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Background: The dermoscopic features of classic patch stage mycosis fungoides (MF) have been described, but data on plaque and tumoral stage as well as rarer MF subtypes is limited. Objective: To evaluate dermoscopic morphology and dermoscopic‐pathological correlations of classic MF stages and investigate dermoscopic features of MF variants. Methods: Patients with histopathologically confirmed lesions of classic MF (patch, plaque and tumoral stage) or folliculotropic, erythrodermic and poikilodermatous MF were included. Standardized evaluation of dermoscopic pictures of the included MF variants and comparative analysis and dermoscopic‐pathological correlation assessment of different stages of classic MF were performed. Results: A total of 118 instances were included (75 classic MF, 26 folliculotropic MF, 9 erythrodermic MF and 8 poikilodermatous MF). Linear/linear‐curved vessels and white scales in the skin furrows were significantly associated with patch‐stage MF, while clustered dotted vessels were related to plaque‐stage MF and peripheral linear vessels with branches, ulceration and red globules separated by white lines to tumour‐stage MF. Moreover, patchy white scales were significantly more common in patches and plaques compared to tumours, whereas focal bright white structureless areas were related to plaque and tumoral stage. Vessels histopathologically corresponded to dilated vascular structures in the dermis, orange structureless areas to either dermal hemosiderin (patch/plaque stage) or dense cellular infiltration (tumours), bright white lines/structureless areas to dermal fibrosis and ulceration to loss of epidermis. The main dermoscopic findings of folliculotropic MF were lack of hairs, dilated follicles and follicular plugs, while erythrodermic MF was mainly characterized by linear/dotted vessels, patchy white scales and focal orange structureless areas and poikilodermatous MF by focal white and brown structureless areas, white patchy scales and brown reticular lines. Conclusion: Dermoscopy may allow a more precise characterization of classic MF and reveal clues suggestive of the main MF variants. [ABSTRACT FROM AUTHOR]

One of the primary objectives of an education system is to prepare students for their adult lives by imparting them with the requisite knowledge, qualifications, and skills that will enable them to confront future challenges effectively. A whitepaper published by the Israeli Ministry of Education titled “The Graduate’s Image” stresses the importance of incorporating specific skills into the school curriculum. However, there is a lack of educational programs that can transform teaching skills into actual practice. In light of this conclusion, we developed the program “Chemistry, Climate & the Numbers in Between” to foster these skills and produce graduates with the ability to adopt a critical approach and a well-informed perspective toward the world. In this paper, we delineated the cognitive skills developed in the program. The results indicate that innovative program can be utilized to integrate several important skills into a chemistry lesson. The program has the potential to equip and empower future citizens to address and tackle global challenges while utilizing cognitive skills using chemistry knowledge. However, it is important to note that learning in this way requires much more time than a regular lesson does and requires a significant commitment and investment from the teacher.

Summary: Mucous membrane pemphigoid (MMP) is an autoimmune blistering, scarring and occasionally mutilating disease that may progress to blindness or airway obstruction. Over the past few years, rituximab (RTX) has emerged as a potential therapeutic solution for MMP; however, the literature regarding its efficacy in the treatment of severe MMP is sparse. We studied four patients with recalcitrant MMP who were treated with RTX. Three of these had recalcitrant laryngeal disease; two were unresponsive to RTX, while the third patient achieved complete remission (CR) but relapsed twice. The fourth patient, who had oral and ocular disease, also achieved CR. In addition, we reviewed 143 cases of MMP treated with RTX reported in the literature to date. Of these, 120 had late observation endpoints, of whom 81 (67.5%) achieved CR, 24 (20%) received partial remission and 15 (12.5%) had no remission. Based on this study, the presence of laryngeal MMP seems to predict refractoriness to RTX treatment. In conclusion, we found that RTX can ameliorate the MMP course and that laryngeal involvement, which is known to be a prognostic factor for severe MMP, may also predict poor response to RTX. [ABSTRACT FROM AUTHOR]

Dermoscopy of primary cutaneous B- and T-cell lymphomas and pseudolymphomas presenting as solitary nodules and tumors: a case-control study with histopathologic correlation. Patient 1 was a 65-year-old man, who presented with a 4-month history of asymptomatic nodules and plaques, 5-50 mm in diameter, with a bruise-like aspect on his upper trunk (Fig. Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare haematopoietic neoplasm originating from plasmacytoid dendritic cell precursors, and typically follows a very aggressive clinical course.1,2 Data on the role of dermoscopy in the diagnosis of lymphoproliferative disorders are expanding, with reports of dermoscopic features of specific cutaneous lymphoma subtypes.3 We report the dermoscopic features of BPDNC in two patients. [Extracted from the article]

