Dermoscopy Two Step Algorithm vs Step

This app is intended to help you interpret the dermoscopic patterns seen with your dermatoscope. You will be asked a series of questions that will lead you to the most probable diagnosis. This app also contains over 80 photos and charts to help you in your diagnosis. No internet connection needed to view the full app. It is all ready for super quick image and information retrieval. There are also 50 interactive cases to solve. Each case starts with a clinical and dermoscopic image and ends with a labelled dermoscopic image pointing out critical structures. This app is based on the 2 step algorithm with the first step involving the determination of whether the lesion is a melanocytic. Melanocytic lesions will be divided into nevi or lesions with varying levels of suspicion for melanoma based on melanoma specific patterns and common nevi patterns. Non-melanocytic lesions will be analyzed to determine if they are suspicious for basal cell carcinoma or squamous cell carcinoma. Common benign lesions such as dermatofibroma, seborrheic keratoses and hemangiomas will be positively identified to avoid unnecessary biopsies. This app will increase your ability to detect skin cancers with greater accuracy thereby decreasing unnecessary biopsies and missing less early melanomas and nonmelanoma skin cancers. Check out https://usatinemedia.com to learn more and watch a video demo of this app narrated by Dr. Richard P. Usatine. Authors: Ashfaq A. Marghoob, MD Memorial Sloan-Kettering Cancer Center New York, New York Richard P. Usatine, MD University of Texas Health Science Center San Antonio, Texas Natalia Jaimes, MD Aurora Skin Cancer Center and Universidad Pontificia Bolivariana Medellin, Colombia To learn more dermoscopy from these authors, see www.americandermoscopy.com. Disclaimer: This app is intended for the education of healthcare professionals and not as a diagnostic and treatment reference for the general population. Disclaimer: While this app may help you in rendering a correct diagnosis, it is not intended to entirely replace the findings on patient history and physical examination including examination of the lesion with side lighting and touch. The final diagnosis rests on properly assimilating the information gained from the patient history, thorough naked eye physical examination, and meticulous dermoscopic inspection of the lesion. 3Gen, Inc. is the sponsor of this app. Visit www.dermlite.com to see their complete line of skin imaging devices. Developed by Usatine Media Richard P. Usatine, MD, Co-President, Professor of Family & Community Medicine, Professor of Dermatology and Cutaneous Surgery, University of Texas Health San Antonio Peter Erickson, Co-President, Lead Software Developer

The Step-by-Step Approach is an evaluation scheme based upon clinical factors and lab testing which allows clinicians, typically in the Peds ED, to decide which young (≤ 90 days old) febrile infants are at high, intermediate, and low risk of invasive bacterial infection (bacteremia, sepsis, meningitis). Risk assessment allows a clinician to choose less intensive, less invasive management of some young febrile infants depending on local standards, local resources, and particulars of the clinical case. The app is adapted from the validation study by Gomez, Mintegi, and colleagues of July, 2016, with their kind permission. The app is intended for use by health care professionals only, not by the lay public, not by parents. The app addresses such common questions as: • what are the five steps in the Step-by-Step approach? • what is the diagnostic accuracy of Step-by-Step? • which special populations warrant additional attention? • what are the cutoff levels for procalcitonin, absolute neutrophil count, c-reactive protein? • how does Step-by-Step compare to Rochester criteria (older scheme which also tries to avoid LP)? • aside from invasive bacterial infections, how does Step-by-Step do assessing for other serious bacterial infections? This app is written and intended for practicing clinicians like Peds ED physicians, pediatricians, and family physicians. The extra educational emphasis is provided for resident physician and medical students to learn as well. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.