What's already known about this topic?

• The histological features of drug rash with eosinophilia and systemic symptoms (DRESS) vary from spongiotic dermatitis to an erythema multiforme-like aspect.
• In DRESS, skin biopsies often show eosinophils and apoptotic bodies.
• Atypical lymphocytes may be found in skin infiltrates.

What does this study add?

• The association of several inflammatory patterns in a single biopsy is suggestive for diagnosis.
• Cutaneous infiltrates can compromise atypical lymphocytes resembling Sézary cells.
• DRESS shows a higher density of inflammatory infiltrates, more apoptosis, associated inflammatory patterns and granzyme B⁺ cells than maculapapular rash.
• Effector T cells are mainly polyclonal granzyme B⁺ CD8⁺ T cells.

What's already known about this topic?

• Demodex mites probably play an important role in the pathogenesis of Demodex-associated skin diseases such as rosacea.
• Reflectance confocal microscopy (RCM) allows the detection and quantification of Demodex mites in vivo.
• In patients with rosacea significantly higher numbers of Demodex folliculorum have been detected compared with healthy controls.

What does this study add?

• In patients with rosacea the density of Demodex mites can be monitored noninvasively during therapy using RCM.
• Repeated examination of the same site showed that the absolute numbers of mites, as well as the number of mites per follicle, significantly decreased.

What's already known about this topic?

• There is some evidence that BRAF mutations are associated with poor prognosis in primary melanoma, although most studies focus on patients with metastatic melanoma.

What does this study add?

• Evidence for clinical and behavioural differences between BRAF^V600E and BRAF^V600K molecular subtypes.
• BRAF mutations are associated with poorer melanoma-specific survival in patients with stage I–III melanoma.
• Mutation status should be considered as a prognostic factor in this group, particularly with adjuvant therapies on the horizon.

What's already known about this topic?

• Quantitative assessment tools indicate that quality of life for people living with cutaneous T-cell lymphoma (CTCL) can be poor.

What does this study add?

• Greater depth of understanding of the extent of the challenges of living with CTCL but also of what is supportive.

What's already known about this topic?

• Several small, single-centre studies have reported histopathological criteria for Sézary syndrome (SS) that allow differentiation from erythrodermic inflammatory dermatoses (EIDs).
• Most histopathological and immunohistochemical criteria have never been evaluated in a multicentre study.

What does this study add?

• Histology of SS skin biopsies revealed a significantly increased degree of epidermotropism and more intraepidermal atypical lymphocytes compared with EID, and Pautrier microabscesses were seen only in SS samples.
• The lymphocytic infiltrate in SS skin samples was found significantly to express PD-1, MUM-1 and Ki-67, and showed less infiltration of CD8⁺ lymphocytes.

What's already known about this topic?

• The prevalence of contact allergy to methylisothiazolinone (MI) has increased dramatically during recent years.

What does this study add?

• In a repeated open application test, we showed that nearly all MI-allergic subjects developed allergic contact dermatitis from using cosmetic rinse-off products containing allowed concentrations of MI (100 ppm or 50 ppm).
• The elicitation threshold is certainly far below 50 ppm.
• The current levels of MI are not safe.

What's already known about this topic?

• The success of Mohs surgery depends on correct interpretation of slides.

What does this study add?

• Pathologists detected incompletely excised basal cell carcinomas on 2% of Mohs slides.
• An additional review of Mohs slides might increase accurate interpretation and therefore prevent skin cancer recurrence.

What's already known about this topic?

• The clinical diagnosis of facial pigmented lesions can be challenging because of the overlapping features of benign and malignant entities.
• Dermoscopy and reflectance confocal microscopy (RCM) can assist in the diagnostic process.

What does this study add?

• This article provides an original perspective regarding the role of dermoscopy and RCM in the diagnosis of facial malignant lesions.
• RCM can be used to assess appropriate treatment options and follow-up protocols for facial lesions.

What's already known about this topic?

• There is an increased risk of multiple comorbidities in patients with psoriasis.

What does this study add?

• Both mild and severe psoriasis presented an increased risk of chronic kidney disease (CKD) and glomerulonephritis, independent of traditional risk factors for CKD.
• The development of CKD in patients with psoriasis was multifaceted. High severity, psoriatic arthritis involvement and concomitant nonsteroidal anti-inflammatory drug use further increased the risk of CKD in patients with psoriasis.

What's already known about this topic?

• Anecdotal evidence suggests a relationship between Darier disease and intellectual disability, but is limited by the absence of control populations.

What does this study add?

• This report confirms that Darier disease is associated with intellectual disability and subclinical impairments in cognitive ability, according to data from the Swedish nation-wide registers.

What's already known about this topic?

• Psoriasis may be associated with increased risk of asthma, but the inverse relationship has not been investigated.

What does this study add?

• Asthma in childhood is associated with a significantly increased risk of psoriasis.

What's already known about this topic?

• Addressing healthcare-associated infections (HCAI) through improved hygiene has been a priority for the National Health Service since 2000.
• Irritant contact dermatitis (ICD) frequently occurs in healthcare workers (HCWs) as a result of hand hygiene measures or wet work.

What does this study add?

• ICD in U.K. HCWs attributed to hand and/or other hygiene has substantially increased since 1996, consistent with interventions to reduce HCAI including the Cleanyourhands campaign.

What's already known about this topic?

• Photodynamic therapy (PDT) is less efficient for actinic cheilitis (AC) than for actinic keratosis.
• Use of an erbium:yttrium–aluminium–garnet ablative fractional laser (Er:YAG AFL) improves the methyl aminolaevulinate (MAL) penetration into deeper portions of lesions.

What does this study add?

• The present study showed Er:YAG AFL-assisted MAL-PDT is better for the treatment of AC and requires fewer sessions than conventional MAL-PDT.

What's already known about this topic?

• Pain is a common and significant side-effect of photodynamic therapy (PDT).
• Scalp nerve blocks are an effective pain reduction strategy during PDT in patients with field cancerization.

What does this study add?

• To the best of our knowledge, this is the first randomized controlled trial comparing scalp nerve blocks, intravenously administered analgesia in combination with cold-air analgesia and cold-air analgesia alone for managing pain during PDT.
• In contrast to scalp nerve blocks, intravenously administered analgesia and cold-air analgesia did not lead to a considerable reduction in pain.

What's already known about this topic?

• The nuclear factor-κB (NF-κB) pathway is a key mediator of inflammation and may be involved in skin ageing.

What does this study add?

• Cultured fibroblasts from donors ≥ 50 years old had higher levels of NF-κB activity than fibroblasts obtained from donors < 50 years old.
• In humans, treatment with an NF-κB inhibitor significantly improved clinical parameters in photodamaged skin.
• These findings support the hypothesis that NF-κB activation may accelerate the skin ageing process.

What's already known about this topic?

• The usual treatment for bullous pemphigoid (BP) is oral corticosteroids but there are concerns that the adverse effects, such as hypertension, diabetes, infections and osteoporosis, contribute to the high morbidity and mortality rate in the elderly BP population.
• There is some evidence from a small randomized controlled trial (RCT) and several open studies to suggest that tetracyclines may be effective in treating BP.

What does this study add?

• This RCT of 256 patients will compare the effectiveness and safety of two strategies for initiating treatment for BP: (i) doxycycline (200 mg daily) vs. (ii) prednisolone (0·5 mg kg⁻¹ body weight daily).
• The results will determine whether doxycycline can be recommended as an effective but safer alternative to oral corticosteroids.