Peter H. Soyer

University of Queensland | UQ · Dermatology Research Centre

Beta‐blockers have generated an exciting discourse for their potential as a cheap, safe, and effective adjunctive therapy for cutaneous melanoma patients, but the field remains murky. This systematic review investigates the association between beta‐blocker use and survival outcomes in cutaneous melanoma patients. We reviewed 12 studies with 21,582...

Background Skin cancer is a prevalent and clinically significant condition, with early and accurate diagnosis being crucial for improved patient outcomes. Dermoscopy and artificial intelligence (AI) hold promise in enhancing diagnostic accuracy. However, the impact of image quality, particularly high dynamic range (HDR) conversion in smartphone ima...

Background While the high accuracy of reported AI tools for melanoma detection is promising, the lack of holistic consideration of the patient is often criticized. Along with medical history, a dermatologist would also consider intra‐patient nevi patterns, such that nevi that are different from others on a given patient are treated with suspicion....

Integrated risk scores (polygenic and non-genetic risk factors) can facilitate risk-stratification, to inform targeted melanoma screening. This mixed-methods pilot study assessed satisfaction, attitudes, and psychosocial impact of a protocol for communicating integrated risk for melanoma using questionnaires (baseline and 1-month post-results) and...

The appearance of new pigmented lesions in adults at high risk seems to occur randomly and is not restricted to UV-exposed areas. Most evolving lesions are benign; however, new lesions that appear on photodamaged skin should be approached with greater caution.

Background Keratinocyte carcinomas such as basal cell carcinomas and squamous cell carcinomas are a major burden affecting morbidity and mortality in solid organ transplant recipients (SOTRs). Best treatment includes frequent skin checks for early detection and surgery for high incidence of skin cancers. Sirolimus is an immunosuppressive drug which...

Importance There is poor accuracy and reproducibility for the histopathologic diagnosis of melanocytic skin lesions, and the provision of clinical information may improve this. Objective To examine the impact of clinical information on the histopathologic diagnosis of melanocytic skin lesions. Evidence Review PubMed, Embase, and Cochrane Library...

Introduction Having many melanocytic nevi on the skin is a risk factor for melanoma. However, the reproducibility of nevus counts in previous studies is limited due to high inter- and intraobserver variation. Despite the introduction of a protocol for counting and reporting of nevi in 1990 by the International Agency for Research on Cancer (IARC),...

Diagnosing and treating skin diseases require advanced visual skills across multiple domains and the ability to synthesize information from various imaging modalities. Current deep learning models, while effective at specific tasks such as diagnosing skin cancer from dermoscopic images, fall short in addressing the complex, multimodal demands of cl...

This systematic review aims to evaluate the prevalence of reductions in psychosocial wellbeing among patient with melanoma in situ (MIS). It also aims to identify factors associated with psychosocial reactions, the instruments used to measure psychosocial outcomes, and to evaluate existing intervention programs for supporting this population. Searc...

Background: In Australia, artificial intelligence (AI) is increasingly being used in the field of melanoma diagnosis. Early diagnosis is arguably the most important prognostic factor for melanoma survival. The use of digital monitoring of naevi, especially dysplastic naevi, might reduce the number of biopsies needed in managing patients at risk of...

Background Approximately 2–20% of cutaneous melanomas (CMs) are diagnosed as amelanotic/hypopigmented melanoma (AHM) and represent a challenge for early diagnosis. Objectives To investigate loss-of-function mutations in key pigmentation genes in matched germline and AHM, as well as pigmented melanoma (PM), tumour DNA samples. Methods Analysis of...

AI image classification algorithms have shown promising results when applied to skin cancer detection. Most public skin cancer image datasets are comprised of dermoscopic photos and are limited by selection bias, lack of standardization, and lend themselves to development of algorithms that can only be used by skilled clinicians. The SLICE-3D (“Ski...

Deep learning models for medical image analysis easily suffer from distribution shifts caused by dataset artifact bias, camera variations, differences in the imaging station, etc., leading to unreliable diagnoses in real-world clinical settings. Domain generalization (DG) methods, which aim to train models on multiple domains to perform well on uns...

Background : Keratinocyte carcinomas such as Basal Cell Carcinomas and Squamous Cell Carcinomas are a major burden affecting morbidity and mortality in solid organ transplant recipients (SOTRs). Best treatment includes frequent skin checks for early detection and surgery for high incidence of skin cancers. Sirolimus is an immunosuppressive drug whi...

