Abstract: Androgenetic alopecia (AGA) is the most prevalent form of hair loss on a global scale. However, the current FDA-approved therapies, including minoxidil (MXD) and finasteride, are often limited by suboptimal follicular targeting, variable patient compliance, and systemic adverse effects. Recent advancements in nanotechnology have yielded promising strategies for the management of AGA. These strategies involve the delivery of drugs to specific follicles, the controlled release of drugs, and the modulation of the follicular microenvironment. Herein, we summarize recent progress in nanotechnology-based approaches for AGA treatment, with emphasis on the following: disease pathophysiology; nanocarrier design principles; nano-enabled microneedle systems; and multifunctional nanomaterials capable of regulating oxidative stress, angiogenesis, inflammation, as well as hair follicle stem cell activity. A discourse is also initiated on the subjects of safety considerations, manufacturing challenges, and regulatory perspectives that are pertinent to clinical translation. Overall, nanotechnology provides a versatile framework for addressing the key limitations of conventional AGA therapies and exhibits considerable potential for future clinical application.

Abstract: Background. In actinic keratosis (AK), clinical clearance after field-directed therapies does not necessarily correspond to histological resolution, resulting in subclinical persistence and risk of recurrence. Objective. To provide a practical, up-to-date framework for non-invasive monitoring of treatment response in AK, integrating clinical assessment and dermoscopy with high-resolution imaging techniques, reflectance confocal microscopy (RCM), line-field confocal optical coherence tomography (LC-OCT), and high-frequency ultrasound (HFUS), and to discuss emerging optical biomarkers based on Raman spectroscopy. Results. For each modality, we summarize pre- and post-treatment imaging patterns, proposed response criteria, recommended follow-up timing, and correlations with clinical outcomes (including clearance and AKASI) and, when available, histological findings. The available evidence is derived from a limited number of observational studies, predominantly involving RCM and LC-OCT, whereas data on HFUS and Raman spectroscopy remain comparatively scarce. RCM and LC-OCT allow in vivo assessment of epidermal architectural normalization and reduction of intraepidermal keratinocyte atypia. HFUS captures quantitative trajectories of superficial dermal remodeling, including changes in the subepidermal low-echogenic band (SLEB) and dermal echogenicity after photodynamic therapy and other field treatments. Dermoscopy remains the first-line tool for routine follow-up but may fail to detect minimal subclinical persistence. Finally, we discuss the potential role of in vivo Raman spectroscopy for dynamic molecular endpoints and its possible integration with artificial intelligence–based analytical approaches. Conclusions. A standardized multimodal follow-up strategy improves the accuracy of treatment-response assessment compared with clinical evaluation alone. We propose a technique-specific checklist of minimal response criteria and a pragmatic temporal assessment scheme, and outline a research roadmap to support validation and clinical implementation of non-invasive imaging–guided monitoring in actinic keratosis.

Abstract: The innate immune system (IIS) constitutes the primary line of defense in multicellular organisms. This evolutionary conserved system provides rapid protection against a wide range of pathogens, including bacteria, viruses, and fungi. Innate responses are initiated within minutes and do not require prior antigenic exposure. Accordingly, novel pathogens are first recognized and countered by the IIS, which subsequently initiates and shapes the adaptive immune response, typically manifesting over several days to weeks. The roles of mast cells (MCs) in acute inflammation and immediate host defense are well established, growing evidence indicates that mast cells can also act as key drivers of chronic, dysregulated inflammation across a range of dermatologic diseases. This review examines the hypothesis that MCs function as highly sensitive sentinels capable of integrating danger signals, initiating cytokine–chemokine cascades, and shaping downstream immune responses. Review highlights emerging concepts regarding mast-cell–mediated transitions from acute to chronic inflammation, the molecular signals that sustain these states, and the mechanistic pathways through which mast cells shape the inflammatory microenvironment. In the context of chronic inflammatory disease, mast cells may become dysregulated, acting as persistent sources of pro-inflammatory cytokines and chemokines even after clearance of the inciting pathogen or allergen. Finally, this review discusses the implications of these insights for potential therapeutic targeting modulating mast cell activity in disorders such as rosacea, atopic dermatitis, psoriasis, and acne vulgaris, where mast-cell–dependent networks may contribute to disease chronicity and treatment resistance.

