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Background and Aims Methods Results Conclusions Solar lentigo is a prevalent skin condition that affects a significant number of individuals. Fortunately, certain traditional Chinese medicines and monomers (TCMM) have proven effective in addressing these concerns. In this study, we evaluated the efficacy and underlying mechanism of TCMM, a combination of TCM and monomers in repairing solar lentigo.We detected and identified the main compounds of TCM using liquid chromatography‐mass spectrometry (LC–MS) and through the approach of network pharmacology, we screened drug and disease targets, visualized networks with Cytoscape software, analyzed targets via Gene ontology and KEGG, clinically validated predictions. In a mouse model, UVB‐induced pigmentation was assessed, and the effects of TCMM were evaluated. A clinical trial on 30 patients validated the depigmenting agent.Active ingredients such as MSH, Butylated hydroxytoluen, Valerophenone, and Geranylacetone aid pigmentation treatment. One hundred and forty‐three crore targets impact PI3K‐Akt, MAPK signaling pathway, ect. pathways. TCMM reduced UVB‐induced pigmentation, water loss, epidermal thickness, and melanin. It inhibited TYR, MITF, AKT1, VEGFA, PTGS2, TNF‐α, IL‐6, IL‐1β. Clinical and microscopic analysis showed significant pigmentation reduction.The treatment of solar lentigo can benefit from the TCMM. By targeting multiple factors and pathways, this approach offers a comprehensive and effective treatment strategy. [ABSTRACT FROM AUTHOR]

Background: Surgical excision with clear histopathological margins is the preferred treatment to prevent progression of lentigo maligna (LM) to invasive melanoma. However, the assessment of resection margins on sun-damaged skin is challenging. We developed a deep learning model for detection of melanocytes in resection margins of LM. Methods: In total, 353 whole slide images (WSIs) were included. 295 WSIs were used for training and 58 for validation and testing. The algorithm was trained with 3,973 manual pixel-wise annotations. The AI analyses were compared to those of three blinded dermatopathologists and two pathology residents, who performed their evaluations without AI and AI-assisted. Immunohistochemistry (SOX10) served as the reference standard. We used a dichotomized cutoff for low and high risk of recurrence (≤ 25 melanocytes in an area of 0.5 mm for low risk and > 25 for high risk). Results: The AI model achieved an area under the receiver operating characteristic curve (AUC) of 0.84 in discriminating margins with low and high recurrence risk. In comparison, the AUC for dermatopathologists ranged from 0.72 to 0.90 and for the residents in pathology, 0.68 to 0.80. Additionally, with aid of the AI model the performance of two pathologists significantly improved. Conclusions: The deep learning showed notable accuracy in detecting resection margins of LM with a high versus low risk of recurrence. Furthermore, the use of AI improved the performance of 2/5 pathologists. This automated tool could aid pathologists in the assessment or pre-screening of LM margins. [ABSTRACT FROM AUTHOR]

Solar lentigo is a common condition that can affect people of all ages and ethnicities. The effectiveness of combining laser and light-based modalities for reducing solar lentigines was evaluated. Patients received treatment for facial solar lentigines with an advanced pulsed light device (BBL® HEROTM) followed by nonablative fractionated 1,927nm laser (MOXITM) in a single session. Nonmalignant solar lentigines were evaluated through assessment of photographs and VISIA scans taken before and after treatment. Nine patients aged 29 to 64 years were included in this report. Across all nine patients, there was a significant increase in percentile for brown spots on VISIA scans post-treatment. Follow-up time was variable; in one patient, a marked reduction in hyperpigmentation was observed almost 20 months post-treatment. The results presented in this report demonstrate that combining BBL HERO and MOXI is effective for reducing solar lentigines. [ABSTRACT FROM AUTHOR]

Background: Solar lentigo, a common epidermal hyperpigmented lesion found in sun‐exposed areas, results from the proliferation of melanocytes and the accumulation of melanin. Although various treatments for solar lentigo have been explored, they often lead to complications, including prolonged erythema and post‐inflammatory hyperpigmentation (PIH), posing significant concerns. Objectives and methods: This study evaluated the safety and efficacy of the Vasculature Salvage Laser Surgery (VSLS) system. We treated six Korean patients, each with solar lentigo, in a single session using the 532‐nm nanosecond neodymium‐doped yttrium aluminum garnet (Nd:YAG) VSLS system, with follow‐up periods ranging from 3 to 10 weeks. Results: The treatment led to the complete removal of pigmented lesions in all patients without resulting in PIH, even in cases where previous laser treatments had failed. The only side effect observed was mild erythema, which resolved over the long term in most instances. Conclusions: The VSLS system emerges as a safe and effective treatment for pigmented lesions, including refractory solar lentigines. Nonetheless, additional studies are required to verify its long‐term efficacy. [ABSTRACT FROM AUTHOR]