Background: Whole-body imaging is the current standard of care for staging all patients presenting with skin lesions of B-cell lymphomas (BCLs), regardless of skin disease extent; however, supporting data are lacking.Objective: To determine the clinical utility of imaging in the detection of systemic involvement in low-grade cutaneous BCLs in the skin.Methods: Retrospective cohort analysis of patients presenting with cutaneous lesions of BCLs at Memorial Sloan Kettering Cancer Center and Stanford University during 1997-2016.Results: At initial staging, of the 522 patients, extracutaneous disease was noted in 3.6% and 8.8% of patients with marginal zone lymphoma (MZL, n = 306) and follicle center lymphoma (FCL, n = 216) histology, respectively. In patients with systemic involvement, imaging alone identified 81.8% (9/11) of MZL cases and 89.4% of follicular lymphoma cases. In primary cutaneous MZL, 1.7% of patients subsequently had extracutaneous involvement (median follow-up 45 months), and in primary cutaneous FCL. 3.0% subsequently had extracutaneous involvement (median follow-up 47 months).Limitations: This was a retrospective study.Conclusion: Imaging is effective at identifying patients with systemic involvement in indolent BCLs present in the skin; however, incidence is low. After negative initial staging, primary cutaneous MZL patients may be followed clinically without routine imaging. [ABSTRACT FROM AUTHOR]

Summary: Grover disease (GD) is an idiopathic dermatosis that typically manifests as itchy papules over the trunk in middle‐aged men. Bullous pemphigoid (BP) is an autoimmune bullous disease that affects older people. Not only are the two diseases easily distinguishable on clinical grounds, they are also characterized by differences in histopathology, pathogenesis and response to treatment Thus, the co‐occurrence of these two conditions in the same patient is usually considered coincidental. In this report, we present a multicentre retrospective analysis of six patients who developed both GD and BP over a short period of time, and in all cases but one, GD preceded BP. We discuss the clinical and histopathological features of these patients, and the suggested mechanisms of the diseases. We conclude that GD might predispose to the development of BP. [ABSTRACT FROM AUTHOR]

Background: Advanced age at diagnosis is considered a poor prognostic factor in mycosis fungoides (MF) and Sézary syndrome (SS). Objective: To evaluate the outcomes and prognostic factors in patients diagnosed at an advanced age (≥65 years) with MF/SS. Methods: Survival, progression rates and various clinical and histopathological variables were studied in a group of 174 elderly patients diagnosed with MF/SS between 1992 and 2015 at a single referral cancer center in the United States. Kaplan–Meier estimates were used to determine survival and progression and Cox proportional hazards regression univariate and multivariate models were used to identify prognostic factors. Results: Of 174 elderly patients, 76.4% were diagnosed with early‐stage (clinical stages IA‐IIA) and 23.6% with late‐stage MF/SS (IIB‐IV). Advanced age was associated with poor overall survival, but not with disease‐specific survival (DSS) or progression‐free survival (PFS). Gender, increasing clinical stage, T and B classifications, elevated lactate dehydrogenase (LDH) levels and development of large cell transformation (LCT) were significant predictors of poor survival or disease progression. Patients with early‐stage MF and <10% total skin involvement (T1 classification) or patch‐only disease (T1a/T2a) showed better PFS with no observed disease‐specific mortality. Folliculotropic MF was associated with poor DSS in patients with early‐stage disease. Conclusions: Older age at diagnosis of MF/SS does not predict worse disease‐specific outcomes. Elderly patients with early‐stage disease, specifically involving less than 10% of the skin surface with patches but without plaques or folliculotropism, have an excellent prognosis. However, the development of LCT is a strong prognostic indicator of poor survival in elderly patients with MF/SS. [ABSTRACT FROM AUTHOR]

Summary: Follicular mucinosis (FM) can present as an acneiform eruption, and is usually a benign variant of primary FM unrelated to cutaneous T‐cell lymphoma (CTCL). We report two cases of women in their twenties who presented with an acneiform rash on the face, arms and back. In both cases, pathological evaluation of the facial papules revealed predominantly mucinous degeneration of the follicular epithelium, with insufficient lymphocytic infiltration or atypia to diagnose mycosis fungoides. These cases are similar to previous reports of acneiform FM. As none of the reported cases progressed to CTCL, we consider that overdiagnosis and overtreatment should be avoided in acneiform FM, but recommend long‐term follow‐up. [ABSTRACT FROM AUTHOR]