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Localized scleroderma (LS), commonly known as morphea, presents a significant clinical challenge due to its chronic, inflammatory nature affecting the skin and potentially underlying tissues. This systematic review explores the innovative approach of combining laser therapy and injectable fillers, specifically hyaluronic acid, for the treatment of LS. We conducted a comprehensive literature review following PRISMA guidelines, examining articles from MEDLINE/PubMed to assess the combined efficacy of these treatments in improving both esthetic and functional outcomes for LS patients. The search yielded 64 articles, with six selected for in-depth analysis for a total of nine patients, covering a range of patient demographics and treatment types. Our review highlights cases where fractional CO2 laser therapy promoted long-term tissue remodeling and instances where hyaluronic acid fillers effectively addressed skin atrophy and volume loss, enhancing both immediate and long-lasting esthetic improvements. The synergy between these treatments suggests a promising dual approach, aiming to maximize esthetic outcomes and to improve the quality of life for LS patients. This review underscores the necessity of further research to establish a comprehensive, evidence-based clinical pathway integrating both treatments for managing LS, thereby enhancing patient satisfaction and addressing the multifaceted nature of this challenging dermatological condition. [ABSTRACT FROM AUTHOR]

Background: Atypical Spitz tumor (AST) is an intermediate category among Spitz melanocytic neoplasms. Sentinel node biopsy (SNB) has been proposed in the clinical management of AST patients, but this approach remains the subject of debate. This systematic review aims to summarize the available evidence on SNB procedures in AST patients. Methods: A comprehensive search was conducted, including MEDLINE/Pubmed, EMBASE, and SCOPUS, through April 2023. Case series, cohort studies, and case–control studies of AST patients were eligible for inclusion. PRISMA guidelines were followed. Results: Twenty-two studies with a total of 756 AST patients were included. The pooled SNB prevalence was 54% (95% CI 32 to 75%), with substantial heterogeneity (I2 90%). The pooled SNB+ prevalence was 35% (95% CI 25 to 46%) with moderate heterogeneity (I2 39%). Lymphadenectomy was performed in 0–100% of SNB+ patients. Overall survival rates ranged from 93% to 100%, and disease-free survival ranged from 87% to 100% in AST patients. Overall and disease-free survival rates were 100% in SNB patients. Pooled survival estimates were not calculated due to the heterogeneous timing of the survival assessment and/or the small size of the subgroups. All studies clearly reported inclusion criteria and measured the condition in a standard way for all participants, but only 50% indicated valid methods for the identification of the condition. Conclusions: The oncologic behavior of AST is related to an almost always favorable outcome. SNB does not seem to be relevant as a staging or prognostic procedure, and its indication remains debatable and controversial. [ABSTRACT FROM AUTHOR]

This article discusses the use of a deep convolutional neural network (CNN) and dermatologist assessment via a mobile app for the detection of melanoma in an Italian real-world setting. The study evaluated the concordance between the CNN model and assessments by dermatologists. The CNN algorithm showed a global performance of 0.67 in terms of the area under the curve (AUC), indicating acceptable diagnostic accuracy. However, the overall concordance between the algorithm and dermatologist assessments was less than satisfactory. The article emphasizes that AI currently serves as a complement rather than a replacement for healthcare professionals' expertise. [Extracted from the article]

Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker. In melanoma, PRAME is typically highly expressed, in contrast to its weak or absent expression in benign nevi, thereby improving the accuracy of differential diagnoses. The diagnostic value of PRAME extends to various lesions. It is significantly expressed in uveal melanoma, correlating to an increased risk of metastasis. In acral melanomas, especially those with histopathological ambiguity, PRAME helps to improve diagnostic accuracy. However, its expression in spitzoid and ungual melanocytic lesions is inconsistent and requires a comprehensive approach for an accurate assessment. In soft tissue sarcomas, PRAME may be particularly helpful in differentiating melanoma from clear cell sarcoma, an important distinction due to their similar histological appearance but different treatment approaches and prognosis, or in detecting dedifferentiated and undifferentiated melanomas. In non-melanoma skin cancers such as basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, the variable expression of PRAME can lead to diagnostic complexity. Despite these challenges, the potential of PRAME as a therapeutic target in melanoma is significant. Emerging immunotherapies, including T-cell-based therapies and vaccines targeting PRAME, are being investigated to exploit its cancer-specific expression. Ongoing research into the molecular role and mechanism of action of PRAME in skin cancer continues to open new avenues in both diagnostics and therapeutics, with the potential to transform the management of melanoma and related skin cancers. [ABSTRACT FROM AUTHOR]

Background: Pancreatic cancer is notorious for its aggressive nature and low survival rate, with less than 10% of patients surviving beyond five years. Early detection is difficult, but skin metastases can be a rare but significant indicator. This systematic review focuses on the epidemiology, clinical features, and histology of skin metastases from pancreatic cancer to determine their importance in early diagnosis and overall management of the disease. Materials and methods: Following PRISMA guidelines, we conducted an exhaustive search of MEDLINE/PubMed, EMBASE, and SCOPUS databases up to June 2023, using specific keywords. Four independent investigators screened the studies using predefined criteria, and two investigators checked the accuracy and consistency of the data extraction. We assessed the quality of the trials using adapted criteria from the Joanna Briggs Institute. A narrative synthesis rather than a meta-analysis was chosen because of the different study designs. Results: The final analysis included 57 patients with skin metastases from pancreatic cancer. Cutaneous metastases, although rare, presented with approximately equal gender distribution and a mean age of 63.4 years. Predominantly non-umbilical (77%), these metastases showed clinical diversity, ranging from asymptomatic nodules to painful or ulcerated lesions. Notably, skin metastases often preceded the diagnosis of primary pancreatic cancer (58%). Primary tumor characteristics revealed different localizations, with adenocarcinoma being the most prevalent histological type (77%). A significant association (p = 0.008) was observed between pancreatic tumor location and the timing of presentation of skin metastases. Tumors located in the body and tail of the pancreas were more likely to manifest skin metastases as an initial clinical manifestation (62.2%) than those in the head of the pancreas (20.8%). Conclusions: In conclusion, although skin metastases are rare, they are important indicators of pancreatic cancer, highlighting the need for multidisciplinary healthcare collaboration and thorough skin examination. Recognizing them could lead to earlier diagnosis, which is crucial in a cancer with limited treatment options. [ABSTRACT FROM AUTHOR]