The dermatoscopic characteristics of shiny white structures (SWS) in malignant skin tumours are well described, but data on benign skin neoplasms are scarce. To evaluate the dermatoscopic features of SWS in common benign tumours, we reviewed our database for histopathologically confirmed cases. Dermatoscopic images were evaluated for the presence of any type of SWS. Images with SWS were further analysed for their quantity, distribution and shape. Of 2420 evaluated benign tumours, 357 (14.8%) displayed SWS. The highest frequencies were observed in pyogenic granuloma (n = 62/100; 62%), angioma (n = 63/113; 55.8%) and adnexal tumours (n = 42/84; 50%). The lowest frequency was found in common naevi (n = 16/1032; 1.6%) and solar lentigo (n = 0). The presence of SWS was not associated with sex or anatomical location. SWS were usually diffuse and multiple. SWS may be present in a broad spectrum of benign tumours and therefore they should not be considered as de facto indicators of malignancy. [ABSTRACT FROM AUTHOR]

The article presents a case study of a late 70s man with a pigmented facial lesion, recently changed in size and color, potentially indicative of lentigo maligna. Topics discussed include differential diagnosis and management options, including excisional biopsy, radiation therapy, and imiquimod treatment, as well as patient decision-making processes in the face of comorbidities and treatment refusal.

Background: In melanomas, mutations in the BRAF gene are common and their occurrence represents an early oncogenic event. Our goal was to determine and compare the frequency of BRAF gene mutations in dysplastic nevi (ND) and melanomas in situ (MIS), as well as whether there is a correlation between the presence of BRAF gene mutations and various anamnestic, clinical, and histopathologic variables. Methods: A total of 175 patients—106 with ND, 41 with MIS, and 28 with lentigo maligna (LM) were included in the study. DNA was extracted from tissue samples and analyzed using the competitive allele-specific TaqMan chain reaction by polymerase in real time to detect the presence of BRAF V600E and V600K mutations. The data were compared with anamnestic, clinical, and histopathological data. Results: There is a statistically significant correlation between the presence of BRAF mutation and the diagnosis of melanoma in situ (χ2 test, χ2 = 29.17, p < 0.0001). Patients with LM had a significantly lower incidence of BRAF mutations compared to patients with ND and MIS. There was a significant correlation between the presence of a BRAF mutation and tumor localization, as well as the age of the patient, but no statistically significant correlation between the presence of a BRAF mutation and sex, tumor size, or previous melanoma diagnosis. Conclusions: BRAF mutations in ND are essentially required; however, they are an insufficient oncogenic trigger for the development of melanoma. This research contributes to a better understanding of the etiopathogenesis of melanoma and the role of ND as possible precursor lesions. [ABSTRACT FROM AUTHOR]

Background: Lentigo maligna (LM) exhibits a particular epidemiological profile compared to other histopathologic subtypes of melanoma, with a propensity for the head and neck area and a higher mean age at diagnosis. Few small‐scale studies have exclusively evaluated the risk factors for the development of LM. Objective: This study aims to compare LM to other histological subtypes of melanoma for the prevalence of known melanoma risk factors, including pigmentary characteristics, history of occupational sun exposure, nevus count, and familial melanoma history. Patients and methods: We conducted a case–control study of 152 patients with LM and 784 patients with other melanoma subtypes (OM). The Mann–Whitney t‐test and Pearson chi‐squared test were used to detect differences between the two groups in continuous and categorical variables, respectively. Univariate and multivariate logistic regression models were then constructed to identify risk factors for developing LM compared to other melanoma subtypes. Results: In multivariate logistic regression analysis, LM was positively associated with a lentigines count >50 and occupational sun exposure compared to OM (OR 2.10, 95% CI 1.35–3.29 and OR 2.18, 95% CI 1.33–3.57, respectively). In contrast, patients with an increased nevus count and fair or medium skin color were less likely to develop LM than OM (OR 0.93, P < 0.001, 95% CI 0.91–0.94, and OR 0.28, P < 0.001, 95% CI 0.17–0.46, respectively). In univariate analysis, LM exhibited a weaker association with all pigmentary traits than OM. No significant associations were found for atypical nevi count and family history. Conclusion: We found significant differences in the prevalence of known melanoma risk factors between LM and other melanoma subtypes, which supports the hypothesis of a distinct pathogenetic pathway of LM. [ABSTRACT FROM AUTHOR]

