Highlights | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Sign In
Views 928
Citations 0
In This Issue of JAMA Dermatology
January 2018


JAMA Dermatol. 2018;154(1):7. doi:10.1001/jamadermatol.2017.1979


Information on the population distribution of histologic diagnoses associated with skin biopsies is unknown. In particular, the epidemiology of melanocytic proliferations, ranging from benign to dysplastic to malignant, is largely unknown. Using natural language processing to analyze electronic medical record pathology reports, Lott et al categorize melanocytic lesions via the MPATH-Dx tool. Overall distribution revealed that 83.1% were class I (benign or mildly dysplastic), while 4.1% were class IV/V (invasive melanoma). A better understanding of the frequency of melanocytic proliferations and their diagnostic characteristics may improve the accuracy of melanoma classification.


Topical steroids have long been used to treat mild to moderate atopic dermatitis (AD). Recent studies reveal that gut microbiota in patients with AD show compositional changes that reduce the number of high butyrate and propionate producers. The resulting proinflammatory state and a loss of gut barrier integrity may be associated with AD pathogenesis. In this randomized clinical trial, Navarro-López et al demonstrate that SCORAD index and topical steroid use decreased significantly in probiotics-treated children. This safe and effective treatment should be considered for children with moderate AD.

Continuing Medical Education

Dermatomyositis is an idiopathic inflammatory myopathy that manifests as inflammation in the skin, muscles, joints, and lungs. Cutaneous involvement may persist despite adequate control in other organ systems. In this cohort study, Wolstencroft et al demonstrate that clinical remission was relatively uncommon. Increasing age, associated malignancy, and mycophenolate mofetil treatment were significantly associated with clinical remission of skin disease, while having anti–melanoma differentiation-associated gene 5 antibodies was significantly associated with worse outcomes.

Solid organ transplant recipients (SOTRs) have a 100-fold risk of squamous cell carcinoma (SCC), and they may develop more aggressive SCCs than immunocompetent individuals. This risk increases for SOTRs with greater cumulative time spent receiving immunomodulatory therapy and with increasing intensity of the regimen. In this cohort study, Cheng et al demonstrate that the increased risk and potential for aggressive SCCs in SOTRs may be managed at a level comparable to high-risk immunocompetent individuals by following current surveillance recommendations and allowing a marginally lower threshold for biopsy of suspect lesions.

The World Health Organization supports a ban on indoor tanning for anyone younger than 18 years, and the US Food and Drug Administration has classified tanning beds as carcinogenic. Forty-two states and the District of Columbia have passed legislation limiting the use of indoor tanning devices for minors. In this cross-sectional telephone survey, Williams et al demonstrate that 37.2% of tanning salons were noncompliant with state legislation. The best compliance with these laws was found in states with tanning bans for all minors, but the need for better law enforcement is clear.