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Subcorneal hematoma is a pigmented skin lesion usually occurring on palms or soles after a trauma or sport activity. Clinically, it may exhibit overlapping features with acral melanoma or acral melanocytic nevi, leading to unnecessary excision of this otherwise harmless skin lesion. The objective was to describe the dermoscopic features in a series of subcorneal hematomas. Dermoscopic images of 15 subcorneal hematomas were evaluated for the presence of different colors and dermoscopic structures. In our series, a red-black hue was the most frequent color seen by dermoscopy (40% of the lesions) and a homogeneous pattern of pigmentation was the most frequent dermoscopic structure (53.3%). Remarkably, 40% of the lesions exhibited a parallel-ridge pattern that is usually found in early melanoma of palms and soles. In 46.7% of the lesions, red-black globules were additionally seen at the periphery as satellites disconnected from the lesion's body. Only two lesions showed either parallel-furrow or fibrillar pattern. A scratch test performed in four lesions, allowed complete or partial removal of the pigmentation. Dermoscopic features of subcorneal hematomas may be similar to those observed in acral melanocytic lesions. Nevertheless, in most cases the correct diagnosis can be facilitated by the presence of a red-black homogeneous pigmentation, often combined with satellite globules. A positive scratch test may be considered as an additional diagnostic clue. IRIS ZALAUDEK, MD, GIUSEPPE ARGENZIANO, MD, H. PETER SOYER, MD, JEAN-HILAIRE SAURAT, MD, AND RALPH P. BRAUN, MD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]

We examined a combined (dermoscopic–pathological) approach to the telediagnosis of melanocytic skin lesions. A store-and-forward teleconsultation was simulated. Dermoscopic and histopathology images from 12 melanocytic lesions were stored in a telepathology workstation. A dermoscopy consultant, a histopathology consultant and an expert in dermoscopic–pathological correlation gave their diagnoses and comments on the images. The consensus diagnosis between two teleconsultants on the original histological slides was regarded as the gold standard. The diagnostic accuracy was 83% (including one false negative diagnosis of malignancy) for teledermoscopy and 100% for teledermatopathology. The combined approach detected one case that showed a much greater atypia on dermoscopy than on histopathology. In this case step-sections of the sample were deemed to be required for definite diagnosis. The combined approach was helpful in detecting macroscopic and microscope sampling errors of melanocytic lesions during teleconsultation. [ABSTRACT FROM AUTHOR]

The article discusses a study on the significance of dermoscopy in the treatment of rosacea, a skin condition. Researchers state that the non-invasive microscopic examination of skin lesions leads to additional data for the therapy as it provides visualization of the vessels utilizing the Dermlite Foto Equipment. Several images of erythematotelangiectatic rosacea including its vascular pattern are also presented.

The development of new primary melanomas in patients treated with vemurafenib has been reported recently in a study by Perier-Muzet et al. The primary outcome of the study was to describe the dermoscopic changes that prompted excision of those melanomas. However, the crucial point raised by the study is the large number of melanomas that were detected. [ABSTRACT FROM AUTHOR]

The syndrome of Birt-Hogg-Dube´ BHD is an autosomal dominant syndrome. characterized by a triad oicuianeous lessons including multiple fibrofolliculomas, trichodiscomas, and acrochordons. There are many clinical expressions, solitary and multiple forms, with or without other skin tumors. In the literature BHD syndrome has been associated with internal malignancy. We describe a patient with multiple firm, skin-colored papules in which the three types of lesion are documented. No signs of systemic disease were present. [ABSTRACT FROM AUTHOR]

Several combinations of different skin tumors occuring one adjacent to the other or even in a single lesion have been described up to date. Collision tumors involving atypical fibroxanthoma and melanoma are extremely uncommon. Herein we present a case of melanoma associated with AFX and discuss on the usefulness of dermoscopy in the clinical diagnosis of collision tumors. [ABSTRACT FROM AUTHOR]

One of the emerging and intriguing applications of reflectance confocal microscopy is the evaluation of 'dynamic' processes of the skin that cannot be otherwise analysed using histopathology that offers a picture of the tissue at one time point. This is nicely illustrated by recent article by Wolberink et al. in the current issue of Exp Dermatol, in which the Authors evaluated patterns and time interval of polymorphonuclear neutrophil ( PMN) migration in psoriatic plaques by means of reflectance confocal microscopy ( RCM). This example underscores that a new era of confocal microscopy is starting, which promises to reveal a dynamic in vivo understanding of the pathophysiology of human skin diseases. [ABSTRACT FROM AUTHOR]