Dermatologists are increasingly managing skin conditions related to climate change In spite of this significant effect on public health, there is a paucity of formal education on climate change, the health impact, and management of this for health care professionals. We propose an action-oriented framework to bridge the gap between climate science...

9502 Background: Lentigo maligna (LM) is a form of melanoma in situ that occurs mainly on sun exposed skin. For patients with LM who are not suitable for surgery due to location, size, patient preference or co-morbidities, topical imiquimod or radiotherapy are alternative non-surgical treatments. There are no prospective randomized controlled trial...

Background A common terminology for diagnosis is critically important for clinical communication, education, research and artificial intelligence. Prevailing lexicons are limited in fully representing skin neoplasms. Objectives To achieve expert consensus on diagnostic terms for skin neoplasms and their hierarchical mapping. Methods Diagnostic te...

POT1 is the second most frequently reported gene (after CDKN2A ) in familial melanoma. Pathogenic variants are associated with earlier onset and/or multiple primary melanomas (MPMs). To date, POT1 phenotypical reports have been largely restricted to associated malignancies, and description of the dermatological landscape has been limited. We identi...

In recent years, there has been a surge in the development of AI-based Software as a Medical Device (SaMD), particularly in visual specialties such as dermatology. In Australia, the Therapeutic Goods Administration (TGA) regulates AI-based SaMD to ensure its safe use. Proper labelling of these devices is crucial to ensure that healthcare profession...

Introduction Artificial Intelligence (AI) has proven effective in classifying skin cancers using dermoscopy images. In experimental settings, algorithms have outperformed expert dermatologists in classifying melanoma and keratinocyte cancers. However, clinical application is limited when algorithms are presented with ‘untrained’ or out-of-distribut...

Metastatic melanoma patients are commonly treated with targeted (e.g., BRAF/MEK inhibitors) and/or immune checkpoint therapies and treatment efficacy is then assessed with radiological scans. These scans are highly effective for the staging of the disease but in terms of follow-up, there are several limitations including the inability to detect min...

Background Actinic keratoses (AK) are pre‐malignant skin lesions caused by chronic sun exposure. Progression from an AK to intraepidermal carcinoma (IEC) and a cutaneous squamous cell carcinoma (SCC) is well known but the rate of transformation to an invasive SCC is highly variable. Since no definitive biomarkers are available, treatment decisions...

Terahertz (THz) imaging has long held promise for skin cancer detection but has been hampered by the lack of practical technological implementation. In this article, we introduce a technique for discriminating several skin pathologies using a coherent THz confocal system based on a THz quantum cascade laser. High resolution in vivo THz images (with...

Background/Objectives Artificial intelligence (AI) holds remarkable potential to improve care delivery in dermatology. End users (health professionals and general public) of AI‐based Software as Medical Devices (SaMD) require relevant labelling information to ensure that these devices can be used appropriately. Currently, there are no clear minimum...

While the average lifetime risk of melanoma worldwide is approximately 3%, those with inherited high-penetrance mutations face an increased lifetime risk of 52-84%. In countries of low melanoma incidence, such as in Southern Europe, familial melanoma genetic testing may be warranted when there are two first degree relatives with a melanoma diagnosi...

Skin lesion recognition using deep learning has made remarkable progress, and there is an increasing need for deploying these systems in real-world scenarios. However, recent research has revealed that deep neural networks for skin lesion recognition may overly depend on disease-irrelevant image artifacts (i.e. dark corners, dense hairs), leading t...

Introduction Three-dimensional (3D) total body photography may improve early detection of melanoma and facilitate surveillance, leading to better prognosis and lower healthcare costs. The Australian Centre of Excellence in Melanoma Imaging and Diagnosis (ACEMID) cohort study will assess long-term outcomes from delivery of a precision strategy of mo...

Background: Nodular melanoma (NM) is a challenge to diagnose early due to its rapid growth and more atypical clinical presentation, making it the largest contributor to melanoma mortality. Objectives: Our study aimed to perform a rare variant allele analysis of whole exome sequenced NM and non-NM patients (minor allele frequency ≤1% Non- Finnish...

Background: As the use of smartphones continues to surge globally, mobile applications (apps) have become a powerful tool for healthcare engagement. Prominent among these are dermatology apps powered by Artificial Intelligence (AI), which provide immediate diagnostic guidance and educational resources for skin diseases, including skin cancer. Obj...