Deep cutaneous mycoses (DCMs) and skin fungal infections can cause significant morbidity until diagnosed and treated. In immunocompromised people, Candida spp., Aspergillus spp., and Fusarium spp. fungi can cause these infections, but dermatophytes, especially Trichophyton rubrum and T. mentagrophytes, are the most common. Superficial erythematous lesions become firm subcutaneous nodules, ulcers, abscesses, or sinus tracts. In advanced cases, DCMs can cause osteomyelitis and bone loss. DCM included mycetoma, a chronic infectious disease of the skin, subcutaneous tissues, and bones. In some areas, it is endemic and can mimic cutaneous tuberculosis or cancerous lesions, making diagnosis difficult. Clinical presentation, radiological findings, and microbiological culture are used to diagnose with molecular methods helping in culture-negative cases. An immunocompetent farmer with a wrist lesion initially suspected as cutaneous squamous cell carcinoma was histologically diagnosed as eumycetoma, emphasizing the importance of considering deep mycoses in highrisk individuals and their heterogeneous clinical presentation. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcoma may show similarities to malignant melanoma, making it difficult to differentiate between these two neoplasms. This systematic review summarizes evidence on cases of sarcoma that were initially diagnosed as melanoma to help clinicians in the diagnostic process. A comprehensive search of key databases identified 23 case reports and 4 case series with a total of 34 patients. Heterogeneous clinical presentation and frequent immunohistochemistry positivity contributed to the initial misdiagnosis. The second assessment was performed due to unusual presentation or uncertain diagnosis, and the final diagnosis was clear cell sarcoma (50%) or other soft tissue sarcomas (50%). EWSR1 translocation was investigated in 50% of cases, among which 94% were found to be positive. This systematic review suggests that a second diagnosis should be considered in cases of atypical lesions, and ESWR1 translocation should be investigated. Background: Sarcoma may show similarities to malignant melanoma in terms of morphologic and immunohistochemical aspects, making it difficult to differentiate between these two neoplasms during the diagnostic process. This systematic review aims to summarize available evidence on cases of sarcoma that were initially diagnosed as melanoma. Methods: A comprehensive search of the MEDLINE/Pubmed, EMBASE, and SCOPUS databases was conducted through March 2023. We included case series and case reports of sarcoma patients that were initially diagnosed as malignant melanoma. PRISMA guidelines were followed. Results: Twenty-three case reports and four case series with a total of 34 patients were included. The clinical presentation was heterogeneous, and the most involved anatomical regions were lower limbs (24%), head/neck (24%), and upper limbs (21%). IHC positivity was reported for S100 (69%), HMB45 (63%), MelanA (31%), and MiTF (3%). The main reasons for a second assessment were unusual presentation (48%) and uncertain diagnosis (28%). EWSR1 translocation was investigated in 17/34 patients (50%) and found to be positive in 16/17 (94%). The final diagnosis was clear cell sarcoma (50%) or other soft tissue sarcomas (50%). Conclusions: Melanoma and some histotypes of sarcoma share many similarities. In cases of atypical lesions, a second diagnosis should be considered, and ESWR1 translocation should be investigated. [ABSTRACT FROM AUTHOR]

Dear Editor, Skin eruptions are commonly observed in patients undergoing anticancer therapy, and with the introduction of new drugs in the antitumor treatment landscape evidence regarding their potential cutaneous adverse effects is still building. We herein report the case of an acquired ichthyosiform reaction induced by apalutamide. [...] [ABSTRACT FROM AUTHOR]

A systematic review and metanalysis published in the British Journal of Dermatology provides data on the global incidence and prevalence of actinic keratosis (AK), a skin condition associated with sun damage. The study found a global prevalence of 14% and an incidence rate of approximately 1.9 per 1000 person years. However, the study noted significant variations in AK rates based on factors such as sex, age, ethnic group, latitude, and ultraviolet light exposure. The authors also highlighted the need for further research on case definition and the natural history of AK. They suggested that AK should be considered a risk indicator for skin cancer rather than a form of cancer itself, emphasizing prevention over treatment. [Extracted from the article]

A 65-year-old man was referred with two adjacent skin lesions located in the right temporal and zygomatic area. A dermoscopic examination revealed features indicative of two basal cell carcinomas, prompting the scheduling of surgical removal. [...] [ABSTRACT FROM AUTHOR]

This letter to the editor discusses the use of artificial intelligence chatbots for providing cancer treatment information. The authors refer to a study that evaluated the responses of a chatbot to common patient queries in dermatology, as well as other studies that assessed the accuracy and reliability of chatbot responses to physician questions and the effectiveness of chatbots in evaluating systemic therapies for plaque psoriasis. The authors emphasize the potential role of large language models in medical education and stress the importance of evaluating the reliability of medical information provided by chatbots. They provide additional resources on retinoids, the natural history of cutaneous propionibacteria, and evidence-based guidelines for acne treatment. [Extracted from the article]

Competing Interests: Conflict of interest: the authors declare no potential conflict of interest.