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Background and Objective: The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0‐1/IGA 0 for the special locations at Week 52 of treatment. Patients and Methods: Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. Results: A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0‐1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. Conclusions: Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis. [ABSTRACT FROM AUTHOR]

Severe cutaneous adverse reactions (SCARs) [Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic syndrome (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed eruption (GBFE)] are severe drug reactions that often require hospitalization and could be fatal. BRAF and MEK inhibitors (BRAF/MEKi) are a standard of care in patients with BRAF‐mutated metastatic melanomas. These agents are administered until disease progression or unacceptable toxicity occurs. This review has focus on BRAF/MEKi‐induced SCARs. A systematic search of the following terms: 'vemurafenib', 'cobimetinib', 'dabrafenib', 'trametinib', 'encorafenib', 'binimetinib', 'Acute Generalized Exanthematous Pustulosis', 'Stevens Johnson syndrome', 'Toxic Epidermal Necrolysis', 'Generalized Bullous Fixed Eruption' 'Drug Hypersensitivity Syndrome', and 'DRESS' in simple combination (every drug with each disease) and all in combination, was performed on MEDLINE, EMBASE, Web of Knowledge and The Cochrane Library repositories, with no restriction on language, for original studies. One hundred sixty‐eight original articles were found, 26 (retrospective series, case reports and conference abstracts) were selected, and 21 were included in the qualitative synthesis. A total of 31 SCAR cases (23 DRESS and 8 SJS/TEN – 1 SJS and 7 TEN –) were identified. Vemurafenib was the culprit drug in all but one case, which was dabrafenib‐induced. Mean time to SCAR onset from drug intake was 15.5 and 11.4 days, for SJS/TEN and DRESS, respectively. For the DRESS cases, hepatic involvement occurred in 96% and renal alterations in 87% of patients. Overall, BRAF/MEKi‐induced SCARs are rare. Among them, vemurafenib is the drug that requires more close monitoring for SCARs. Prior immunotherapy can favour SCARs. Vemurafenib DRESS is likely to occur within the first fifteen days of treatment accompanied by hepatic and renal involvement. Following vemurafenib‐induced SCAR resolution, switching to dabrafenib seems to be a safe alternative for these patients' treatment. [ABSTRACT FROM AUTHOR]

Background: The SCORTEN score is a specific predictor of mortality for patients with Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). There is little evidence in support of the common immunomodulating therapies for SJS/TEN. Objectives: To systematically assess the effectiveness of several therapies for SJS/TEN through the SCORTEN score. Methods: Databases were searched for original studies on the use of SCORTEN. Six meta‐analyses were carried out on patients with SJS/TEN who received supportive care only or in combination with immunomodulating drugs: corticosteroids, cyclosporine, etanercept, immunoglobulins or a combination of corticosteroids with immunoglobulins. A multivariate meta‐regression and a network meta‐analysis were also performed. Results: Of 3893 studies identified, fifty‐two involving 2466 patients with SJS/TEN were preselected. Data from thirty‐eight of these studies (1827 patients) were finally pooled, and results [log(SMR)] from meta‐analyses were as follows: −0.13 (95% CI, −0.42,0.16) for corticosteroids, −0.39 (95% CI, −0.87,0.09) for immunoglobulins, 0.13 (95% CI, −0.15,0.40) for supportive treatment, −0.88 (95% CI, −1.47, −0.29) for cyclosporine, −0.95 (95% CI, −1.82, −0.07) for etanercept and − 0.56 (95% CI, −0.94, −0.19) for immunoglobulins plus corticosteroids. The meta‐regression analysis confirmed that cyclosporine and immunoglobulins plus corticosteroids were associated with less deaths than predicted by SCORTEN. In the network meta‐analysis, no treatment achieved a significant reduction in the SMR. Limitations: Heterogeneity and quality of the included studies. Conclusions: Some treatments for SJS/TEN show a better performance, but there is not sufficient evidence to recommend its widespread use in all patients. [ABSTRACT FROM AUTHOR]

