Accuracy of an artificial intelligence as a medical device as part of a UK-based skin cancer teledermatology service.

Introduction: An artificial intelligence as a medical device (AIaMD), built on convolutional neural networks, has demonstrated high sensitivity for melanoma. To be of clinical value, it needs to safely reduce referral rates. The primary objective of this study was to demonstrate that the AIaMD had a higher rate of correctly classifying lesions that did not need to be referred for biopsy or urgent face-to-face dermatologist review, compared to teledermatology standard of care (SoC), while achieving the same sensitivity to detect malignancy.

Severe progressive scarring pembrolizumab-induced lichen planopilaris in a patient with metastatic melanoma.

Lichenoid reactions are one of the many cutaneous immune-related adverse events seen with the use of immune checkpoint inhibitors, particularly anti-PD1 inhibitors. We present a rare care of severe lichen planopilaris secondary to pembrolizumab, with progression even after cessation of immunotherapy. It is important to recognise the significant long-term impact of these cutaneous adverse effects on patient's quality of life.

Unusual presentation of a spinal epidural abscess.

A 59-year-old female patient presented with a 3-day history of abdominal pain and confusion. She had no significant medical history. On admission her Glasgow Coma Scale was 14/15; she was septic and examination revealed right upper quadrant tenderness.