Carcinoma(BCC),Actinic Keratosis(AK),Seborrheic Keratosis(SK),Nevus(N),Squamous Cell Carcinoma(SCC),and Melanoma(M)common skin diseases.Besides,segmentation is performed using deep Convolutional Neural Networks(CNN).Furthermore,three types of features are extracted from segmented skin lesions:ABCD rule,GLCM,and in-depth features.AlexNet transfer learning is used for deep feature extraction,while a support vector machine(SVM)is used for classification.Experimental results show that SVM outperformed other studies in terms of accuracy,as AK disease achieved 100%accuracy,BCC 92.7%,M 95.1%,N 97.8%,SK 93.1%,SCC 91.4%with a global accuracy of 95.4%.
文摘One of the most critical steps in medical health is the proper diagnosis of the disease.Dermatology is one of the most volatile and challenging fields in terms of diagnosis.Dermatologists often require further testing,review of the patient’s history,and other data to ensure a proper diagnosis.Therefore,finding a method that can guarantee a proper trusted diagnosis quickly is essential.Several approaches have been developed over the years to facilitate the diagnosis based on machine learning.However,the developed systems lack certain properties,such as high accuracy.This study proposes a system developed in MATLAB that can identify skin lesions and classify them as normal or benign.The classification process is effectuated by implementing the K-nearest neighbor(KNN)approach to differentiate between normal skin and malignant skin lesions that imply pathology.KNN is used because it is time efficient and promises highly accurate results.The accuracy of the system reached 98%in classifying skin lesions.
基金This work is supported by 2018 Sugon Intelligent-Factory on Advanced Computing Devices(No.MIIT2018-265-137).
文摘Skin lesion recognition is an important challenge in the medical field.In this paper,we have implemented an intelligent classification system based on convolutional neural network.First of all,this system can classify whether the input image is a dermascopic image with an accuracy of 99%.And then diagnose the dermoscopic image and the non-skin mirror image separately.Due to the limitation of the data,we can only realize the recognition of vitiligo by non-skin mirror.We propose a vitiligo recognition based on the probability average of three structurally identical CNN models.The method is more efficient and robust than the traditional RGB color space-based image recognition method.For the dermoscopic classification model,we were able to classify 7 skin lesions,use weighted optimization to overcome the unbalanced data set,and greatly improve the sensitivity of the model by means of model fusion.The optimization and expansion of the system depend on the increase of database.
文摘AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtainedfrom our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of longterm immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series. CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.
基金The 2019 Project of Sichuan Sexual Sociology and Sex Education Research Center(SXJYZ1912)The first batch of doctoral special scientific research funds of Sichuan University of Arts and Sciences(2019BS003R)。
文摘Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated medicine.The existing skin health management in China is still based on the medical concept of"professional refinement and specialist differentiation",and still fails to solve many negative effects caused by the fragmentation of medical knowledge and the mechanization of clinical medical practice.Therefore,based on the concept of integrated medicine,this paper puts forward a new concept of skin health management integrated medicine.However,in order to establish this brand-new integrated medical view of skin health management,we should focus on the medicine for the diagnosis and treatment of skin diseases,the physical and mental health management of skin patients,the integration of traditional Chinese medicine and western medicine for the diagnosis and treatment of skin diseases,the combination of prevention and treatment of skin diseases,the cooperation of medical and nursing care for the health management of skin diseases,and the development of skin health care industry,speed up the skin disease health management integration of medical practice and other aspects.
基金Supported by Special Project of Traditional Chinese Medicine Scientific Research of Henan Province(2018ZY2005,20-21ZY2013)。
文摘By combing the mechanism and advantages of traditional Chinese medicine(TCM)soaking and washing and combining TCM syndrome differentiation with western medicine differentiation of diseases,guided by the view that"the principle of external treatment is that of internal treatment",this article discusses the differentiation and treatment ideas of palmoplantar keratosis by TCM soaking and washing,which will provide a reference for clinical treatment.
文摘Cutaneous leishmaniasis is a neglected tropical skin endemic disease, with worldwide distribution. By 2020 in the Americas, Mexico was in 12th place with 11 states reporting new cases. Molecular biology with different targets for diagnosis and species identification has been used for decades, also dermoscopy, a non-invasive diagnostic tool has shown its usefulness. We present the first case of cutaneous leishmaniasis in non-endemic place (Guerrero, Mexico) identifying Leishmania mexicana with molecular biology, and treated with itraconazole.
文摘Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reported improvements in inflammatory skin conditions in individuals treated with FMT,but larger studies are needed to clarify this possible relationship between the skin and the gut microbiome.We conducted a single-center,retrospective chart review to assess changes in acne,dermatitis herpetiformis and/or celiac disease,eczema,and psoriasis.Due to the retrospective nature of this study and the limitations of the current electronic medical record,we were unable to adequately assess cases of these diseases in relation to FMT.However,this study informs us that improvements in retrospective data are needed to formally evaluate this possible association.The better,but more cumbersome,study design would be a prospective,observational study.We encourage others to pursue further interdepartmental research on the influence of the gut microbiome on inflammatory skin diseases.
