In addition to environmental insults, family history represents a significant risk factor for malignant melanoma. Melanoma is associated with a complex genetic heterogeneity, with cyclin-dependent kinase inhibitor 2A (CDKN2A or p16) and melanocortin-1 receptor (MC1R) gene mutations contributing to melanoma risk. In this case report, Eliason et al describe a patient from a familial melanoma pedigree with 7 primary melanomas on the right side of her body, the first occurring 5 years after atmospheric testing in the 1950s during which that side of her body was exposed to ionizing radiation. Genetic testing revealed deleterious homozygous CDKN2A and MC1R mutations. In this case, multiple primary melanomas were likely the result of environmental exposures superimposed on a highly vulnerable genetic predisposition.
The pathogenesis of androgenetic alopecia (AGA) involves androgens and a genetic predisposition. In this population-based cross-sectional survey in Taiwan, Su and Chen investigate whether environmental factors such as smoking may play a role. The prevalence of AGA increased steadily with advancing age, regardless of family history. Smoking status, current amount of cigarette smoking, and smoking intensity were significantly associated with AGA, suggesting that patients with early onset of AGA may well receive smoking cessation advice to prevent further worsening.
Even for experienced dermatologists, acral melanocytic nevi may be difficult to differentiate from early acral melanoma by clinical evaluation alone. Acral melanocytic nevi present unique dermoscopic features, including the parallel furrow pattern and its globular and double-lined variants, the latticelike pattern, the fibrillar pattern, and the nontypical pattern. Digital dermoscopic surveillance with short-term monitoring is a valuable tool for early detection of melanoma. In this retrospective analysis of digital dermoscopic follow-up of 230 nevi located on acral volar skin, Altamura et al classified the type and frequency of dermoscopic changes over time. The parallel furrow pattern was the most frequent and the most dynamic dermoscopic pattern of acral melanocytic nevi.
Health-related quality of life is a crucial outcome in cancer research and clinical care, particularly for nonfatal cancers for which alternative therapies exist. Cutaneous basal cell and squamous cell carcinomas are typically nonfatal. In this prospective cohort study of consecutive patients with nonmelanoma skin cancer, Chen et al identified predictors of skin-related quality of life after treatment of nonmelanoma skin cancer. The strongest independent predictor of skin-related quality of life after therapy was skin-related quality of life before therapy. Mental health status, comorbidity, and race were the only other independent predictors of quality of life. Tumor characteristics were not related to quality-of-life outcomes.
Outbreaks of dermatologic diseases such as staphylococcal infections, tinea corporis, and arthropod bites occur frequently after hurricanes and flooding. In this retrospective cohort study, Noe et al determined the extent and scope of an outbreak of skin eruptions that affected civilian construction workers living and working on a New Orleans military base after hurricanes Katrina and Rita made landfall. Four clinical entities were identified. Most common was papular urticaria, followed by bacterial folliculitis, fiberglass dermatitis, and brachioradial photodermatitis. People working and living in posthurricane environments may be at increased risk of arthropod exposure, and the authors offer strategies for avoiding dermatologic diseases.
Multiple Primary Melanomas in a CDKN2A Mutation Carrier Exposed to Ionizing Radiation. Arch Dermatol. 2007;143(11):1365. doi:10.1001/archderm.143.11.1365