Background: The SCORTEN score is a specific predictor of the probability of death for patients diagnosed with Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Objectives: To evaluate the overall accuracy of SCORTEN and the influence of several moderators such as age, sex, geographical region and age of the study. Methods: A systematic search was performed on MEDLINE, The Cochrane Library, EMBASE, SCOPUS and Web of Knowledge, with no restriction on language (last update 5 February 2019 for all databases). Original studies on the use of SCORTEN were eligible. The standardized mortality ratio (SMR), defined as the quotient between the number of deaths observed and the number expected following SCORTEN, was taken as the measurement of analysis. Results: Sixty‐four papers were part of the main meta‐analysis carried out in the study. A pooled log(SMR) of −0.0889 (95% CI: −0.2023 to 0.0245) was obtained, suggesting a reasonable behaviour of SCORTEN as a predictor of mortality. The possible influence of several factors in the accuracy of SCORTEN was studied by means of meta‐regression models. Multivariate meta‐regression allowed finding that the mean age of the patients and the ending year of the study are the only factors that significantly influence SCORTEN predictions. The mean age of the group of patients was associated with a significant increase in the observed/expected ratio, whereas a progressive reduction in the observed/expected ratio can be appreciated over the years. Finally, an underestimation of mortality was found for SCORTEN values of 3 or less and the opposite for those above 3 (SCORTEN range: 0–7). Conclusions: The rarity of the disease and the heterogeneity of the studies included are major limitations. Despite the overall remarkable accuracy displayed by SCORTEN, the influence of several factors, as comorbidities (e.g. renal impairment), involved body surface area and patient's age, seem of enough relevance to consider a redefinition of the scale. [ABSTRACT FROM AUTHOR]

Table 1 describes age-specific cumulative incidences of COVID-19 and COVID-19 related events and compares them with the general population by means of the overall SIRs. Patients with primary cutaneous lymphoma are at risk for severe COVID-19. Our study suggests that PCL patients should be considered at risk for severe COVID-19, requiring reinforced preventive measures and prioritization in vaccination strategies. [Extracted from the article]

Background: The most effective treatment modality for actinic keratosis (AK) is photodynamic therapy (PDT). Major obstacles of PDT are the need of a special illumination device and pain accompanying the illumination. These issues may be overcome by replacing an artificial high‐power light source with natural daylight for more extended illumination at lower light doses. Objective: To determine whether BF‐200 ALA (a nanoemulsion gel containing 7.8% 5‐aminolaevulinic acid) is non‐inferior to MAL (a cream containing 16% methyl‐aminolaevulinate) in the treatment of mild‐to‐moderate AK with daylight PDT (dPDT). Non‐inferiority of the primary efficacy variable (total lesion clearance rate per patient's side 12 weeks after PDT) is established if the mean response for BF‐200 ALA is no worse than for MAL, within a statistical margin of Δ = −12.5%. Methods: The study was performed as an intraindividual comparison with 52 patients in seven centres in Germany and Spain. Each patient received one dPDT. Results include clinical endpoints as well as 1‐year follow‐up results. Results: Twelve weeks after a single dPDT, 79.8% of the AK lesions treated with BF‐200 ALA gel and 76.5% of the lesions treated with MAL cream were completely cleared. The median of differences was 0.0 with a one‐sided 97.5% CI of 0.0, establishing non‐inferiority (P < 0.0001). Results for secondary efficacy parameters were in line with the primary outcome. Recurrence rates 1 year after the treatment were 19.9% for lesions treated with BF‐200 ALA and 31.6% for lesions treated with MAL. Adverse reactions including pain were mostly mild and transient and identical to those previously described for dPDT. Conclusion: Daylight PDT of AK with BF‐200 ALA is well‐tolerated and non‐inferior to MAL/dPDT. The study demonstrates a trend towards higher efficacies after 3 months and significantly lower recurrence rates after 1 year follow‐up. [ABSTRACT FROM AUTHOR]

Summary: Background: Promoter methylation of tumour suppressor genes (TSGs) has recently been implicated in the pathogenesis of several types of cancer. Regarding melanoma, over 100 genes that contribute to its pathogenesis have been identified to be aberrantly hypermethylated. Objectives: This is a retrospective observational study that aims to analyse the prevalence of CpG island methylation in a series of primary melanomas, to identify the associations with the main clinicopathological features, and to explore the prognostic significance of methylation in melanoma survival. Materials and methods: DNA methylation was analysed using methylation‐specific multiplex ligation‐dependent probe amplification in a series of 170 melanoma formalin‐fixed paraffin‐embedded tumour samples. The relationship between the methylation status, known somatic mutations and clinicopathological features was evaluated. Disease‐free survival (DFS) and overall survival (OS) were displayed by the Kaplan–Meier method. Results: In the entire cohort, one or more genes were detected to be methylated in 55% of the patients. The most prevalent methylated genes were RARB 31%, PTEN 24%, APC 16%, CDH13 16%, ESR1 14%, CDKN2A 6% and RASSF1 5%. An association between aberrant methylation and aggressive clinicopathological features was observed (older age, increased Breslow thickness, presence of mitosis and ulceration, fast‐growing melanomas, advancing stage and TERT mutations). Furthermore, Kaplan–Meier survival analysis showed a correlation of methylation and poorer DFS and OS. Conclusions: Aberrant methylation of TSGs is a frequent event in melanoma. It is associated with aggressive clinicopathological features and poorer survival. Epigenetic alterations may represent a significant prognostic marker with utility in routine practice. [ABSTRACT FROM AUTHOR]

