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).
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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.
Prompt and Intensive Antiviral Chemoprophylaxis in Nursing Home Influenza Outbreaks
Findings suggest intensive chemoprophylaxis of 70% or more of residents in response to influenza outbreaks in NHs within the first 2 days is associated with a lower 14-day risk of hospitalization among residents, with additional evidence to support a benefit when 60% or more or 80% or more of residents receive chemoprophylaxis. These findings could strengthen evidence-based recommendations to inform best practices in managing influenza outbreaks in NHs.
KEY FINDINGS: Study results suggest that clinicians should initiate antiviral chemoprophylaxis for at least 70% of eligible NH residents within 2 days of outbreak detection to lower risk of hospitalization.
BACKGROUND: Influenza outbreaks in nursing homes (NHs) pose a substantial threat to older adults, often resulting in morbidity and mortality. The Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of America (IDSA) recommend prompt postexposure prophylaxis, also termed chemoprophylaxis or prophylaxis with oseltamivir, for all residents who are not ill to limit influenza spread in NHs. Purpose of the study is to examine whether initiating antiviral chemoprophylaxis for 70% or more of eligible NH residents within 2 days of influenza outbreak detection is associated with lower all-cause mortality and hospitalization at 14 and 30 days.
DETAILS: Retrospective cohort study using a sequential cluster-randomized target trial emulation and randomize-censor-weight approach for influenza outbreaks (September 1, 2018-May 31, 2022) in 12 US NH corporations. Eligibility criteria were age 18 years or older, present on the outbreak-detection day, no antiviral use in the preceding 7 days, no influenza in the past 14 days, and complete baseline data. Residents were followed up until hospitalization or death, an NH discharge to a nonacute-care location, or the end of follow-up. Data were analyzed from February 2023 to January 2026.
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Exposures: Intensive antiviral chemoprophylaxis with oseltamivir (>=70% of eligible residents within 2 days of outbreak detection) or nonintensive antiviral chemoprophylaxis (0% to <70% of eligible residents).
Outcomes were all-cause death and hospitalizations within 14 and 30 days of outbreak detection. Discrete-time hazard models with pooled logistic regression were applied to estimate weighted risks, risk differences (RDs), and risk ratios (RRs).
Among 404 outbreaks in 318 NHs, 35,086 resident-trial observations (29,683 residents; median age 78 [IQR, 68- 86] years; 60% women; 81% White; 76% vaccinated) met eligibility criteria. Intensive oseltamivir prophylaxis was randomized to 17,155 observations; 17,931 were randomized to nonintensive care. At 14 days, intensive prophylaxis vs nonintensive yielded an RD of -0.06% (95% CI, -0.73% to 0.93%) and an RR of 0.96 (95% CI, 0.56-1.57) for death, and an RD of -0.96% (95% CI, -1.78% to -0.19%) and an RR of 0.79 (95% CI, 0.64-0.96) for hospitalization. At 30 days, the hospitalization differences persisted but were less precise and there continued to be no difference in death.
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Source: Silva, J. B. B., Hsieh, H. T., Howe, C. J., et al. Prompt and Intensive Antiviral Chemoprophylaxis in Nursing Home Influenza Outbreaks. JAMA Internal Medicine.. 2026; 186(6): 714-722. Published: June, 2026. DOI: 10.1001/jamainternmed.2026.0401
Safety and Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Patients with Psoriasis and Type 2 Diabetes Mellitus
Treatment with SGLT2i was associated with favorable clinical outcomes in patients with psoriasis and comorbid T2DM. These findings support investigation of SGLT2i as an adjunct therapy in this population.
KEY FINDINGS: Treatment with SGLT2i was associated with favorable clinical outcomes in patients with psoriasis and comorbid T2DM. These findings support investigation of SGLT2i as an adjunct therapy in this population.
BACKGROUND: Psoriasis is a chronic inflammatory disease associated with multiple comorbidities, including:
- Type 2 diabetes mellitus (T2DM)
- Cardiovascular disease
- Chronic kidney disease (CKD)
- Psychiatric disorders
- Psoriasis and T2DM share common inflammatory pathways and may increase the risk of developing one another.
- While DPP4 inhibitors (DPP4i) and GLP-1 receptor agonists (GLP1RA) have shown benefits in psoriasis, the impact of SGLT2 inhibitors on psoriasis-related outcomes remained unclear.
