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A case study describing the successful treatment with 5-azacytidine of interstitial granulomatous dermatitis (IGD) with underlying myelodysplastic syndrome (MDS) is presented. The patient presented with symmetrical, erythematous, infiltrated, annular and partially urticarial plaques on the thighs, trunk as well as on both arms. Topics covered include the clinical history of the patient, the causal relationship between IGD and MDS, and the histopathologic characteristics of IGD.

Competing Interests: Conflicts of interest Dr Abu Rached received funding, travel support, and/or personal honoraria for lectures from Novartis Pharma and Johnson & Johnson that were independent of the work submitted. Dr Hessam has received honoraria for participation in advisory boards, in clinical trials, and/or as a speaker from AbbVie Inc, AbbVie Deutschland GmbH & Co KG, Bristol-Myers Squibb GmbH & Co KGaA, Novartis Pharma GmbH, Bristol-Myers Squibb GmbH & Co. KGaA, Almirall Hermal GmbH. Prof Bechara has received honoraria for participation in advisory boards, in clinical trials, and/or as a speaker from AbbVie Inc, AbbVie Deutschland GmbH & Co KG, Boehringer Ingelheim Pharma GmbH & Co KG, Novartis Pharma GmbH, UCB Pharma, Incyte Corporation, and JanssenCilag GmbH, MoonLake. Prof Stockfleth has received lecture fees from Almirall, Leo, Pierre Favre and Philips. Dr Ocker has received honoraria as a speaker and/or travel support from Novartis Pharma GmbH, Incyte Biosciences Corporation, and Janssen. Prof Gambichler has received speakers and/or advisory board honoraria from BMS, Sanofi-Genzyme, MSD, Novartis Pharma, Roche, Abbvie, Almirall, Janssen, Lilly, Pfizer, Pierre Fabre, and Merck-Serono outside the submitted work. Drs Herbst and Skrygan have no conflicts of interest to declare.

Background: Skin metastases are an important co-morbidity in melanoma. Despite broad adoption, electrochemotherapy implementation is hindered by a lack of treatment indications, uncertainty regarding procedural aspects, and the absence of quality indicators. An expert consensus may harmonize the approach among centres and facilitate comparison with other therapies., Methods: An interdisciplinary panel was recruited for a three-round e-Delphi survey. A literature-based 113-item questionnaire was proposed to 160 professionals from 53 European centres. Participants rated each item for relevance and degree of agreement on a five-point Likert scale, and received anonymous controlled feedback to allow revision. The items that reached concordant agreement in two successive iterations were included in the final consensus list. In the third round, quality indicator benchmarks were defined using a real-time Delphi method., Results: The initial working group included 122 respondents, of whom 100 (82 per cent) completed the first round, thus qualifying for inclusion in the expert panel (49 surgeons, 29 dermatologists, 15 medical oncologists, three radiotherapists, two nurse specialists, two clinician scientists). The completion rate was 97 per cent (97 of 100) and 93 per cent (90 of 97) in the second and third rounds respectively. The final consensus list included 54 statements with benchmarks (treatment indications, (37); procedural aspects, (1); quality indicators, (16))., Conclusion: An expert panel achieved consensus on the use of electrochemotherapy in melanoma, with a core set of statements providing general direction to electrochemotherapy users to refine indications, align clinical practices, and promote quality assurance programmes and local audits. The residual controversial topics set future research priorities to improve patient care., (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)