Browsing by Author "Navarrete Dechent, Cristian Patricio"

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    A methodology for developing dermatological datasets: lessons from retrospective data collection for AI-based applications
    (2025) Pedro Pérez, Alma Alheli; Romero Jofré, Pamela Ignacia; Vidaurre, Soledad; Cabanas, Ana M.; Galaz, Atsuko; Hidalgo Acuña, Leonel Esteban; Carrasco, Karina; Tamez-Peña, José Gerardo; Díaz-Domínguez, Ricardo; Navarrete Dechent, Cristian Patricio; Mery Quiroz, Domingo Arturo
    Purpose The integration of artificial intelligence into dermatological research has underscored the need for robust and well-structured dermatological datasets. However, these datasets vary widely in their development processes, and there is currently no standard methodology to create such datasets. This work identifies three pressing needs for the building of dermatological datasets focus on skin tumor classification: the need for multimodal datasets, the definition of minimum metadata requirements, and the inclusion of underrepresented populations to address the scarcity of health data. Methods We propose a practical methodology to create dermatological datasets from clinical records, incorporating both images and patient metadata. The process consists of four key stages: getting the institutional review board approval and analysis of clinical information sources, data recording and structuring, processing of clinical data and images, and quality assessment. This methodology was derived from hands-on experience in building two datasets from Chilean and Mexican populations, respectively. Results The methodology allows the creation of well-structured datasets by simplifying data organization and enabling replication. Each step includes practical guidance for dealing with typical challenges, such as image metadata categorization and technical validation by dermatologists and computer scientists. Conclusion Our contribution offers a reproducible, scalable, and interdisciplinary framework for creating dermatological datasets, especially useful for countries initiating dataset creation. In addition to the methodological proposal, we highlight common pitfalls and offer recommendations to mitigate them.
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    A Review of Metadata and Deep Learning Strategies for Skin Lesion Classification
    (2025) Pedro Perez, Alma Alheli; Romero Jofre, Pamela Ignacia; Vidaurre, Soledad; Navarrete Dechent, Cristian Patricio; Mery Quiroz, Domingo Arturo
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    Author Correction: A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis
    (2024) Salinas Espinoza, María Paz; Sepúlveda, Javiera; Hidalgo, Leonel; Peirano, Dominga; Morel, Macarena; Uribe, Pablo; Rotemberg, Verónica; Briones, Juan; Mery, Domingo; Navarrete Dechent, Cristian Patricio
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    Effect of weekly vitamin D supplementation on the severity of atopic dermatitis and type 2 immunity biomarkers in children: A randomized controlled trial
    (2024) Borzutzky Schachter, Arturo José; Iturriaga Ortiz, Carolina Alejandra; Pérez Mateluna, Guillermo Andres; Cristi, Francisca; Cifuentes Aguila, Lorena Isabel; Silva‐Valenzuela, Sergio; Vera Kellet, Cristián Andrés; Cabalín Arenas, Carolina Andrea; Hoyos Bachiloglu, Rodrigo Andres; Navarrete Dechent, Cristian Patricio; Cossio Traverso, Maria Laura; Le Roy, Catalina; Camargo, Jr, Carlos A.
    Background: Vitamin D (VD) deficiency is common among patients with atopic dermatitis (AD) and often associated with severity. However, randomized trials of VD supplementation in AD have had equivocal results, and there is little information regarding the effect of VD supplementation on type 2 immunity in AD patients.Objectives: To investigate the efficacy of VD supplementation to decrease severity of AD and to alter type 2 immunity biomarkers.Methods: We performed a randomized, double-blind, placebo-controlled trial. We randomly assigned 101 children with AD to weekly oral vitamin D3 (VD3) or placebo for 6 weeks. The primary outcome was the change in the Severity Scoring of AD (SCORAD).Results: Mean age of subjects was 6.3 ± 4.0 years, and baseline SCORAD was 32 ± 29. At baseline, 57% of children were VD deficient, with no difference between groups. Change in 25(OH)D was significantly greater with VD3 than placebo (+43.4 ± 34.5 nmol/L vs. +2.3 ± 21.2 nmol/L, p < 0.001). SCORAD change at 6 weeks was not different between VD and placebo (-5.3 ± 11.6 vs. -5.5 ± 9.9, p = 0.91). There were no significant between-group differences in change of eosinophil counts, total IgE, Staphylococcal enterotoxin specific IgE, CCL17, CCL22, CCL27, LL-37 or Staphylococcus aureus lesional skin colonization. Vitamin D receptor (VDR) gene single nucleotide polymorphisms FokI, ApaI and TaqI did not modify subjects' response to VD supplementation.Conclusions: Among children with AD, weekly VD supplementation improved VD status but did not modify AD severity or type 2 immunity biomarkers compared to placebo (ClinicalTrials.gov NCT01996423).