The tumour cells, arranged on a myxoid ground between bundles of thickened collagen (Fig. c), consisted of small, round tumour cells with hyperchromatic nuclei and of large, polygonal-shaped tumour cells with abundant eosinophilic cytoplasm (Fig. d). (b) At scanning magnification, the entire dermis was seen to be infiltrated by a neoplasm with desmoplastic growth pattern; (c) tumour cells arranged on a myxoid matrix and between bundles of thickened collagen; (d) small, round tumour cells with hyperchromatic nuclei and large, polygonal-shaped tumour cells with abundant eosinophilic cytoplasm. In our case, the tumour cells expressed CK AE1/3 but the findings of negativity for CK CAM 5.2 and p40 and positivity for myogenic regulatory proteins ruled out sarcomatoid or metastatic carcinoma. [Extracted from the article]

The article presents a case study of a 42-year-old woman with a seven-year history of symmetrical telangiectatic lesions on her feet that spread to her lower extremities, abdomen and arms. The patient was diagnosed with cutaneous collagenous vasculopathy and was treated with pulsed dye laser. It discusses utaneous collagenous vasculopathy as one of the uncommon primary vascular disorders.

Photodynamic therapy (PDT) and imiquimod are two excellent treatments for actinic keratosis but are often not well tolerated by patients. To ascertain which treatment is better tolerated and which produces greater patient satisfaction. A secondary objective was to determine the factors related to the patient's tolerance to each treatment. Patients with at least five actinic keratosis lesions on the face and scalp were selected. The patients were randomized to receive treatment with PDT with methyl aminolaevulinate or treatment with imiquimod. Tolerance, satisfaction and predisposition to repeat the treatment were evaluated. Most patients exhibited good or acceptable tolerance to both PDT and imiquimod treatment. There was a higher percentage of patients treated with PDT (93%) who were very satisfied compared with imiquimod (62%) ( P = 0·004). Most patients treated with either one of the two options would repeat the same treatment. No significant relationship was found between age, sex, working time exposed to the sun, phototype and hair colour and the tolerance to both treatments. Both PDT and imiquimod are treatments that are generally well tolerated. While both treatments provide a high level of satisfaction, PDT appears to be slightly superior in this regard. [ABSTRACT FROM AUTHOR]

Background Malignant melanoma risk factors have been studied in different geographical area populations. However, no study has focused on risk factors which are more frequently associated to the over 60's age group. Methods A case-control study was performed that included 160 patients age ≥ 60 years diagnosed of cutaneous melanoma and 318 controls matched for age and sex. Both groups were assessed, by personal interview and physical examination, for different phenotype characteristics (hair and eye color, phototype), the presence of other cutaneous lesions (solar lentigines, actinic keratoses and nevi), degree and type of solar exposure and personal and family past history of cutaneous or non-cutaneous cancer. Differences were evaluated by contingency tables and univariate and multivariate logistic regression. Results Of 17 factors, those risk factors with a strong effect on the development of melanoma in the elderly were: fair eyes, severe sunburns, years of occupational sun exposure, smoking, > 50 melanocytic nevi and personal history of NMSC and other non-cutaneous neoplasias. Conclusions Tobacco smoking is an independent risk factor for cutaneous melanoma in the elderly. Intense (both acute and chronic) sun exposure and constitutional features, such as tumor susceptibility (NMSC, non-cutaneous neoplasias, and multiple nevi) are also associated with melanoma risk. All these factors should help to better design educational campaigns in older people. [ABSTRACT FROM AUTHOR]