This article discusses a dermatological condition called annular lichenoid dermatitis of youth (ALDY), which primarily affects young individuals and commonly appears on the groin and flanks. ALDY is often misdiagnosed due to its similarity to other dermatoses, leading to delays in diagnosis and treatment. This study aimed to characterize the dermoscopic findings of ALDY and compare them to other similar dermatoses. The main dermoscopic clue of ALDY was the presence of brown-grey dots, which were more common in hyperpigmented and hypopigmented lesions. However, the absence of this finding does not rule out ALDY. The study had limitations due to the rarity of ALDY and the small sample size. [Extracted from the article]

Discusses the case of a 77-year-old female patient diagnosed with porokeratosis using dermoscopy technique. Size of lesion; Cell characteristics; Characteristics of lesions.

Topical photodynamic therapy (PDT) is a non-invasive treatment modality frequently used in dermatology to treat superficial skin cancers but also some inflammatory or infectious dermatoses. PDT appears a more and more promising therapeutic option also for cutaneous lymphomas, either of T- or B-cell origin. It is a well-tolerated treatment and has excellent cosmetic outcomes, less side effects compared to other therapies (steroids, surgery, radiotherapy, and so on), no particular contraindications, and is easily repeatable in case of relapses. However, how PDT works in the treatment of cutaneous lymphoproliferative diseases is poorly understood and the literature data are still controversial. Further randomized, controlled clinical trials involving a greater number of patients and centers with a long follow-up are necessary to assess the efficacy of PDT and establish a unique standardized treatment protocol in relation to the lymphomatous disease and the type, thickness, and location of the lesions. [ABSTRACT FROM AUTHOR]

Skin, mental health and the central nervous system (CNS) are connected by a deep link. It is not only the aesthetic and sometimes the disfiguring aspects of dermatological conditions that can cause a severe psychological burden; also, different studies have shown how chronic skin-inflammatory diseases may influence the activity of the CNS and vice versa. Moreover, the skin and brain share a common embryogenic origin. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting the hair follicles of the apocrine regions. The main clinical features are nodules, abscesses, cysts, fistulae and disfiguring scars. Pain and stinking discharge from fistulae are often present. It is not surprising that the psychological burden associated with HS is frequently a challenge in dermatologists' daily routines. Patients often suffer from depression and anxiety, but also from substance abuse, psychotic and bipolar disorders and an increased suicide risk. The aim of this article is to review the main psychiatric disorders associated with HS and their pathophysiology. Research on Pubmed was conducted with the key words Hidradenitis suppurativa, psychiatric, depression, anxiety, bipolar, schizophrenia, abuse, suicidal. A high incidence of psychiatric disorders has been described in HS compared to controls. Hidradenitis suppurativa is not a rare disease, and acknowledging the HS psychological burden, psychiatric-associated diseases and associated biomolecular pathways will help dermatologists to better care for their patients. [ABSTRACT FROM AUTHOR]

Psoriasis is one of the commonest inflammatory skin diseases determining a very high impact on patients' quality of life and daily activities and relationships. Several biologic therapies have been approved through the years for the treatment of moderate‐to‐severe plaque psoriasis, and efficacy and safety profile have been analyzed in clinical trials. Ixekizumab is an immunoglobulin G subclass 4 monoclonal antibody that selectively targets and binds IL‐17A with high specificity and affinity. Inhibiting IL‐17A activity, ixekizumab reduces and turns down levels of inflammation, resulting in the clinical improvement of the disease. Long‐term efficacy and safety profile of ixekizumab have been investigated and reported in the UNCOVER trials, but in literature there are only few studies based on real life experience. We present the efficacy and safety profile of ixekizumab in a cohort of 779 patients affected by moderate‐to‐severe plaque psoriasis and treated with ixekizumab in 11 Italian dermatology hospitals, with a follow‐up of care until 192 weeks. [ABSTRACT FROM AUTHOR]