The superfamily Stromboidea is a clade of morphologically distinctive gastropods which include the iconic Strombidae, or 'true conchs'. In this study, we present the most taxonomically extensive phylogeny of the superfamily to date, using fossil calibrations to produce a chronogram and extant geographical distributions to reconstruct ancestral ranges. From these results, we confirm the monophyly of all stromboidean families; however, six genera are not monophyletic using current generic assignments (Strombidae: Lentigo, Canarium, Dolomena, Doxander; Xenophoridae: Onustus, Xenophora). Within Strombidae, analyses resolve an Indo‐West Pacific (IWP) clade sister to an East Pacific/Atlantic clade, together sister to a second, larger IWP clade. Our results also indicate two pulses of strombid diversification within the Miocene, and a Tethyan/IWP origin for Strombidae—both supported by the fossil record. However, conflicts between divergence time estimates and the fossil record warrant further exploration. Species delimitation analyses using the COI barcoding gene support several taxonomic changes. We synonymise Euprotomus aurora with Euprotomus bulla, Strombus alatus with Strombus pugilis, Dolomena abbotti with Dolomena labiosa, and Dolomena operosa with Dolomena vittata. We identified cryptic species complexes within Terebellum terebellum, Lambis lambis, "Canarium" wilsonorum, Dolomena turturella and Maculastrombus mutabilis. We reinstate Rimellopsis laurenti as a species (previously synonymised with R. powisii) and recognise Harpago chiragra rugosus and Lambis truncata sowerbyi valid at the rank of species. Finally, we establish several new combinations to render Lentigo, Dolomena, and Canarium monophyletic: Lentigo thersites, Dolomena robusta, Dolomena epidromis, Dolomena turturella, Dolomena taeniata, Dolomena vanikorensis, D. vittata, "Canarium" wilsonorum, Hawaiistrombus scalariformis, Maculastrombus mutabilis, Maculastrombus microurceus. [ABSTRACT FROM AUTHOR]

Advanced melanoma and nonmelanoma skin cancer or cutaneous metastases not amenable to surgery often require alternate therapy. Although surgery is first‐line treatment for early‐stage melanoma, it can be challenging with multifocal disease, sites with high morbidity, large lesions such as lentigo maligna on the head and neck, and patients with comorbidities that add surgical risk. Intratumoral therapy is a safe method of treating advanced melanoma which avoids the toxicities of systemic therapies. Our review examined the overall response rates and adverse effects of the following experimental and standard intralesional agents: ipilimumab, rose bengal (PV‐10), cathelicidin LL37, SD‐101, coxsackie A21 V937, and talimogene laherparepvec. Injection of oncolytic virus, immune‐modulating drugs, cytotoxic agents, or studied combinations was well‐tolerated and effective alternative treatments for advanced melanoma and cutaneous metastases. Response to treatment was observed in both injected and noninjected lesions demonstrating systemic antitumor effects of these intralesional therapies. Further utility of intralesional agents can be explored as neoadjuvant treatment of large lentigo maligna lesions or those in cosmetically sensitive areas. Intralesional therapy should be developed further for morbidity reduction in challenging melanoma cases. [ABSTRACT FROM AUTHOR]

A 14‐year‐old girl presented with a facial‐pigmented lesion suspicious of melanoma clinically and dermoscopically. In vivo, reflectance confocal microscopy (RCM) findings excluded melanoma by revealing typical epidermal honeycomb and cobblestone patterns. Well‐defined follicular contours were seen at the dermal–epidermal junction; there were no elongated, “medusa head‐like” follicular protrusions or folliculotropism, which are classical findings seen in lentigo maligna. With this report, we aim to demonstrate the significance of utilizing RCM technology in difficult to diagnose lentiginous pigmented lesions. [ABSTRACT FROM AUTHOR]

