Machine Learning Applications in the Evaluation and Management of Psoriasis: A Systematic Review

Background: Machine learning (ML), a subset of artificial intelligence (AI) that aims to teach machines to automatically learn tasks by inferring patterns from data, holds significant promise to aid psoriasis care. Applications include evaluation of skin images for screening and diagnosis as well as clinical management including treatment and complication prediction. Objective: To summarize literature on ML applications to psoriasis evaluation and management and to discuss challenges and opportunities for future advances. Methods: We searched MEDLINE, Google Scholar, ACM Digital Library, and IEEE Xplore for peer-reviewed publications published in English through December 1, 2019. Our search queries identified publications with any of the 10 computing-related keywords and “psoriasis” in the title and/or abstract. Results: Thirty-three studies were identified. Articles were organized by topic and synthesized as evaluation- or management-focused articles covering 5 content categories: (A) Evaluation using skin images: (1) identification and differential diagnosis of psoriasis lesions, (2) lesion segmentation, and (3) lesion severity and area scoring; (B) clinical management: (1) prediction of complications and (2) treatment. Conclusion: Machine learning has significant potential to aid psoriasis evaluation and management. Current topics popular in ML research on psoriasis are the evaluation of medical images, prediction of complications, and treatment discovery. For patients to derive the greatest benefit from ML advancements, it is helpful for dermatologists to have an understanding of ML and how it can effectively aid their assessments and decision-making.

[1]  J. Röning,et al.  Comparison of actual psoriasis surface area and the psoriasis area and severity index by the human eye and machine vision methods in following the treatment of psoriasis. , 1998, Acta dermato-venereologica.

[2]  Michael Rains,et al.  Objective measurement of erythema in psoriasis using digital color photography with color calibration , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[3]  A. Alexis,et al.  Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. , 2014, The Journal of clinical and aesthetic dermatology.

[4]  J. Lipoff,et al.  Natural Language Processing of Reddit Data to Evaluate Dermatology Patient Experiences and Therapeutics. , 2020, Journal of the American Academy of Dermatology.

[5]  Mohammad Aldeen,et al.  Automatic psoriasis lesion segmentation in two-dimensional skin images using multiscale superpixel clustering , 2017, Journal of medical imaging.

[6]  Achim Hekler,et al.  Deep learning outperformed 136 of 157 dermatologists in a head-to-head dermoscopic melanoma image classification task. , 2019, European journal of cancer.

[7]  Jin-Shiuh Taur Neuro-Fuzzy Approach to the Segmentation of Psoriasis Images , 2003, J. VLSI Signal Process..

[8]  Mohammad Aldeen,et al.  Automatic Scale Severity Assessment Method in Psoriasis Skin Images Using Local Descriptors , 2020, IEEE Journal of Biomedical and Health Informatics.

[9]  Mohammad Aldeen,et al.  Psoriasis image representation using patch-based dictionary learning for erythema severity scoring , 2018, Comput. Medical Imaging Graph..

[10]  Jasjit S. Suri,et al.  A novel and robust Bayesian approach for segmentation of psoriasis lesions and its risk stratification , 2017, Comput. Methods Programs Biomed..

[11]  Kalpana Raja,et al.  Drug Repurposing Prediction for Immune-Mediated Cutaneous Diseases using a Word-Embedding-Based Machine Learning Approach. , 2019, The Journal of investigative dermatology.

[12]  H M Mashaly,et al.  Classification of Papulo‐Squamous skin diseases using image analysis , 2012, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[13]  Jasjit S. Suri,et al.  Computer-aided diagnosis of psoriasis skin images with HOS, texture and color features: A first comparative study of its kind , 2016, Comput. Methods Programs Biomed..

[14]  A. Armstrong,et al.  Psoriasis prevalence among adults in the United States. , 2014, Journal of the American Academy of Dermatology.

[15]  J. Röning,et al.  Application of machine vision to assess involved surface in patients with psoriasis , 1997, The British journal of dermatology.

