結論（CONCLUSION）
本章試圖藉由探討術語、形態學、型態辨識，以及若干將有助於強化臨床病理相關性 (clinicopathologic correlation) 實務的技術，為皮膚科學的學習提供一份導論與基本的結構性架構。所期望的最終結果是更準確的診斷與更好的病人照護。
其他圖與表，「其餘健康者的急性皮膚疹 (Acute cutaneous eruptions in otherwise healthy individuals)」，可於我們的電子書中取得（存取碼請見封面內頁）。
-
Swerdlin A, Berkowitz C, Craft N. Cutaneous signs of managing cutaneous pigmented lesions: primary care physicians versus dermatologists. J Gen Intern Med. 2006;21:678–682.2. Tran H, Chen K, Lim AC, et al. Assessing diagnostic
-
Fuertes L, Santonja C, Kutzner H, Requena L.
child abuse. J Am Acad Dermatol. 2007;57:371–392.19. Chuh AA. Rash orientation in pityriasis rosea: a quali-
Immunohistochemistry in dermatopathology: a review of the most commonly used antibodies (Part II). Actas Dermosifiliogr. 2013;104:181–203.38. Argenziano G, Soyer HP, Chimenti S, et al. Dermoscopy of tative study. Eur J Dermatol. 2002;12:253–256.20. McLaurin CI. Unusual patterns of common dermatoses skill in dermatology: a comparison between general practitioners and dermatologists. Australas J Dermatol. 2005;46:230–234.3. Nast A, Griffiths CE, Hay R, et al. The 2016 International in blacks. Cutis. 1983;32:352–355. 358–360.21. Lo Schiavo A, Ruocco E, Russo T, et al. Locus minoris pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003;48:679–693.39. Kittler H, Rosendahl C, Cameron A, Tschandl P.
resistentiae: an old but still valid way of thinking in medicine. Clin Dermatol. 2014;32:553–556.22. Wang T, Zhang M, Zhang Y, et al. Wolf’s isotopic response
League of Dermatological Societies’ revised glossary for the description of cutaneous lesions. Br J Dermatol. 2016;174:1351–1358.4. Taylor SC, Cook-Bolden F. Defining skin of color. Cutis.
Dermatoscopy: An Algorithmic Method Based on Pattern Analysis. Vienna: Facultas; 2011.40. Lallas A, Tzellos T, Kyrgidis A, et al. Accuracy of dermo- after herpes zoster infection: a study of 24 new cases and literature review. Acta Derm Venereol. 2019;99:953–959.23. Ruocco E, Baroni A, Donnarumma G, Ruocco V.
2002;69:435–437.5. Lester JC, Taylor SC, Chren MM. Under-representation of scopic criteria for discriminating superficial from other subtypes of basal cell carcinoma. J Am Acad Dermatol. 2014;70:303–311.41. Zalaudek I, Kreusch J, Giacomel J, et al. How to diagnose
Diagnostic procedures in dermatology. Clin Dermatol. 2011;29:548–556.24. Ponka D, Baddar F. Wood lamp examination. Can Fam skin of colour in dermatology images: not just an educational issue. Br J Dermatol. 2019;180:1521–1522.6. Thong HY, Jee SH, Sun CC, Boissy RE. The patterns of nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part I. Melanocytic skin tumors. J Am Acad Dermatol. 2010;63:361–374.42. Dupuy A, Dehen L, Bourrat E, et al. Accuracy of standard
Physician. 2012;58:976.25. Singh S, Grummer SE, Hancox JG, et al. The extent melanosome distribution in keratinocytes of human skin as one determining factor of skin colour. Br J Dermatol. 2003;149:498–505.7. Pappert AS, Scher RK, Cohen JL. Longitudinal pigmented of dermatopathology education: a comparison of pathology and dermatology. J Am Acad Dermatol. 2005;53:694–697.26. Smoller DR, Hiatt KM. How to maximize information nail bands. Dermatol Clin. 1991;9:703–716.8. Dominguez-Cherit J, Roldan-Marin R, Pichardo-Velazquez dermoscopy for diagnosing scabies. J Am Acad Dermatol. 2007;56:53–62.43. Lallas A, Giacomel J, Argenziano G, et al. Dermoscopy in from a skin biopsy. In: Dermatopathology: The Basics. New York: Springer Science-Business Media; 2009:37–61.27. Pariser RJ, Divers A, Nassar A. The relationship between
P, et al. Melanonychia, melanocytic hyperplasia, and nail melanoma in a Hispanic population. J Am Acad Dermatol. 2008;59:785–791.9. Meleti M, Vescovi P, Mooi WJ, et al. Pigmented lesions general dermatology: practical tips for the clinician. Br J Dermatol. 2014;170:514–526.44. Mubki T, Rudnicka L, Olszewska M, Shapiro J.
