Prurigo pigmentosa is an inflammatory dermatosis that rarely occurs in Europe and mostly affects young women. Here, we describe the typical clinical and dermoscopic criteria so that therapy can be initiated as early as possible. The 17-year-old patient presented here shows that this disease can also be observed in Western Europe and in men, and that doxycycline is a very effective treatment option.
UNASSIGNED: Die Prurigo pigmentosa ist eine in Europa wenig verbreitete entzündliche Dermatose, an der meist junge Frauen leiden. Wir beschreiben hier die typischen klinischen und dermatoskopischen Kriterien, damit frühestmöglich eine Therapie eingeleitet werden kann. Der hier vorgestellte 17-jährige Patient zeigt, dass diese Erkrankung auch in Westeuropa und bei Männern beobachtet werden kann und Doxycyclin eine sehr wirksame Therapieoption darstellt.

Poor differentiation is strongly associated with poor outcomes in cutaneous squamous cell carcinoma (CSCC). In addition, the National Comprehensive Cancer Network (NCCN) guidelines designate poorly differentiated tumors as \"very high risk\". Despite its clear prognostic implications, there is no standardized grading system for CSCC differentiation in common use today. CSCC differentiation is graded inconsistently by both dermatopathologists and Mohs surgeons, and reliability studies have demonstrated suboptimal inter- and intra-rater reliability in both of these groups. The absence of a standardized and reliable grading system has impeded the use of differentiation in CSCC staging, despite its apparent correlation with disease outcomes. We performed a comprehensive review of the literature summarizing historical CSCC differentiation grading systems, as well as grading systems in non-cutaneous head and neck SCC as a point of reference. Relevant articles were identified by searching Embase and PubMed, as well as by reviewing reference lists for additional articles and histology textbook excerpts. CSCC grading systems that were identified and summarized include the historical Broders system, the World Health Organization system, the College of American Pathologists\' system, and a system described by a 2023 Delphi consensus panel of dermatopathologists.

UNASSIGNED: Melanoma is the ninth most prevalent and the second most lethal tumour. The aetiology and pathogenesis remain uncertain. It occurs in elderly people, over the fifth decade, and is predominant in males. Clinically, they present as an asymptomatic macular or nodular growth. The prognosis is impacted by the size of the tumour and distant metastases. Patients with distant metastases have a 5-year survival rate of less than 30%, constituting metastasis as the major cause of melanoma-related fatality. Currently, the mainstay of treatment for metastatic melanoma is immunotherapy due to the inoperable state, radioresistant nature of the tumour and high chances of cytotoxicity in chemotherapy. A senile male patient, who was diagnosed with oral malignant melanoma of the maxillary buccopalatal gingiva with distant metastasis to the liver and the prostate, is reported here. Although metastasis to the liver is common among malignant melanomas, in this case metastasis to the prostate gland highlights the rarity.

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A standard metric for melanoma detection is the number needed to biopsy (NNB). This metric has been used to evaluate practicing dermatologists, dermatology advanced practice professionals, and primary care providers. This metric, however, has rarely been applied to residency clinics. We aimed to determine the NNB at the University of Colorado residency clinics. Moreover, we sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on NNB. This study is a retrospective analysis of biopsies performed from 2016 to 2022 at the Denver Health Medical Center and the Rocky Mountain Regional Veteran Affairs dermatology clinics. Differential diagnosis at the time of biopsy was searched for keywords including melanoma, melanoma in situ, and lentigo maligna. Skin biopsies that included re-excisions were excluded. The NNB was subsequently generated by dividing the number of biopsied lesions with suspected melanoma by the number of histologically confirmed melanomas. The data was further separated by pre-COVID-19 (2016-February 2020), COVID-19 shutdown period (March 2020-July 2020), and post-COVID-19 (March 2020-present). Demographic data, including age, sex, race, and Fitzpatrick type, were collected. There were 2230 biopsies with suspected melanoma in the differential diagnosis at both clinic sites from 2016 to 2022. Of these, 362 were histologically confirmed melanoma. Total NNB was 6.16. The pre-COVID-19 NNB was 5.86, and the post-COVID-19 NNB was 6.91. Residency clinics have NNB similar to published values of practicing dermatologists. Furthermore, within these clinics, the impact of the COVID-19 pandemic was appreciated by a relative, although statistically insignificant, increase in NNB.

Gender disparity in melanoma is a complex issue where sex hormones could be engaged. Differences in genetic variations are important in understanding the mechanisms of sex disparity in melanoma. Post-transcriptional regulation of prostaglandin-endoperoxide synthase (PTGS2) mRNA occurs through a complex interplay of specific trans-acting RNA-binding proteins and microRNAs. MiR-146a is a key player in melanoma, modulating immune responses and tumor microenvironment (TME). Polymorphisms in PTGS2 gene rs20415GC have been associated with an increased risk of melanoma. Epistasis between polymorphisms rs20415GC was investigated by genotyping 453 melanoma patients and 382 control individuals. The effects of testosterone and 17β-estradiol were analyzed in keratinocytes and two melanoma cell lines. The rs2910164GG showed a higher risk in the presence of the genotype rs20417CC in the male population. Testosterone and 17β-estradiol act differently on PTGS2 and miR-146a expression, depending on the cell type. Testosterone augments PTGS2 gene expression in keratinocytes and miR-146a in melanoma cells. While 17β-estradiol only increases miR-146a expression in HaCaT cells. The present study indicates a sex-specific relation between miR-146a and PTGS2 polymorphisms with melanoma cancer risk. Testosterone and 17β-estradiol act differently on the expression of PTGS2 and miR-146a depending on the skin cell type.

Urinary bladder with concurrent colonic melanoma is an exceptionally uncommon occurrence, posing a diagnostic challenge for clinicians. While rare, it warrants consideration as a potential differential diagnosis, particularly in patients without a history of melanoma who present with persistent hematuria due to its aggressive nature. We present a case of a 55-year-old female with malignant melanoma involving the colon and urinary bladder presenting with hematuria. Given the scarcity of cases and variability in clinical management approaches, there is a pressing need for research efforts to establish standardized protocols and conduct trials to guide clinical practice in this rare entity.

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Skin cancer is a significant public health issue, and computer-aided diagnosis technology can effectively alleviate this burden. Accurate identification of skin lesion types is crucial when employing computer-aided diagnosis. This study proposes a multi-level attention cascaded fusion model based on Swin-T and ConvNeXt. It employed hierarchical Swin-T and ConvNeXt to extract global and local features, respectively, and introduced residual channel attention and spatial attention modules for further feature extraction. Multi-level attention mechanisms were utilized to process multi-scale global and local features. To address the problem of shallow features being lost due to their distance from the classifier, a hierarchical inverted residual fusion module was proposed to dynamically adjust the extracted feature information. Balanced sampling strategies and focal loss were employed to tackle the issue of imbalanced categories of skin lesions. Experimental testing on the ISIC2018 and ISIC2019 datasets yielded accuracy, precision, recall, and F1-Score of 96.01%, 93.67%, 92.65%, and 93.11%, respectively, and 92.79%, 91.52%, 88.90%, and 90.15%, respectively. Compared to Swin-T, the proposed method achieved an accuracy improvement of 3.60% and 1.66%, and compared to ConvNeXt, it achieved an accuracy improvement of 2.87% and 3.45%. The experiments demonstrate that the proposed method accurately classifies skin lesion images, providing a new solution for skin cancer diagnosis.
皮肤癌是一个重要的公共卫生问题，计算机辅助诊断技术可以有效地减轻这一负担。在采用计算机辅助诊断时，准确识别皮肤病变类型至关重要。为此，本文提出一种基于Swin-T与ConvNeXt的多级注意力逐级融合模型，采用分层Swin-T与ConvNeXt分别提取全局与局部特征，并提出残差通道注意力与空间注意力模块进一步提取有效特征；利用多级注意力机制对多尺度全局与局部特征进行处理；针对浅层特征因离分类器较远而丢失的问题，采用逐级聚合的思想，提出逐级倒置残差融合模块动态调整提取的特征信息。本文通过均衡采样策略以及焦点损失，解决皮肤病变类别不平衡的问题。在ISIC2018、ISIC2019数据集上进行测试，其准确率、精确率、召回率和F1-Score分别是96.01%、93.67%、92.65%、93.11%与92.79%、91.52%、88.90%、90.15%。与Swin-T相比，准确率分别提升了3.60%和1.66%；与ConvNeXt相比，准确率分别提升了2.87%和3.45%。实验表明，本文提出的方法能够准确分类皮肤病变图像，为皮肤癌的诊断提供了新的解决方案。.