Case 2: A persistent hyperpigmented plaque on the neck
Notice bibliographique
Résumé
A 12-year-old girl was referred for a two-month history of hyperpigmented lesions on her anterior neck. Her medical history was significant for treatment with clobazam for unprovoked seizure two months before appearance of lesions. She was otherwise healthy and family history was unremarkable. Physical examination revealed multiple brownish reticulated macular patches of hyperpigmentation on the anterior and lateral aspects of the neck (Figures 1A and 1C). Given the distribution and appearance of the lesions, a diagnostic manoeuvre was performed, which resulted in complete removal of the lesion (Figure 1B and 1D). PanelsAandCdemonstrate reticulate, hyperpigmented plaques on the anterior neck. PanelsBandDdemonstrate the same area after a diagnostic manoeuvre The lesion was completely removed with firm rubbing with ethyl alcohol, establishing the diagnosis of terra firma-forme dermatosis. Terra firma-forme dermatosis is a benign cutaneous dermatological condition that affects children and adults with normal grooming habits, with common sites found to be on the neck and trunk (1). Typical presentation is of dirt-coloured patches and plaques that are resistant to conventional washing with soap and water, but easily treated with ethyl alcohol, which completely removes the lesions (1,2). Histological studies have revealed epidermal acanthosis and papillomatosis, as well as prominent lamellar hyperkeratosis (3). The differential diagnoses, which have varied clinical presentation, include pityriasis versicolour, a common superficial fungal infection; acanthosis nigricans, which is characterized by hyperpigmented, velvety plaques on the skin associated with a variety of systemic disorders, many of which are characterized by insulin resistance; dermatitis neglecta, in which the hyperpigmented lesions are due to inadequate cleansing of the skin, and soap and water are able to removed the lesion; and confluent and reticulated papillamatosis of Gougerot and Carteaud, a dermatosis of unknown etiology in which the hyperpigmentation is believed to be secondary to an increased number of melano-somes and treatment has been shown to be successful with topical tretinoin as well as oral antibiotics (1). Despite its typical clinical presentation, the disorder is not well known by physicians, which can lead to misdiagnosis, and costly tests and treatments as well as patient anxiety. Clinical awareness, therefore, provides simple and quick resolution while avoiding unnecessary investigations and therapies. Terra firma-forme dermatosis is a common entity but is often mistaken for conditions such as pityriasis versicolour and acanthosis nigricans. It is not associated with poor hygiene and cannot be washed off with soap and water. Rubbing with ethyl alcohol is an easy way to both confirm the diagnosis and to treat the lesion.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,007 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».