biopsy technique and uncertainty in the histopathologic diagnosis of melanoma. Dermatol Online J. 1999;5:4.28. Ng JC, Swain S, Dowling JP, et al. The impact of partial of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:606–616.10. James WD, Carter JM, Rodman OG. Pigmentary demar-
Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations. J Am Acad Dermatol. 2014;71431. e1–e11.45. Bafounta ML, Beauchet A, Aegerter P, Saiag P. Is biopsy on histopathologic diagnosis of cutaneous melanoma: experience of an Australian tertiary referral service. Arch Dermatol. 2010;146:234–239.29. Rao R, Jindal A, Bhogal B, Pai SB. Direct immunofluores- dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a metaanalysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol. 2001;137:1343–1350.46. Kittler H, Pehamberger H, Wolff K, Binder M. Diagnostic cence microscopy of skin biopsy samples preserved in honey. J Am Acad Dermatol. 2017;76:761–763.30. Ackerman AB. Histologic Diagnosis of Inflammatory Skin cation lines: a population survey. J Am Acad Dermatol. 1987;16:584–590.11. Nordlund JJ, Abdel-Malek ZA. Mechanisms for post- accuracy of dermoscopy. Lancet Oncol. 2002;3:159–165.47. Carli P, de Giorgi V, Chiarugi A, et al. Addition of
Diseases. A Method by Pattern Analysis. Philadelphia: Lea & Febiger; 1978.31. Ackerman AB, Boer A, Bennin B, et al. Histologic inflammatory hyperpigmentation and hypopigmentation. Prog Clin Biol Res. 1988;256:219–236.12. Jablonski NG, Chaplin G. The evolution of human skin dermoscopy to conventional naked-eye examination in melanoma screening: a randomized study. J Am Acad Dermatol. 2004;50:683–689.48. Argenziano G, Puig S, Zalaudek I, et al. Dermoscopy
Diagnosis of Inflammatory Skin Diseases:An Algorithmic Method Based on Pattern Analysis. 3rd ed. New York: Ardor Scribendi; 2005.32. Fung MA, Barr KL. Current knowledge in inflammatory coloration. J Hum Evol. 2000;39:57–106.13. Ben-Gashir MA, Hay RJ. Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterparts. Br J Dermatol. 2002;147:920–925.14. Jones A, Walling H. Retiform purpura in plaques: a improves accuracy of primary care physicians to triage lesions suggestive of skin cancer. J Clin Oncol. 2006;24:1877–1882.49. Vestergaard ME, Macaskill P, Holt PE, Menzies SW.
dermatopathology. Dermatol Clin. 2012;30:667–684.33. Zelger BW, Sidoroff A, Orchard G, Cerio R.
Non-Langerhans cell histiocytoses. A new unifying concept. Am J Dermatopathol. 1996;18:460–504.34. Requena L, Kutzner H. Invisible dermatoses. Pathologe.
morphological approach to diagnosis. Clin Exp Dermatol. 2007;32:596–602.15. Bolognia JL, Orlow SJ, Glick SA. Lines of Blaschko. J Am
Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159:669–676.50. Menzies SW. Evidence-based dermoscopy. Dermatol Clin.
2002;23:54–64.35. Logan ME, Zaim MT. Histologic stains in dermatopa-
Acad Dermatol. 1994;1:157–190.16. Boyd A, Nelder K. The isormorphic response of Koebner.
thology. J Am Acad Dermatol. 1990;22:820–830.36. Fuertes L, Santonja C, Kutzner H, Requena L.
Int J Dermatol. 1990;29:401–410.17. Weiss G, Shemer A, Trau A. The Koebner phenomenon:
2013;31:521–524.51. Tromme I, Sacré L, Hammouch F, et al. Availability of
Immunohistochemistry in dermatopathology: a review of the most commonly used antibodies (Part I). Actas Dermosifiliogr. 2013;104:99–127.
review of the literature. J Eur Acad Dermatol Venereol. 2002;16:241–248.
digital dermoscopy in daily practice dramatically reduces the number of excised melanocytic lesions: results from an observational study. Br J Dermatol. 2012;167:778–786.
總結而言，機器學習與 AI 在未來幾乎必定會在臨床實務中引導與協助醫師。或許將不再需要以人工計算 PASI 這類分數，或是在黑色素細胞性病灶的診斷灰色地帶中將更容易縮小範圍、執行全人口的皮膚癌篩檢，以及進行半自動化的遠距醫療／分流。自動化的預測性分期系統或許會取代 TNM 分期系統。然而，何者將成為現實，取決於醫師與研究者、技術進展、病人、政治、公司、倫理考量與監管機構。此外，鑑於篇幅限制，還有許多其他應用與技術在此並未涵蓋或僅簡略提及。最後，機器學習領域步調快速，而對相關文獻的批判性回顧，在理解 AI 的新概念與新可能性上至關重要。