Objectives To assess the efficacy of the novel anti-IL-23 monoclonal antibody guselkumab in a real-life observational cohort of patients with early PsA. Methods We conducted an observational study on patients with early PsA followed by the joint dermatology-rheumatology clinics of two Italian centres starting therapy with guselkumab for severe skin involvement. Each patient was evaluated at baseline and every 24 weeks for one year, recording Disease Activity Index for PsA (DAPSA), PASI, VAS Pain, VAS Prutitus, Patient's Global Assessment (PtGA) and assessing DAPSA response. Results Twenty-four patients were recruited (16 women). The mean duration of skin disease was 12.5 years (CI 8; 17), but all patients had a shorter articular disease duration, 21.29 months (CI 15.9; 26.68). At baseline, all patients displayed a moderate cutaneous disease with a mean PASI of 15.2 (CI 11.7–18.6) and high disease activity, characterized by mean DAPSA of 26.84 (CI 22.49–31.19). An inflammatory low back pain was reported by five patients (20%) with a mean BASDAI 5.1 (CI 4,38–5,85) at baseline. The majority of guselkumab-treated patients (n  = 18; 75%) reached DAPSA remission or DAPSA low disease activity after six months. Seventeen out of 24 patients completed 12 months of treatment, 11 of them (65%) in low disease activity, six (35%) in remission. All patients with axial disease reported improvement of inflammatory low back pain at week 24 with a mean BASDAI 2.98 (CI 2,18– 3,77). No significant side effects were reported. Conclusions Real-life data on a cohort of early PsA patients confirm the efficacy and safety of guselkumab on peripheral and axial manifestations. [ABSTRACT FROM AUTHOR]

Basal cell naevus syndrome is an inherited autosomal dominant genetic disorder characterised by multiple basal cell carcinomas (BCC), skeletal, neurological and opthalmological abnormalities. The treatment of choice of the often multiple and large BCC consists of a combined approach including surgery, liquid nitrogen and other topical treatment modalities. Imiquimod 5% cream is an immune-responsemodifying drug with antiviral and anti-tumour activity. Recent reports have associated the immune-stimulant properties of imiquimod with the exacerbation of several autoimmune skin diseases, such as eczema, psoriasis, vitiligo and lichenoid dermatitis. Here we report a patient with basal cell naevus syndrome who developed a lichen planopilaris on the same site of the scalp, which had been previously treated with two cycles of imiquimod for multiple BCC. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa is an inflammatory skin disease that presents a recurrence of painful and suppurating lesions in the apocrine gland‐bearing regions, with a strong impact on the patients' life quality. Despite its peculiar presentation, early forms are often underestimated by patients and this would inevitably result in late diagnosis and delayed therapy. Objectives: Improved communication around the disease could facilitate self‐diagnosis and a quicker response from healthcare practitioners, especially in this moment when we dispose of effective treatment against this disease. Methods: A HS awareness campaign was conducted for 2 years with the help of a media agency and a patients' association. Results: Results confirm that a better communication has a strong impact on the disease awareness. Conclusions: This paper demonstrates that the more this disease awareness is carried on, the more quick, effective and efficient the patient's management could be. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on the dermatoscopic characteristics seen in papules of Dowling-Degos disease (DDD) published in previous issue of the journal.

Abstract: Syringocystadenoma papilliferum is a benign adnexal neoplasm frequently seen in association with other adnexal tumours. We report the dermoscopic features of three cases of syringocystadenoma papilliferum developing in naevus sebaceus. Clinically the lesions were characterised by exophytic papillary structures. Dermoscopically, polymorphous vessels were the prevalent feature. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates the dermoscopy features of small and large size basal cell carcinoma (BCC). Methods used in the study were dermoscopic images of 100 BBCs proven histopathologically and the examination of dermoscopy was performed through a polarized device. Results show that there were 43 lightly pigmented lesions, 46 as pigmented and 11 as heavily pigmented

