Software imagery expands diagnostic choices

"For the dermatologist, the system can assist in identifying the difficult and very rare diseases, such as those found within the fever-and-a-rash differential, drug eruptions or internationally acquired infectious disease or bioterrorism-related disease," says Dr. Papier, who is also co-founder and chief scientific officer for Logical Images, the software's marketer and developer. He is also an associate professor of dermatology and medical informatics, School of Medicine and Dentistry, University of Rochester.

"I think dermatologists, residents and students do well with atlases and image Web sites they currently use for preparing talks and Powerpoint presentations," Dr. Papier says. "But "VisualDx builds a pictorial differential diagnosis by key patient features, rather than a look-up by diagnosis. Unlike the typical atlas, the variations in disease presentations are displayed, a feature important to dermatology education," Dr. Papier says.

One million images The photos have been sorted from more than one million images provided by collections at New York University, University of Rochester, and private collections including the pediatric collection of Nancy Esterly, M.D., program director, dermatology, Medical College of Wisconsin, and the lifetime collection of Vic Newcomer, M.D., University of California, Los Angeles. The entire system also includes a database of more than 800 generic medications matching with more than 70 disease states the medications may induce. The international travel database also links countries worldwide or any state within the U.S. with risks for disease in travelers. The subscription-based service is also updated biannually.

User-friendly "You can input both visual information through icons and enter keywords that may be important to the work-up of the patient," Dr. Papier says.

The images are displayed by relevance to the information provided and can be viewed in three sizes to scroll through and see the spectrum of disease.

Since its introduction in March 2001, many hospitals have installed the system to make diagnoses more uniform throughout various departments.