Background Photodynamic therapy (PDT) is an effective treatment for actinic keratoses, Bowen’s disease and basal cell carcinoma. The main drawback of PDT is pain during application. Objectives To compare the efficacy of supratrochlear and supraorbital nerve block with cold air analgesia to control the pain experienced during PDT. Methods A controlled open clinical trial was conducted in 34 patients having multiple actinic keratoses in the frontal region treated with PDT. On one side of the frontal region the supratrochlear and supraorbital nerves were blocked, while on the other side cold air was used as the method of analgesia. Pain was recorded on a visual analogue scale after treatment. Results Thirty-one of 34 patients reported less pain in the zone treated with nerve block. This difference was statistically significant. Conclusions Nerve block is superior to cold air and is an easy, safe, effective means of controlling the pain associated with PDT. [ABSTRACT FROM AUTHOR]

Some clinical, pathological and genetic features have been associated to familial melanoma, particularly multiple melanoma and earlier age at diagnosis. To compare the clinical, epidemiological and pathological differences between familial and sporadic melanoma patients in Valencia, Spain, a series of 959 patients with cutaneous melanoma were selected at a single institution. For this study the following variables were selected: age, sex, melanoma site and presence of solar lentigines on the melanoma surrounding skin, histological subtype, tumor thickness, stage, family and personal history of cutaneous melanoma and of other neoplasias, personal history of non-melanoma skin cancer, past personal history of severe sunburns, cutaneous phenotype (phototype, hair and eyes colors number of common nevus, number of atypical nevi, presence of solar lentigines). Forty-one (4.28%) familial and 918 sporadic melanoma were identified. Among the multiple variables studied, a younger age at diagnosis (median age of 42 vs 53 years), higher frequency of the presence of at least one clinically atypical nevus (36.1% vs 17.7%), multiple melanomas (12.2% vs 3.4%) and red/blonde hair (33.3% vs 18.9%), and a lower rate of cases with solar lentigines in melanoma site (33.3% vs 56.3%) were found for familial cases. Except for hair color and age, the other variables remained statistically significant after the multivariate study. Interestingly, no acral melanomas were found among the familial cases. In summary, phenotypic risk factors for familial melanoma are a tendency to develop multiple melanomas, to have clinically atypical nevi and to present less actinic damage at the melanoma site. All these results enhance the relevancy of genetic susceptibility associated to the ability to produce atypical nevi and partly to a higher sensitivity to the sun. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the case of a 30-year-old male patient with atrophic dermatofibrosarcoma protuberans with fusion of the collagen type I α 1 gene with the platelet-derived growth factor beta-chain.

Background Location of the tumour is a well-known prognostic factor for recurrence of basal cell carcinoma (BCC). We have observed that tumours located in the nasolabial fold may deserve a particular attention. Objective The aim of this study is to evaluate the behaviour of BCC located on the nasolabial fold in comparison to a control group of patients with BCC in lower risk sites, and to detect characteristics which may imply a more complicated treatment or the consideration of adjuvant treatment. Methods A series of 24 patients with BCC located on the nasolabial fold were retrospectively recruited from our database of Mohs surgery from January 1997 to December 2000. A control group of 37 patients with BCC located on the cheek or forehead were selected from the same database. The differences between both groups in clinical, surgical and histological terms were evaluated. Results BCC on the nasolabial fold presented with shorter evolution time from first symptom, had a smaller size, had been less frequently treated before and showed mostly non-aggressive histologic subtype, but needed more surgical stages and more complex reconstruction. Conclusion We have observed that BCC on the nasolabial fold, despite presenting with better clinical and histological features, needed more complicated surgery. In our opinion, this location warrants a particular attention and further prospective studies should be made to corroborate our findings. [ABSTRACT FROM AUTHOR]

Background Melanotic pigmentations in scars consecutive to the excision of melanocytic tumours can be secondary to a reactive phenomenon related to the scar tissue or to a recurrence of the melanocytic lesion excised in the first case. Recurrent naevi may sometimes adopt unusual features that make them difficult to differentiate from a melanoma. Objectives To describe the clinical, dermoscopic and histological features of melanotic pigmentations in scars consecutive to the excision of melanocytic tumours, and to correlate the histological diagnosis with the dermoscopic features. Methods This was a prospective cohort study using macrophotography, dermoscopy and histopathological study. Ninety-five melanotic pigmentations (77 patients) in scars secondary to the excision of melanocytic tumours were prospectively collected in the Department of Dermatology at the Instituto Valenciano de Oncología in Valencia, Spain. Histopathological study was performed in 57 scars. Results Thirteen dermoscopic structures were identified. Four criteria allowed a differentiation between reactive and specific melanocytic pigmentations. Presence of globules and presence of heterogeneous pigmentation were features associated with specific melanocytic pigmentations ( P < 0.0001). Presence of a regular network and presence of streaks were more frequently found in reactive pigmentations ( P = 0.023 and 0.026, respectively). Conclusions Dermoscopic examination of melanotic pigmentations in excision scars of melanocytic tumours provides useful information about the origin of that pigmentation. Based on such information, recurrent naevi can be differentiated from reactive pigmentations in most cases. Excision and histopathological diagnosis continue to be imperative in some cases of recurrent naevi with atypical clinical features. [ABSTRACT FROM AUTHOR]

