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Summary: Background: The 'rainbow pattern' was initially described as a highly specific dermoscopic feature of Kaposi sarcoma. Since then, it has been reported in many benign and malignant cutaneous tumours, including a few malignant melanomas (MMs). Aim: To determine the frequency and presentation of this dermoscopic pattern in primary cutaneous MMs in comparison to other cutaneous tumours. Methods: The presence of a rainbow pattern was evaluated in a sample of 1100 dermoscopic images of different melanocytic and nonmelanocytic cutaneous neoplasms. Results: The rainbow pattern was observed in 23 of 245 (9.4%) MM and 44 of 855 (5.1%) non‐MM neoplasms. MMs presenting this feature were generally thicker: 82.6% > 1 mm and 43.0% > 2 mm. Compared with non‐MMs, rainbow pattern in MMs was more commonly focal (82.7% vs. 36.4% nonfocal, P = 0.001) and associated with > 2 dermoscopic structures associated with MM (100% vs. 9% with fewer, P = 0.001). Conclusion: The rainbow pattern is a dermoscopic sign that can occasionally be observed in invasive MMs. In MMs, this feature is usually associated with other dermoscopic criteria of MM and located in a focal and eccentric area, as opposed to a diffuse and isolated presentation in non‐MM neoplasms. [ABSTRACT FROM AUTHOR]

Histopathological findings Ectopic fat lobules were observed in the superficial reticular dermis extending up to the papillary dermis, and proliferating around the periadnexial adventitial dermis, perieccrine and perivascular areas. In Goltz syndrome, the clusters of mature adipocytes in the dermis are also accompanied by an atrophic dermis and absent skin appendages. Clustered yellow papules in the posterior axilla of a middle-aged woman. [Extracted from the article]

Background: Melanoma in young adults significantly impacts the survival of this age group. There are limited studies that analyze melanoma characteristics in young patients. We aimed to describe the epidemiological, clinical, and histological characteristics of melanoma in young adults and their temporal trends over the last decades., Methods: A retrospective observational study was conducted, involving 399 melanoma patients aged 18-44, over a 30-year period (1993-2022). Patients were divided into two groups based on their date of diagnosis (period 1, 1993-2007, and period 2, 2008-2022)., Results: Age at diagnosis was higher in the most recent period (34.3 vs 37; p=0.001). Over time, there was a reduction in thickness (1 vs 0.68 mm; p=0.01), a rise in melanomas located on the head and neck (6.5% vs 14.8%) and extremities (42.2% vs 45%), along with a decrease on the trunk (51.3% vs 40.2%) (p=0.009); and an increase in lentigo maligna (2.3% vs 5.3%) and superficial spreading melanomas (76.5% vs 84%), along with reduction in nodular types (16.1% vs 5.9%) (p=0.012). Women had, compared to men, higher limb melanoma prevalence (56.3% vs 27.1%; p<0.001), family history (11.7% vs 5.1%; p=0.020), lower thickness (0.69 vs 1.10; p= 0.001) and better prognosis (14.4% vs 20.9% deaths; p=0.012)., Conclusions: Melanoma diagnoses in young adults occur at progressively advanced ages, with a rise in melanomas situated on the head and extremities and in histological types linked to prolonged sun exposure. Strategies like minimizing sun exposure from a young age and encouraging self-examination could lead to improved survival rates., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Competing Interests: Conflicts of interest None disclosed.

Introduction: Dermoscopic algorithms for melanoma diagnosis could be time-expending, and their reliability in daily practice lower than expected., Objective: To propose a simplified dermoscopic algorithm for melanoma diagnosis., Material and Methods: A multicenter retrospective analysis of 1,120 dermoscopic images of atypical melanocytic tumors (320 melanomas and 800 non-melanomas) was performed. An algorithm based on polychromia, asymmetry in colors or structures, and some melanoma-specific structures was designed. Univariate and multivariate logistic regression analysis was calculated to estimate the coefficients of each potential predictor for melanoma diagnosis. A score was developed based on the dermoscopic evaluations performed by four experts blinded to histological diagnosis., Results: Most melanomas had ≥3 colors (280; 84.5%), asymmetry in colors or structures (289; 90.3%), and at least one melanoma-specific structure (316; 98.7%). PASS score ≥3 had a 91.9% sensibility, 87% specificity, and 88.4% diagnostic accuracy for melanoma. PASS algorithm showed an area under the curve (AUC) of 0.947 (95% CI 0.935-0.959)., Limitations: This study was retrospective. A comparison between the performances of different dermoscopic algorithms is difficult because of their designs., Conclusion: PASS algorithm showed a very good diagnostic accuracy, independently of the observers' experience, and it seems easier to perform than previous dermoscopic algorithms., (© 2023 the International Society of Dermatology.)