[16]  Matthew T. Patrick,et al.  Genetic signature to provide robust risk assessment of psoriatic arthritis development in psoriasis patients , 2018, Nature Communications.

[17]  Manoranjan Dash,et al.  PsLSNet: Automated psoriasis skin lesion segmentation using modified U-Net-based fully convolutional network , 2019, Biomed. Signal Process. Control..

[18]  Sanjiv J. Shah,et al.  Application of Machine Learning to Determine Top Predictors of Non-calcified Coronary Burden in Psoriasis: an Observational Cohort Study. , 2019, Journal of the American Academy of Dermatology.

[19]  Jasjit S. Suri,et al.  Exploring the color feature power for psoriasis risk stratification and classification: A data mining paradigm , 2015, Comput. Biol. Medicine.

[20]  Elizabeth J Horn,et al.  National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. , 2008, Journal of the American Academy of Dermatology.

[21]  H. Haenssle,et al.  Man against machine: diagnostic performance of a deep learning convolutional neural network for dermoscopic melanoma recognition in comparison to 58 dermatologists , 2018, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  Chin-Wang Tao,et al.  Segmentation of psoriasis vulgaris images using multiresolution-based orthogonal subspace techniques , 2006, IEEE Transactions on Systems, Man, and Cybernetics, Part B (Cybernetics).

[23]  S. Feldman,et al.  Psoriasis assessment tools in clinical trials , 2005, Annals of the rheumatic diseases.

[24]  Anabik Pal,et al.  Psoriasis skin biopsy image segmentation using Deep Convolutional Neural Network , 2018, Comput. Methods Programs Biomed..

[25]  Jasjit S. Suri,et al.  Reliability analysis of psoriasis decision support system in principal component analysis framework , 2016, Data Knowl. Eng..

[26]  E. Orenberg,et al.  Drugs in exacerbation of psoriasis. , 1986, Journal of the American Academy of Dermatology.

[27]  Juan Lu,et al.  Automatic Segmentation of Scaling in 2-D Psoriasis Skin Images , 2013, IEEE Transactions on Medical Imaging.

[28]  Vijanth S. Asirvadam,et al.  3D surface roughness measurement for scaliness scoring of psoriasis lesions , 2013, Comput. Biol. Medicine.

[29]  Gläser,et al.  Hyperpigmentation due to topical calcipotriol and photochemotherapy in two psoriatic patients , 1998, The British journal of dermatology.

[30]  Tobias Fuchs,et al.  Design of an Algorithm for Automated, Computer-Guided PASI Measurements by Digital Image Analysis , 2018, Journal of Medical Systems.

[31]  Vladimir Vezhnevets,et al.  A Survey on Pixel-Based Skin Color Detection Techniques , 2003 .

[32]  Alexander H. Waibel,et al.  Skin-Color Modeling and Adaptation , 1998, ACCV.

[33]  Jasjit S. Suri,et al.  Reliable and accurate psoriasis disease classification in dermatology images using comprehensive feature space in machine learning paradigm , 2015, Expert Syst. Appl..

[34]  Halil Kilicoglu,et al.  Using semantic predications to uncover drug-drug interactions in clinical data , 2014, J. Biomed. Informatics.

[35]  Dani Ihtatho,et al.  Area assessment of psoriasis lesions for PASI scoring , 2009, Journal of medical engineering & technology.

[36]  W. Eyler,et al.  PSORIATIC ARTHRITIS. , 1965, Henry Ford Hospital medical bulletin.

[37]  Josep Malvehy,et al.  Technique Standards for Skin Lesion Imaging: A Delphi Consensus Statement , 2017, JAMA dermatology.

[38]  Ilias Maglogiannis,et al.  Overview of Advanced Computer Vision Systems for Skin Lesions Characterization , 2009, IEEE Transactions on Information Technology in Biomedicine.

[39]  A. Armstrong,et al.  Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. , 2013, JAMA dermatology.

[40]  H. Valdez,et al.  Early quantification of systemic inflammatory-proteins predicts long-term treatment response to Tofacitinib and Etanercept: Psoriasis response predictions using blood. , 2019, The Journal of investigative dermatology.

