Asymptomatic erythematous atrophic plaque in a kidney transplant recipient
Notice bibliographique
Résumé
A 76-year-old Caucasian male presented to the dermatology clinic for an annual full-body skin exam. The patient had a kidney transplant in 2010 for end-stage renal disease secondary to glomerulonephritis. Induction therapy included methylprednisolone and basiliximab. At presentation, his immunosuppressive regimen included tacrolimus, prednisone, and leflunomide. As the donor kidney was positive for polyomavirus infection, leflunomide was selected for treatment as a combination immunosuppressive and antiviral agent. The patient had no history of transplant rejection. The patient was referred in 2011, one year posttransplant, for routine skin examinations. The patient had no history of skin cancer prior to immunosuppression. The patient did not receive a dermatology consultation pretransplant for risk assessment. However, since his transplant and referral to the dermatology clinic, multiple histopathologically confirmed skin cancers, including basal cell carcinoma and Bowen’s disease, were diagnosed. Each cancer was excised with negative margins and no evidence of recurrence at follow-up visits. He was also treated for multiple precancerous skin lesions. At his most recent routine dermatology visit, a suspicious lesion was identified. Physical examination revealed a well-demarcated, double-rimmed plaque with a thinned center measuring 1.2 cm by 0.8 cm on the left lateral lower leg (Figure 1, Figure 2). The patient did not describe the lesion as painful, pruritic, or evolving. He did not report a history of repetitive sun exposure or burns to the affected area.FIGURE 2Low (A) and high power (B) microscopy of the lesion. The coronoid lamella is best visualized with high power microscopy (B). It is characterized by a column of parakeratosis overlying the epidermis. This image represents an example of the lesion and is not from the patient described in the caseView Large Image Figure ViewerDownload Hi-res image Download (PPT) 1What is your diagnosis of the lesion in Figures 1 and 2?aBasal cell carcinomabSeborrheic keratosiscPorokeratosisdActinic keratosiseVerruca vulgaris2What is classically seen on dermoscopic visualization of this lesion? aBranching vessels and blue-gray ovoid nestsbUlceration with a central mass of keratincInterruption of skin lines and prominent hemorrhagesdWell-defined, raised peripheral annular structureeLinear sulci with keratin plugging3What is the most concerning natural history of this lesion if it remains untreated?aMalignant transformationbPersistent lesion without evolutioncBenign enlargement of lesiondSpontaneous regressioneUlceration and spontaneous bleeding4What is the typical histopathological presentation of this type of lesion?aPresence of a narrow column of parakeratotic cellsbPigmented hyperkeratosis and acanthosiscAreas of increased melanogenesisdIntracellular edema and lymphoplasmacytic infiltrate
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
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 tête enseignante, 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 ».