Abstract: Background: Cellulite is a highly prevalent condition with dermal and subcutaneous alterations poorly captured by visual grading systems. Ultrasound has emerged as a non-invasive imaging modality capable of objectively quantifying morphological fea-tures relevant to cellulite. This systematic review evaluated the evidence on ultrasound for the diagnosis, structural characterization, and treatment monitoring of cellulite, identifying methodological limitations and research gaps. Methods: This systematic re-view (PROSPERO:CRD420251185486) followed PRISMA statement. Searches were conducted in PubMed, Scopus, and CENTRAL up to November 2025. Risk of bias was evaluated using ROBINS-I and the Newcastle–Ottawa Scale. Results: Nine studies involving 785 participants were included. Ultrasound frequencies ranged from 12 to 35 MHz, with some scanners operating across broader bandwidths. Despite variability in devices, acquisition protocols, and clinical comparators, all studies consistently demonstrated that ultrasound quantifies key structural characteristics of cellulite. Diagnostic investigations reported moderate-to-strong correlations (r ≈ 0.31–0.64) between ultra-sound-derived measures and clinical severity scores. Interventional studies showed measurable reductions in dermal and subcutaneous thickness, decreased adipose protrusion height, and improved dermal echogenicity across multiple treatment modalities. Ultrasound frequently detected microstructural remodeling not readily visible on clinical examination. Conclusions: Ultrasound is a valuable imaging modality for objectively characterizing cellulite and monitoring treatment-induced tissue remodeling. Standardized acquisition protocols, validated analytic criteria, and larger controlled studies are needed to support integration into routine dermatologic and aesthetic practice. The quantitative and reproducible nature of ultrasound-derived parameters also provides a suitable foundation for future integration with data-driven and artificial intelligence–based image analysis frameworks.

Abstract: Post-inflammatory hyperpigmentation (PIH) is a common pigmentary disorder characterized by excessive melanin production following skin inflammation. Histamine, a key inflammatory mediator, is known to stimulate melanogenesis via H2 receptors; however, the underlying calcium signaling mechanisms remain largely unexplored. In this study, we investigated the role of the ORAI1-STIM1 complex in histamine-induced melanogenesis using B16F10 melanoma cells and normal human epidermal melanocytes (NHEMs). Histamine (10–30 μM) significantly increased melanin content (2.5–2.8-fold), an effect specifically abolished by the H2 antagonist famotidine. Notably, while acute histamine application failed to trigger immediate calcium influx, chronic exposure significantly enhanced store-operated calcium entry (SOCE) capacity by approximately 2.8-fold, providing evidence for a functional remodeling of the Ca2+ signaling machinery. Histamine-induced melanogenesis was significantly suppressed by intracellular calcium chelation, pharmacological inhibition of ORAI1 (BTP-2 or Synta-66), and siRNA-mediated silencing of ORAI1 or STIM1, but not ORAI2, ORAI3, or STIM2. Our findings demonstrate that chronic histamine exposure drives hyperpigmentation through ORAI1-STIM1-mediated SOCE remodeling, establishing this complex as a promising therapeutic target for the treatment of PIH and related inflammatory pigmentary disorders.

Abstract: Bruton's tyrosine kinase (BTK) inhibitors have revolutionized the treatment landscape for patients with indolent lymphoid malignancies such as chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma (MCL). The most common adverse events include cardiac arrhythmia, bleeding, infection, diarrhoea, arthralgias, hypertension and skin changes. Second-generation BTK inhibitors, e.g. acalabrutinib and zanubrutinib, and the non-covalent BTK inhibitor pirtobrutinib, are less toxic than the first-generation BTK inhibitor ibrutinib. The most common skin toxic symptoms related to BTKi treatment include haemorrhage, bleeding events, bruising, skin ecchymoses and contusion; these are particularly common in patients treated with ibrutinib. Other dermatologic symptoms include rash, cellulitis, skin infections, subcutaneous abscesses and peripheral oedema. This article discusses the development of skin symptoms in patients with ibrutinib and newer BTK inhibitors, and summarises their clinical and pathological characteristics. A literature search was performed using PubMed, Web of Science, and Google Scholar for articles published in English. Additional relevant publications were obtained by reviewing the references from the chosen articles.