A new outbreak of monkeypox virus (MPXV) infection, a zoonotic infection endemic in Central and West Africa, is spreading throughout the world with new epidemiology and clinical features. Our aim was to characterize patients presenting to Dermatology emergency room with a MPXV infection between 15 May and 30 June 2022 in a tertiary hospital in Madrid, Spain. We collected 53 patients and describe their clinical, demographic and epidemiological characteristics and followed their evolution. Most of the patients were men who had sex with men with high-risk sexual practices and no recent travels abroad. Most of them (91%) had had a sexually transmitted infection before. All patients had typical skin lesions consisting of vesicular-pustular rash with central umbilication which was localized or disseminated. The most frequent extracutaneous symptoms were fever, painful regional lymphadenopathy and asthenia. Proctitis was present in more than one third of patients. All patients were diagnosed by real time polymerase chain reaction of samples obtained from skin lesions. Pharyngeal and/or rectal exudates demonstrated MPXV in 74% of patients. The current worldwide outbreak of MPXV infections shows epidemiological and clinical differences from previous ones. Clinicians should be aware of these characteristics to correctly diagnose this emerging disease., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Melanoma patients have a higher risk of developing additional melanomas. Predisposing factors of a second primary melanoma in patients without any genetic predisposition are not well established., Objectives: The aim of this study was to identify risk factors related to the development of a second primary melanoma in order to know which patients should be followed up closely., Methods: A longitudinal study was performed at Hospital Gregorio Marañón (Madrid, Spain), based on follow-up data of patients diagnosed with cutaneous melanoma from 1998 to 2020., Results: After a median follow-up of 82 months, 58 out of 1523 (3.8%) patients developed a second melanoma. In 11 patients (19%), a second melanoma was diagnosed more than 10 years after their first melanoma. Second melanomas more commonly had a lower mean tumour thickness than the first ones, but 8 out of 58 (13.8%) had a higher tumour thickness than their first melanoma. Skin phototype I-II, having more than 50 melanocytic nevi, and recurrent sunburns were associated with the development of a second melanoma. In multivariate analysis, skin phototype I-II (odds ratio [OR] = 5.41; p &lt; 0.001) and a higher number of nevi (OR = 3.44; p &lt; 0.001) remained as independent risk factors for the development of a second melanoma., Conclusions: Patients with fair skin phototype and more than 50 melanocytic nevi are at increased risk of developing a second primary melanoma and should be closely monitored throughout their lives to detect earlier additional melanomas., (© 2023 S. Karger AG, Basel.)

Extensive subtypes of alopecia areata (AA) (totalis, universalis, or multifocal) still have no approved and effective treatments in Europe, although Janus kinase inhibitors, such as baricitinib, are promising treatments that have been recently approved by the FDA. Nowadays, the higher costs and the lower experience with Janus kinase inhibitors, provide more difficulties in its accessibility. On the other hand, different corticosteroids regimens have been evaluated with conflicting results from decades. In 2016, a new regimen of mini pulse corticosteroid therapy with oral dexamethasone (MPCT-OD) 0.1mg/kg/day twice per week for adult patients with alopecia areata totalis or universalis, was reported to be effective with a lower rate of adverse effects. We performed a retrospective and multicentric study to collect data from patients with extensive forms of alopecia areata who had received MPCTOD (0.1 mg/kg/day twice weekly of dexamethasone) for at least 24 weeks. We included adult patients (≥18 years) with extensive forms of AA (SALT index ≥ 10) that did not respond to previous treatments. Variables including epidemiological and clinical data were recorded. Therapeutic response was assessed through the % change in SALT score (from 0 to 100%) and the changes in eyebrow and eyelash alopecia index (EBA, ELA) from baseline to 24 weeks after the beginning of the treatment. Dexamethasone dosage, duration of the treatment, time until response, time to relapse, adverse effects, and discontinuation were also recorded., (© 2022 Wiley Periodicals LLC.)

Background and Objectives: Digital melanoma is an uncommon form of acral melanoma that is anatomically restricted to the finger. The aim of this study is to provide specific epidemiological and clinical information about this subtype of melanoma, as well as to identify differences in recurrence and survival depending on the anatomical sublocation., Patients and Methods: We describe a group of 45 Caucasian patients with digital melanoma divided into three groups: nail unit melanoma (group A), finger skin melanoma (group B), and those melanomas that involve both nail and adjacent skin (group C)., Results: The mean tumor thickness was 4.66 mm, and the most common histological subtype is acral lentiginous melanoma. Group C was more frequent in older men and was thicker and more frequently ulcerated (P < 0.05). In addition, patients in group C developed distant metastases more frequently and had a significantly lower median disease-free survival (26.60 months) compared with group A (69.47 months) and group B (89.81 months) (P < 0.05)., Conclusions: According to our results, digital melanoma limited to nail apparatus or finger skin was associated with a better prognosis, while those affecting both nail apparatus and skin showed lower melanoma-specific survival., (© 2022 the International Society of Dermatology.)