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    Manejo de carcinomas queratinocíticos perioculares com cirurgia micrográfica de Mohs e preditores de reconstrução complexa: estudo retrospectivo
    (2024) Peirano, Dominga; Vargas, Sebastián; Hidalgo Acuña, Leonel Esteban; Donoso Mena, Francisca; Albuseme, Eugenia; Sanhueza Zamora, Felipe Alberto; Cardenas De La Torre, Consuelo Paz; Droppelmann Droppelmann, Katherine Ann; Castro, Juan Camilo; Uribe González, Pablo Francisco; Zoroquiain Vélez, José Pablo; Navarrete Dechent, Cristian Patricio
    Fundamentos: O câncer de pele é o tipo mais frequente em todo o mundo e o mais frequente tumor periocular. Os carcinomas queratinocíticos (CQ) localizados em áreas perioculares são considerados tumores de alto risco. A cirurgia micrográfica de Mohs (CMM) é considerada a primeira linha para o tratamento do CQ de alto risco, com menor taxa de recorrência do que a excisão ampla convencional. Objetivo: Descrever as características clinico-patológicas do CQ periocular tratado com CMM em um centro universitário terciário no Chile. Métodos: Estudo retrospectivo unicêntrico de pacientes com CQ localizado na região periocular, submetidos à CMM entre 2017 e 2022. Detalhes da CMM foram registrados. Resultados: Foram incluídos 113 pacientes com carcinomas perioculares. A média de idade foi de 59 ± 13 anos; 52% eram mulheres. A localização mais frequente foi o canto medial do olho (53%), seguido da pálpebra inferior (30,1%). O tipo histológico mais frequente de carcinoma basocelular (CBC) foi o nodular (59,3%). Em relação à CMM, o número médio de estágios foi de 1,5 ± 0,7, e 54% dos casos necessitaram de apenas um estágio para atingir margens livres. Até o momento, nenhuma recorrência foi relatada. Tumores maiores que 8,5 mm em seu maior diâmetro ou 43,5 mm² foram mais propensos a necessitar de reconstrução complexa.
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    Multiple familial trichoepithelioma: confirmation via dermoscopy.
    (2016) Navarrete Dechent, Cristian Patricio; Bajaj, Shirin; Marghoob, Ashfaq A; González, Sergio; Muñoz, Daniel
    Trichoepitheliomas are uncommon benign adnexal neoplasms that originate from the hair follicles. Multiple familial trichoepithelioma constitute an autosomal dominant disease characterized by the appearance of multiple flesh-colored, symmetrical papules, tumors and/or nodules in the central face and occasionally on the scalp. Although clinical diagnosis is usually straightforward in light of the family history and naked-eye examination, dermoscopy may aid in its confirmation. Dermoscopy of each papule revealed in-focus arborizing vessels, multiple milia-like cysts and rosettes amidst a whitish background. In a patient with multiple facial papules revealing a dermoscopic appearance described above, the diagnosis of sporadic or familial multiple trichoepithelioma should be considered.
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    "One blade, two cuts?" A multidisciplinary survey investigating practice variability of scalpel blade change for simultaneous excision of multiple skin lesions in the same patient
    (WILEY, 2024) Pietkiewicz, Pawel; Stefaniak, Aleksandra; Giedziun, Piotr; Calik, Jacek; Lewandowicz, Michal; Mazur, Ewelina; Cantisani, Carmen; Navarrete Dechent, Cristian Patricio; Akay, Bengue N.; Szepietowski, Jacek C.; Rosendahl, Cliff
    Background: Skin cancer incidence increases globally, requiring effective preventive measures and evidence-based treatment strategies. Current guidelines advocate for surgical excision as a first-line treatment for most early skin cancers. The study investigated practices regarding changing scalpel blades when excising multiple skin lesions in the same patient during the same visit (CSB) and explored how beliefs about iatrogenic seeding influence individual norms of practice.MethodsA multidisciplinary survey was conducted among 173 medical specialists involved in skin cancer care. Participants provided demographic information, years of experience, and practices regarding CSB in four clinical scenarios (first excised tumor: basal cell carcinoma, squamous cell carcinoma, melanoma suspect, and evident melanoma). Practice variations based on specialty, experience, and beliefs about seeding risk were statistically assessed.ResultsSurgeons exhibited a significantly higher tendency to change blades compared to non-surgeons across all diagnoses. Iatrogenic seeding (56.52%) and clinical training (18.84%) were the main reasons provided for CSB. Beliefs about seeding risk did not differ significantly between specialties.ConclusionsAlthough the practice of CSB lacks strong scientific rationale, the approach to this practice significantly varies among different medical specialties. Healthcare professionals should critically evaluate and standardize evidence-based practices to ensure optimal patient care and mitigate potential harm.
