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The incidence of melanoma has been dramatically increasing over the last decades. Melanoma is considered to have a high metastatic potential and it can progress due to hematogenous metastasis or via lymphatic vessels. Different patterns of recurrence have been described, namely, local, satellite, and in transit metastasis (LCIT), lymphatic, and systemic metastasis. With a more advanced melanoma stage at diagnosis, there is a higher risk for systemic metastasis in comparison to LCIT; in contrast, early-stage melanoma tends to recur more frequently as LCIT and less commonly as systematic metastasis. The aim of this review was to summarize the patterns of recurrence of cutaneous melanoma, giving the clinician a practical summary for diagnosis, prognosis, and surveillance. There is a knowledge gap of the common patterns of recurrence that needs to be addressed to better identify patients at high risk of disease recurrence and personalize surveillance strategies as well as patient counseling.

Introduction: Among the various widely recognized basal cell carcinoma (BCC) clinical patterns, linear basal cell carcinoma (LBCC) is an uncommon morphologic variant of BCC. Objective: Describe the clinical and dermoscopic characteristics of LBCC. Methods: Retrospective study including LBCC cases from 5 dermatology centers in North and South America. Biopsy-proven primary BCCs, that presented with at least 3:1 length:width ratio on physical examination, irrespective of tumor subtype or location, were included. Clinical and dermoscopic analysis were performed by 2 experts in dermoscopy. Results: Eighteen cases of LBCC met our inclusion criteria and were included in the study. Median age at diagnosis was 86.0 years, 10 patients (58.8%) were males. Regarding anatomic location, 11/18 (61.1%) were located on the head and neck, 5/18 (27.7%) cases were found on the trunk, and 2 on lower extremities (11.1%). Under dermoscopy, 15/18 (83.3%) of LBCC were pigmented. All tumors displayed at least one of the BCC-specific dermoscopic criteria the most common being blue-grey globules (72.2%). Conclusions: Dermoscopy might be useful in the differentiation of LBCC from other diagnoses presenting as linear lesions such as scars, scratches/erosions, and tattoos, among others. Some of these lesions might be confused by naked eye examination alone.

Background: Therapeutic success in acne patients not only depends in the appropriate selection of drugs but also on patient’s treatment adherence or compliance. Lack of adherence is a very important problem both in general medicine and in dermatologic practice. Objective: To evaluate the impact of oral and written counseling in adherence to treatment in acne patients. Patients and Methods: Eighty patients were randomized into a two study groups of 40 patients each in which instructions were given in a written note (besides oral counseling) and reinforced by a telephone within 15 days of onset, and a control group that received indications as usual (oral counseling in-office only). Both groups were followed-up, evaluating adherence to treatment according to self-reporting of patients at 30, 60, 90 days and 6 months. Results: Better adherence to treatment was observed in the intervention group, being statistically significant only in the first month of treatment (80% versus 62%, p = 0.043). The beneficial effect of written counseling plus a phone call diluted in subsequent months. Conclusion: Written counseling significantly improves adherence in the first month of treatment. Good adherence could also lead to more effective treatments so it seems reasonable to use time and resources to optimize adherence to treatment.

Trichoepitheliomas are uncommon benign adnexal neoplasms that originate from the hair follicles. Multiple familial trichoepithelioma constitute an autosomal dominant disease characterized by the appearance of multiple flesh-colored, symmetrical papules, tumors and/or nodules in the central face and occasionally on the scalp. Although clinical diagnosis is usually straightforward in light of the family history and naked-eye examination, dermoscopy may aid in its confirmation. Dermoscopy of each papule revealed in-focus arborizing vessels, multiple milia-like cysts and rosettes amidst a whitish background. In a patient with multiple facial papules revealing a dermoscopic appearance described above, the diagnosis of sporadic or familial multiple trichoepithelioma should be considered.