Background: Q‐switched (QS) Nd: YAG laser is one of the treatment options for solar lentigines (SLs). However, the incidence of post‐inflammatory hyperpigmentation (PIH) is a common complication, especially in dark‐complexioned skin. Isobutylamido thiazolyl resorcinol (ITR) has been reported as a preventive modality for ultraviolet B (UVB)‐induced hyperpigmentation. Aims: This study aims to evaluate the efficacy and safety of ITR for the prevention of laser‐induced PIH. Patients/Methods: A randomized, evaluator‐blinded study including 24 subjects with SLs was conducted. Three SLs of each patient were randomized into three groups, which were to apply ITR twice daily, once daily, and no application for 2 weeks. Thereafter, 532‐nm QS Nd: YAG laser was performed. Incidence of laser‐induced PIH, relative melanin index (RMI), mean luminance score (L*), hyperpigmentation score, and adverse events were recorded for 2 months post‐laser. Results: The incidence of PIH at the 4th week after laser treatment was significantly lower in the ITR twice‐daily group compared to the no‐application group (20.83% vs. 50%, p = 0.028). There was no statistically significant difference in RMI, mean L*, and hyperpigmentation score between treatments at all visits. No serious adverse events were reported regarding ITR application and laser treatment. Conclusion: Two‐week application of ITR prior to QS: Nd YAG laser treatment may potentially reduce the incidence of PIH. A longer duration of application, including after the laser procedure, may be more beneficial for the prevention of laser‐induced PIH. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Reflectance confocal microscopy (RCM) has shown promise in predicting surgical outcomes by non‐invasively detecting subclinical lentigo maligna (melanoma) (LM/LMM).To assess the effects of presurgical mapping using handheld RCM (HH‐RCM) on surgical treatment, follow‐up outcomes and management decisions.A total of 117 consecutive LM/LMM cases (2015–2023) were included. The diagnostic accuracy of HH‐RCM in detecting subclinical LM and invasive components was evaluated. The primary endpoints included histological margin status and changes in management based on the outcomes of the HH‐RCM mapping procedure. Margin and follow‐up outcomes were compared to a historical cohort before HH‐RCM was introduced in our center (n = 94) (2003–2014).HH‐RCM detected subclinical LM in 60% (n = 60) of cases. The median mapping duration was 14 min (range 4–50). In 27% (n = 33), the mapping procedure resulted in modified management, the majority consisting of limited surgery with adjuvant imiquimod (n = 15) or imiquimod monotherapy (n = 14). The remaining cases (n = 84) underwent HH‐RCM‐assisted surgery. Histological margins were cleared in 96.5% of the patients with a median histological margin of 3.0 mm, significantly higher than 81% in the historical cohort (median 2.0 mm) (p = 0.001). The sensitivity and specificity for detecting the extent of subclinical LM were 94% (95% CI 80.4–99.3) and 84% (95% CI 70.3–92.7), respectively. The negative predictive value for the detection of LMM was 94% (95% CI 84.4–97.7), and 75% of the initially missed LMM (n = 12) were identified during the HH‐RCM mapping procedure. The study cohort had a 1.6% local recurrence rate compared with 25% in the historical cohort.Integrating HH‐RCM as the standard of care could lead to more personalized treatment strategies for LM/LMM and allows for the selection of patients suitable for nonsurgical treatment. [ABSTRACT FROM AUTHOR]

Introduction: Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AKs) on the face and scalp in adults to ensure excellent patient tolerability due to the mild side effects and the brief application time compared to other topical therapies on the market. A growing body of evidence suggests that, beyond their primary function, the treatments for AKs and the cancerization field may inadvertently confer substantial cosmetic benefits to patients. Methods: We report a single-center retrospective case series of patients referred to the Dermatology Unit of the University Hospital of Messina, Italy, between February and December 2023 seeking treatment for AKs in the context of photodamaged areas in which the application of tirbanibulin 1% ointment induced, besides clearance of AKs, anti-aging effects on both skin texture and solar lentigos. Results: Seven patients affected by Olsen grade 1–2 AKs experienced a powerful rejuvenating effect in the treated areas, with a marked efficacy in skin lightening and clearance of solar lentigo. Conclusions: Tirbanibulin 1% ointment seems able to improve skin aging as a desirable side effect at the site of application for AKs on chronic photodamaged skin. Such preliminary observation needs further confirmation in real-life studies on larger cohorts of patients, to explain the pathogenic mechanisms responsible for such aesthetically relevant results. [ABSTRACT FROM AUTHOR]