Background The association of melanoma with HLA class II loci is under extensive debate. Different investigators have found discrepant results due to, at least in part, sample size, patient series heterogeneity, choice of control population and differences in the techniques employed for the detection of HLA antigens and alleles. Objectives This study was designed to analyse the possible association of melanoma with HLA class II loci with regard to different clinic pathological factors and to investigate other risk factors for melanoma susceptibility, such as HLA homozygosity. Patients and methods HLA-DRB1, -DQA1 and -DQB1 genotyping was performed for 117 eastern Spanish patients presenting with primary melanoma. Results Although there were no significant alterations in the phenotypic frequencies of HLA-DQA1, -DQB1 or -DRB1 alleles in any subgroup of patients when compared with controls, patients exhibited a statistically significant increase in HLA-DQA1 homozygosity rate. This DQA1 homozygosity-specific association was particularly dependent on some features in melanoma patients such as light hair colour, skin type I or II, early age at diagnosis, absence of atypical naevi, or abscence of atypical naevus syndrome phenotype (aetiological fractions about 10-20%). Analysis of homozygosity for single DQA1 alleles showed an increased homozygosity rate for DQA1*0505 and DQA1*0301 in comparison with controls. These DQA1 alleles are in strong linkage disequilibrium with DQB1*0301 in white populations, and DQB1*0301 homozygous individuals were significantly increased in red in or fair-haired patients (relative risk 5.65). Conclusions Our results indicate that the contribution of HLA class II alleles to primary melanoma incidence is not significant in the Spanish population. However, homozygosity for the HLA-DQA1 locus (and, perhaps, for the HLA-DQB1*0301 allele) might be considered a potential risk factor for developing melanoma depending on the person's genetic background and, perhaps, on certain environmental conditions. [ABSTRACT FROM AUTHOR]

Videomicroscopy has been found to be useful in determining the depth of ectasia of vascular malformations. Different patterns that hypothetically could predict the response of a vascular malformation to pulsed dye laser have been described. Our purpose was to determine if the dermoscopy pattern was able to predict the response to pulsed dye laser therapy and if it was independent of other known clinical variables. Thirty-three consecutive children presenting for evaluation or treatment of vascular malformations underwent videomicroscopy previous to pulsed dye laser therapy. Sixty-nine representative areas were evaluated before and after laser therapy. Other clinical factors, including location of the malformation, the patient's age and sex, and previous therapy, were also included in the analysis. We found that the dermoscopy pattern was differently distributed depending on the anatomic area. A superficial pattern was not present in the centrofacial area. An undefined pattern was most often present when a previously treated area was imaged. A superficial pattern independently predicted a good response to laser. The location of the lesion was another independent factor influencing the outcome. A new pattern consisting of a pale circular area surrounding a central brownish dot is described as negatively influencing the response to laser therapy. We concluded that videomicroscopy is a good tool for assessing which vascular malformations can be adequately treated with laser therapy, although other anatomic factors can influence the response. Videomicroscopy is particularly helpful in deciding when to end the treatment because it objectively shows when no further response can be expected, and is helpful for demonstrating this to patients and their parents. [ABSTRACT FROM AUTHOR]

Xeroderma pigmentosum (XP) is an autosomal recessive disease in which patients have a 1000-fold increased risk of developing cutaneous neoplasms. Management of patients with XP is a difficult therapeutic challenge as they usually present with many cutaneous malignancies and continue to form skin tumours at a high rate. We describe a 19-year-old woman with XP who had been previously treated with many different therapeutic approaches. She had an excellent clinical response of her multiple small pigmented basal cell carcinomas and pigmentary changes using imiquimod 5% cream with only minor side-effects. [ABSTRACT FROM AUTHOR]