Abstract:

Rosacea is a chronic skin condition, characterized by persistent inflammation, manifesting primarily on the face and causing redness, papules, pustules, and phymatous changes. The etiology of rosacea is multifactorial, with immune system factors playing a crucial role in its pathogenesis. The scientific literature contains an increasing number of studies that suggest a correlation between rosacea and the gut microbiota. Small intestinal bacterial overgrowth (SIBO) is defined as an excessive proliferation of potentially pathogenic bacteria within the small intestine of the gastrointestinal system. Multiple factors have been posited to explain the pathogenesis of rosacea, and the presence of SIBO has been identified as a potential factor in its occurrence. A decrease in the Lactobacillus genus, Prevotella copri, Lachnospiraceae, and Faecalibacterium within the gut microbiota may initiate inflammation related to rosacea. These bacterial species are crucial for regulating the intestinal mucosa. The findings indicate that there is an increase of Bacteriodes, Acidaminococcus and Megasphaera, and Ruminococcus in the gut microbiome of patients with rosacea. Probiotics can be advantageous for managing the intestinal microbiome, while Rifaximin treatment has shown efficacy in addressing inflammatory rosacea lesions associated related to SIBO. The present review has been undertaken with the objective of enhancing our comprehension of SIBO in rosacea. The emphasis has been placed on the pathogenetic mechanisms and the shift in the gut microbiota that will lead to understanding probiotic benefits and therapy options in rosacea patients.

Abstract:

Sexual health is a fundamental component of quality of life that is frequently compromised in cancer patients. In melanoma care, these issues remain under addressed despite increasing survivorship. This scoping review aimed to map the current literature on sexual health concerns in melanoma patients. Following PRISMA-ScR guidelines, five databases were searched (2010–2025). Ten studies met the inclusion criteria, including cross-sectional, qualitative, and systematic reviews. Sexual dysfunction affected up to 52% of melanoma patients, with higher prevalence in men (68.9%) than women (41.3%). Contributing factors included visible scarring, hormonal imbalances (e.g., testosterone deficiency in 69% of men receiving immunotherapy), body image concerns, anxiety, and depression. Women were more affected by body image and recurrence anxiety, while men experienced higher rates of treatment-induced hypogonadism. Sexual health concerns are highly prevalent yet systematically overlooked in melanoma care. Gaps remain in longitudinal data, cultural considerations, and evidence-based interventions. Routine screening and integrated psychosocial support are critical to improving patient-centered survivorship care.

Abstract:

Background/Objectives: Recognizing several proposed serum biomarkers for chronic spontaneous urticaria, we investigated correlations among IL-6, ESR, CRP, CBC values, total IgE, thyroid abnormalities, ANA, D-dimer, and vitamin D in individuals with CSU/ Methods: In this prospective study of 41 patients with CSU, we assessed disease severity and quality of life using UAS7, daily UAS, UCT, DLQI, and CU-Q2oL. Concurrently, we measured serum IL-6, ESR, CRP, CBC, total IgE, thyroid antibodies and hormones, ANA, D-dimer, and vitamin D. Results: Serum parameter levels (IL-6, CBC, ESR, CRP, thyroid findigs, D-dimer, vitamin D) were most often slightly elevated, while basophil counts were frequently reduced. T4 showed a significant dependence on CSU duration(r=−0.328; p=0.036); basophil concentration significantly negatively correlated daily disease activity (daily UAS; r=−0.475; p=0.002); and with DLQI (r=−0.358 to −0.359; p≤0.034); basopenia was more frequent in patients with moderate/severe CSU than in those with mild disease or remission, as measured by daily UAS (79% vs. 37%; p=0.020); basophil concentration was the only biomarker useful in assessing CSU severity/daily UAS (sensitivity 78.6%; specificity 63%, p=0.028); ESR as the only significant predictor for UAS7 severity (p=0.038). Conclusions: These promising results highlight the need for replication in a study with a greater number of CSU patients.

