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Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Snapshot Dx Quiz— In this monthly online-only quiz, the first question (“What is your diagnosis?”) relates to the clinical image above, while additional questions concern the findings reported in a JID article that provides new information about that disease entity.
Patients with psoriasis are often treated with topical glucocorticoids (GCs), supporting the idea that local depletion of GCs in psoriatic skin contributes to disease pathogenesis. Although de novo GC synthesis occurs in skin, the relevance of these steroids has previously been overlooked as the hypothalamic-pituitary-adrenal axis provides the majority of GCs. Hannen and colleagues found that localized GC production was nearly absent in psoriasis skin due to decreased synthesis and increased steroid sulfation.
The authors of this multicentre European study explain that electrochemotherapy (ECT) is regarded as an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia.
The interactions between melanocytes and hair progenitor cells and the source of the hair pigmentation regulator stem cell factor (SCF) have remained unclear. Recently, Liao and colleagues discovered that cells that express KROX20, a zinc finger transcription factor, in the hair follicle (HF) identify a sublineage of HF cells that give rise to the hair shaft. These hair shaft progenitor cells provide SCF for maintenance of mature melanocytes in the upper HF matrix, enabling hair pigmentation. Ablation of Scf in these Krox20 lineage cells results in complete absence of hair pigmentation.
Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Cells to Surgery Quiz— In this monthly online-only quiz, the first question (“What is your diagnosis?”) relates to the clinical image above, while additional questions concern the findings reported in a JID article that provides new information about that disease entity.
On 19 June 1937, the Society for Investigative Dermatology (SID) was founded, and its formation was announced in the first issue of the Journal of Investigative Dermatology (JID). In that announcement, the newly elected officers and directors stated that the goals of this new organization were to focus on investigative work in contrast to “purely clinical reports” and to bring together “….all the numerous types of investigative work dealing with the skin.” They also stated that the new SID would focus on “…numerous types of investigative work dealing with the skin, its functions and reactions, both physiologic and pathologic.” Finally, they recognized that this work was being done by both dermatologists and nondermatologists, and they sought to bring all of these individuals and their work together.
Psoriasis has been associated with an increase in myocardial infarctions. Several registries have shown reductions in major adverse cardiovascular events in psoriasis patients and rheumatoid arthritis patients treated with tumor necrosis factor-α antagonists. Many assume that the reduction in cardiovascular events can be attributed to the anti-inflammatory effect of tumor necrosis factor blockers, but a 52-week study conducted by Bissonnette and coworkers failed to show a reduction in cardiovascular inflammation in psoriasis patients treated with adalimumab.
Dusingize et al. used a prospective observational cohort study to demonstrate a decreased risk of basal cell carcinoma and an increased risk of squamous cell carcinoma among smokers. This association disappeared after stratifying for skin screening visits, demonstrating the important role of detection bias. In the absence of randomized clinical trials, well-designed and critically analyzed observational studies can provide similarly valuable evidence.
Extracellular matrix deposition is required for wound healing. Studies by Sato et al. reveal a role for parathyroid hormone 2 receptor (PTH2R) in extracellular matrix production in wounds. Deficiencies in PTH2R or its ligand tuberoinfundibular peptide of 39 residues (TIP39) delayed repair, and TIP39 treatment accelerated healing. TIP39-PTH2R signaling induced decorin expression, which may explain the beneficial effects of PTH2R signaling on healing. These studies identify a novel role for PTH2R signaling in extracellular matrix production.
Big data is a term used for any collection of datasets whose size and complexity exceeds the capabilities of traditional data processing applications. Big data repositories, including those for molecular, clinical, and epidemiology data, offer unprecedented research opportunities to help guide scientific advancement. Advantages of big data can include ease and low cost of collection, ability to approach prospectively and retrospectively, utility for hypothesis generation in addition to hypothesis testing, and the promise of precision medicine.
Hannen et al. report that cutaneous glucocorticoidogenesis and expression of glucocorticoid receptors are inhibited in psoriatic skin. These findings substantiate the previous concept that deficient feedback of local proopiomelanocortin and glucocorticoids on cutaneous immunity contributes to inflammatory and autoimmune dermatoses. Restoration of efficient endogenous glucocorticoid signaling represents a realistic goal in treating psoriasis.
For more than a century the Halstedian hypothesis of contiguous metastasis from the primary tumor through the lymphatics to distant sites shaped the lymph node surgery for melanoma. We challenge this dogma of serial metastatic dissemination. A single-center series of 2299 patients with cutaneous metastatic melanoma was investigated to analyze overall survival (OS) and distant metastasis-free survival (DMFS) of stage IV patients with or without primary lymphatic metastasis. Results were then compared with those of 2134 patients from three independent centers of the German Central Malignant Melanoma Registry.
Cutaneous squamous cell carcinoma (cSCC) is an increasing health burden in Caucasian populations. We prospectively assessed risk factors for tumour-specific and overall survival in 1434 patients who underwent surgery for cSCC between Jan 24, 2005, and May 29, 2015. A total of 2149 invasive cSCCs were analysed. Univariate and multivariate survival analyses included tumour thickness, horizontal size, body site, histological differentiation, desmoplastic growth, history of multiple cSCC, and immunosuppression.
Melanoma incidence has been increasing in light-skinned populations worldwide, but the reasons for the increase have been controversial. Our prior assessment in California non-Hispanic whites showed substantial increases in invasive melanoma incidence for tumors of all thicknesses in all neighborhoods categorized by socioeconomic status (SES) between 1988-1992 and 1998-2002. To understand whether these trends continued, we updated our assessment to include the diagnosis period 2008-2012 and more accurate pathologic stage at diagnosis.