This project is dedicated to my father Ferdinando Gianotti, who was one of the first pioneers in the art of pediatric dermatology. I am sure he would not have needed Lampyris 101 to make a correct diagnosis.

(R. Gianotti)

Foreword 2nd Edition

LAMPYRIS 101 has travelled around the world, flying over the 5 continents and being installed by many people.

It became useful to many; to someone, at first LAMPYRIS 101 (or its creators?) caused some troubles, but to the same "someones" LAMPYRIS 101 (or its creators?) became good friends afterwards.

During its travelling around the globe, LAMPYRIS 101 collected a lot of reviews, comments, suggestions, ideas, compliments and even some criticisms. All this stuff has been collected and taken into consideration, and now LAMPYRIS 101 is ready to engage a new phase.

Today LAMPYIRIS 101 is stronger than before, loaded by 50 additional diseases and around 600 additional digital pictures, additional functionalities (and heavily enhanced the existing ones, including a significantly better management of images).

LAMPYRIS 101 is ready to begin a new travel around the world (we think and hope so).

The LAMPYRIS 101 Team

If you don't know or don't remember the beginning of the story, read here...

"The first time I envisioned a computer program assisting a dermatopathologist or surgical pathologist in the process of diagnosing inflammatory skin diseases was in 1993. I had just returned home from a highly stimulating and fruitful stay in "7J" at New York University with A.B. Ackerman, M.D.

At that time, dermatopathologists were using computers mostly as word-processors. Nobody could have ever imagined that a single CD-ROM could contain more than 5000 digital pictures and histopathological data of 400 skin diseases and more. I was immediately mesmerised by Bernie Ackermans masterly approach to diagnostic dermatopathology and I continuously wondered whether this method would be reproducible by a computer system.

Just for fun I began with a project developing a computer program containing two main features; on the one hand it would help its user to store and retrieve the plethora of details associated with dermatopathological concepts and entities - and on the other there would be a new quality of flexibility exceeding the possibilities of a static algorithmic program. In an evolutionary way the system would grow dynamically with its user's insights, observations, and even modifications of defined histological entities. In short, a custom built highly flexible computer based diagnostic system.

I wanted colleagues in all parts of the world, such as a dermatopathologist living in Bora Bora (lucky guy) to be able to file data and pictures of whatever new exotic dermatitis never been observed before, or a Russian dermatopathologist from St. Petersburg, to create a new pattern such as "panniculitis with dense lichenoid inflammation" and to file his personal histopathological criteria for further use, for comparison with other entities and for implementation in the algorithmic decision tree.

In September 2000, I met Heinz Kutzner, a dermatopathologist from Lake Constance in southern Germany who was immediately enthusiastic and exceptionally supportive for the feasibility of this new dynamic and evolutionary diagnostic system. Heinz joined the endeavour on the spot with high spirits not yet knowing that thousands of histological pictures lay ahead of him.

Not long thereafter, I contacted Mr. Giovanni Moretti, a computer programmer, who wrote the Lampyris 101 software in a highly professional way reading my lips and mind and more.

Lampyris 101 has been created in one year full of stimulating discussions and fruitful co-operation. It is based on the concept of histological reaction patterns originally conceived by Hermann Pinkus and then so masterly brought into full bloom by Bernie Ackerman in his classical book about inflammatory skin diseases.

Why does Lampyris use the pattern concept? Simply because a schematic algorithmic pattern approach is the best and logical basis for a computer to store and retrieve all necessary information about inflammatory skin disorders. In fact, Lampyris works with a few basic patterns that again contain various sub patterns which in turn comprise different diseases.

In this way, the user is able to make any kind of search. Example: by applying the search mode one may match eosinophils with plasma cells and spongiosis, and within no time at all precise information will be provided, which otherwise would have taken hours to retrieve from indices, long chapters, journal articles, personal files, and slide boxes.

However, the most fascinating and truly new aspect of Lampyris is its dynamic and evolutionary part. The static algorithmic tree has been abandoned. Instead, the user may make any changes and modifications he or she wants. Using the present database as both a platform and a framework, a new database can be built effortlessly. It is feasible to add or delete histopathological features and to modify the accompanying syllabus by providing new information, personal notes, or references. Most important, new patterns, sub patterns, and diseases in conjunction with digital pictures can be added.

With all these modifications and new observations one will finally obtain a perfect custom made tool fulfilling all the requirements of a dynamic algorithm. Besides, for each one of us, it is of paramount importance to carry the evolution of diagnostic reaction patterns in inflammatory skin disorders many steps further. This is part and requirement of our dermatopathological heritage.

Lampyris should function quite well in this particular field of dermatopathology because the algorithm is based on objective criteria: neutrophils, spongiosis or psoriasiform hyperplasia are exactly the same for Italians, Germans, and Americans. This is different in the field of nevomelanocytic proliferations which epitomise dermatopathology as a highly subjective art requiring much experience and intuition.

Notwithstanding these limitations, those who wish may build their own completely new diagnostic systems in any conceivable field of pathology - just by using the existing Lampyris framework. Even for the computer neophyte Lampyris 101 makes it feasible to start with a blank sheet of paper and to build an expert system in the field of neuropathology, hematopathology and others within a short time and without much frustrating effort."

 

Raffaele Gianotti
Milan
Heinz Kutzner
Friedrichshafen
H.Kutzner - R.Gianotti - G.Moretti

 

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