An Elderly Woman with a Diffuse Annular Eruption
Bibliographic record
Abstract
Diagnosis: borderline leprosy. The diagnosis of leprosy was suspected on the basis of the presence of erythematous annular skin lesions associated with hypoesthesia in a woman originating from the Philippines, where Mycobacterium leprae infection is endemic. It was confirmed by punch biopsy of an active skin lesion on the forehead (figure 1), which revealed granulomatous dermatitis, neural inflammation, and easily identifiable acid-fast bacilli (AFB) (figure 2). Bacterial and fungal cultures were sterile. Leprosy, also known as Hansen disease, is a chronic granulomatous infection of the skin and peripheral nerves by the noncultivable obligate intracellular pathogen M. leprae. Globally, the majority of cases occur in India, South America, and Southeast Asia [1]. In North America, it is usually seen among immigrants from regions where the disease is endemic and typically occurs within the first year after arrival [2]. Unfamiliarity with this disease may lead to delayed diagnosis, as in this case. Humans are the major reservoirs of M. leprae, although infection can occur in other animals (e.g., the 9-banded armadillo and monkeys) [3]. The proposed major route of human transmission is by aerosolized nasal droplets. Direct skin contact plays little, if any, role [1].
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".