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BACKGROUND Over the past decade, several studies have shown that potential of artificial intelligence (AI) in dermatology. However, there has yet to be a systematic review evaluating the usage of AI specifically within the field of Mohs micrographic surgery (MMS). OBJECTIVE In this review, we aimed to comprehensively evaluate the current state, efficacy, and future implications of AI when applied to MMS for the treatment of nonmelanoma skin cancers (NMSC). MATERIALS AND METHODS A systematic review and meta-analysis was conducted following PRISMA guidelines across several databases, including PubMed/MEDLINE, Embase, and Cochrane libraries. A predefined protocol was registered in PROSPERO, with literature search involving specific keywords related to AI and Mohs surgery for NMSC. RESULTS From 23 studies evaluated, our results find that AI shows promise as a prediction tool for precisely identifying NMSC in tissue sections during MMS. Furthermore, high AUC and concordance values were also found across the various usages of AI in MMS, including margin control, surgical recommendations, similarity metrics, and in the prediction of stage and construction complexity. CONCLUSION The findings of this review suggest promising potential for AI to enhance the accuracy and efficiency of Mohs surgery, particularly for NMSC. [ABSTRACT FROM AUTHOR]

Understanding the genetic adaptations that occurred as humans migrated out of Africa to higher latitudes helps explain on a population-wide level how UV radiation (UVR) exposure will have varying consequences and benefits in patients of different skin pigmentations. It has been hypothesized that the need for efficient vitamin D synthesis was the primary driver for the skin-lightening process that evolutionarily occurred as humans migrated to higher latitudes. This review analyzes the level of support for the hypothesis that skin lightening occurred to enable adequate vitamin D synthesis in populations that migrated to areas with less UVR. Our literature search supported the hypothesis that through natural selection and intricate genetic adaptations, humans who migrated to areas with lower levels of UVR underwent a skin-lightening process to avoid the consequences of vitamin D deficiency. Our review includes an analysis of migration patterns out of Africa and how these affected pigmentation genes that are found in certain ethnic populations can be used to better understand this critical adaptation process when counseling patients on the need for sun protection. [ABSTRACT FROM AUTHOR]

This article discusses a case of delayed onset eruptive keratoacanthomas in a 77-year-old male patient who had received pembrolizumab treatment for non-small-cell lung cancer. The patient developed a painful and pruritic eruption on his left upper extremity five months after completing a two-year course of pembrolizumab. The lesions were successfully managed with topical and intralesional corticosteroids. The article highlights the importance of continued clinical monitoring following drug cessation and offers conservative management strategies for pembrolizumab-induced eruptive keratoacanthomas. [Extracted from the article]

Background: There is literature that suggests metformin may play a protective role against the development of non-melanoma skin cancers. Given the significant burden of disease non-melanoma skin cancers represent, the possibility of a widely available and generally well-tolerated medication such as metformin as part of the prevention and treatment ladder warrants further research., Objective: This study aims to evaluate the potential of metformin in reducing the risk of non-melanoma skin cancers, specifically squamous cell carcinoma and basal cell carcinoma, using the All of Us research database., Methods: A retrospective case-control analysis was conducted using the All of Us database. Propensity score matching and multivariable regression analyses were performed to evaluate the impact of metformin on the incidence of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) while controlling for confounding variables., Results: Our results indicate a reduced risk of non-melanoma skin cancer following exposure to metformin in individuals diagnosed with both SCC and BCC. Subgroup analyses revealed that metformin exposure was associated with a decreased risk of BCC across all sex and ethnicity groups. Metformin use was also associated with a significantly lower risk of SCC, with univariable and multivariable ORs consistently showing reduced odds. However, metformin exposure was not significantly associated with decreased SCC risk in African American patients., Conclusion: Our study's findings indicate a potential protective effect of metformin against skin cancer, particularly in patients with skin of color. Further prospective research is necessary to substantiate metformin's role in skin cancer chemoprevention within these populations.J Drugs Dermatol. 2024;23(12):1089-1095. doi:10.36849/JDD.8249.