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Much of the economic burden in melanoma screening results from excisions and biopsies of benign lesions, especially in patients with multiple melanocytic nevi. Dermoscopy may reduce the number of unnecessary excisions, although irregular dermoscopic features still prompt unnecessary excisions. In this study, Argenziano et al demonstrate that the comparative approach to dermoscopy (assessment of the nevus in the context of multiple lesions) may dramatically reduce the number of unnecessary excisions compared with the morphologic approach (assessment of a single lesion).
Natalizumab is a humanized monoclonal antibody directed against the cellular adhesion molecule α4 integrin. Natalizumab interrupts inflammatory processes and has been used as monotherapy for highly active relapsing-remitting multiple sclerosis. Four cases of melanoma have been reported in association with natalizumab use. In this cohort study, Castela et al demonstrate the same rate of clinical and dermoscopic changes of nevi under natalizumab therapy compared with the spontaneous evolution of nevi reported in the literature. These data support the absence of malignant transformation of nevi owing to the inhibition of α4 integrin by natalizumab.
Pemphigus herpetiformis (PH) is a rare immunobullous disorder with clinical features of dermatitis herpetiformis and immunopathologic features of pemphigus. In most cases, the target antigen is desmoglein 1 (Dsg1), although rare patients manifest anti-Dsg3 autoantibodies. Although the association of cancer with immunobullous disease is well described, PH is only rarely reported in association with a neoplasm. In this case report, Prado et al describe the first patient with PH, an underlying lung neoplasm, and IgG autoantibodies directed against Dsg3 and an unknown 178-kDa protein. It remains unclear if the anti–178-kDa protein autoantibodies were involved with this patient's unusual presentation.
The quest for consistent clinical assessment has led to the development of objective grading methods for characterization and quantification of photodamage. To date, no valid and reliable photographic assessment scale of forearm skin sun damage has been developed. McKenzie et al used 96 standardized photographs of forearm skin for grading by an expert dermatologist and 5 community dermatologists using an existing 9-category scale. The expanded Dermatologic Assessment Form Forearm Photographic Assessment scale has great potential to yield highly consistent scoring of forearm sun damage in study participants.
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disease of the axilla, inframammary, and inguinal areas. Therapies include lifestyle changes, antibiotics, retinoids, and immunosuppressive, biological, and surgical therapies. In this prospective, controlled clinical trial, Xu et al demonstrate that the long-pulsed 1064-nm Nd:YAG laser is a novel and effective treatment option for HS. This laser may penetrate deeply enough for selective photothermolysis of the follicular unit and destruction of organized inflammatory lesions in the dermis, offering a noninvasive, well-tolerated, and effective treatment option for patients with this debilitating disease.
This Month in Archives of Dermatology. Arch Dermatol. 2011;147(1):13. doi:10.1001/archdermatol.2010.398