Abstract: Background: Epidemiological studies have established a positive association between water hardness, chlorine content, and the prevalence or severity of atopic dermatitis (AD). These environmental factors are known to exacerbate skin barrier dysfunction and increase discomfort in individuals with atopy-prone skin. Objectives: This research aimed to objectify the detrimental effects of hard and chlorinated water on atopic skin, both under controlled experimental conditions and in real-life settings. The studies assessed the efficacy of a daily dermocosmetic routine (comprising a cleanser and moisturizer adapted for atopy-prone skin) for reducing water-induced discomfort and improving the quality of life. Methods: Three clinical studies were conducted: one experimental comparative study of repeated washing or immersion with hard, chlorinated, and soft water, and two intra-individual 21-day studies on hard water and swimming pool water (chlorinated) exposure in real-life conditions. Results: Cumulative exposure to hard water (HW) and chlorinated water (CW) increased TEWL, while soft water (SW) had no significant effect on barrier function. The dermocosmetic routine significantly improved skin hydration and barrier function, with TEWL significantly decreasing by 25% (HW), 17% (CW), and 20% (SW) compared to untreated areas. In real-life studies, 21-day use of the products significantly reduced skin discomfort and improved quality of life. Conclusion: Repeated exposure to hard and chlorinated water can exacerbate skin discomfort and clinical symptoms of atopic dermatitis. An adapted daily dermocosmetic routine can significantly mitigate these effects, improving barrier function, skin comfort, and daily quality of life.

Abstract: Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas presenting in the skin without evidence of extracutaneous disease at diagnosis. They encompass a broad clinicopathologic spectrum dominated by cutaneous T-cell lymphomas (CTCL), primarily mycosis fungoides (MF) and Sézary syndrome (SS), and by distinct entities of primary cutaneous B-cell lymphomas (PCBCL). Recent updates of the WHO–EORTC classification have refined disease definitions and introduced new entities and lymphoproliferative disorders, with direct consequences for prognosis and therapeutic decision-making. Parallel advances in genomics and im-munobiology have revealed recurrent alterations in T-cell receptor (TCR) signalling, JAK–STAT and NF-κB pathways, as well as hallmarks of immune evasion in the tumour microenvironment, providing a rationale for targeted and immune-based therapies. This narrative review, written from a dermatologic perspective, summarises current concepts in the classification, epidemiology and clinicopathologic features of the major PCL subtypes. We discuss key molecular drivers of CTCL and PCBCL, practical aspects of diagnosis and staging at the interface between dermatology, pathology and haematology, and the role of non-invasive imaging. We then review the contemporary therapeutic armamentarium, including skin-directed therapies, systemic biologic agents and chemotherapy, and emphasise pivotal trials of antibody-drug conjugates and immune therapies such as brentuximab vedotin and mogamulizumab. Finally, we highlight unmet needs, including diagnostic delay, real-world prognostic stratification, manage-ment of advanced and relapsed disease, and the integration of biomarkers into person-alised care. Dermatologists occupy a central role in early recognition, longitudinal monitoring and multidisciplinary management of PCLs, and ongoing collaboration between specialties is essential to translate molecular insights into improved patient outcomes.

Abstract: Desmoplastic melanoma (DM) is a rare, aggressive melanoma subtype with high local recurrence rates (20-60%) following surgical excision. This systematic review evaluated the efficacy of adjuvant radiotherapy (RT) in improving local control and survival outcomes in DM patients. Following Preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines, we searched PubMed/MEDLINE, ScienceDirect, Scopus, CINAHL, and EBSCO databases from inception through December 2025.. Thirteen studies (10 retrospective cohorts, 3 prospective trials) met the inclusion criteria. quality assessment using JBI tools revealed 69% high quality and 31% moderate quality studies. Adjuvant RT significantly reduced local recurrence rates from 17.2% (surgery alone) to 7.6% (surgery plus RT), representing a 56% relative risk reduction. All hypofractionated RT (e.g. 30 Gy/5 fractions) achieved comparable local control rates (90-95% at 5 years). High-risk features including positive margins, Breslow depth ˃4 mm, and neurotropism identified patients deriving greatest benefits from RT. Adjuvant radiotherapy significantly improves local control in DM following surgical excision and should be considered standardized of care for high-risk patients. Future randomized trials are needed to established definitive treatment.