Purpose of this study is to evaluate the safety and effectiveness of SGLT2 inhibitors in patients with psoriasis and concomitant T2DM, compared with:
- DPP4 inhibitors (DPP4i)
- GLP-1 receptor agonists (GLP1RA)
DETAILS: This emulated target trial included adults with psoriasis and T2DM initiating SGLT2i, DPP4i, or GLP1RA between 2013 and 2025. SGLT2i initiators were propensity score-matched to DPP4i initiators and GLP1RA initiators, respectively. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the outcomes. A total of 8799 SGLT2i initiators and 8799 matched DPP4i initiators with psoriasis and comorbid T2DM, and 11,550 SGLT2i initiators and 11,550 matched GLP1RA initiators, were included. Compared with DPP4i, treatment with SGLT2i was associated with significantly lower all-cause mortality (HR = 0.633, 95% CI = 0.564-0.711) and reduced risks of emergency visits (HR = 0.915, 95% CI = 0.871-0.961), acute kidney injury (HR = 0.834, 95% CI = 0.759-0.916), chronic kidney disease (HR = 0.866, CI = 0.791-0.949), end-stage renal disease (HR = 0.555, 95% CI = 0.438-0.703), and severe sepsis (HR = 0.689, CI = 0.594-0.799). Compared with GLP1RA, treatment with SGLT2i was associated with reduced risks of asthma (HR = 0.822, 95% CI = 0.713-0.946), depression (HR = 0.887, CI = 0.801-0.983), sleep disorders (HR = 0.856, CI = 0.783-0.936), and malignancies (HR = 0.852, 95% CI = 0.764-0.951).
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Source: Cheng, D., Ji, H., Theodosakis, N., et al. Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Psoriasis and Comorbid Type 2 Diabetes: A Population-Based Target Trial Emulation Journal of the American Academy of Dermatology. 2026; 94(6): 1686-1696. Published: June, 2026. DOI: 10.1016/j.jaad.2026.02.008
Corrective and Restorative Dermatology in Cancer Survivors
Advances in cancer therapies have resulted in a growing population of long-term cancer survivors with chronic dermatological sequelae, such as persistent alopecia, nail abnormalities, pigmentary disorders, telangiectasias, scarring, mucosal alterations, and chronic radiation-induced skin changes. Dermatological sequelae may cause functional impairment, psychological distress, altered body image, and reduced quality of life.
KEY FINDINGS: Supportive oncodermatology, originally focused on the acute treatment phase, must evolve to address the long-term needs of the growing cancer survivor population. Preventive strategies, such as scalp cooling during chemotherapy, are vital, as existing treatments for established sequelae like PCIA and radiation-induced scarring have limited efficacy. While topical minoxidil and, more recently, oral minoxidil have shown promise for hair density improvements, and lasers are effective for telangiectasias, the management of many chronic dermatological sequelae remains largely extrapolated from other dermatological conditions rather than specifically validated for cancer survivors. Multidisciplinary follow-up programs are essential to address the complex functional, cosmetic, and psychological needs of these patients.
BACKGROUND: With the increasing effectiveness of modern oncological treatments, the population of cancer survivors is rapidly expanding. Consequently, clinical focus is shifting from the management of acute treatment-related toxicities to the long-term or late sequelae of cancer therapy. Among these, dermatological conditions—such as persistent alopecia, nail disorders, scarring, pigmentary alterations, and chronic radiation-induced skin changes—are highly visible, often persistent, and can significantly impair the quality of life, body image, and psychological well-being of survivors. While supportive oncodermatology is well-established for active treatment settings, structured care during the survivorship phase remains significantly underdeveloped.
DETAILS: This review defines "restorative oncodermatology" as the management of dermatological manifestations persisting for at least six months after the completion of anticancer therapy. Such conditions include both persistent toxicities that are slow to regress and true long-term sequelae resulting from treatment-induced tissue damage. Epidemiological data indicates that these issues are prevalent; for example, up to 59% of adult survivors of childhood cancer report chronic skin-related problems, and approximately 30% report visible scarring or disfigurement. Specific conditions addressed include persistent chemotherapy-induced alopecia (PCIA), which affects between 1% to approximately 40% of patients depending on the regimen , and radiation-induced scarring alopecia, where a threshold of approximately 36 Gy is associated with a 50% probability of severe alopecia. The article also explores the management of chronic nail changes, pigmentary alterations, hair growth disorders like hirsutism and hypertrichosis, and mucosal sequelae. Despite the high prevalence and impact of these dermatological sequelae, dedicated survivorship-oriented dermatological care is rarely implemented. There is an urgent requirement to improve knowledge in this field and provide specialized care, particularly for childhood and adolescent cancer survivors, who are especially vulnerable to the effects of these conditions on their physical appearance and identity development. Dermatologists must play a central role in long-term survivorship by performing surveillance for secondary skin cancers and delivering restorative treatments that help patients navigate life after cancer.
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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.
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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.
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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
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