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In This Issue of JAMA Dermatology
October 2016


JAMA Dermatol. 2016;152(10):1075. doi:10.1001/jamadermatol.2015.3289


The diagnosis of some cutaneous cancers remains challenging even with dermoscopy tools. Reflectance confocal microscopy (RCM) may be a useful tool to prevent unnecessary excisions of benign lesions while catching malignant melanomas that are dermoscopically inconspicuous. In this prospective study, Borsari et al demonstrate that RCM had a 95.3% sensitivity and 83.9% specificity for diagnosis of skin cancer. The most favorable locations for RCM use were the head and neck, in part because of the thin epidermis and the fact that dermoscopy findings are often ambiguous in these sites.


Several studies find that most women report engaging in pubic grooming and hair removal in the 21st century, including total removal of all pubic hair. These practices pose some potential risk of injury, most often related to shaving. In this questionnaire survey, Rowen et al demonstrate that women groom for social events as well as health care visits. Women were far more likely to groom if their partner also groomed and if their partner preferred that they groom. Grooming was less associated with specific sexual activity and relationship type and more associated with age, race, and educational level.

Inflammatory pathways of psoriasis share similarities with the mechanisms identified in atherosclerosis, and the association between psoriasis and cardiovascular disease due to accelerated coronary artery disease is well established. In this prospective, controlled clinical study of patients treated with biologic therapies approved for psoriasis, Hjuler et al demonstrate that treatment with these agents was associated with reduced coronary artery disease (CAD) progression in patients with moderate to severe psoriasis. It remains unclear to what extent this reduced CAD progression translates into a reduced risk of cardiovascular events.

Keratinocyte carcinoma, often called nonmelanoma skin cancer (NMSC), accounts for substantial health care cost burdens. However, basal cell and squamous cell carcinoma exclusion by most cancer registries in North America impedes epidemiological research and health policy decision making. Administrative health insurance claims databases offer the opportunity to identify NMSCs using diagnosis and procedural codes submitted for reimbursement. In this retrospective study, Chan et al applied recursive partitioning to derive and validate a claims-based algorithm for identifying NMSC, demonstrating the value of this method in deriving valid claims-based algorithms.

Antagonist antibodies to programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) have shown remarkable activity in many tumor types. Recent US Food and Drug Administration approval of such agents for advanced melanoma and other cancers has hastened the need to better characterize their unique toxic effects profiles. In this case series, Shi et al describe a range of cutaneous adverse effects seen with anti–PD-1/PD-L1 agents, but a papular eruption with associated scale and a lichenoid pattern on histologic analysis was most common. Further investigation is needed to determine if there is an association between cutaneous adverse effects and tumor response.

Continuing Medical Education