An ugly duckling is an obviously different skin lesion from surrounding lesions of an individual, and the ugly duckling sign is a criterion used to aid in the diagnosis of cutaneous melanoma by differentiating between highly suspicious and benign lesions. However, the appearance of pigmented lesions, can change drastically from one patient to anoth...

Background Immunosuppressive drugs such as tacrolimus have revolutionized our ability to transplant organs between individuals. Tacrolimus acts systemically to suppress the activity of T-cells within and around transplanted organs. However, tacrolimus also suppresses T-cell function in the skin, contributing to a high incidence of skin cancer and a...

Skin lesions known as naevi exhibit diverse characteristics such as size, shape, and colouration. The concept of an "Ugly Duckling Naevus" comes into play when monitoring for melanoma, referring to a lesion with distinctive features that sets it apart from other lesions in the vicinity. As lesions within the same individual typically share similari...

Dermoscopy aids in melanoma detection; however, agreement on dermoscopic features, including those of high clinical relevance, remains poor. Herein we attempted to evaluate agreement among experts on 'exemplar images' not only for the presence of melanocytic-specific features but also for spatial localization. This was a cross-sectional, multicente...

MITF E318K moderates melanoma risk. Only five MITF E318K homozygous cases have been reported to date, one in association with melanoma. This novel report uses 3D total-body-photography (TBP) to describe the dermatological phenotype of a homozygous MITF E318K individual. The case, a 32-year-old male, was diagnosed with his first of six primary melan...

Background Skin in UV‐exposed areas may develop UV‐induced actinic damage in DNA sequences leading to proliferation of keratinocyte carcinoma, a type of non‐melanoma skin cancer. Actinic keratosis (AK) represents early‐stage in situ squamous cell carcinoma. It develops from the basal cell layer and may be present in subclinical stages, being report...

We investigated whether human preferences hold the potential to improve diagnostic artificial intelligence (AI)-based decision support using skin cancer diagnosis as a use case. We utilized nonuniform rewards and penalties based on expert-generated tables, balancing the benefits and harms of various diagnostic errors, which were applied using reinf...

Introduction: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up. Objectives: To obtain general consensus on the diagnosis, treatment, and follow-up for LM. Methods: A modified Delphi method was used. The invited participants were either members of the Interna...

Skin lesion recognition using deep learning has made remarkable progress, and there is an increasing need for deploying these systems in real-world scenarios. However, recent research has revealed that deep neural networks for skin lesion recognition may overly depend on disease-irrelevant image artifacts (i.e. dark corners, dense hairs), leading t...

Deep neural networks have demonstrated promising performance on image recognition tasks. However, they may heavily rely on confounding factors, using irrelevant arti-facts or bias within the dataset as the cue to improve performance. When a model performs decision-making based on these spurious correlations, it can become untrustable and lead to ca...

Importance: The extent to which major high-risk features of squamous cell carcinomas (SCCs) in organ transplant recipients (OTRs) differ from SCCs in the general population is not known. Objective: To quantify the relative frequency of perineural invasion, invasion below the dermis, lack of cellular differentiation, and tumor diameter greater th...

Background: Population-wide screening for melanoma is not cost-effective, but genetic characterisation could facilitate risk stratification and targeted screening. Common MC1R red hair colour (RHC) variants and MITF E318K separately confer moderate melanoma susceptibility, but their interactive effects are relatively unexplored. Objectives: Eval...

The main carcinogen for keratinocyte skin cancers (KCs) such as basal and squamous cell carcinomas is ultraviolet (UV) radiation. There is growing evidence that accumulation of mutations and clonal expansion play a key role in KC development. The relationship between UV exposure, epidermal mutation load, and KCs remains unclear. Here, we examined t...

Background: Risk prediction tools have been developed for keratinocyte cancers (KCs) to effectively categorize individuals with different levels of skin cancer burden. Few have been clinically validated nor routinely used in clinical settings. Objectives: To assess whether risk prediction tool categories associate with interventions including ch...

Melanoma may arise within a pre-existing nevus, but commonly forms in the skin adjacent to nevi. We have performed global DNA methylation profiling using the Illumina EPIC array (>800K loci) of 32 dermoscopically ('globular' vs 'non-globular' pattern) and histopathologically classified nevi, together with matching adjacent perilesional skin, and di...

Skin lesion recognition using deep learning has made remarkable progress, and there is an increasing need for deploying these systems in real-world scenarios. However, recent research has revealed that deep neural networks for skin lesion recognition may overly depend on disease-irrelevant image artifacts (i.e. dark corners, dense hairs), leading t...