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    Patterns of reconstruction following margin-controlled surgery for melanoma of the lentigo maligna type of the head and neck
    (Springer Nature, 2025) Navarrete Dechent, Cristian Patricio; Veldhuizen, Inge J.; Aleissa, Saud; Dusza, Stephen W.; Rossi, Anthony M.; Lee, Erica H.; Nehal, Kishwer S.
    Melanoma of the lentigo maligna (LM) type is most commonly located on the head and neck region. This subtype of melanoma poses surgical challenges due to its location on anatomically sensitive areas and frequent presence of subclinical extension. To analyze the reconstruction patterns of LM patients undergoing margin-controlled surgery. An observational study was conducted at Memorial Sloan Kettering Cancer Center, enrolling patients who underwent staged excision for the LM between November 2006 and April 2019. The study included 519 patients. Following margin-controlled surgery, the size of the surgical defects varied: <10 mm(36.2%), 10 and 30 mm (36.8%), and > 30 mm (27%). A flap reconstruction was the most common reconstructive technique (42.6%), followed by primary closure (32.6%), and graft (21.8%). Age was significantly associated with reconstruction type, with older patients more likely to undergo graft reconstructions (p = 0.014). Larger defects (> 30 mm) were reconstructed with grafts and flaps more often compared to smaller defects (p < 0.001 and p = 0.02, respectively). Understanding the scope of reconstruction is important for effective pre-surgical counseling and treatment planning. These findings highlight the importance of personalized strategies considering patients’ age and defect size.
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    Pityriasis Versicolor-A Narrative Review on the Diagnosis and Management
    (MDPI, 2023) Labedz, Nina; Navarrete Dechent, Cristian Patricio; Kubisiak-Rzepczyk, Honorata; Bowszyc-Dmochowska, Monika; Pogorzelska-Antkowiak, Anna; Pietkiewicz, Pawel
    This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.
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    Reflectance confocal microscopy reduces biopsies in adults and children: A prospective real-life study
    (Elsevier Inc., 2025) González Valdés, Sebastián Alejandro; Bustos, Sergio; Donoso Mena, Francisca; Caussade, Marie-Chantal; Antúnez Lay, Andrea Carolina; Droppelmann Droppelmann, Katherine Ann; Uribe González, Pablo Francisco; Pellacani, Giovanni; Abarzúa Araya, Alvaro Rodrigo; Navarrete Dechent, Cristian Patricio
    Background: Reflectance confocal microscopy (RCM) is a non-invasive imaging modality that has been used to evaluate melanocytic and non-melanocytic equivocal lesions and to guide biopsy decisions. Objective: To assess the usefulness of RCM in a real-life clinical setting, evaluate its performance in the pediatric subgroup, and compare the rate of saved biopsies between the general dermatology setting and the skin cancer unit. Methods: This prospective, single-center study was conducted between February 2021 and January 2024, including 1,285 clinically equivocal skin lesions referred for RCM. Diagnosis was recorded and correlated to the gold standard biopsy or clinical follow-up. Results: We obtained an overall 70% RCM-histopathological concordance for specific diagnoses, with higher performance in older patients, head and neck lesions, non-pigmented lesions, and non-melanocytic lesions, particularly basal cell carcinomas. A significant percentage of biopsies were potentially avoided (58.6%), especially in pediatric patients (88.2%). Limitations: Single-center study, not all lesions had histopathological confirmation, and the pediatric group was relatively small. Conclusion: RCM is a valuable diagnostic tool for equivocal skin lesions in real-life practice. It significantly reduces the number of biopsies, thereby enhancing patient care.