文摘Fungal disease affects more than a billion people worldwide,resulting in different types of fungus diseases facing life-threatening infections.The outer layer of your body is called the integumentary system.Your skin,hair,nails,and glands are all part of it.These organs and tissues serve as your first line of defence against bacteria while protecting you from harm and the sun.The It serves as a barrier between the outside world and the regulated environment inside our bodies and a regulating effect.Heat,light,damage,and illness are all protected by it.Fungi-caused infections are found in almost every part of the natural world.When an invasive fungus takes over a body region and overwhelms the immune system,it causes fungal infections in people.Another primary goal of this study was to create a Convolutional Neural Network(CNN)-based technique for detecting and classifying various types of fungal diseases.There are numerous fungal illnesses,but only two have been identified and classified using the proposed Innovative Fungal Disease Diagnosis(IFDD)system of Candidiasis and Tinea Infections.This paper aims to detect infected skin issues and provide treatment recommendations based on proposed system findings.To identify and categorize fungal infections,deep machine learning techniques are utilized.A CNN architecture was created,and it produced a promising outcome to improve the proposed system accuracy.The collected findings demonstrated that CNN might be used to identify and classify numerous species of fungal spores early and estimate all conceivable fungus hazards.Our CNN-Based can detect fungal diseases through medical images;earmarked IFDD system has a predictive performance of 99.6%accuracy.
文摘BACKGROUND Chloracne is a rare skin condition that is caused by systemic exposure to halogenated aromatic compounds.The main characteristic of chloracne is blackhead,and in severe cases,it can be accompanied by systemic symptoms.Sodium 3,5,6-trichloropyridin-2-ol(STCP)is a necessary precursor compound for the production of chlorpyrifos and triclopyr,which are extensively used as a pesticide and herbicide,respectively.STCP is also a chlorophenol that has been associated with chloracne.STCP poisoning could induce mild myelin sheath damage.We herein report three cases with chloracne due to exposure to STCP.CASE SUMMARY Three young men,aged 29,33,and 26 years,respectively,in the same workplace had polymorphic skin lesions,characterized mainly by comedones and cysts,and one of them also had acne like lesions in the genital area.These clinical manifestations appeared when they were exposed to STCP for 3 d,1 wk,and 2 wk,respectively.Among them,polyneuropathy and liver damage occurred.We performed dermoscopy and clinical and laboratory tests on these patients.Additionally,histopathology was used for further diagnosis in the serious patient.These patients were diagnosed with chloracne and separated from STCP.The patients were prescribed oral viaminate capsules,topical adapalene gel,and regular hematologic follow-up for aspartate transaminase and lipids.They are still under follow-up.There was no new lesions and the laboratory tests returned to normal in two patients.Pigmentation and shallow scars remained in the original areas of papules.However,in the most serious patient,new papules still appeared intermittently.All these remind us that the treatment of chloracne caused by STCP is difficult,and we should attach great importance to this new compound related with the neuropathy and chloracne.CONCLUSION STCP is becoming a new chemical product to induce chloracne,which should attract the attention of all medical professionals,especially dermatologists.Due to the lack of knowledge on the new chemical,the diagnosis of chloracne cannot be made in time.Chloracne still deserves our attention.
文摘Lumpy skin disease(LSD)is a transboundary disease affecting cattle and has a detrimental effect on the cattle industries in numerous countries in Africa,Europe and Asia.In 2021,LSD outbreaks have been reported in almost all of Thailand's provinces.Indeed,fitting LSD occurrences using mathematical models provide important knowledge in the realm of animal disease modeling.Thus,the objective of this study is to fit the pattern of daily new LSD cases and daily cumulative LSD cases in Thailand using mathematical models.The first-and second-order models in the forms of Lorentzian,Gaussian and Pearson-type VII models are used to fit daily new LSD cases whereas Richard's growth,Boltzmann sigmoidal and Power-law growth models are utilized to fit the curve of cumulative LSD cases.Based on the root-mean-squared error(RMSE)and Akaike information criterion(AIC),results showed that both first and second orders of Pearson-type VII models and Richard's growth model(RGM)were fit to the data better than other models used in the present study.The obtained models and their parameters can be utilized to describe the LSD outbreak in Thailand.For disease preparedness purposes,we can use the first order of the Pearson-type VII model to estimate the time of maximum infected cases occurring when the growth rate of infected cases starts to slow down.Furthermore,the period when the growth rate changes at a slower rate,known as the inflection time,obtained from RGM allows us to anticipate when the pandemic has peaked and the situation has stabilized.This is the first study that utilizes mathematical methods to fit the LSD epidemics in Thailand.This study offers decision-makers and authorities with valuable information for establishing an effective disease control strategy.