Abstract:

In endemic regions where simultaneous larval tick bites are common, early species-level information obtained from eschar lesions can meaningfully change pre-symptomatic triage. We report a 78-year-old woman found after ~24 hours of wandering with multiple clustered eschars on the legs and attached ticks on the trunk. PCR and Sanger sequencing of two removed ticks and ten representative eschars identified Amblyomma testudinarium in all samples. Because A. testudinarium is a known vector of severe fever with thrombocytopenia syndrome (SFTS) virus but not of Rickettsia japonica, we deprioritized Japanese spotted fever and focused targeted monitoring on early SFTS features. The patient remained asymptomatic and was transferred to long-term care. This case illustrates that, particularly in high-incidence settings with numerous bite sites, selective PCR of representative eschars provides a rapid and resource-sparing means to infer vector species and tailor risk assessment before symptom onset. Emphasizing eschar-based species identification in endemic areas can concentrate testing where pretest probability is highest, streamline surveillance, and support shared decision-making in frontline practice.

Abstract: Melanoma survival has improved markedly in the past decade with new systemic agents. A key molecular hallmark is aberrant telomerase activation, largely driven by telomerase reverse transcriptase (TERT) promoter mutations (which are present in 50–82% of cases). These mutations represent the most frequent noncoding alteration in melanoma. Telomerase activation results in replicative immortality by maintaining telomere length, so cancer cells bypass senescence and apoptosis. However, the relationship between telomerase activity and melanoma cell population doubling time remains poorly defined. Pathways linking telomerase expression to accelerated cell cycle progression require further study. While telomerase inhibitors show preclinical promise, clinical application is limited by delayed cytotoxicity and resistance mechanisms. No review has yet mapped evidence connecting telomerase activity with melanoma proliferation kinetics and doubling time. Materials and Methods: A scoping review was conducted using Scopus, ScienceDirect, MEDLINE/PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Keywords included “telomerase,” “melanoma,” “cancer,” “cell proliferation,” and “doubling time.” The PRISMA framework guided our analysis of published studies. Results: Telomerase is clinically relevant for diagnosis, prognosis, and therapy. Biomarkers such as telomere length, telomerase activity, and TERRA expression correlate with disease stage and survival. Therapeutic strategies include enzyme inhibitors (e.g., Imetelstat), cytotoxic nucleotide incorporation, telomere destabilization, and immunotherapies such as peptide or dendritic cell vaccines, DNA vaccines, and CAR-T cells. Resistance often arises through alternative telomere maintenance mechanisms. Targeting extratelomeric TERT functions offers promise but remains complex. Conclusions: Telomerase drives melanoma progression through telomere-dependent and independent mechanisms, influencing proliferation, survival, metabolism, and genome stability. Clarifying these processes is essential for developing biomarkers and therapies that effectively target telomerase, overcome resistance, limit cancer progression and potentially provide another useful therapeutic option against melanoma.

