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Competing Interests: Conflicts of interest the authors declare they have no conflicts of interest.

Background: A number of mutations related to malignant melanoma (MM) have been identified, and of the mutated genes, BRAF has been found to be altered in > 50% of cases. Most of these have been BRAF V600E mutations, whereas the incidence of BRAF V600K may vary from 10% to 30%. Little is known about the clinical prognostic correlations of BRAF V600K MMs. We evaluated the clinical and dermoscopic features, incidence, therapy response and outcomes in the medium to long term., Aim: To compare the clinical and dermoscopic characteristics, the response to systemic therapies and the prognosis among MMs with BRAF V600E and BRAF V600K mutations., Methods: We retrieved the data of patients tested in our centre for MM from 2012 to 2015, including clinical features, dermoscopic pictures, clinical history and tumour mutations. Only patients with BRAF V600E and BRAF V600K mutations were included. Any MMs positive for BRAF V600K mutation were collected, and the number of V600K cases and their features were used to extract the same number of patients with BRAF V600E from our database using a matching method. The clinical and dermoscopic presentation, therapy response and disease progression of the two groups were then evaluated., Results: In total, 132 cases of BRAF V600E-mutated MMs were identified, and then randomized with a propensity-score method to match the 10 retrieved cases of BRAF V600K mutation. Both groups had a nodular appearance to the tumours and an advanced disease stage, and no significant differences in dermoscopic features were highlighted. During the follow-up period, four patients with BRAF V600K died of disease-specific causes. Moreover, we found a higher frequency of metastasis, a faster disease progression and more rapid mortality in patients with BRAF V600K., Conclusion: Despite the small size of this study, the results show similar clinical and dermoscopic characteristics between V600E and V600K mutations, but compared with BRAF V600E MMs, BRAF V600K MMs seem to be less responsive to therapy and have a worse prognosis., (© 2022 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)

Objectives: Malignant acral melanoma (AM) is relatively infrequent in white patients. Molecular investigations have returned variable results regarding the mutational pattern. We sought to describe the mutation profile and clinicopathologic features of AM., Methods: We investigated BRAF, KIT, and NRAS mutational status in a series of 31 AM samples from white patients., Results: Nodular melanoma was the most common histopathologic subtype (48.4%), followed by acral lentiginous melanoma (25.8%) and superficial spreading melanoma (25.8%). BRAF, KIT, and NRAS mutational rates were 12.9%, 17.2%, and 30.0%, respectively. We observed significant associations between KIT mutational status and a thinner Breslow thickness compared with wild-type (WT) status (P = .002), NRAS mutation status and younger age compared with WT. In patients presenting at least one mutation, triple-WT patients presented metastases most frequently., Conclusions: Although these data represent preliminary results, better knowledge of tumor biology and prognosis of AM can support the clinical approach and follow-up., (© American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: The extension of atypical melanocytes to the hair follicle, also termed melanoma folliculotropism, is poorly evaluated and its role is contradictory. We performed an observational study focusing on anatomical areas rich in follicles, such as the head and neck region., Methods: Primary head and neck melanomas diagnosed in the Melanoma Unit, Policlinic Sant'Orsola-Malpighi, University of Bologna were analyzed. Folliculotropism was evaluated with a quantitative and morphologic parameter. Statistical analyses were performed correlating patients' prognosis with folliculotropism and other clinical and histopathologic factors., Results: The study was carried out on a sample of 62 patients. The diffuse distribution (atypical melanocytes present in more than three contiguous follicular units) correlated with scalp localization, nodular subtype, higher Breslow thickness, and a poorer prognosis., Conclusions: We believe that folliculotropism should be further investigated and reported by pathologists during the histologic diagnosis of melanoma., (© American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The literature still lacks comprehensive assessments on the features of neonatal hair and scalp characteristics., Objectives: To evaluate the clinical and dermoscopic features of scalp hair in newborns, including measurement of hair density, length and diameter., Methods: Forty-five newborns were recruited for the study. For each patient, data regarding sex, age at consultation, delivery method, gestational age and maternal age at delivery were collected. A clinical score of hair density was created by investigators in order to divide the neonates into two groups: group 1 included neonates with poor and slightly poor hair density and group 2 included neonates with quite good and good hair density. Each patient underwent scalp videodermatoscopy., Results: Based on their clinical score, 15 newborns had good hair density, while 30 had poor hair density. Among the parameters evaluated by the investigators, only weight at birth significantly correlated with neonatal hair density. Two neonates presented a frontal-temporal pattern of hair loss. Videodermatoscopy revealed that nine neonates, all in the poor hair density group, had a particular hair shaft dermoscopic feature, characterized by the presence of widespread thin hair., Conclusion: On the basis of the results obtained from our study, we propose a new classification of transient neonatal hair loss. We have found two different hair types: 'neonatal type', rarely observed, that appears in the first 4 weeks of life with a frontal-temporal pattern; and 'classic type', more frequently observed, appearing at 8-12 weeks of life with a predominant occipital pattern., (© 2013 British Association of Dermatologists.)

Background: Subungual squamous cell carcinoma (SSCC) is the most common malignancy of the nail unit. Mohs micrographic surgery (MMS) is a microscopically controlled surgical technique that has a high cure rate for skin cancers despite allowing narrow surgical margins., Objective: To evaluate the long-term effectiveness of MMS in the treatment of SSCC, and in particular its ability to reduce the number of digital amputations., Methods: Fifteen patients diagnosed with SSCC were treated with MMS as the first-line surgical approach, and were followed up for between 2 and 5 years., Results: SSCC was completely excised in 13 patients, while two patients required amputation of the distal phalanx. For tumours with predominantly exophytic growth, clinical and radiological findings were found not to be reliable indicators of bone invasion. No recurrences were detected on follow-up., Conclusion: Our results show that MMS provides a high cure rate for SSCC and reduces the number of amputations needed. MMS should become the first-line surgical approach for SSCC., (© 2012 The Authors. BJD © 2012 British Association of Dermatologists.)