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The incidence of primary cutaneous melanoma has been increasing dramatically for several decades. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is nearly always curative with early detection of disease. In this update of the guidelines of care, we will discuss the treatment of patients with primary cutaneous melanoma. We will discuss biopsy techniques of a lesion clinically suspicious for melanoma and offer recommendations for the histopathologic interpretation of cutaneous melanoma. We will offer recommendations for the use of laboratory and imaging tests in the initial workup of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, we will provide recommendations for surgical margins and briefly discuss nonsurgical treatments. Finally, we will discuss the value and limitations of sentinel lymph node biopsy and offer recommendations for its use in patients with primary cutaneous melanoma. [ABSTRACT FROM AUTHOR]

Case: A 51-year-old woman underwent stage I of a 2-stage revision for a prosthetic knee infection with a vancomycin-impregnated articulating cement spacer followed by IV vancomycin and ceftriaxone. Four weeks later, she developed fevers, a diffuse cutaneous eruption, lymphadenopathy, transaminitis, and acute renal tubular necrosis before being diagnosed with drug reaction with eosinophilia and systemic syndrome (DRESS)., Conclusion: DRESS is a rare, potentially life-threatening adverse drug reaction with cutaneous manifestations and multiorgan involvement. Although rare, its incidence in orthopaedic patients is likely to increase with the aging population. It must be recognized early to minimize end-stage organ dysfunction and mortality., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B495)., (Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.)

Background: Few comparative data are available on age-related changes in skin color among different ethnic groups. The aim of the study was to measure and analyze the skin color and color heterogeneity in four different ethnic groups living in the same local environment and to determine the effects of age on these skin color characteristics., Methods: Female volunteers (385) from four ethnic populations (African-American, Caucasian, Chinese and Mexicans) living in the same city were enrolled after informed consent. Skin color was measured on two facial areas, forehead and cheek. The subjects were further divided into six age ranges: 19-30, 31-40, 41-50, 51-60, 61-70 and 71-87 years to determine any age-related effects on the skin color and color heterogeneity in both areas., Results: According to the L(*)a(*)b(*) CIE system, clarity (fairness/lightness) was found to be lower in the African-American group whereas the hue was lower in Caucasians, which means more red skin. A clear, statistically significant darkening of the skin with age was observed in all ethnic groups, while evidence of yellowing of the skin was shown in the Chinese volunteers. Overall, the skin color of the face of African-Americans was more heterogeneous than in the other ethnic groups, but showed the least increase with age., Conclusion: Our study revealed interesting differences in skin color and color heterogeneity with respect to ethnicity and age-related alterations. Data obtained are very useful in improving our knowledge about the skin of people of different origins and helps in the development of specific cosmetic products that are well adapted to all these populations.