[41]  Tanya Shakir Jarad,et al.  ACCURATE SEGMENTATION OF PSORIASIS DISEASES IMAGES USING K-MEANS ALGORITHM BASED ON CIELAB ( L * A * B ) COLOR SPACE 1 , 2017 .

[42]  Sebastian Thrun,et al.  Dermatologist-level classification of skin cancer with deep neural networks , 2017, Nature.

[43]  Dong Hun Lee,et al.  Smartphone-based multispectral imaging and machine-learning based analysis for discrimination between seborrheic dermatitis and psoriasis on the scalp. , 2019, Biomedical optics express.

[44]  Daniel B. Shin,et al.  Risk of myocardial infarction in patients with psoriasis. , 2006, JAMA.

[45]  Amal Mudallali Statement , 1988, Definitions.

[46]  P. Shekelle,et al.  Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation , 2016, British Medical Journal.

[47]  A. Navarini,et al.  Observer‐independent assessment of psoriasis‐affected area using machine learning , 2020, Journal of the European Academy of Dermatology and Venereology : JEADV.

[48]  John Paoli,et al.  Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks , 2019, JAMA dermatology.

[49]  Y. Fujisawa,et al.  Deep‐learning‐based, computer‐aided classifier developed with a small dataset of clinical images surpasses board‐certified dermatologists in skin tumour diagnosis , 2018, The British journal of dermatology.

[50]  Achim Hekler,et al.  Skin Cancer Classification Using Convolutional Neural Networks: Systematic Review , 2018, Journal of medical Internet research.

[51]  St Lt Pushkar Aggarwal Data augmentation in dermatology image recognition using machine learning , 2019, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[52]  W. Stoecker,et al.  Unsupervised border detection in dermoscopy images , 2007, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[53]  Saurabh Pal,et al.  Classification of Skin Disease using Ensemble Data Mining Techniques , 2019, Asian Pacific journal of cancer prevention : APJCP.

[54]  Mahadev Satyanarayanan,et al.  Computer-aided classification of melanocytic lesions using dermoscopic images. , 2015, Journal of the American Academy of Dermatology.

[55]  Jasjit S. Suri,et al.  First review on psoriasis severity risk stratification: An engineering perspective , 2015, Comput. Biol. Medicine.

[56]  Woohyung Lim,et al.  Deep neural networks show an equivalent and often superior performance to dermatologists in onychomycosis diagnosis: Automatic construction of onychomycosis datasets by region-based convolutional deep neural network , 2018, PloS one.

[57]  S. Han,et al.  Classification of the Clinical Images for Benign and Malignant Cutaneous Tumors Using a Deep Learning Algorithm. , 2018, The Journal of investigative dermatology.

[58]  A. Adamson,et al.  Machine Learning and Health Care Disparities in Dermatology. , 2018, JAMA dermatology.

[59]  Constantine Butakoff,et al.  Automatic change detection and quantification of dermatological diseases with an application to psoriasis images , 2007, Pattern Recognit. Lett..

[60]  A. Navarini,et al.  Smart identification of psoriasis by images using convolutional neural networks: a case study in China , 2020, Journal of the European Academy of Dermatology and Venereology : JEADV.

[61]  A. Troxel,et al.  The risk of stroke in patients with psoriasis. , 2009, The Journal of investigative dermatology.

[62]  A. Ogdie,et al.  Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study. , 2014, Rheumatology.

[63]  Jasjit S. Suri,et al.  A novel approach to multiclass psoriasis disease risk stratification: Machine learning paradigm , 2016, Biomed. Signal Process. Control..

[64]  Stein Olav Skrøvseth,et al.  Performance of a dermoscopy-based computer vision system for the diagnosis of pigmented skin lesions compared with visual evaluation by experienced dermatologists , 2014, Artif. Intell. Medicine.

[65]  Aldo A. Faisal,et al.  The Artificial Intelligence Clinician learns optimal treatment strategies for sepsis in intensive care , 2018, Nature Medicine.