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    Reflectance confocal microscopy terminology for non-melanocytic skin lesions: A Delphi consensus of experts
    (Elsevier Inc., 2025) Navarrete Dechent, Cristian Patricio; Longo, Caterina; Liopyris, Konstantinos; Ardigo, Marco; Ahlgrimm-Siess, Verena; Bahadoran, Phillipe; Carrera, Cristina; Braga, Juliana Casagrande Tavoloni; Chen, Chih-Shan J.; Correa, Lilia; Carvahlo, Nathalie de; Durkin, John; Farnetani, Francesca; Grant-Kels, Jane M.; Gill, Melissa; Gonzalez, Salvador; Hartmann, Daniela; Hoffman-Wellenhof, Rainer; Huho, Albert; Ludzik, Joanna; Malvehy, Josep; Marghoob, Ashfaq A.; Moscarella, Elvira; Oliviero, Margaret; Puig, Susana; Rabinovitz, Harold; Rao, Babar; Rezze, Gisele G.; Rossi, Anthony M.; Rubinstein, Gene; Ruini, Cristel; Sattler, Elke; Soyer, H. Peter; Schwartz, Rodrigo; Thng, Steven; Ulrich, Martina; Witkowski, Alexander; Dusza, Stephen W.; Guitera, Pascale; Pellacani, Giovanni; Scope, Alon; Jain, Manu
    Background There is lack of uniformity in reflectance confocal microscopy (RCM) terminology. Objective To establish expert consensus on a standardized set of RCM terms that describe non-melanocytic lesions (NML). Methods We invited RCM experts to participate in a Delphi-consensus study. Fifty-nine RCM descriptors were extracted from a previous systematic review on RCM terminology for describing NML. Of these, 35 items were presented as 4 groups of synonymous terms and 24 items as single, non-synonymous terms. For the first round, an agreement threshold was set at >70%. Participants could also propose new terms. Terms with ≤70% agreement and newly proposed terms were carried over to the next round. For subsequent rounds, agreement threshold was set at >50%. Results The study was conducted between June 2021 and May 2023. Forty-two of 44 (95%) invited experts participated. Three iterative Delphi rounds were completed, resulting in a consensus list of 36 terms, including 32 synonymous- and 4 non-synonymous- terms for describing NML. Limitations Only experts were included. We did not evaluate definitions of terms in the study. Conclusions We propose a simplified list of RCM terms, vetted by RCM experts, for describing and diagnosing NML. Uniform terminology could benefit clinical practice, research, and education.
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    Response to comments on the Letter to the Editor titled "Differentiating basal cell carcinoma from intradermal nevi along the eyelid margin with dermoscopy: A case series''
    (Mosby-Elsevier, 2021) Williams, Natalie M.; Navarrete Dechent, Cristian Patricio; Marghoob, Ashfaq A.; Abarzua Araya, Álvaro Rodrigo; Salerni, Gabriel; Jaimes, Natalia
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    The role of ultraviolet-induced fluorescence dermatoscopy for the detection of multiple aggregated yellow-white globules in basal cell carcinoma
    (American Academy of Dermatology, Inc., 2024) Navarrete Dechent, Cristian Patricio; Pietkiewicz, Pawel; Astronave, Gisel; Marghoob, Nadeem G.; Dusza, Stephen W.; Lorenzoni Gaete, María Josefina; Boleira, Manuela; Cristopher, Michael; Valdivia Agüero, Rosario del Pilar; Bustos, Sergio; Jaimes, Natalia; Kurpis, María; Hidalgo Acuña, Leonel Esteban; Abarzúa Araya, Alvaro Rodrigo; Zoroquiain Velez, José Pablo; Uribe González, Pablo Francisco; Cárdenas de la Torre, Consuelo Paz; Droppelmann Droppelmann Katherine Ann; Marghoob, Ashfaq A.
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    Ultraviolet induced fluorescent dermoscopy for the diagnosis of skin tumors: A multicenter study
    (2025) Navarrete Dechent, Cristian Patricio; Pietkiewicz, Pawel; Abarzua Araya, Alvaro Rodrigo; Valdivia Agüero, Rosario Del Pilar; Dusza, Stephen W.; Anriot, Julien; Garces Cea, Javiera; Villagran Essmann, Sofia Paz; Bustos Crisostomo, Sergio Eduardo; González Valdes, Sebastián Alejandro; Ibañez Ibañez, Samuel; Boleira, Manuela; Jaimes, Natalia; Swanson, David; Hidalgo Acuña, Leonel Esteban; Droppelmann Droppelmann, Katherine Ann; Cardenas De La Torre, Consuelo Paz; Uribe González, Pablo Francisco; Marghoob, Ashfaq A.
    Abstract:BackgroundUltraviolet-induced fluorescent dermoscopy (UVFD) is a novel dermoscopic technique that has shown potential to improve diagnostic accuracy for select conditions in small case series. However, its performance has not yet been assessed in a large cohort of cutaneous tumors.ObjectiveTo evaluate the role of UVFD in cutaneous tumors.MethodsThis retrospective, multicenter study included consecutive lesions assessed at three tertiary care clinics in Chile, France, and Poland. Standard polarized dermoscopic images and UVFD images were independently reviewed by two expert dermoscopists, with consensus evaluation. Established dermoscopic criteria, as well as border definition and the presence of “ochre color,” were specifically assessed.Results551 lesions were included. The most frequent diagnosis was basal cell carcinoma (28.2%) followed by melanocytic nevus (18.6%), and melanoma (12.8%). Keratin, comedo-like openings, and fissures and ridges were better seen under UVFD. The border definition of lesions was also better seen under UVFD. Ochre color was seen under UVFD mostly in invasive melanomas.LimitationsRetrospective study. Some tumors were underrepresented.ConclusionUVFD enhances specific keratin-related dermoscopic structures and colors. It also provides for better border delineation and may help in identifying invasive melanomas via the presence of ochre color.