Abstract: Background: Psoriasis and psoriatic arthritis (PsA) occasionally coexist with antinu-clear antibody (ANA) positivity, cutaneous lupus erythematosus (CLE), or systemic lupus erythematosus (SLE), creating one of the most challenging therapeutic overlap scenarios in immunodermatology. Divergent immune pathways—IL-23/Th17-driven psoriatic inflammation versus type I interferon–mediated autoimmunity—generate unique vulnerabilities when systemic treatments are used. Objectives: To synthesize treatment outcomes, lupus-related safety signals, and mechanistic insights across systemic therapies in patients with psoriasis or PsA who also exhibit ANA positivity, CLE, or SLE. Methods: A systematic review following PRISMA 2020 guidelines was performed across PubMed/MEDLINE, Embase, Cochrane, Scopus, and ClinicalTrials.gov. Thir-ty-three eligible reports (29 unique clinical studies; 1,429 patients) were included and organized into six prespecified overlap subgroups. Mechanistic and translational studies—including ustekinumab and deucravacitinib SLE trial data and IL-17 inhibi-tor–induced CLE reports—were incorporated for contextual interpretation. Results: IL-23 inhibitors demonstrated the most favorable cross-disease safety, show-ing no signal for CLE worsening, SLE flares, or drug-induced autoimmunity. IL-17 in-hibitors maintained excellent psoriatic efficacy but showed a consistent association with de novo or exacerbated CLE. TNF-α inhibitors carried the highest risk for ANA seroconversion, dsDNA induction, drug-induced lupus, and lupus flares. Ustekinumab exhibited a stable safety profile across lupus-spectrum disease despite mixed efficacy in formal SLE trials. TYK2 inhibition provided dual modulation of IL-23 and type I in-terferon pathways and showed emerging utility in psoriasis/PsA with CLE or SLE. Apremilast, methotrexate, and mycophenolate mofetil remained reliable non-biologic options. Phototherapy required caution in ANA-positive or lupus-susceptible popula-tions. Conclusions: IL-23 inhibition and TYK2 inhibition appear to offer the most balanced combination of efficacy and safety for psoriatic disease complicated by lupus-spectrum autoimmunity. IL-17 inhibitors and TNF-α inhibitors warrant caution or avoidance in CLE- or SLE-prone patients. Personalized treatment should integrate psoriatic versus lupus disease dominance, ANA/ENA profile, CLE subtype, and mechanistic risk. Pro-spective, biomarker-driven studies are needed to guide therapy in this increasingly recognized overlap population. (PROSPERO registration: CRD420251241279).

Abstract: Background: Cutaneous wounds are common in outpatient care, but national patterns of who manages them and how antimicrobials are used remain unclear. Objectives: To characterize outpatient specialty involvement and antimicrobial use for acute and chronic cutaneous wound visits in the United States. Methods: We conducted a retrospective cross-sectional analysis of 2011–2019 National Ambulatory Medical Care Survey (NAMCS) data. Cutaneous wound visits were identified using prespecified ICD-9-CM and ICD-10-CM codes and classified as acute (open or traumatic wounds and burns) or chronic (pressure injuries and lower-limb ulcers). Survey weights were applied to estimate national visit volumes, specialty shares, and antimicrobial utilization patterns. Results: We identified 45.1 million cutaneous wound visits, representing 0.8% of all outpatient visits, of which about two thirds were acute and one third chronic. Primary care physicians accounted for the largest share of wound visits, while dermatologists managed 3.9% of overall wound visits, 2.4% of acute visits, and 7.4% of chronic visits. Among 156.6 million medications recorded at wound visits, antimicrobials represented 13.1% overall, 14.9% in acute visits, and 10.2% in chronic visits. Cephalexin accounted for 32.1% of antimicrobial medications overall and 39.2% in acute visits, whereas chronic wound visits had a more heterogeneous antimicrobial profile that included topical mupirocin, cephalexin, trimethoprim–sulfamethoxazole, and topical nystatin. Conclusions: Outpatient cutaneous wound care in the United States is delivered predominantly by primary care clinicians and relies heavily on a small set of systemic and topical antimicrobials, highlighting opportunities to strengthen antimicrobial stewardship and expand dermatology’s role in chronic wound management.

