- The Washington Times - Wednesday, January 19, 2005

ROCHESTER, N.Y. - A 4-year-old boy arrived at an Iowa hospital with a fever, swollen lymph glands and various visible clues: a diffuse rash, cracked lips and peeling skin around his fingernails.

Dr. Mark Graber, an emergency-room veteran, quickly suspected Kawasaki syndrome, a rare condition that can lead to fatal aneurysms.

The boy already had visited several doctors and emergency rooms, but “the diagnosis was missed,” Dr. Graber said.

To ensure that he was on the right path, Dr. Graber typed his observations into a visual-diagnosis software application that’s designed to pinpoint illnesses that appear on the skin, from chickenpox or Lyme disease to AIDS complications or anthrax exposure.

Homing in on an explanation for rashes, blisters or lesions might seem as if it is a fairly straightforward task. But thousands of diseases have visible symptoms, plus thousands of uncommon manifestations, and front-line doctors are often stumped.

Dr. Art Papier saw a growing need for a technological answer to the question: “What am I looking at?” as the ranks of medical dermatologists were steadily depleted in the 1990s by a shift to cosmetic surgery.

“You either train more skin experts, which we’re not doing, or you make the generalists smarter,” said Dr. Papier, a University of Rochester associate professor of dermatology who in 1999 co-founded Logical Images, the developer of VisualDx software.

VisualDx contains nearly 10,000 medical photographs culled from 1.2 million accumulated since the 1940s in private archives and colleges.

The software was first licensed to hospitals, medical schools and internists in March 2001. The market grew dramatically after the October 2001 anthrax attacks killed five persons, rattling a nervous nation. The software already had a biological-warfare segment that showed, in vivid color, the progressions of long-eradicated diseases like smallpox.

With the government allocating more than $1 billion a year to improve bioterrorism readiness, Logical Images has deals with big-name clients, from the federal Centers for Disease Control and Prevention to hospital systems in New York City and Washington.

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