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Disease activity in vitiligo is difficult to assess in the absence of inflammatory signs such as erythema or scaling. Limited evidence is available on circulating markers that are linked to progressive vitiligo. In this cross-sectional, prospective study, Speeckaert et al demonstrate that serum levels of soluble CD25 (sCD25) and sCD27 molecules were elevated in patients with vitiligo. Serum sCD25 levels were significantly lower in patients treated with topical calcineurin inhibitors, and serum sCD27 levels were lower in patients with recent repigmentation. These data demonstrate a potential for these biomarkers to be used in monitoring treatment responses.
By definition, in situ melanoma is confined to the epidermis with theoretically no risk of metastasis. However, in situ melanoma does rarely metastasize, and patients die of the disease. The presence of occult invasion is a possible explanation for this occurrence. In this case series, Bax et al demonstrate that occult microinvasion was found in up to one-third of unequivocal in situ melanoma cases. History, physical examination (including of the lymph nodes), education, and surveillance recommendations should be based on a very low, but not zero, risk of melanoma metastasis.
Highlights. JAMA Dermatol. 2016;152(11):1181. doi:https://doi.org/10.1001/jamadermatol.2015.3296
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