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Competing Interests: The authors declare no conflict of interest.

Neoplastic alopecia (NA) is defined as an organized hair loss in single or multiple areas of the scalp caused by a primary tumor that has metastasized to the skin of the scalp. Due to its localization and clinical appearance, NA should be placed in differential diagnosis with alopecia areata or other entities. To date, pathognomonic dermoscopic criteria of NA have not yet been described: the absence of classical criteria of other scalp diseases in addition to a major neovascularization with on-focus arborizing vessels and erosions or ulcerations may help the clinician to suspect a diagnosis of secondary alopecia. Dermatologists should pay more attention to these rare forms of secondarism because in exceptional cases, a simple alopecia of the scalp can hide a new, relapsing or metastatic neoplasia., Competing Interests: The authors declare to have no conflicts of interest for the publication of this article., (Copyright © 2021 by S. Karger AG, Basel.)

Actinic keratosis (AK) is a very common skin disease caused by chronic sun damage, which in 75% of cases arises on chronically sun-exposed areas, such as face, scalp, neck, hands, and forearms. AKs must be considered an early squamous cell carcinoma (SCC) for their probable progression into invasive SCC. For this reason, all AK should be treated, and clinical follow-up is recommended. The aims of treatment are: (i) to clinically eradicate evident and subclinical lesions, (ii) to prevent their evolution into SCC, and (iii) to reduce the number of relapses. Among available treatments, it is possible to distinguish lesion-directed therapies and field-directed therapies. Lesion-directed treatments include: (i) cryotherapy; (ii) laser therapy; (iii) surgery; and (iv) curettage. Whereas, field-directed treatments are: (i) 5-fluorouracil (5-FU); (ii) diclofenac 3% gel; (iii) chemical peeling; (iv) imiquimod; and (v) photodynamic therapy (PDT). Prevention plays an important role in the treatment of AKs, and it is based on the continuous use of sunscreen and protective clothing. This review shows different types of available treatments and describes the characteristics and benefits of each medication, underlining the best choice., (© 2020The International Society of Dermatology.)

The association of melanoma with a preexisting nevus is still a debated subject. Histopathological data support an associated nevus in approximately 30% of all excised melanomas. The annual risk of an individual melanocytic nevus becoming malignant is extremely low and has been estimated to be approximately 0.0005% (or less than 1 in 200,000) before the age of 40 years, to 0.003% (1 in 33,000) in patients older than 60 years. Current understanding, based on the noticeable, small, truly congenital nevi and nevi acquired early in life, is that the first develops before puberty, presents with a dermoscopic globular pattern, and persists for the lifetime, becoming later a dermal nevus in the adult. In contrast, acquired melanocytic nevi develop mostly at puberty and usually undergo spontaneous involution after the fifth decade of life. The purpose of this review is to analyze the data of the literature and to propose, on the basis of epidemiological and clinical-dermoscopic characteristics, a new model of melanogenesis of nevus-associated melanoma., Competing Interests: Competing interests: The authors have no conflicts of interest to disclose., (©2020 Vezzoni et al.)

Lyme disease is a tick-borne illness, which is typically caused by Borrelia Burgdoferi. Over time, a typical Borreliosis skin reaction takes shape, i.e. the formation of an annular erythema that tends to expand centrifugally with erythematous edges whose diameter can reach up to 20 cm. The symptoms of Lyme disease are not only cutaneous but there may be a systemic involvement. Obviously, this disease can also affect pregnant women and for this reason this review aims to summarize the main ways of treatment to avoid worsening of the clinical condition in the mother and an eventual, albeit rare, involvement of the fetus.

