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Background: Targeted therapies in melanoma have shown clinical benefit in incrementing the overall survival of metastatic patients. However, cutaneous adverse events have been frequently associated with these drugs., Methods: We report our experience in the management of patients treated with dabrafenib for metastatic melanoma, focusing on the monitoring of pigmented lesions. Dermatologic evaluation was performed during the first visit, at the start of each treatment and subsequently after every four weeks. Global nevi count, videodermoscopy of suspected lesions, and surgical excisions when necessary were performed at the beginning of the treatment and every fourth week. All other cutaneous adverse events (cAEs) were noted and documented. Eleven patients were included., Results: The most important cAEs included palmo-plantar hyperkeratosis, diffuse xerosis and pigmented lesion changes. Regarding the latter, in 6 patients, especially in the first months of treatment, we observed hyperpigmentation and hyperkeratosis of the nevi, of the pigmented mucosae and, in one patient, hyperkeratotic changes on a cutaneous metastasis. Histopathology of the excised lesions showed one ex novo melanoma occurrence and benign changes to pre-existing nevi., Conclusions: The awareness of the importance of sequential monitoring of pigmented lesions, with particular attention to the lesions of new onset, is crucial for the best management of these complex patients.

Background: The prognosis of cutaneous melanoma is correlated to histopathologic parameters such as Breslow thickness, the presence of mitosis, ulceration and lymphatic involvement at the moment of the diagnosis. On the other hand, the prognostic value of parameters such as age, sex, and tumor localization are still a matter of debate. We evaluated herein the prognostic factors in melanoma patients during a long-term follow-up (60 months)., Methods: Melanoma patients presenting stage IB-III at diagnosis were included. Breslow thickness, ulceration, lymphatic involvement, patients' age, sex and tumor localization were correlated to patients' prognosis. Univariate Cox regressions and multivariate Cox proportional-hazards regression were performed. Successively, Kaplan-Meier was used for variables significantly associated with overall melanoma survival., Results: A total of 115 melanoma patients were included in this study. During follow-up 82 (72.17%) patients survived and 33 (28.7%) died. In our dataset, Breslow thickness >2 mm (P=0.0007), patients age >50 years (P=0.005) and positive sentinel lymph node (P=0.0003) seem to be the most important variables correlated with the presence of metastases at 5 years follow-up. However distant metastases were also observed during follow-up in 14/26 patients presenting negative sentinel lymph node at diagnosis., Conclusions: Given the vital importance of target drugs and the newly introduced immunotherapies in cutaneous melanoma management, we would suggest that mutational analyses should also be extended to the subgroup of patients presenting microstaging parameters related to a poor prognosis in a long-term follow-up of 60 months.

The melanoma of the genital mucosa is a rare melanocytic neoplasm that affects both sexes. The diagnosis is often delayed; videodermatoscopy may represent a useful diagnostic tool. The treatment is complex and multidisciplinary. We report the main diagnostic features and therapeutic approaches for mucosal melanoma of the genital tract.

Granuloma annulare (GA) is a self-limited benign inflammatory dermatosis of unknown origin characterized by the development of papules arranged in an annular, circinate pattern, mainly involving the extensor surfaces of lower and upper extremities. The diagnosis depends on clinical and histological features. There are four main variants of GA: localized GA (LGA), subcutaneous GA (SGA), generalized GA (GGA) and perforating GA (PGA) and 2 uncommon subtypes: papular umbilicated GA and linear or segmental GA. Children most commonly present with the localized and subcutaneous forms. The aim of this review was to provide an update on the etiology, diagnosis and management of GA focusing on the pediatric age.

Aim: Pediatric inflammatory vulvitis (PIV) is clinically characterized by itching, soreness and inflammation and can be due to both an infective process and a non-specific irritative process, especially in atopic patients. Sometimes these non-specific PIVs, that tend to be recurrent, can be overinfected, with exacerbation of the clinical features. The importance of the cleansers, emollients, and the kind of textiles that enter in direct contact all day long with the inflamed skin, is well known. The study objective is the evaluation of the safety and efficacy of the transpiring, slightly elastic knitted silk briefs, with anti-bacterial and non-irritating properties, registered as Dermasilk®, in recurrent PIV., Methods: The study we conducted was a prospective cohort study of 12 pre-pubertal girls, aged between 2 and 10 years, affected by recurrent PIV, that used Dermasilk® briefs in association to conventional treatments., Results: Dermasilk® briefs have proven to be an effective and safe adjuvant product available for use in association with conventional drugs for the treatment of recurrent PIV., Conclusion: Dermasilk® briefs play an important role in the management of the flares of recurrent PIV, proven by an earlier resolution of symptoms, as well as in the maintenance of the remission and in the prevention of overinfections.

Aim: The aim of this study was to investigate the effect of sunlight during summer holidays and to assess the seasonability of atopic dermatitis in 43 consecutive patients with mild-moderate atopic dermatitis referring to the Pediatric Outpatient Clinic of the University of Bologna., Methods: Patients had to answer an open questionnaire., Results: The collected data showed that 74.4% of the patients affected by mild-moderate atopic dermatitis had complete resolution during summer holidays, 16.3% had improvement and only 9.3% had no modification of atopic dermatitis severity, confirming the seasonability of the disease, with improvement during summertime and worsening in the other seasons. Seaside holidays produced a significantly greater improvement than mountains holidays, with complete resolution of the disease in 91.2% versus 11.1% of patients, P<0.01. Conclusion. These data support the hypothesis on the positive effect of UV radiation on atopic dermatitis in patients without eczema after local therapy with corticosteroids or immunomodulators, but are in contrast with those reported by other authors from Northern Europe. This discrepancy is probably due to the latitude and different climate. In the Mediterranean area and in southern locations greater improvements are observable.