Photoaging pigmentation conditions such as senile lentigo and melasma show epidermal melanogenic activity and dermal abnormalities, including collagen degradation. A dermal rejuvenation strategy with skin‐lightening therapy directly acting on melanocytes is suggested for photoaging pigmentation. This study investigates whether collagen biostimulation can result in skin lightening of photoaging skin. A split‐face clinical trial was conducted, involving 40 subjects with facial melasma and senile lentigo. Subjects received a poly‐DL‐lactic acid (PDLLA) treatment on one side of their face, whereas the contralateral side received a treatment of normal saline as a control. Assessments were scheduled every month after completing treatments for up to 3 months. Pigmentation was evaluated using the L* value as measured with a chromameter and by investigator global assessment scores (IGA). Subjects reported different outcomes in terms of overall skin quality, including pigmentation, wrinkles and elasticity. Skin biopsies were obtained before the treatment and 4 weeks after completing the treatment. Fontana‐Masson, Masson‐Trichrome and Verhoeff‐van Gieson staining, and fibroblast‐specific protein 1 (FSP1) immunostaining were conducted. The PDLLA treatment demonstrated significant improvements in the L* values and IGA scores from 8 weeks after the subject completed their treatments. These improvements were sustained over a 12‐week assessment period. The subjects reported substantial reductions in both pigmentation and wrinkle severity and elasticity throughout the assessment period. Fontana‐Masson staining showed a marked decrease in pigmentation upon a PDLLA injection compared to the baseline values. Increased immunogenicity of FSP1 and increases in collagen and elastic fibre staining were observed. This study demonstrated remarkable improvements in photoaging pigmentation along with collagen production with a collagen biostimulator. Thus, collagen biostimulators represent a promising therapeutic approach for addressing photoaging signs associated with melasma and senile lentigo. (ClinicalTrials.gov Identifier: NCT05913102). [ABSTRACT FROM AUTHOR]

Lentigo maligna (LM) is a melanoma in situ that is prevalent in chronically sun-damaged skin. Characterized by a slow growth pattern and high mutation rates due to chronic UV exposure, LM poses diagnostic and therapeutic challenges, particularly given its tendency to mimic other skin lesions and its occurrence in cosmetically sensitive areas. Its diagnosis is based on an integrated approach using dermoscopy and reflectance confocal microscopy (RCM). Despite its slow progression, LM can evolve into lentigo maligna melanoma (LMM), making its treatment necessary. Treatment modalities encompass both surgical and non-surgical methods. Surgical treatments like Wide Local Excision (WLE) and Mohs Micrographic Surgery (MMS) aim for clear histological margins. WLE, a standard melanoma surgery, faces challenges from LM's subclinical extensions, which increase the recurrence risk. MMS, effective for large or poorly defined lesions, is defined by precise margin control while considering cosmetic outcomes. Non-surgical options, including radiotherapy and imiquimod, are alternatives for non-surgical candidates. Radiotherapy has been effective since the 1950s, offering good control and cosmetic results, especially for older patients. Imiquimod, an immunomodulator, shows promise in treating LM, though its application remains off-label. The increasing incidence of LM/LMM necessitates a balance in treatment choices to minimize recurrence and maintain cosmetic integrity. A multidisciplinary approach, integrating clinical examination with dermoscopy and RCM and histological assessment, is essential for accurate diagnosis and effective LM management. [ABSTRACT FROM AUTHOR]

BACKGROUND: Improving the appearance of lentigines on the hands is a key component to hand rejuvenation. Soft tissue fillers revolumize hands, but do not address pigmentary changes. OBJECTIVE: This study investigated the effiacy of a 15% trichloroacetic acid (TCA) + 3% glycolic acid (GA) combination peel in improvement of appearance of hand lentigines. METHODS: A prospective evaluator-blinded, split-hand study was performed using a 15% TCA + 3% GA peel to treat patients with hand lentigines. Subjects received a total of 3 treatments at 4-week intervals on 1 hand, with the other hand serving as an untreated control. Final photographs were taken 12 weeks after the last treatment. Two blinded board-certified dermatologists graded improvement in hand lentigines using a 5-point scale. RESULTS: Eighteen of 20 patients completed the study (90%). The mean age was 64.4 years (SE 1.6, range 51–71). The mean pain scores were 3.8 (SE 0.4) on a 10-point scale (1 = no pain, 10 = extremely painful). Blinded evaluators correctly identified the after-treatment photographs in 16 patients (88%). Physician and patient-graded mean improvement of lentigines was significant for treated versus control hands (p <.01). No adverse events were noted. CONCLUSION: A series of three 15% TCA + 3% GA peels are effective and safe in the treatment of hand lentigines. [ABSTRACT FROM AUTHOR]

Background: Information on lentigo maligna (LM) and lentigo maligna melanoma (LMM) in the 21st century is scarce. We aimed to elucidate the incidence of LM and LMM using the Surveillance, Epidemiology, and End Results (SEER) 17 Registries. Methods: The data of patients diagnosed between 2000 and 2019 were extracted from the SEER database. The percentage of LM/LMM cases among all melanoma patients, age‐standardized incidence rates, estimated annual percentage changes, and the cumulative incidence of LMM after LM were calculated. Results: The SEER data yielded 95,175 patients with LM/LMM between 2000 and 2019. Cases of LM/LMM accounted for 15.7% of all melanomas. The age‐standardized incidence per 100,000 person‐years for LM increased from 4.16 to 5.61 and for LMM from 1.33 to 2.35 between 2000 and 2019. The annual increase in incidence of LM was 2.42%, and that of LMM was 3.32%. The cumulative incidence of LMM after a primary LM after 10‐year follow‐up was 0.94%. Conclusions: This study provides the first comprehensive analysis of the epidemiological status of LM/LMM in the United States in the 21st century using the population‐based SEER data. [ABSTRACT FROM AUTHOR]

