Pattern recognition - Altmeyers Encyclopedia

Pattern recognition Definition Pattern Recognition: For dermatology, pattern recognition plays an essential role. The diagnostic procedure of pattern recognition is best explained in terms of Gestalt theory: "A whole is not only more than the sum of its parts; the parts belong together inseparably and compositionally in the intermediate structure intended for them". Gestalt theorists therefore experience a whole. For example, they do not listen to individual notes but to a melody, they do not see a tree but the whole, the forest and its changes.Notice: The whole is more than the sum of its parts.However, an indispensable condition for the recognition of a pattern is that one has developed a feeling and a knowledge for the whole. One can discover - completely in the sense of Kant - "nothing, whose possible structure would not be already given or pre-experienced in the thinking of the observer".Reduced to a simple formula: One recognizes only what one knows or has already seen!It is indisputable that two people never see and recognize everything in the same way. Therefore, medical pattern recognition does not require agreement on all details, but rather agreement on certain fixed points relevant to the diagnosis, so-called diagnostic "beacons". Transferred to dermatology, this means that for certain diagnoses it is not the individual finding "diagnosis - that is decisive", for example not the individual florescence, but the overall clinical impression, the "Clinical Pattern Recognition".The "Clinical Pattern-Recognition" has a very high value in the clinical practice of diagnosis, probably unconsciously for most physicians. In (re)recognizing clinical patterns, the examiner involuntarily uses the principle of image analysis. He analyzes the topographic spreading pattern, i.e. an image that the efflorescences have drawn as a "pattern" on the skin. This results in a recognition value characteristic of a particular diagnosis or group of diagnoses.Distribution Patterns: The following will be a listing of the known topographical distribution patterns, which are not specific to a particular disease. However, they are relevant in their diagnostic recognition values, so that their detection and recognition can be given a certain diagnostic value. With this pattern recognition, differential diagnostic analysis is facilitated quite substantially. When analyzing frequencies and specificities, it becomes clear that different patterns have a high diagnostic value, while others do not. Thus, an analysis of a recognizable pattern, i.e., a simple morphological analysis procedure, often succeeds in taking a decisive step towards the final diagnosis. For this, the examiner uses the same procedure that he uses when looking at a picture. First, the image is viewed from a greater distance (distant or macro) before turning to the details of the image in close-up mode, i.e. at a reading distance. This also applies to the dermatological examination method.Distant or macro pattern: concerns the distribution pattern of efflorescences in relation to the major body regions. This pattern is visible when viewed from a 2m or greater distance.Close-up or detailed pattern: concerns the distribution pattern of efflorescences in relation to each other. This pattern becomes apparent at the reading distance.Microscopic (near) pattern: concerns the particular distribution pattern when examined by reflected light microscopy.Distribution pattern: distant or macro pattern (distribution pattern recognizable at 2m).localized: limited to a single body region (e.g. lip) disseminated (multiple, solitary efflorescences, distributed over one or more body regions, as if scattered)universal: the entire skin surface is affected (example: erythroderma).symmetrical: axisymmetrical distribution pattern; meaning: always endogenously triggered (e.g. infectious exnathema or drug exanthema)grossly asymmetric (zoster; nevus flammeus, cutaneous mosaics; other skin infections)preferentially extensor (psoriasis vulgaris)preferentially flexural (atopic eczema, lichen (ruber) planus)arranged in the Blaschko lines or following another cutaneous mosaic (ILVEN, nevus flammeus)associated with a dermatome (segmental) (characteristic of zoster)associated with Langer's tension lines of the skin (pityriasis rosea, parapsoriasis en petites plaques, Kaposi's sarcoma)line-shaped or band-shaped pattern (band-shaped morphea, drainage marks in burns)on light-exposed areas = solar pattern (light dermatoses, systemic lupus erythematosus; dermatomyositis, dermatitis solaris, actinic damage and actinic-induced tumors)only in textile-covered areas (scabies; bug bites, cercarial