Survival and Tumor Characteristics Of Patients Presenting With Single Primary Versus Second Primary Melanoma Lesions
Patients with second primary melanomas demonstrated a significant survival advantage and thinner lesions compared with those with single primary melanomas. The reported tumor distributions support the role of full body skin examinations, with attention to the region of initial diagnosis.
KEY FINDINGS: Patients with second primary melanomas demonstrated a significant survival advantage and thinner lesions compared with those with single primary melanomas. The reported tumor distributions support the role of full body skin examinations, with attention to the region of initial diagnosis.
BACKGROUND: Patients with single primary melanomas have an increased risk of developing subsequent melanomas. Secondary tumors diagnosed within and after 3 months are termed "synchronous" and "asynchronous," respectively. Purpose of the study is to compare tumor distributions and survival characteristics between patients with second primary melanomas and those with single primary melanomas.
DETAILS: Retrospective cohort study. Data were collected from an institutional database from 14,029 patients with a diagnosis of a primary melanoma seen between 1970 and 2004. The synchronous and asynchronous cohorts demonstrated significantly improved survival probabilities compared with the single primary cohort (P = .04 and .002, respectively). Single primary lesions (2.2 ± 2.3 mm) were significantly thicker than the first-identified synchronous (2.0 ± 1.7 mm) and asynchronous (1.7 ± 1.3 mm) lesions. Synchronous lesions were more likely to be anatomically concordant compared with asynchronous lesions (55.7% vs 38.2%, P < .001).
Our Most Popular Resources
Copyright © Elsevier Ltd. All rights reserved.
Source: Sarver, M. M., Rames, J. D., Beasley, G. M., et al. (2023). Survival and Tumor Characteristics Of Patients Presenting With Single Primary Versus Second Primary Melanoma Lesions. Journal of the American Academy of Dermatology. 2023; 88(5): 1033-1039. Published: May, 2023. DOI: 10.1016/j.jaad.2022.04.046.
Efficacy of Low-Dose Oral Isotretinoin Combined with Fractional Microneedle Radiofrequency Versus Low-Dose Oral Isotretinoin Monotherapy in the Treatment of Moderate-To-Severe Acne Vulgaris
Early active treatment with isotretinoin and FMRF is safe and better than isotretinoin monotherapy over 44 weeks regarding severity, reduced erythema, and improved surface roughness in moderate-to-severe acne vulgaris. This encourages early and effective treatment of acne to mitigate acne scarring and improve patients' quality of life.
Summary
A Randomized Controlled Comparative Study
[Posted 19/May/2026]
AUDIENCE: General Surgery, Family Medicine
KEY FINDINGS: Early active treatment with isotretinoin and FMRF is safe and better than isotretinoin monotherapy over 44 weeks regarding severity, reduced erythema, and improved surface roughness in moderate-to-severe acne vulgaris. This encourages early and effective treatment of acne to mitigate acne scarring and improve patients' quality of life.
BACKGROUND: Oral isotretinoin is the standard therapy for severe acne. However, scarring may persist. Fractional microneedling radiofrequency (FMRF) improves both inflammatory lesions and scars with minimal downtime. In this study, we compare isotretinoin monotherapy and concurrent isotretinoin and FMRF for active acne regarding clinical outcomes. The GAGS scores of isotretinoin and FMRF were significantly lower than those of isotretinoin monotherapy from weeks 12-44 (-79.69% vs. -60.34% at week 44, respectively; p < 0.001). Isotretinoin and FMRF showed significantly greater lesion count reductions than isotretinoin monotherapy at follow-up visits from weeks 12-44. Isotretinoin and FMRF showed significantly lower hemoglobin levels than isotretinoin monotherapy at weeks 32 and 44 (p = 0.029 and p < 0.001, respectively). Skin surface roughness improved substantially and persistently from week 12-44.
DETAILS: In this parallel two-group comparative study, patients received either low-dose isotretinoin monotherapy for 20 weeks (n = 34) or low-dose isotretinoin concurrently with 5 monthly FMRF sessions (n = 36). Outcomes were assessed at baseline and weeks 12, 20, 24, 32, and 44. The primary endpoints were Global Acne Grading System (GAGS) scores and inflammatory/non-inflammatory lesion counts. Secondary endpoints were hemoglobin indices and skin roughness.
Our Most Popular Resources
Copyright © Wiley Periodicals LLC. All rights reserved
Source: Disphanurat, W., Leeyangyuen, P,, and Srisantithum, B. Efficacy of Low-Dose Oral Isotretinoin Combined With Fractional Microneedle Radiofrequency Versus Low-Dose Oral Isotretinoin Monotherapy in the Treatment of Moderate-To-Severe Acne Vulgaris: A Randomized Controlled Comparative Study. Lasers in Surgery and Medicine. 2026; 58(4): 321-330. Published: April, 2026. DOI: 10.1002/lsm.70120.