Hydroquinone has been used for years for multiple conditions, including melasma, post-inflammatory hyperpigmentation, dyschromia from photoaging, and solar lentigines. It is known to be a very effective lightening agent, but several concerns have been raised about this widely used agent. The recent U.S. ban on over-the-counter skin lightening products containing hydroquinone has prompted further questioning of the safety of this widely used agent. While there have been prior informative, large-scale reviews on the safety of hydroquinone, new findings have since been reported. Here, we provide an updated review of studies published in the past 15 years on hydroquinone safety. [ABSTRACT FROM AUTHOR]

Although the pathogenesis of solar lentigo (SL) involves chronic ultraviolet (UV) exposure, cellular senescence, and upregulated melanogenesis, underlying molecular-level mechanisms associated with SL remain unclear. The aim of this study was to investigate the gene regulatory mechanisms intimately linked to inflammation in SL. Skin samples from patients with SL with or without histological inflammatory features were obtained. RNA-seq data from the samples were analyzed via multiple analysis approaches, including exploration of core inflammatory gene alterations, identifying functional pathways at both transcription and protein levels, comparison of inflammatory module (gene clusters) activation levels, and analyzing correlations between modules. These analyses disclosed specific core genes implicated in oxidative stress, especially the upregulation of nuclear factor kappa B in the inflammatory SLs, while genes associated with protective mechanisms, such as SLC6A9, were highly expressed in the non-inflammatory SLs. For inflammatory modules, Extracellular Immunity and Mitochondrial Innate Immunity were exclusively upregulated in the inflammatory SL. Analysis of protein–protein interactions revealed the significance of CXCR3 upregulation in the pathogenesis of inflammatory SL. In conclusion, the upregulation of stress response-associated genes and inflammatory pathways in response to UV-induced oxidative stress implies their involvement in the pathogenesis of inflammatory SL. [ABSTRACT FROM AUTHOR]

Background: Due to the lack of a large series of benign and malignant vulvar lesions, the features of dermoscopy are not well established. Objective: The aim of our study was to describe the epidemiological profile and the clinical and dermoscopic characteristics that may indicate malignancy or benignity in vulvar hyperpigmentation. Materials and Methods: From June 2020 to June 2023, we conducted a retrospective, prospective study involving 42 patients with 59 pigmented lesions. Results: The parallel, homogeneous, and globular patterns were observed in benign lesions (nevi, lentigo, melanosis). The cerebriform pattern was observed in seborrheic keratosis and Bowen's disease (BD). In cases of BD, we also observed white, structureless areas, glomerular vessels, a homogeneous brownishgray area, and brown dots. Conclusion: Good clinico-dermoscopic correlation should guide the diagnosis and management of pigmented vulvar lesions. Dermoscopy may be helpful in distinguishing between a benign lesion and a malignant lesion, yet in cases of doubt, a biopsy may be necessary. [ABSTRACT FROM AUTHOR]

Background: The 1064 nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser was developed to treat unwanted pigmentation in the skin such as lentigines caused by photoaging, and tattoos from dye/ink insertion. This laser has also been used for non-ablative epidermal rejuvenation (skin toning). Objective: To evaluate changes in skin tone, skin texture and overall improvement after a series of treatments with the QS Nd:YAG laser. Methods: Participants received seven full-face treatments with M22 or Stellar M22, a 1064 nm QS Nd:YAG laser, at 2-week intervals. The investigators and participants evaluated the improvement in skin tone and texture at 1, 3 and 6 months after the last treatment. Patient satisfaction, patient discomfort, downtime and adverse events were recorded. Histological changes in the treated area were also evaluated. Results: Thirteen women with a median age of 45 years (range, 34–61 years) were included in the study. The majority of the participants (53.9%) had skin type VI. One month after the last treatment session, 38% of participants reported good to very good improvement. This value increased to 100% participant improvement at both the 3-month and 6-month follow-up visits. The reduction in melanin index and the histological analysis demonstrated that the laser procedure contributed to a reduction in epidermal melanin content. Treatments were not associated with high levels of pain or discomfort. The most common immediate post-treatment response was erythema and edema. Most participants were satisfied with the resulting treatment outcome. Conclusion: Skin treatment with the 1064 nm QS Nd:YAG laser module on the M22 and Stellar M22 devices, using a large spot size, low fluence, moderately high repetition rate, improves skin tone and texture in patients with skin types II–VI. [ABSTRACT FROM AUTHOR]