dermatitis, trombidiosis)occurring in seborrheic (sebaceous gland-rich) zones (acne, seborrheic dermtitis, pityriasis versicolor, etc.)at exogenous contact points = caused by external contact (contact allergic dermatitis; cold and heat damage; other toxic damage)orthostatically oriented = at sites influenced by orthostasis = mostly lower legs; in bedridden patients back and buttocks (lymphedema of the lower legs; chronic venous insufficiency; purpura pigmentosa progressiva).arteficial (= "peculiar" patterns that cannot be explained somatically: skin is bruised, scratched, traumatized with tools; artifacts of the skin).Distribution pattern: detail or near pattern (recognizable at reading distance): In the detail or near pattern, the topographical relationship of the individual efflorescences to each other is evaluated. It is recognizable when the skin lesions are viewed at a reading distance. It is to be recognized whether further special patterns are recognizable.Distribution pattern: Microscopic pattern (revealed by reflected light microscopic examination): Further findings may be revealed by reflected-light microscopic examination. This has a high diagnostic value for the trained examiner, especially in tumor diagnostics. The following close-up or detailed patterns are of initial diagnostic significance:grouped (multiple efflorescences distributed in groups over a limited region (e.g. herpetiform in herpes simplex or zoster); special feature: satellite-like (satellitosis in metastatic malignant melanoma)merged (confluent; several efflorescences have united to form a larger lesion; recognizable by further individual efflorescences contacting with other efflorescences. Example: anular urticaria; landmark psoriasis vulgaris).follicular (acne vulgaris, folliculitis)marginalized (marginalized e.g. in tinea corporis)homogeneously filled, areal; nummular eczemaring-shaped (special feature: cocard-shaped = ring-in-ring structure)linear detail pattern (e.g. in scabies) lightning figure-like (livedo pattern)arcuate or garland-like (serpentine): erythema anulare centrifugum, tinea corporisType of demarcation of lesions:sharp (as if drawn with a sharp pencil): Urticaria fuzzy (border splintered; the transition from healthy to diseased skin is fluid, border not always clearly recognizable): contact allergic dermatitis. Profile Pattern RecognitionPattern recognition plays an essential role in dermatology. The diagnostic procedure of pattern recognition is best explained in terms of Gestalt theory: "A whole is not only more than the sum of its parts; the parts belong together inseparably and compositionally in the intermediate structure intended for them". Gestalt theorists therefore experience a whole. For example, they do not listen to individual notes but to a melody, they do not see a tree but the whole, the forest and its changes.Notice: The whole is more than the sum of its parts.However, an indispensable condition for the recognition of a pattern is that one has developed a feeling and a knowledge for the whole. One can discover - completely in the sense of Kant - "nothing, whose possible structure would not be already given or pre-experienced in the thinking of the observer".Reduced to a simple formula: One recognizes only what one knows or has already seen!It is indisputable that two people never see and recognize everything in the same way. Therefore, medical pattern recognition does not require agreement on all details, but rather agreement on certain fixed points relevant to the diagnosis, so-called diagnostic "beacons". Transferred to dermatology, this means that for certain diagnoses it is not the individual finding "diagnosis - that is decisive", for example not the individual florescence, but the overall clinical impression, the "Clinical Pattern Recognition".The "Clinical Pattern-Recognition" has a very high value in the clinical practice of diagnosis, probably unconsciously for most physicians. In (re)recognizing clinical patterns, the examiner involuntarily uses the principle of image analysis. He analyzes the topographic spreading pattern, i.e. an image that the efflorescences have drawn as a "pattern" on the skin. This results in a recognition value that is characteristic for a certain diagnosis or a certain diagnosis group.Distribution pattern The following will be a listing of known topographic patterns of distribution, which are not specific to a particular disease. However, they are relevant in their diagnostic recognition values, so that their detection and recognition can be given a certain diagnostic value. With this pattern recognition, differential diagnostic analysis is facilitated quite substantially. When