Dermato

Background/Objectives: Melanoma remains one of the most malignant types of skin cancer with rising incidence numbers, despite the progress made in the prevention and management of the disease. Recent technological advancements, such as developments in the field of molecular biology, imaging, and artificial intelligence (AI), have led to a paradigm shift in the diagnosis, assessment, and management of melanoma. The current review aims to integrate current research on melanoma, moving beyond the boundaries of conventional histological analysis. Methods: This is a critical appraisal narrative review that focuses on recent studies in the areas of translation research and digital health with regard to melanoma. This research particularly targeted recent studies within the last five years, with landmark studies implicated when appropriate. Evidence was synthesized within the major categories that include epidemiology, early diagnosis, histopathology, predictive biomarkers, genetic/epigenetic changes, AI-assisted diagnostic platforms, and novel therapeutic platforms & targets. Results: Early detection techniques, innovative imaging, and biomarker-guided risk adjustment can improve diagnostic accuracy and prognostic stratification. The potential of AI in dermoscopy, digital pathology, and decision analytical systems is evident, although validation, bias, and integration issues need to be addressed. Advances in immunotherapy, targeted therapies, and novel molecular/immunological targets are expanding and facilitating integrated and personalized management. Conclusions: There is a trend in melanoma research to shift towards an integrated diagnostic platform that involves the use of AI, molecular characterization, and clinical inputs to enable more accurate and personalized diagnoses. To realize this potential, there is a need to validate, collaborate, and address ethics and implementation.

Background/Aims: This study aimed to undertake a systematic literature review to compare the effectiveness of narrowband UVB (nb-UVB) therapy with Psoralen + UVA (PUVA) or Psoralen + UVB treatments in individuals with vitiligo. Methods: A comprehensive search was executed across multiple electronic databases (PubMed, Embase, Cochrane, Scopus, Web of Science, LILACS) and grey literature repositories (Google Scholar, LIVIVO, OpenGrey, ProQuest). Methodological quality was independently assessed by two reviewers employing the Cochrane RoB 2 tool; consensus was achieved through consultation with a third reviewer when necessary. The main efficacy endpoint was repigmentation. Results: From 4758 initial records, four randomized controlled trials that satisfied the inclusion criteria were identified. The aggregated results from these studies indicated that nb-UVB, either alone or combined with psoralen (P-nbUVB), produced better repigmentation outcomes compared to PUVA. Conclusions: Nb-UVB phototherapy demonstrated superior repigmentation efficacy, improved color matching, and a faster clinical response relative to PUVA. The addition of psoralen (P-nbUVB) further enhanced therapeutic outcomes, particularly in VASI scores and in areas typically less exposed to resunlight.

Background and Objectives: Merkel cell carcinoma (MCC) is a rare, aggressive, invasive cutaneous neuroendocrine carcinoma. It commonly affects the skin of the extremities and head and neck regions in elderly patients. In situ MMC represents MMC confined to the epidermis. Incipient MCC is a descriptive term that represents in situ MCC with early focal dermal microinvasion. In situ MCC and incipient MCC have a much better prognosis than MCC. In this study, we aimed to address the clinicopathologic features of early lesions of MCCs, including both incipient and in situ forms. Methods: We conducted a PubMed search using the following keywords: (“Merkel cell carcinoma” OR “Merkel carcinoma” OR “Merkel” OR “MCC”) AND (“in situ” OR “incipient” OR “intraepidermal”) AND (“skin” OR “cutaneous”. The inclusion criteria included (i) human studies, and (ii) case reports and series published in the English language with the above-mentioned search keywords. Studies not meeting all inclusion criteria were excluded. Results: Incipient and in situ MCCs are extremely rare events (15 case reports). They usually appear as tiny (2 mm to 6 mm) erythematous papules or nodules over the skin. Immunohistology (for CK20, EMA, and neuroendocrine markers) was required to establish the diagnosis of these lesions. Conclusions: MCCs carry a significantly high mortality rate due to their aggressive nature. However, for in situ MCC and incipient MCC, local surgical excision is usually curative, and the prognosis is excellent. Therefore, dermatologists and dermatopathologists should remain vigilant for these forms of early lesions of MCCs. This will help with early detection and prompt treatment.