Lentigo maligna (LM) is a melanoma in situ with distinct clinical features and histology. It commonly affects men after the sixth decade of life. Incidence rates of LM have increased based on early 21st century data from different countries; however, data are suboptimal. Data from England show a plateauing crude incidence between 2013 and 2019. By comparison, invasive melanoma and other types of melanoma in situ commonly appears in younger age groups (median age 58 and 67 years old, respectively) and incidence is rising. The most important risk factors for LM include fair skin and cumulative ultraviolet solar radiation exposure. Although LM is limited to the epidermis and connected skin adnexa, it may progress to invasive LM melanoma. The reported rate of malignant progression varies, reflecting a challenge for LM epidemiology research as often lesions are removed on diagnosis. LM poses a challenge in diagnosis and management. Although it can be diagnosed clinically or dermoscopically, histopathological assessment of biopsied skin tissue remains the gold standard. Reflectance confocal microscopy allows for better appreciation of the complexity of LM at a cellular level, often progressing beyond clinical margins. Management of LM may involve Mohs micrographic surgery or excision, although recurrence may occur even with 5 mm clinical margins. Imiquimod cream may be effective, but incomplete treatment and recurrence has been reported. Conservative management with observation or radiotherapy may be used in selected patients' cases. Five-year net survival rates are excellent. This paper reviews the natural history, epidemiology, aetiology, pathogenesis, diagnosis and management of LM. [ABSTRACT FROM AUTHOR]

Background /Purpose: Melasma and solar lentigo (SL) are major benign hyperpigmented lesions, and both have been shown to involve the dermal vasculature. This review discusses current knowledge regarding the clinical characteristics of dermal vascularity in melasma and SL, as well as the results of relevant molecular biological investigations. Methods: PubMed and Google Scholar were searched in December 2023 to identify articles related to melasma, SL, and the dermal vasculature in these lesions. Results: Vascular morphologies in melasma and SL have been detected by histological and non‐invasive methods, including modalities such as optical coherence tomography. Biological studies have indicated that factors secreted from vascular endothelial cells, such as stem cell factor and endothelin‐1, can promote melanogenesis. With respect to phototherapy, blood vessel‐targeting laser treatments are expected to provide long‐term suppression of pigmentation, but this regimen is only effective when dilated capillaries are visible. Conclusion: In both melasma and SL, clinical and experimental investigations are revealing the contributions of dermal vascularity to hyperpigmentation. More effective treatment may require identification of hyperpigmentation subtypes. In the future, knowledge of treatment (including phototherapy) is expected to accumulate through reliable and validated non‐invasive measurements. [ABSTRACT FROM AUTHOR]

Background Lentigo maligna/lentigo maligna melanoma (LM/LMM) is usually diagnosed in older patients, when lesions are larger. However, it is important to detect it at an earlier stage to minimize the area for surgical procedure. Objectives To determine and define clinical, dermoscopic and reflectance confocal microscopy (RCM) features of LM/LMM in patients<50 years old. Methods This was a multicentre study involving tertiary referral centres for skin cancer management. The study included cases of consecutively excised LM/LMM arising in patients<50 years of age with a histopathological diagnosis of LM/LMM and a complete set of clinical and dermoscopic images; RCM images were considered when present. Results In total, 85 LM/LMM of the face from 85 patients<50 years were included in the study. A regression model showed a direct association with the size of the lesion (R2=0.08; P=0.01) and with the number of dermoscopic features at diagnosis (R2=0.12; P<0.01). In a multivariable analysis, an increasing number of dermoscopic features correlated with increased patient age (P<0.01), while the presence of grey colour was a predictor of younger age at diagnosis (P=0.03). RCM revealed the presence of melanoma diagnostic features in all cases (pagetoid cells and atypical nesting). Conclusions LM is not a disease limited to older people as previously thought. LM presenting in young adults tends to be smaller and with fewer dermoscopic features, making its diagnosis challenging. Careful evaluation of facial pigmented lesions prior to cosmetic procedures is imperative to avoid incorrectly treating early LM as a benign lesion. [ABSTRACT FROM AUTHOR]