Background: The presence of an atypical (irregular) pigment network (APN) can indicate a diagnosis of melanoma. This study sought to analyze the APN with texture measures. Methods: For 106 dermoscopy images including 28 melanomas and 78 benign dysplastic nevi, the areas of APN were selected manually. Ten texture measures in the CVIPtools image analysis system were applied. Results: Of the 10 texture measures used, correlation average provided the highest discrimination accuracy, an average of 95.4%. Discrimination of melanomas was optimal at a pixel distance of 20 for the 768 × 512 images, consistent with a melanocytic lesion texel size estimate of 4–5 texels per mm. Conclusion: Texture analysis, in particular correlation average at an optimized pixel spacing, may afford automatic detection of an irregular pigment network in early malignant melanoma. [ABSTRACT FROM AUTHOR]

The article reports on the case of a 30-year-old woman who developed two primary melanomas on her left lower extremity where atypical melanocytic skin lesions were seen in a quadrant or segmented distribution. She was diagnosed with a quadrant or segmental atypical nevus syndrome. Surgical excision of the nevi is impractical because it may not save the patient from the development of de novo melanoma within the affected site. Patients benefit from digital dermoscopic follow-up.

Background: Skin lesion color is an important feature for diagnosing malignant melanoma. New basis function correlation features are proposed for discriminating malignant melanoma lesions from benign lesions in dermoscopy images. The proposed features are computed based on correlating the luminance histogram of melanoma or benign labeled relative colors from a specified portion of the skin lesion with a set of basis functions. These features extend previously developed statistical and fuzzy logic-based relative color histogram analysis techniques for automated mapping of colors representative of melanoma and benign skin lesions from a training set of lesion images. Methods: Using the statistical and fuzzy logic-based approaches for relative color mapping, melanoma and benign color features are computed over skin lesion region of interest, respectively. Luminance histograms are obtained from the melanoma and benign mapped colors within the lesion region of interest and are correlated with a set of basis functions to quantify the distribution of colors. The histogram analysis techniques and feature calculations are evaluated using a data set of 279 malignant melanomas and 442 benign dysplastic nevi images. Results: Experimental test results showed that combining existing melanoma and benign color features with the proposed basis function features found from the melanoma mapped colors yielded average correct melanoma and benign lesion discrimination rates as high as 86.45% and 83.35%, respectively. Conclusions: The basis function features provide an alternative approach to melanoma discrimination that quantifies the variation and distribution of colors characteristic of melanoma and benign skin lesions. [ABSTRACT FROM AUTHOR]

We describe a fully automated system for the classification of acral volar melanomas. We used a total of 213 acral dermoscopy images (176 nevi and 37 melanomas). Our automatic tumor area extraction algorithm successfully extracted the tumor in 199 cases (169 nevi and 30 melanomas), and we developed a diagnostic classifier using these images. Our linear classifier achieved a sensitivity (SE) of 100%, a specificity (SP) of 95.9%, and an area under the receiver operating characteristic curve (AUC) of 0.993 using a leave-one-out cross-validation strategy (81.1% SE, 92.1% SP; considering 14 unsuccessful extraction cases as false classification). In addition, we developed three pattern detectors for typical dermoscopic structures such as parallel ridge, parallel furrow, and fibrillar patterns. These also achieved good detection accuracy as indicated by their AUC values: 0.985, 0.931, and 0.890, respectively. The features used in the melanoma–nevus classifier and the parallel ridge detector have significant overlap.Journal of Investigative Dermatology (2008) 128, 2049–2054; doi:10.1038/jid.2008.28; published online 6 March 2008 [ABSTRACT FROM AUTHOR]

Congenital melanocytic nevi carry a risk for malignant transformation into melanoma, therefore early detection of suspicious features is crucial to reduce mortality rates. Dermoscopy improves the early detection of melanoma while reducing the number of unnecessary excisions of benign pigmented skin lesions. Dermoscopically, congenital melanocytic nevi are often characterized by the presence of a cobblestone pattern, but to date, little is known about the dermoscopic features of acral congenital melanocytic nevi. We report an acral congenital melanocytic nevus typified by the presence of three different dermoscopic patterns that are commonly seen in acquired melanocytic nevi of palms and soles. [ABSTRACT FROM AUTHOR]

The article discusses a study on the significance of dermoscopy in the skin disease psoriasis including the emergence of Auspitz's sign. The researchers Francisco Vázuez López, MD and others explain the use of non-invasive diagnostic technique helps in identifying the difference between psoriasis and skin tumors, and in evaluating other ailments such as lichen planus and dermatitis. Several images are presented which include psoriatic plaque, twisted capillary loops, and vessels.