analyzing frequencies and specificities, it becomes clear that different patterns have a high diagnostic value, while others do not.Thus, an analysis of a recognizable pattern, i.e., a simple morphological analysis procedure, often succeeds in taking a decisive step towards the final diagnosis. For this, the examiner uses the same procedure that he uses when looking at a picture. First, the image is viewed from a greater distance (distant or macro) before turning to the details of the image in close-up mode, i.e. at a reading distance. This also applies to the dermatological examination method.Distant or macro pattern: concerns the distribution pattern of efflorescences in relation to the major body regions. This pattern becomes visible when viewed from a 2m or greater distance.Close-up or detailed pattern: concerns the distribution pattern of efflorescences in relation to each other. This pattern becomes apparent at the reading distance.Microscopic (near) pattern: concerns the particular distribution pattern when examined by reflected light microscopy.Distribution pattern: distant or macro pattern (distribution pattern recognizable at 2m).localized: limited to a single body region (e.g. lip) disseminated (multiple, solitary efflorescences, distributed over one or more body regions, as if scattered)universal: the entire skin surface is affected (example: erythroderma).symmetrical: axisymmetrical distribution pattern; meaning: always endogenously triggered (e.g. infectious exnathema or drug exanthema)grossly asymmetric (zoster; nevus flammeus, cutaneous mosaics; other skin infections)preferentially extensor (psoriasis vulgaris)preferentially flexural (atopic eczema, lichen (ruber) planus)arranged in the Blaschko lines or following another cutaneous mosaic (ILVEN, nevus flammeus)associated with a dermatome (segmental) (characteristic of zoster)associated with Langer's tension lines of the skin (pityriasis rosea, parapsoriasis en petites plaques, Kaposi's sarcoma)line-shaped or band-shaped pattern (band-shaped morphea, drainage marks in burns)on light-exposed areas = solar pattern (light dermatoses, systemic lupus erythematosus; dermatomyositis, dermatitis solaris, actinic damage and actinic-induced tumors)only in textile-covered areas (scabies; bug bites, cercarial dermatitis, trombidiosis)occurring in seborrheic (sebaceous gland-rich) zones (acne, seborrheic dermtitis, pityriasis versicolor, etc.)at exogenous contact points = caused by external contact (contact allergic dermatitis; cold and heat damage; other toxic damage)orthostatically oriented = at sites influenced by orthostasis = mostly lower legs; in bedridden patients back and buttocks (lymphedema of the lower legs; chronic venous insufficiency; purpura pigmentosa progressiva).arteficial (= "peculiar" patterns that cannot be explained somatically: skin is bruised, scratched, traumatized with tools; artifacts of the skin).Distribution pattern: detail or near pattern (recognizable at reading distance). In the case of the detail or near pattern, the topographical relationship of the individual efflorescences to one another is evaluated. It is recognizable when the skin lesions are viewed at a reading distance . It is to be recognized whether further special patterns are recognizable.Distribution pattern: Microscopic pattern (revealed by reflected light microscopic examination) Further findings can be obtained by means of a reflected-light microscopic examination. This has a high diagnostic value for the trained examiner, especially in tumor diagnostics. The following close-up or detailed patterns are of initial diagnostic significance:grouped (multiple efflorescences distributed in groups over a limited region (e.g. herpetiform in herpes simplex or zoster); special feature: satellite-like (satellitosis in metastatic malignant melanoma)merged (confluent; several efflorescences have united to form a larger lesion; recognizable by further individual efflorescences contacting with other efflorescences. Example: anular urticaria; landmark psoriasis vulgaris).follicular (acne vulgaris, folliculitis)marginalized (marginalized e.g. in tinea corporis)homogeneously filled, areal; nummular eczemaring-shaped (special feature: cocard-shaped = ring-in-ring structure)linear detail pattern (e.g. in scabies) lightning figure-like (livedo pattern)arcuate or garland-like (serpentine): erythema anulare centrifugum, tinea corporisType of demarcation of lesions:sharp (as if drawn with a sharp pencil): Urticaria fuzzy (border splintered; the transition from healthy to diseased skin is fluid, border not always clearly recognizable): contact allergic eczema

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