Background Compared with the general population, people with a previous melanoma are at increased risk of developing another primary melanoma. Understanding the risk factors associated with multiple primary melanomas can inform patient education and tailored surveillance. Objectives To examine the risk factors for subsequent primary melanoma in people with a previous melanoma, by conducting a systematic review and meta-analysis of the available data. Methods A systematic literature search was conducted in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase and MEDLINE. Studies that reported a risk estimate or raw frequencies and conducted between 1982 and August 2022 were included. Adjusted risk estimates were prioritized over univariable risk estimates. PRISMA reporting guidelines were followed. Random effects meta-analysis was conducted to derive pooled estimates. Quality assessment was conducted by two researchers using the Newcastle-Ottawa scale. GRADE was used to rate the certainty and quality of the evidence. Results Data from 27 studies involving 413 181 participants were pooled and analysed. Risk factors assessed included age and sex, environmental, lifestyle, phenotypic, genetic and histopathological factors, and there was wide variation in how they were categorized and analysed. Independent risk factors identified from pooled analyses included male sex [hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.40–1.53], increasing age per 10 years (HR 1.19, 95% CI 1.14–1.24), light skin colour (HR 1.44, 95% CI 1.23–1.70), family history [odds ratio (OR) 1.79, 95% CI 1.25–2.56], CDKN2A mutation (OR 5.29, 95% CI 2.70–10.37), a high or moderate naevus count [OR 2.63 (95% CI 1.61–4.30) and OR 1.64 (95% CI 1.07–2.51), respectively], one or more atypical naevi (OR 3.01, 95% CI 1.52–5.97), first lesions occurring on the head or neck, lentigo maligna subtype (HR 1.16, 95% CI 1.15–1.17), other subtype (HR 1.14, 95% CI 1.03–1.27) and inadequate sun protection (HR 1.85, 95% CI 0.98–3.50). Based on the GRADE criteria, there was high to very low confidence in the pooled effect estimates. Conclusions This meta-analysis identified several consistent, independent risk factors for the development of subsequent primary melanoma. These findings will help stratify the risk of subsequent melanoma, tailor skin-check schedules and inform patient education. [ABSTRACT FROM AUTHOR]

Background: Solar lentigines are common hyperpigmented lesions typically appearing after 50 years of age and associated with negative psychological effects in affected individuals. Topical depigmenting products, such as hydroquinone and even the Kligman's formula, are usually ineffective for treating lentigines. Stabilized cysteamine has been recently shown to be as effective as the modified Kligman's formula for treating melasma. In this study, we evaluated the therapeutic effect of a stabilized cysteamine on solar lentigines. Methods: A vehicle‐controlled, double‐blind, and randomized study was performed on 30 patients with solar lentigines. Stabilized cysteamine or vehicle control creams were applied on solar lentigines on the dorsum of the hands daily for 12 weeks. Clinical measurements with colorimetry and visual analog scale were performed at baseline, 4, 8, and 12 weeks. Results: Statistically significant results were obtained in the cysteamine group versus the vehicle control group. Stabilized cysteamine provided a 40% reduction in colorimetric values (p < 0.002) versus a 2% reduction in the vehicle group (p < 0.405). Cysteamine also provided a 40% reduction in VAS (p < 0.001) versus a 2% reduction in the vehicle group (p < 0.245). Conclusion: Significant improvement of solar lentigines was observed after 12 weeks of application of stabilized cysteamine by all evaluation methods. Stabilized cysteamine represents a highly effective topical treatment for solar lentigines and can be considered as one of the first topical therapies effective on this hyperpigmentary disorder. [ABSTRACT FROM AUTHOR]

This article, published in Experimental Dermatology, explores the molecular pathogenesis of lentigos, which are hyperpigmented skin lesions that commonly appear on sun-exposed areas of the body. The researchers performed transcriptomic microarray analysis on lentigo samples to identify potential biomarkers. They found that miR-4521, a microRNA, was highly expressed in lentigos compared to control skin samples. Further analysis suggested that miR-4521 may regulate proteosomal degradation and autophagy. This study provides valuable insights into the molecular mechanisms underlying lentigo formation. [Extracted from the article]

This article discusses the use of phototherapy in the treatment of pigmentary disorders, such as melasma, senile lentigo, and vitiligo. It emphasizes the importance of targeting vascular characteristics in hyperpigmentary disorders and highlights the role of energy-based devices, such as lasers and radiofrequency, in controlling dermal changes. The article also addresses the need for photoprotection in preventing and treating hyperpigmentary disorders, particularly in Asian populations. Additionally, it explores the effectiveness of phototherapy as the cornerstone treatment for vitiligo and discusses strategies for treating challenging areas and enhancing the efficacy of repigmentation. [Extracted from the article]