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SPCM specimen analysis by dermato-pathologists revealed four superficial spreading melanomas, including one invasive (Breslow thickness 0-3 mm) and three intraepidermal melanomas, which were subsequently surgically re-excised with lateral safety margins of 5 mm (for intraepidermal melanomas) or 10 mm (invasive melanoma). Second primary cutaneous melanoma in patients with advanced melanoma treated with anti-programmed-death-receptor-1 monoclonal antibodies Dear Editor, Cases of second primary cutaneous melanoma (SPCM), which were mostly BRAF-wildtype, have been reported in patients with BRAF-inhibitor-treated advanced cutaneous melanoma.1 Anti-programmed-death-receptor-1 (anti-PD-1) monoclonal antibodies (mAbs) nivolumab and pembrolizumab have also revolutionized the prognosis of these patients, but 10-15% of them experience grade 3-4 adverse events according to common terminology criteria for adverse events. [Extracted from the article]

Summary: Background: Genital psoriasis is often under‐recognized. Objectives: To assess the instantaneous prevalence of genital psoriasis and describe its clinical features, association with a particular subtype of psoriasis and its impact on general and sexual quality of life (QoL). Methods: GENIPSO is a prospective study conducted by private and hospital‐based dermatologists. This study featured the consecutive inclusion of patients consulting for extragenital psoriasis. The clinical features of psoriasis and genital psoriasis were recorded and QoL and sexual health questionnaires were distributed to patients. Results: Overall, 335 of 776 patients (43·2%) included in the study had genital involvement. All were aware that they had genital lesions but only 135 patients (40%) declared that they had been previously examined. Genital lesions were associated with male sex, severity of psoriasis, age of onset > 20 years, inverse psoriasis and involvement of scalp, nail and external auditory canal, but were not associated with obesity, psoriatic arthritis and active sex life. Itching was the main symptom. Genital psoriasis was associated with impairment of QoL and sexual health according to the Dermatology Life Quality Index and the Female Sexual Function Index. Conclusions: Genital psoriasis has a high prevalence in patients consulting for extragenital psoriasis, which affects QoL, and should be taken into account by dermatologists in order to optimize global care. What's already known about this topic? Genital psoriasis is frequent but under‐recognized. What does this study add? The instantaneous prevalence of genital psoriasis in patients consulting for extragenital psoriasis was 43·2%.All patients were aware of their genital psoriasis but only 40% declared having had a previous examination of the genital area by a dermatologist. What are the clinical implications of this work? Owing to its frequency and impact on general and sexual quality of life, genital psoriasis should be screened in all patients, including those already receiving treatment for psoriasis. Respond to this article Linked Comment:Ryan. Br J Dermatol 2019; 180:460–461. Plain language summary available online [ABSTRACT FROM AUTHOR]

Background Recent studies have independently implicated the chemokine CXCL12 and its receptors, CXCR4 and CXCR7, in the pathophysiology of Kaposi sarcoma ( KS). Objectives We investigated whether the CXCL12/ CXCR4- CXCR7 protein trio could constitute KS biomarkers. Methods Endothelial and spindle cells positive for CXCL12/ CXCR4- CXCR7, human herpesvirus-8 latency-associated nuclear antigen ( LANA), Ki67 antigen (proliferation) and vascular endothelial growth factor ( VEGF) were quantitated in skin lesions from patients with AIDS-associated KS, patients with classic KS and patients with angiomas, using immunohistochemistry and quantitative image analysis (16, 21 and 20 skin lesions, respectively). Plasma CXCL12 concentrations were measured by enzyme-linked immunosorbent assay from 20 patients with AIDS- KS, 12 HIV-infected patients without KS and 13 healthy donors' samples. Results Cells positive for CXCL12, CXCR4, CXCR7, LANA, Ki67 and VEGF were significantly enriched in patients with AIDS-associated KS and classic KS vs. angiomas ( P < 0·001), and in nodular vs. macular/papular KS lesions ( P < 0·05). CXCL12, CXCR4 and CXCR7 detection correlated with LANA, Ki67 and VEGF detection ( r > 0·4; P < 0·05). However, plasma CXCL12 concentrations did not differ between patients with AIDS-associated KS, HIV-infected patients without KS, and healthy donors. Conclusions The CXCL12/ CXCR4- CXCR7 trio is upregulated in KS and correlates with KS pathophysiological markers and the severity of skin lesions. Histological assessment of the CXCL12 axis could serve as a valuable biomarker for KS diagnosis and progression. [ABSTRACT FROM AUTHOR]

Competing Interests: Conflicts of interest C.L. declares financial interests with Amgen, Bristol Myers Squibb, Merck Serono, MSD, Novartis, Pierre Fabre and Roche.

Background: Corticosteroids (CS) with or without adjuvant immunosuppressant agents are standard treatment for pemphigus vulgaris (PV). The efficacy of adjuvant therapies in minimizing steroid-related adverse events (AEs) is unproven., Objectives: To utilize data collected in a French investigator-initiated, phase III, open-label, randomized controlled trial to demonstrate the efficacy and safety of rituximab and seek approval for its use in PV., Methods: This was an independently conducted post hoc analysis of the moderate-to-severe PV subset enrolled in the Ritux 3 study. Patients were randomized to rituximab plus 0·5 or 1·0 mg kg -1 per day prednisone tapered over 3 or 6 months, or 1·0 or 1·5 mg kg -1 per day prednisone alone tapered over 12 or 18 months, respectively (according to disease severity). The primary end point was complete remission at month 24 without CS (CRoff) for ≥ 2 months, and 24-month efficacy and safety results were also reported., Results: At month 24, 34 of 38 patients (90%) on rituximab plus prednisone achieved CRoff ≥ 2 months vs. 10 of 36 patients (28%) on prednisone alone. Median total cumulative prednisone dose was 5800 mg in the rituximab plus prednisone arm vs. 20 520 mg for prednisone alone. Eight of 36 patients (22%) who received prednisone alone withdrew from treatment owing to AEs; one rituximab-plus-prednisone patient withdrew due to pregnancy. Overall, 24 of 36 patients (67%) on prednisone alone experienced a grade 3/4 CS-related AE vs. 13 of 38 patients (34%) on rituximab plus prednisone., Conclusions: In patients with moderate-to-severe PV, rituximab plus short-term prednisone was more effective than prednisone alone. Patients treated with rituximab had less CS exposure and were less likely to experience severe or life-threatening CS-related AEs. What's already known about this topic? Pemphigus vulgaris (PV) is the most common type of pemphigus. Corticosteroids, a standard first-line treatment for PV, have significant side-effects. Although their effects are unproven, adjuvant corticosteroid-sparing agents are routinely used to minimize steroid exposure and corticosteroid-related side-effects. There is evidence that the anti-CD20 antibody rituximab is effective in the treatment of patients with severe recalcitrant pemphigus and in patients with newly diagnosed pemphigus. What does this study add? This study provides a more detailed analysis of patients with PV enrolled in an investigator-initiated trial. Rituximab plus prednisone had a steroid-sparing effect and more patients achieved complete remission off prednisone. Fewer patients experienced grade 3 or grade 4 steroid-related adverse events than those on prednisone alone. This collaboration between academia and industry, utilizing independent post hoc analyses, led to regulatory authority approvals of rituximab in moderate-to-severe PV., (© 2019 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)