Eosinophilic folliculitis ( EF) is an idiopathic dermatitis included in the spectrum of eosinophilic pustular follicular reactions. Demodex folliculorum has been implicated as contributing to the pathogenesis of human immunodeficiency virus-associated EF, but it has not been described outside this context. We present an immunocompetent 65-year-old white man with a 5-year history of recurrent pruritic erythematous and oedematous lesions on his face, neck and scalp. Histopathologically, an eosinophilic microabcess with Demodex folliculorum mite within a pilosebaceous follicle was seen, and considered the causal agent. There were also accumulations of eosinophil granules on collagen bundles, and flame figure formations in the dermis. We believe that 'eosinophilic follicular reaction' is an appropriate term to describe this case of EF induced by D. folliculorum and thus distinguish it from the idiopathic form of EF. Moreover, this case suggests that D. folliculorum can sometimes induce an eosinophilic immune reaction. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Growth rate as a prognostic factor in localized invasive cutaneous melanoma," by Tejera-Vaquerizo A. and colleagues in the 2010 issue.

A letter to the editor is presented regarding the dermoscopic findings of a pigmented basal cell carcinoma and a melanoma.

Prurigo pigmentosa is a rare inflammatory disease of unknown origin, first reported from Japan, with only 33 cases described in non-Japanese patients. We describe a 13-year-old girl with a pruriginous symmetrical eruption of papules and vesicles affecting her back, neck and chest of 1 month duration. She remembered a similar, but lighter eruption, 2 months before. As the initial diagnosis was of a vesiculobullous form of Darier disease, treatment with isotretinoin 40 mg/day was started with good response. Histological study showed a superficial perivascular and interstitial dermatitis composed predominantly of lymphocytes. The epidermis was spongiotic, with exocytosis of lymphocytes and some neutrophils and necrotic keratinocytes. All these findings were consistent with prurigo pigmentosa. The lesions resolved leaving a light brown reticulate hyperpigmentation. Prurigo pigmentosa has never been reported in prepubescent patients, the vesiculobullous forms are unusual, and the only treatments used previously are sulphonamides, tetracyclines and macrolides. We report a 13-year-old Caucasian girl with vesiculobullous prurigo pigmentosa successfully treated with isotretinoin. [ABSTRACT FROM AUTHOR]

A 60-year-old woman presented with a pigmented lesion on the upper left gingival mucosa of 2 years duration. The lesion was in an area where a dental metallic prosthesis had been inserted into a nearby tooth several years earlier. A biopsy of the affected mucosa showed aggregates of pigmented granules varying in size in the dermis, extracellular matrix and within macrophages; these did not stain with melanin stains. The diagnosis was consistent with an amalgam tattoo. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented that discusses the medical condition of lentiginous melanoma.

The article presents a case study of a 22 year old woman presented with an asymptomatic lesion on the retroauricular area which had appeared some months before. Topics discussed include dermoscopic evaluation using contact polarized dermoscopy without liquid interface revealing telangiectatic vessels traversing lesion, combination of dermoscopic structures being observed in the case of adamantinoid trichoblastoma (AT), arborizing telangiectasia, dotted vessels and glomerular vessels observed.

A letter to the editor is presented in response to the article "Reticular telangiectatic erythema: a reactive clinicopathological entity related to the presence of foreign body," in the previous issue.

The author comments on a research article "Dermoscopy-guided surgery in basal cell carcinoma" by G. Caresana and others, which appeared in the 2010 issue of "Journal of the European Academy of Dermatology." Topics discussed include role of surgical excision for treatment of basal cell carcinoma, use of dermoscopy, a non-invasive method, for skin examination and importance of cooperation between dermatologists and radiation oncologists.

A letter to the editor is presented regarding the clinical and pathological findings of granuloma faciale, a non-conventional leucocytoclastic vasculitis with lesions arising usually on the face, published in the previous issue.

This article presents case study of a 20 year old male employed in the laboratory of a plastic paint factory. He met with an occupational accident in which a container of 100% 1, 6-hexanediol diacrylate split over his right thigh, soaking his trousers. It took him 15 minutes to take them off and wash himself properly. At the time, he noticed no discomfort or lesions on the skin. After 12 days, he felt a burning sensation, then itching and some tiny lesions on the inner anterior aspect of the right thigh, the inner aspect of the knee and a few scattered on the left thigh. The lesions on the right thigh quickly evolved into erythematoedermatous plaque with well-defined edges. The lesions completely resolved with a 0.1% betamethasone dipropionate cream.