The development and validation of a decision aid to enhance shared decision-making for the management of actinic keratosis.

Actinic keratoses (AKs) are common pre-malignant lesions. There are numerous management options including active surveillance, multiple topical therapies, cryotherapy, curettage and cautery, and photodynamic therapy, each with their own risks, benefits and efficacy. Best practice currently involves shared decision-making between patient and clinician, particularly in the setting of multiple management options.

Cutaneous manifestations of myelodysplastic syndrome: A systematic review.

Myelodysplastic syndrome (MDS) may present with specific skin lesions, such as leukaemia cutis, which is a well known poor prognostic marker of leukaemia with a high risk of acute leukaemic transformation. However, less is known regarding non-specific cutaneous manifestations of MDS including the prevalence, types and their prognostic and therapeutic significance, which we aimed to determine through this systematic review. We searched electronic databases (PubMed, Medline and EMBASE) from inception up to 26 January 2023 for studies reporting cutaneous manifestations of MDS.

Prognosis of naevoid melanomas.

Introduction: There appear to be several variants of naevoid melanoma suspected as having different outcomes, but follow-up studies have been few. We aimed to assess the prognosis of naevoid melanomas in a multi-centre study.

Material And Methods: From histopathology records we ascertained patients in the UK, Australia and Italy diagnosed with maturing naevoid melanoma (n = 65; 14; 7 respectively) and nodular/papillomatous naevoid melanoma (12; 6; 0), and patients with superficial spreading melanoma (SSM) from UK (73) and Australia (26).

The development and validation of a decision aid to facilitate patient choice of surgery versus radiotherapy for high-risk basal cell carcinoma.

Basal cell carcinoma (BCC) is an increasingly common cancer. For high-risk BCCs, there are several treatment options, with similar efficacies. The current best practice in deciding upon a particular treatment is for a patient-centred approach.

Defining the Validity of Skin Self-Examination as a Screening Test for the Detection of Suspicious Pigmented Lesions: A Meta-Analysis of Diagnostic Test Accuracy.

Background: Skin self-examination (SSE) is widely promoted for the detection of suspicious pigmented lesions. However, determining screening accuracy is essential to appraising the usefulness of SSE.

Objectives: The aim of this work was to pool estimates from studies of SSE diagnostic accuracy in the detection of suspicious pigmented lesions.

Female Immunity Protects from Cutaneous Squamous Cell Carcinoma.

Purpose: Cancer susceptibility and mortality are higher in males, and the mutational and transcriptomic landscape of cancer differs by sex. The current assumption is that men are at higher risk of epithelial cancers as they expose more to carcinogens and accumulate more damage than women. We present data showing women present with less aggressive primary cutaneous squamous cell carcinoma (cSCC) and early strong immune activation.

ETS1, nucleolar and non-nucleolar TERT expression in nevus to melanoma progression.

TERT (telomerase reverse transcriptase) is the catalytic component of telomerase. TERT shows little expression in normal somatic cells but is commonly re-expressed in cancers, facilitating immortalization. Recently-discovered promoter mutations create binding sites for ETS-family transcription factors to upregulate TERT.

Use of a validated screening tool for psoriatic arthritis in dermatology clinics.

Dermatology clinics represent a key opportunity to screen patients with psoriasis for psoriatic arthritis (PA) which often remains unrecognised. A significant proportion of adults with psoriasis develop arthropathy [5] with around two-thirds having progressive arthritis.[6] NICE has recognised this by the annual use of a validated screening tool such as psoriasis epidemiological screening tool (PEST) on all psoriasis patients without PA.

Quantitative Imaging In Vivo of Functioning Lymphatic Vessels Around Human Melanoma and Benign Nevi.

Objectives: The density of functioning human lymphatics in vivo and of immunohistochemically defined lymphatics was quantified around melanomas, benign nevi, and matched normal skin, to assess the current lymphangiogenesis paradigm. We investigated whether histological and functioning density increased around melanomas compared with benign nevi or matched skin; whether functioning and histological density increased similarly; and whether larger increases occurred around metastatic melanomas.

Methods: Functioning density was quantified in vivo as the total amount of human dermal microlymphatics taking up fluorescent marker injected at the lesion margin.

Acute localised exanthematous pustulosis (ALEP) induced by clindamycin in pregnancy.

Acute generalised exanthematous pustulosis (AGEP) or toxic pustuloderma (TP) is an uncommon though well-recognised cutaneous hypersensitivity reaction that is usually drug-induced. It presents with a triad of scattered sterile pustules, fever and malaise. Acute localised exanthematous pustulosis (ALEP) is a rare and unusual variant of AGEP.

A quantitative examination of lymph drainage from perilesion skin in human melanoma.

Background: An increase in lymph flow from melanomas to draining lymph nodes has been reported in animal studies. It has been postulated that this contributes to metastatic potential of cancers. Data from animal studies are not easily extrapolated to humans; animal studies use immunosuppressed animals modified to overexpress lymphangiogenic growth factors, injected with human tumor cell lines, or manipulated to develop aggressive tumors.

Lymphatic dysfunction, not aplasia, underlies Milroy disease.

Objective: Milroy disease is an inherited autosomal dominant lymphoedema caused by mutations in the gene for vascular endothelial growth factor receptor-3 (VEGFR-3, also known as FLT4). The phenotype has to date been ascribed to lymphatic aplasia. We further investigated the structural and functional defects underlying the phenotype in humans.

Papulonecrotic tuberculid in an HIV-positive patient.

We present a 33-year-old HIV-positive man who presented with a two-year history of a non-itchy papular eruption, associated with night sweats, headaches, poor memory and weight loss. On examination, he had erythematous papular lesions with necrotic centres on the face, arms and torso with no systemic abnormalities. A skin biopsy eventually led to the diagnosis of papulonecrotic tuberculid, and treatment with quadruple therapy resulted in resolution of his rash and systemic symptoms.

Schnitzler's syndrome: successful treatment with anakinra.

A 44-year-old man presented with a 2-year history of an intermittent urticarial rash, malaise, weight loss, night sweats, headaches and bone pains. Initial investigations indicated an elevated erythrocyte sedimentation rate, white cell count and a monoclonal immunoglobulin-M paraprotein. Histological examination revealed a perivascular mixed inflammatory infiltrate with leukocytoclasis, nuclear dust without fibrinoid necrosis and extravasated red blood cells.