{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:05:42Z","timestamp":1790183142046,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100017569","name":"Salzburger Landesregierung","doi-asserted-by":"publisher","award":["servEB: Global Data and Patient Management for Rare Genetic"],"award-info":[{"award-number":["servEB: Global Data and Patient Management for Rare Genetic"]}],"id":[{"id":"10.13039\/501100017569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Epidermolysis bullosa (EB) defines a group of rare, inherited and currently incurable genetic disorders characterized by excessive skin fragility, with blistering and wounding of skin and mucous membranes upon minor mechanical trauma. Accurate wound assessment is imperative for measuring and longitudinal monitoring of disease activity and for determining the most accurate treatment. In this work, we describe the annotation of clinical images from EB patients and the subsequent training of both classical convolutional neural networks and state\u2010of\u2010the\u2010art transformer\u2010based architectures for the segmentation of various categories of EB skin wounds. Utilising our dataset of 260\u2009EB images from 18 patients and the corresponding 536 expert\u2010annotated segmentation masks, we train and evaluate five different model architectures and compare their performance against human inter\u2010annotator agreement. External evaluation was not possible because no comparable annotated EB datasets are available. Our results demonstrate that transformer\u2010based models, particularly Mask2Former, achieve near\u2010expert\u2010level segmentation accuracy in five of the seven categories and even surpass human inter\u2010annotator agreement in two. Models based on convolutional neural networks perform noticeably worse and generally fail to accurately segment rarely occurring classes. Averaged over all categories, Mask2Former achieved a mean dice similarity coefficient (DSC) of 52.9%, compared to an inter\u2010annotator agreement of 55.9%. These results indicate that Mask2Former has the potential to serve as a clinical decision support system to improve wound segmentation and categorization. Furthermore, this model provides a foundation for planned future applications in automated wound measurement, wound progression monitoring and documentation and the development of a smartphone\u2010based telemedicine application.<\/jats:p>","DOI":"10.1111\/exd.70356","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:25:38Z","timestamp":1788999938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>AI<\/scp>\n                    \u2010Based Segmentation of Wound Types Caused by Epidermolysis Bullosa"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5529-0154","authenticated-orcid":false,"given":"Georg","family":"Wimmer","sequence":"first","affiliation":[{"name":"Department of Artificial Intelligence and Human Interfaces Paris Lodron University Salzburg  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9518-8701","authenticated-orcid":false,"given":"Christian","family":"Puttinger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3471-9755","authenticated-orcid":false,"given":"Pamina","family":"Schlager","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0590-3877","authenticated-orcid":false,"given":"Roland","family":"Zauner","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Gemeier","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-0720","authenticated-orcid":false,"given":"Tobias","family":"Welponer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5255-8140","authenticated-orcid":false,"given":"Christine","family":"Prodinger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Diem","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Ude\u2010Schoder","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Guttmann\u2010Gruber","sequence":"additional","affiliation":[{"name":"EB Research Institute GmbH  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1056-362X","authenticated-orcid":false,"given":"Bernadette","family":"Liemberger","sequence":"additional","affiliation":[{"name":"EB Research Institute GmbH  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Laimer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6085-9170","authenticated-orcid":false,"given":"Johann W.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Artificial Intelligence and Human Interfaces Paris Lodron University Salzburg  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.18921"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.01.016"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/S41598\u2010020\u201078799\u2010W"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24010706"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imu.2022.100884"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00371\u2010025\u201004133\u2010Y"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.15082"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.70135"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2196\/58553"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/1932409"},{"key":"e_1_2_12_12_1","first-page":"299","volume-title":"Bildverarbeitung F\u00fcr Die Medizin","author":"Wimmer G.","year":"2026"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","unstructured":"T.\u2010Y.Lin M.Maire S. J.Belongie et\u00a0al. \u201cMicrosoft COCO: Common Objects in Context \u201dComputing Research Repository(2014) http:\/\/arxiv.org\/abs\/1405.0312.","DOI":"10.1007\/978-3-319-10602-1_48"},{"key":"e_1_2_12_14_1","unstructured":"J.Long E.Shelhamer andT.Darrell \u201cFully Convolutional Networks for Semantic Segmentation \u201dComputing Research Repository(2014) http:\/\/arxiv.org\/abs\/1411.4038."},{"key":"e_1_2_12_15_1","unstructured":"L.\u2010C.Chen G.Papandreou F.Schroff andH.Adam \u201cRethinking Atrous Convolution for Semantic Image Segmentation \u201dComputing Research Repository(2017) http:\/\/arxiv.org\/abs\/1706.05587."},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","unstructured":"A.Howard M.Sandler G.Chu et\u00a0al. \u201cSearching for MobileNetV3 \u201dComputing Research Repository(2019) http:\/\/arxiv.org\/abs\/1905.02244.","DOI":"10.1109\/ICCV.2019.00140"},{"key":"e_1_2_12_17_1","first-page":"12077","volume-title":"Advances in Neural Information Processing Systems","author":"Xie E.","year":"2021"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","unstructured":"B.Cheng I.Misra A. G.Schwing A.Kirillov andR.Girdhar \u201cMasked\u2010Attention Mask Transformer for Universal Image Segmentation \u201d2022 IEEE\/CVF Conference on Computer Vision and Pattern Recognition (CVPR) (2022) 1280\u20131289 https:\/\/doi.org\/10.1109\/CVPR52688.2022.00135.","DOI":"10.1109\/CVPR52688.2022.00135"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","unstructured":"L.Fidon W.Li L. C.Garc\u0131\u0301a\u2010Peraza\u2010Herrera et\u00a0al. \u201cGeneralised Wasserstein Dice Score for Imbalanced Multi\u2010Class Segmentation Using Holistic Convolutional Networks \u201dComputing Research Repository(2017) http:\/\/arxiv.org\/abs\/1707.00478.","DOI":"10.1007\/978-3-319-75238-9_6"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","unstructured":"T.\u2010Y.Lin P.Goyal R. B.Girshick K.He andP.Doll\u00e1r \u201cFocal Loss for Dense Object Detection \u201dComputing Research Repository(2017) http:\/\/arxiv.org\/abs\/1708.02002.","DOI":"10.1109\/ICCV.2017.324"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2307\/3001968"}],"container-title":["Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/exd.70356","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/exd.70356","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/exd.70356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:27:47Z","timestamp":1790180867000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/exd.70356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/exd.70356"],"URL":"https:\/\/doi.org\/10.1111\/exd.70356","archive":["Portico"],"relation":{},"ISSN":["0906-6705","1600-0625"],"issn-type":[{"value":"0906-6705","type":"print"},{"value":"1600-0625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70356"}}