Long-Term Control of Human Papillomavirus-Related Focal Epithelial Hyperplasia in an Human Immunodeficiency Virus-Positive Patient Using Methylene Blue-Mediated Photodynamic Therapy
Topical MB-mediated PDT successfully managed HPV-related FEH in an immunocompromised individual with history of valve disease. This outcome supports the need for further validation through clinical trials.
KEY FINDINGS: PDT mediated by MB is an effective and affordable approach for treating FEH associated with HPV in immunosuppressed patients, offering favorable outcomes and improved quality of life.
BACKGROUND: Human papillomavirus (HPV) infections are a major cause of oral lesions, and in individuals living with HIV, lesions such as focal epithelial hyperplasia (FEH) may persist or exhibit atypical features, potentially progressing to more severe conditions if untreated. Managing oral HPV lesions in immunocompromised patients is challenging, as conventional therapies may carry higher risks or show limited efficacy.
DETAILS: This study reports the case of a 49-year-old HIV-positive male with valve disease and arthritis, requiring crutches for mobility. He presented with multiple painless oral lesions, diagnosed as FEH associated with oral HPV, and had previously undergone unsuccessful treatments. Photodynamic therapy (PDT) using methylene blue (MB) and a red laser was proposed as a treatment. Topical MB-mediated PDT successfully cleared the FEH lesions, with no recurrence observed over 24 months.
Our Most Popular Resources
Copyright © Wiley Periodicals LLC. All rights reserved
Source: de Araújo, J. C., Paiva, H. C., Faara, P. M. M., et al. Long-Term Control of Human Papillomavirus-Related Focal Epithelial Hyperplasia in an Human Immunodeficiency Virus-Positive Patient Using Methylene Blue-Mediated Photodynamic Therapy. A Case Report. Lasers in Surgery and Medicine. 2026; 58(2): 70-73. Published: February, 2026. DOI: 10.1002/lsm.70091
Hypopigmentation Following Picosecond Laser Treatment for Melasma
While hypopigmentation is rare with PSL treatment, it can occur even with conservative low-fluence settings and adequate intervals between sessions. One possible mechanism is thermal beam- stacking, where slow hand movement during treatment may lead to repeated pulses on the same area. This can result in localised thermal accumulation, potentially causing subcellular disruption of melanosomes without overt melanocyte loss.
Summary
A Case Series
[Posted 13/Jan/2026]
AUDIENCE: General Surgery, Dermmatology, Internal Medicine
KEY FINDINGS: While hypopigmentation is rare with PSL treatment, it can occur even with conservative low-fluence settings and adequate intervals between sessions. One possible mechanism is thermal beam- stacking, where slow hand movement during treatment may lead to repeated pulses on the same area. This can result in localised thermal accumulation, potentially causing subcellular disruption of melanosomes without overt melanocyte loss. These findings suggest the need for clinician vigilance in monitoring for hypopigmentation, as re-pigmentation may not be achievable. Larger, controlled studies are needed to clarify risk factors and guide safer practice.
BACKGROUND: Picosecond lasers (PSL) are increasingly used for treating melasma, with fewer adverse effects reported compared to Q-switched lasers (QSL). However, the incidence of hypopigmentation following PSL treatment remains unexplored in detail. This case series aims to explore outcomes of hypopigmentation following PSL therapy in patients with melasma, and explore potential contributing factors.
DETAILS: A retrospective chart review identified four patients with hypopigmentation following PSL treatment for melasma, including one referral from another clinic. Across the cohort, 796 patients underwent 3096 sessions between 2021 and 2025. Treatments used 755 and/or 1064-nm wavelengths at low fluences, with intervals of 4–12 weeks. Three in-clinic patients (0.38%, 95% CI 0.13%–1.10%) and one referral developed hypopigmentation. Changes occurred across both wavelengths and beam profiles. Histology demonstrated preserved melanocyte density with reduced melanin pigment and melanosome content. None of the cases showed meaningful re-pigmentation at 6-month follow-up. No cases of post-inflammatory hyperpigmentation (PIH) were observed.
Our Most Popular Resources
What Is the Diagnostic Capacity of Existing Severity Scoring Tools for Nail Psoriasis?
Both N-NAIL and NAPSI provide accurate cutoff values in a psoriasis population. Therefore, these scoring tools may not only be used to assess severity but also in clinical trials for the inclusion of NP patients in a psoriasis population to create homogeneity between studies.
KEY FINDINGS: Both N-NAIL and NAPSI provide accurate cutoff values in a psoriasis population. Therefore, these scoring tools may not only be used to assess severity but also in clinical trials for the inclusion of NP patients in a psoriasis population to create homogeneity between studies. Authors prefer using the N-NAIL, with a cutoff value of 2, because it showed better accuracy compared to the NAPSI.