Cutaneous squamous cell carcinoma (cSCC) is the second most frequent nonmelanoma skin cancer (NMSC). The majority of in situ cSCC [cSCC (Tis)] can be cured surgically, while local advanced and metastatic ones require other treatments, but there are no therapies approved by U.S. Food and Drug Administration (FDA). Available treatments for these stages included radiotherapy, chemotherapy as cisplatin, but responses to these treatments are usually of short duration. Programmed death-1 (PD-1) inhibitors (pembrolizumab, nivolumab, and cemiplimab) are an innovative immunologic treatment that now has been shown to be useful for the treatment of advanced cSCC. Nowadays, data about the response rate with the use of PD-1 inhibitors in cSCC are still few and, especially, the duration of the response after the start of treatment is short. Moreover, the number of cases is too small to express the beneficial effects of these treatments, although most data reported in the literature show quite good response rates. This review focused on some of the studies and associated results through an interesting research on search engines of all the cases about these systemic drugs, analyzing effects and side effects, and the research has been conducted considering published cases since March 2016 to October 2019., (© 2020 Wiley Periodicals, Inc.)

The cutaneous adverse effects of gemcitabine include allergic skin rash frequently associated with pruritus, alopecia, sweating, dermatitis with boils, and ulcerations. We report the case of a patient that developed inflammation of seborrheic keratoses after gemcitabine treatment.

The Koebner phenomenon is well described and well known in clinical practice. Sometimes it can take on a linear appearance, the diagnosis of which can be facilitated by the use of dermatoscopy. In this case, we present a comparison between a linear Koebner phenomenon on light and dark skin, reporting the salient dermatoscopic characteristics and relating them to histopathology.

Introduction: Cutaneous melanoma is the sixth most common malignant cancer in the USA. Among different subtypes of melanoma, nodular melanoma (NM) accounts about 14% of all cases but is responsible for more than 40% of melanoma deaths. Early diagnosis is the best method to improve melanoma prognosis. Unfortunately, early diagnosis of NM is particularly challenging given that patients often lack identifiable risk factors such as many moles or freckles. Moreover, early NM may mimic a range of benign skin lesions that are not routinely excised or biopsied in every day practice. For this reason, specific clinical and skin imaging clues have been proposed to improve early detection of NM. Areas covered: The review discusses about the noninvasive tools to diagnose thin melanoma, particularly NM. Expert commentary: Currently, dermatologists present a wide opportunity of diagnostic tools. Current data suggest that the early diagnosis of NM is a major challenge as the majority of early NM are symmetric, roundish, and lack specific pattern. Another promising strategy is based on recent data suggesting that artificial intelligence based on deep convolutional neural networking is able to outperform average dermatologist. Further research is necessary to validate the performance of this method in the real world and in the clinical setting.

Histological and capillaroscopy alterations of capillary circulation in psoriasis are well known: the most common of them are the increase of "minor dystrophies", the higher haematic flux in the psoriatic plaques and the abnormal visibility of the venous subpapillary plexus (in arthropathic less than 65-year-old patients). The predisposition of psoriatic patients to a vascular damage has often been stressed in literature. In the present study, we have evaluated the effects of systemic etretinate or PUVA therapy on capillary functions. We examined the nail-folds of 30 patients (ranging 15-64 years) affected by diffuse psoriasis for less than three years. This study has been performed by using a Leitz capillary microscopy. We evaluated the percentage of capillary minor dystrophies (type I-IV) and the flow rate before and after 1 month of treatment. These parameters were assessed by means of a 1-4 rating scale. Our results underline that a significant percentage of 1st type dystrophies is a prognostic rather than a diagnostic parameter in the capillaroscopic evaluation of psoriasis.

This lesion began two months after a tick bite on the left breast, occurring during a trip in Karst (highland behind the city of Trieste). This area represents an ecological shell for Ixodes ricinus, hard tick often infested with Borrelia burgdorferi, the aetiological agent of Lyme disease. Some days after tick-bite, the patient developed a typical ECM of the left breast; this lesion resolved in two months. Shortly after, an erythematous, infiltrated nodule appeared on the left areola; ist size was about two cm. Histological diagnosis confirmed that the lesion was a LABC; the lymphocytic infiltrate consisted in a large number of B cell (detected with monoclonal antibodies). Indirect immunofluorescence for Borrelia burgdorferi (after absorption with Treponema phagedenis) was positive (titre 1/128-IgG). The lesion was treated with doxycycline, 200 mg/day per os for two weeks. The lesion cleared up three months after the end of therapy. Till today (two year thereafter), the patient didn't present with local or general signs of Lyme borreliosis; furthermore the serological test for Borrelia burgdorferi became negative.