Abstract: Background: Extramammary Paget’s disease (EMPD) is a rare intraepithelial adenocar-cinoma that typically involves apocrine gland–bearing areas such as the vulva, scrotum, and perianal region. Suprapubic localization is exceptionally uncommon, particularly in male patients, often leading to delayed diagnosis due to its nonspecific presentation. Case Presentation: We report the case of an 80-year-old male presenting with a persistent erythematous, pruritic plaque in the suprapubic region that was unresponsive to topical corticosteroids and antifungal therapy. Clinical examination revealed a well-demarcated erythematous lesion with superficial erosion and scaling. Videodermoscopy and Line-Field Confocal Optical Coherence Tomography (LC-OCT) revealed features sug-gestive of intraepidermal neoplasia. Histopathological examination demonstrated large, atypical Paget cells within the epidermis, showing abundant pale cytoplasm and pleo-morphic nuclei arranged in a pagetoid distribution. Immunohistochemistry showed strong positivity for Cytokeratin 7 (CK7) and negativity for CK20 and CDX2, confirming the diagnosis of primary EMPD. The patient underwent wide local excision with clear margins, followed by an uneventful recovery. No recurrence was observed during one-year follow-up under dermatologic surveillance. Conclusion: This case highlights the diagnostic challenges of EMPD in atypical locations such as the suprapubic region. Non-specific clinical and dermoscopic features frequently result in misdiagnosis and delayed treatment. Integration of non-invasive imaging techniques like LC-OCT can assist in early detection and biopsy guidance. Histopatho-logical and immunohistochemical evaluation remain essential for accurate diagnosis and differentiation from other malignancies. Early recognition and complete surgical excision are crucial for optimal outcomes and recurrence prevention.

Abstract:

Surgery continues to represent the central curative modality for melanoma despite major advances in systemic immunotherapy and targeted treatments. Contemporary surgical strategies aim to maintain oncologic safety while minimizing functional and aesthetic morbidity through optimized excision margins, highly selective use of sentinel lymph node biopsy (SLNB), and the omission of routine completion lymph node dissection (CLND). Rapid integration of neoadjuvant and adjuvant immunotherapies has begun to redefine surgical indications, timing, and extent—particularly for intermediate-stage and locoregionally advanced disease. Parallel innovations in Mohs micrographic surgery, reconstructive flap design, lymphatic reconstruction, and minimally invasive techniques further broaden the possibilities for individualized intervention. This expanded review synthesizes current evidence, ongoing controversies, and emerging trends that are shaping the future of melanoma surgery, highlighting how precision oncology, immunologic profiling, and technological advances are transforming the surgeon’s role and enabling more tailored, less invasive, and outcomes-focused management.

Abstract: Background: Folliculitis is a common inflammatory condition for which non-antibiotic topical options remain limited. This pilot study evaluated the performance and safety of a medical device gel containing hyaluronic acid and hydrogen peroxide, already in use in dermatologic practice. The study generated preliminary efficacy outcomes and assessed the viability for a future comparative trial on folliculitis.Methods: This open-label, non-comparative, post-marketing clinical follow-up study enrolled adults (aged 18–45 years) diagnosed with folliculitis. Patients applied the gel at home for eight weeks following the device’s instructions for use. Efficacy was assessed by the number of lesions, Total Severity Score (TSS), Investigator Global Assessment of Performance (IGAP), patient satisfaction, and Dermatology Life Quality Index (DLQI). Safety was evaluated by recording adverse events (AEs).Results: Thirteen patients (mean age 30.1 ± 7.72) were included. The duration of enrollment and its rate met the assumptions for carrying out the future comparative trial. The mean number of lesions decreased three-fold from baseline to week 8 (p = 0.005), while TSS improved by 66.6% (p = 0.002). All participants reported high or very high treatment satisfaction. The mean IGAP at week 8 was 1.39 ± 0.65, and DLQI scores indicated a marked improvement in quality of life. Two mild, transient site effects were recorded.Conclusions: This pilot study confirmed favorable safety and performance outcomes for the hyaluronic acid/hydrogen peroxide gel in patients with folliculitis. The findings support its use in daily dermatologic practice and provide feasibility data for a future randomized comparative trial.

Abstract: Verrucous carcinoma is a rare subtype of squamous cell carcinoma can occur anywhere of our body. Differential diagnosis between verrucous carcinoma and benign lesions like squamous cell papilloma is crucial to avoid inappropriate treatment. Surgical excision with reconstruction offers favorable outcomes, emphasizing the significance of compre-hensive management and long-term follow-up to monitor recurrence. Increased aware-ness of verrucous carcinoma’s clinical features and diagnostic challenges is essential for early detection and effective treatment, ultimately improving patient outcomes and re-ducing morbidity associated with this rare malignancy.