BACKGROUND: It is challenging to distinguish nail psoriasis (NP) from nonspecific nail changes, contributing to heterogeneity in clinical trials. Existing scoring tools for NP are currently used to assess severity after diagnosis is established. The aim of this study is to evaluate the diagnostic performance of two of these severity scoring tools.
DETAILS: A cohort study was conducted with psoriasis patients and matched controls. Fingernails were scored using the Nail Psoriasis Severity Index (NAPSI) and the Nijmegen-Nail Psoriasis Activity Index Tool (N-NAIL). To determine their diagnostic properties, cutoff values were established. Receiver operating characteristic (ROC) curves were constructed, and sensitivity and specificity were calculated for various cutoff points. The best cutoff value was chosen based on the Youden Index and clinical reasoning. In total, 104 psoriasis patients were included, of which 68 were clinically diagnosed with NP. For the N-NAIL, a cutoff value of 2 showed the best accuracy in the psoriasis population (sensitivity = 83.8% and specificity = 83.3%) and the general population (sensitivity = 83.8% and specificity = 67.3%). For the NAPSI, a cutoff value of 7 showed the best accuracy in the psoriasis population (sensitivity = 80.9% and specificity = 69.4%), while a cutoff value of 10 was optimal in the general population (sensitivity = 72.1% and specificity = 70.2%).
Our Most Popular Resources
Copyright © John Wiley & Sons Ltd. All rights reserved.
Source: Rikken, E. C. C., van Hal, T. W., van den Reek, J. M. P. A., et al. What Is the Diagnostic Capacity of Existing Severity Scoring Tools for Nail Psoriasis? International Journal of Dermatology. 2026; 65(1): 86-92. Published: January, 2026. DOI: 10.1111/ijd.70024.
Practical Approaches for Seborrheic Keratosis Treatment: Curettage Versus 532-nm Lithium Borate Laser Versus Cryotherapy
DPP-4 inhibitors offer a safer alternative to meglitinides in T2D patients with Stage 5 CKD with lower severe renal outcomes and hypoglycemia risk. Hypoglycemia risk is lower with DPP-4i due to glucose-dependent insulinotropic action. DPP-4i are weight neutral, helpful in normal or lower BMI patients.
Summary
A Prospective Interventional Study
[Posted 29/Sep/2025]
AUDIENCE: General Surgery, Internal Medicine, Hematology
KEY FINDINGS: Curettage remains optimal for thick, hyperkeratotic SKs, enabling histopathological confirmation. The 532 nm laser, preferred subjectively for convenience, may suit small, non-hyperkeratotic lesions but warrants further validation. Propane-butane cryotherapy offers a cost-effective alternative. The discordance between patient preferences (prioritizing convenience) and clinical efficacy underscores the need for personalized treatment strategies balancing outcomes, tolerability, and cosmetic expectations.
BACKGROUND: Seborrheic keratosis (SK) is the most prevalent benign skin tumor associated with aging, posing esthetic concerns and potential discomfort. The rising demand for cosmetic interventions prompts the exploration of effective removal methods. This study compares three treatment modalities: curettage, 532 nm laser, and propane-butane cryotherapy.
DETAILS: A prospective interventional clinical study was conducted with 30 subjects, treating 123 SK using curettage, 532 nm laser, and propane-butane cryotherapy. Randomized allocation and evaluations at 0, 4, 8, and 12 weeks were employed. Objective measures included clearance rates (assessed by a dermatologist) and blinded cosmetic ratings by 125 observers. Subjective outcomes encompassed patient-reported pain (VAS), side effects, satisfaction, and preferences. Curettage achieved the highest clearance rate (87.5% vs. laser: 55%, cryotherapy: 50%; p < 0.01). However, patients perceived complete healing most frequently with laser (90% vs. curettage: 87%, cryotherapy: 53%). Despite lower efficacy, 67% favored laser for future treatments, valuing minimal bleeding and no dressings. Observers rated curettage's cosmetic outcomes superior (50% vs. laser: 22.5%). Laser caused the fewest side effects (mean 0.93/lesion) but highest pain (VAS: 4.62 vs. cryotherapy: 3.85). Cryotherapy showed efficacy comparable to laser (50% vs. 55%) but more adverse events.
Our Most Popular Resources
Copyright © Wiley Periodicals LLC. All rights reserved
Source: Timmermann, V., Krengel, S., Mrowka, P,, et al. (2024). Practical Approaches for Seborrheic Keratosis Treatment: Curettage Versus 532-nm Lithium Borate Laser Versus Cryotherapy: A Prospective Interventional Study. Lasers in Surgery and Medicine. 2025; 57(7): 581-589. Published: September, 2025. DOI: 10.1002/lsm.70042.
Specialty: