Epidemiology and Risk Factors of Melanoma: A Review

We are currently witnessing a worldwide increase in the incidence of melanoma. Incidence in Europe is about 25 cases per 100,000 population, while in Australia it reaches a rate of 60 new cases per 100,000. While the epidemiological curves of the 1980's and 1990's suggested an increase in the incidence of melanoma across all age groups, the last 10 years' data indicates a 5% reduction in the incidence of thin melanoma in young individuals aged between 15 and 24. This suggests a positive impact of primary prevention campaigns [1-2]. The risk factors associated with melanoma are different and multifactorial: on one hand there is a genetic predisposition, as evidenced by the increased risk in patients with dysplastic nevus syndrome, with familial melanoma or familial melanoma syndromes; on the other hand, the unprotected interaction between UV rays and phototypes I-II increases the risk of developing melanoma, especially in case of sunburns in pediatric age. This review aims to summarize melanoma epidemiology and risk factors

R\uf6tliche L\ue4sion am Stamm

Anamnese 1 Ein 65-j\ue4hriger Patient, der im Gesichtsbereich bereits chronische Lichtsch\ue4den aufwies, wurde im Rahmen des Nierentransplantationsscreenings wegen einer neu aufgetretenen r\uf6tlichen L\ue4sion in unserer Ambulanz vorstellig. Der Patient selbst bemerkte die L\ue4sion nicht. Anamnese 2 Eine 59-j\ue4hrige Patientin kam wegen multipler N\ue4vi zur allj\ue4hrlichen Routinekontrolle. Die neu aufgetretene r\uf6tliche Papel am R\ufccken rechts war ihr nicht aufgefallen

Prevalence of nevi, atypical nevi, and lentigines in relation to tobacco smoking

Background Melanocytic nevi have a complex evolution influenced by several endogenous and exogenous factors and are known risk factors for malignant melanoma. Interestingly, tobacco use seems to be inversely associated with melanoma risk. However, the association between tobacco use and nevi and lentigines has not yet been evaluated. Methods We investigated the prevalence of nevi, atypical nevi, and lentigines in relation to tobacco smoking in a cohort of 59 smokers and 60 age- and sex-matched nonsmokers, using a questionnaire and performing a total body skin examination by experts. Results No significant differences were detected between smokers and nonsmokers in the numbers of nevi, atypical nevi, and lentigines in sun-exposed areas (p = 0.966, 0.326, and 0.241, respectively) and in non-sun-exposed areas (p = 0.095, 0.351, and 0.546, respectively). Conclusion Our results revealed no significant differences in the prevalence of nevi, atypical nevi, and lentigines between smokers and nonsmokers in sun-exposed and non-sun-exposed areas

Desmoplastic Trichoepithelioma and Melanocytic Nevus: Dermoscopic and Reflectance Confocal Microscopy Presentation of a Rare Collision Tumor

A 27-year-old woman presented with a 2-year history of an asymptomatic papule located on her right cheek. The physical examination revealed a firm, well-defined with a raised annular border, skin-colored papule, 5 mm in maximum diameter

Dermoscopy of Mycobacterium marinum Skin infection: A Challenging Diagnosis

Dear Editor, Mycobacterium (M.) marinum is a slow-growing atypical mycobacterium found mainly in saltwater environments. Infection occurs following inoculation of a skin lesion and manifests as a localized granuloma; in fact, the most common cause of infection with M. marinum is the exposure of traumatized skin to affected aqueous environments (1), and it most commonly involves individuals with occupational and recreational exposure to non-chlorinated water (2). An erythematous or bluish 0.5 to 3.0 cm nodule usually develops at the inoculation site, while ulceration can occur later and subsequent lesions may be present along the lymphatic drainage. We present the first case in the literature describing the dermatoscopic characteristics of a microbiologically proven Mycobacterium marinum skin infection, although more cases are certainly needed to identify the main dermatoscopic features of this infection. In January 2019, a 66-year-old patient was referred to our Dermatological Clinic reporting the appearance of two purplish nodules about 2 months earlier, located on the back of the hand and on the left thumb (Figure 1) and of erythematous purplish appearance and quite painful to palpation. Based on the clinical presentation, infection with atypical mycobacteria, botryomycosis, fungal infection (Cryptococcus neoformans, Histoplasma capsulatum) and infection with Francisella tularensis were considered in the differential diagnosis. The patient was asked if he had an aquarium at home and he confirmed this by telling us of his passion for aquariums, which made the diagnosis easier. Dermatoscopic examination performed on the two lesions at the center of the first nodule located on the hand showed a whitish area surrounded by an erythematous background with fine scaling and dotted vessels and orange-whitish central areas with looped concentric monomorphic vessels (Figure 2, a). However, the thumb lesion had a purplish background with multiple structured rounded areas with orangish appearance surrounded by looped vessels arranged in a crown-like shape (Figure 2, b). It is interesting to note the dermoscopic-histological correlation in this disease: the orangish areas in fact correspond to a granulomatous dermatitis, characterized by inflammatory nodular infiltrate within the dermis (tuberculoid granulomas) (3). Clinically and dermoscopically, the nodules had two different sets of features because they were in different stages of development: the nodule of the thumb was older than the other one on the hand, which the patient reported was of recent onset, also confirmed by the presence of suppuration and ulceration. Both lesions had orange areas in the context of an erythematous background which led us to investigate a granulomatous disease. A deep culture examination and a skin biopsy were thus performed, showing Mycobacterium marinum infection. Oral therapy with clarithromycin 500 mg twice daily for 4 weeks was started and healing occurred in about 21 days. We present this case to emphasize the role of dermoscopy in differential diagnosis of granulomatous disease and to show dermoscopic clues that have not yet been described and that can be used in the future to establish very early diagnosis of this infection, reducing the diagnostic delay

Doxycycline, a widely used antibiotic in dermatology with a possible anti-inflammatory action against IL-6 in COVID-19 outbreak

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Bullous pemphigoid triggered by dulaglutide: a case report and a review of the literature

Bullous pemphigoid (BP) is an autoimmune disease with a chronic relapsing course, predominantly affecting elderly people. Drugs are one of the possible triggers. A class of antidiabetic drugs often associated with the development of BP are inhibitors of dipeptidyl peptidase 4 (DPP-4 inhibitors or gliptins), while less known is the association with glucagon-like-peptide-1 receptor agonists. We describe a case of BP caused by dulaglutide and summarize the other few cases described in the literature. As a class of drugs widely used in clinical practice, it is important to know about this possible adverse event

Management of advanced melanoma in the COVID-19 era

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