AI can analyze smartphone ‘rash selfies’ to diagnose Lyme disease

Artificial intelligence can be used to evaluate smartphone photos of suspicious rashes and detect Lyme disease earlier, according to a new study.

Lyme disease affects roughly 300,000 people in the US every year and is transmitted through the bite of an infected deer tick. 

A painless rash, called Erythema migrans (EM), usually appears a week or so later, followed by more serious symptoms including fever, headache, chills, joint pain and swollen lymph glands.

Lyme disease is most effectively treated if caught early. 

Untreated, it can cause cognitive impairment, chronic fatigue, heart palpitations and painful swelling that can last from months to years.

A team at Johns Hopkins trained computers to scan images of ‘rash selfies’ and differentiate EM from healthy skin, with a success rate of over 90 percent.

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According to a report in the journal Computers in Biology and Medicine, scientists at Johns Hopkins Applied Research Laboratory used images of Erythema migrans, other dermatological conditions and healthy skin to ‘train’ deep-learning computers to pick out skin infected with Lyme disease.

The AI correctly discerned Erythema migrans from healthy skin 94 percent of the time and had 72 percent accuracy choosing between EM and rashes caused by cellulitis, herpes and other conditions.

In patients already diagnosed with Lyme disease, the system positively identified EM 86 percent of the time.

The rash appears as a ring around the bite mark, starting between 2 and 2.5 inches wide and expanding up to six to 12 inches, or even more.

Lyme disease is caused by a bite from a tick infected with the bacteria Borrelia burgdorferi. Untreated, it can cause cognitive impairment, chronic fatigue, heart palpitations and painful joint swelling that can last from months to years

A team at Johns Hopkins trained computers to scan images of ‘rash selfies’ and differentiate Erythema migrans, the ring-like rash associated with Lyme disease, from healthy skin and other dermatological conditions. The top left four pictures all show Lyme disease rashes

‘Being able to analyze the rash images using artificial intelligence and deep learning enables us to more accurately diagnose that a patient has Lyme disease, determine the stage of the illness and establish a more appropriate treatment plan,’ says John Aucott, director of the Johns Hopkins Lyme Disease Clinical Research Center.

Misdiagnosis of Lyme disease, especially early, is common because the rash can often disappear before more serious symptoms send a patient to a doctor.

Even if it hasn’t, EM can be mistaken for other dermatological inflammations to the naked eye.

Blood tests to detect antibodies for Borrelia burgdorferi, the bacteria that cause Lyme disease, are often unreliable, while skin biopsies are time-consuming and not always available to clinicians.

‘In the near future, if you notice a round, red skin rash, you can take a picture of it as soon as possible to share with your physician,’ Aucott said. ‘That way, even if the rash disappears and you still have Lyme disease symptoms, your physician can make the correct diagnosis using our analysis technique.’

HOW CAN YOU PREVENT TICK BITES? 

Shower as soon as possible after coming indoors to more easily find ticks and wash them off

Try to Avoid Direct Contact with Ticks

• Avoid wooded and brushy areas with high grass and leaf litter
• Walk in the center of trails 

Repel Ticks on Skin and Clothing

• Use repellent that contains 20% or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours
• Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth 
• Use products that contain permethrin on clothing; treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings. Pre-treated clothing is available and may be protective longer
• The Environmental Protection Agency (EPA) has an online tool to help you select the repellent that is best for you and your family 

Find and Remove Ticks from Your Body

• Shower as soon as possible after coming indoors to more easily find ticks and wash them off 
• Upon return from tick-infested areas, conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body  
• Parents should check children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair
• Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs  
• Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors 
• If the clothes require washing first, hot water is recommended; cold and medium temperature water will not kill ticks effectively   

 Source: Centers for Disease Control and Prevention