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Mohs micrographic surgery (MMS) is a good treatment option for epithelial neoplasms, especially when localized in areas where tissue conservation is crucial, such as the nail unit (NU). MMS is a method of radical excision offering high cure rates due to the margin control and functional preservation. Our aim is to provide a review on the use of MMS for the treatment of the most common nail tumours. We revised the current literature on the use of MMS to treat malignant neoplasms (Bowen's disease, squamous cell carcinoma, melanoma, basal cell carcinoma, keratoacanthoma, carcinoma cuniculatum) and benign neoplasms (onychomatricoma and glomus tumour). MMS represents a successful surgical option for nail tumours, firstly in terms of tissue conservation: the NU anatomy is complex and the preservation of the component structures is imperative for its functionality. Secondly, due to the surgical radicality, which is essential not only for the clearing of malignant tumours, but also for benign cases, in order to reduce recurrences. Although a conservative treatment of NU melanoma with MMS has been proposed, in our experience, the conservative approach with functional surgery is a good option for the treatment of non‐invasive melanoma (in situ and Ia). [ABSTRACT FROM AUTHOR]

Background Melanocytic naevi located in special sites, such as the vulvar mucosa might present peculiar clinical and dermatoscopic features. Objectives We describe a management proposal of a genital naevus associated with inflammatory disorders that aims to facilitate the clinical and pathologic diagnosis. Methods Videodermoscopy of a genital naevus associated with lichen sclerosus of an 8-year-old girl, was carried out before and 2 months after treatment with topical steroids. An excisional biopsy and immunohistochemical studies with HMB-45, MART -1 and molecular studies with p 16 staining were performed. Results The features of the melanocytic lesion associated with lichen sclerosus were troublesome on the basis of clinical and videodermoscopic evaluation. Histopathologic and immunohistochemical examination performed after topical treatment, showed a compound melanocytic naevus with an underlying inflammation consistent with lichen sclerosus. Conclusions The evaluation of genital naevi should take into account the presence of inflammatory disorders, not uncommon in such location. Treatment of the latter and short follow-up of the patients, can avoid over-diagnosis of malignancies and extensive surgical procedures. [ABSTRACT FROM AUTHOR]

The article discusses a study related to evaluation of the presence of human papillomavirus (HPV) in squamous cell carcinoma (SCC) of the scalp using HPV amplification and detection methods. Topics discussed include aetiological correlation between HPV types such as HPV-16 and HPV-18 with types of anogenital carcinoma, cervical cancer and oropharyngeal papillomatosis, frequent ultraviolet radiation (UVR) exposure and sunburns due to tanning, and increased risk of premalignant lesion.

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. [ABSTRACT FROM AUTHOR]

Axillary granular parakeratosis (GP) was first described in 1991 as a peculiar eruption presenting with erythematous hyperpigmented and hyperkeratotic papules and plaques of the cutaneous folds frequently associated with pruritus. Histopathology shows a characteristic picture with a conspicuous granular appearance of the parakeratotic horny layer. Until now, only 24 adults, mainly women aged over 40 years, have been reported with GP. We demonstrate that this condition can also occur in young children. Four children aged between 10 and 24 months had asymptomatic hyperpigmented scaling papules 2-3 mm in diameter located on the groin, lower back, buttocks and flanks. In all cases the mothers reported the habit of frequent washing followed by application of many topical products. Biopsy revealed the same features in all four patients: the epidermis showed a thickened horny layer with a unique compact parakeratosis with maintenance of the stratum granulosum and marked retention of keratohyaline granules throughout the stratum corneum. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the detection of human papillomavirus (HPV) genotypes in specimens of BRAF inhibitor-associated verrucous keratosis (BAVK) obtained from patients who received vemurafenib. Topics discussed include the cofactors that may play a role in the pathogenesis of BAVKs. The need to conduct larger studies that investigate the presence of other subtypes of HPV is also cited.

Linked Article: Longo et al. Br J Dermatol 2019; 180:1473–1480. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on use of Mohs micrographic surgery for treatment of lentigo maligna.