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In This Issue of JAMA Dermatology
July 2019


JAMA Dermatol. 2019;155(7):771. doi:10.1001/jamadermatol.2018.3523


Moreno and colleagues performed a retrospective cross-sectional study to identify the histological characteristics associated with an invasive component of lentigo maligna melanoma. Incisional partial biopsies were taken from 96 patients with a diagnosis of primary cutaneous melanoma in either the lentigo maligna or lentigo maligna melanoma forms. Biopsy results showed that the presence of rows of melanocytes, subepidermal clefts and nests, and a decreased degree of solar elastosis was associated with an invasive component of the disease. LeBoit provides the Editorial.


Using a retrospective, multicenter cohort study, Colboc and coauthors investigated the location, morphologic features, and chemical composition of calcific uremic arteriolopathy calcifications. Cutaneous biopsy results from 29 patients showed that the calcifications were composed of pure calcium-phosphate apatite, were circumferentially located on small to medium-sized blood vessels, and were associated with interstitial deposits, unlike the control arteriosclerotic vessel calcifications, which had no interstitial deposits and thickened vessel walls, suggesting a different pathogenetic mechanism. Dominguez provides the Editorial.

Editorial and Related Article

Reddy and coinvestigators performed a cross-sectional analysis of patients with hidradenitis suppurativa, psoriasis, and a matched control group to evaluate the comparative comorbidity burden of patients with hidradenitis suppurativa. Using the Charlson Comorbidity Index, patients with hidradenitis suppurativa had a significantly higher comorbidity index, and therefore a significantly higher comorbidity burden, when compared with patients with psoriasis and matched control cohorts.

Author Audio Interview and Continuing Medical Education

Ruiz and colleagues performed a cohort study to compare the performance of the new eighth edition of the American Joint Committee on Cancer Staging Manual (AJCC 8) with the Brigham and Women’s tumor classification system (BWH) for head and neck cutaneous squamous cell carcinoma. The AJCC 8 classified twice as many tumors as high tumor class compared with the BWH. Additionally, the BWH demonstrated higher specificity and positive predictive values for identifying cases at risk for metastasis or death. The AJCC 8’s lack of distinction between high tumor classes increased the chances of inappropriate upstaging of low-risk disease in patients with head and neck cutaneous squamous cell carcinoma.

In a retrospective, matched-cohort study, Wang and colleagues evaluated the association of leukemia cutis, an important yet understudied manifestation of leukemia, with the course of acute myeloid leukemia. Patients with acute myeloid leukemia with leukemia cutis were matched with 3 patients with acute myeloid leukemia alone and their respective probabilities of survival were compared. Results showed that 5-year survival among patients with acute myeloid leukemia with leukemia cutis was approximately 30% shorter than the 5-year survival among patients with acute myeloid leukemia alone. Patients with leukemia cutis also had a higher risk of extramedullary organ burden.