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Background: Primary cutaneous mucinoses (PCM) are rare diseases characterized by dermal or follicular mucin deposits. Objectives: A retrospective study characterizing PCM to compare dermal with follicular mucin to identify its potential origin on a single‐cell level. Material and Methods: Patients diagnosed with PCM between 2010 and 2020 at our department were included in this study. Biopsy specimens were stained using conventional mucin stains (Alcian blue, PAS) and MUC1 immunohistochemical staining. Multiplex fluorescence staining (MFS) was used to investigate which cells were associated with MUC1 expression in select cases. Results: Thirty‐one patients with PCM were included, 14 with follicular mucinosis (FM), 8 with reticular erythematous mucinosis, 2 with scleredema, 6 with pretibial myxedema and one patient with lichen myxedematosus. In all 31 specimens, mucin stained positive for Alcian blue and negative for PAS. In FM, mucin deposition was exclusively found in hair follicles and sebaceous glands. None of the other entities showed mucin deposits in follicular epithelial structures. Using MFS, all cases showed CD4+ and CD8+ T cells, tissue histiocytes, fibroblasts and pan‐cytokeratin+ cells. These cells expressed MUC1 at different intensities. MUC1 expression in tissue histiocytes, fibroblasts, CD4+ and CD8+ T cells, and follicular epithelial cells of FM was significantly higher than the same cell types in the dermal mucinoses (p < 0.001). CD8+ T cells were significantly more involved in expression of MUC1 than all other analysed cell types in FM. This finding was also significant in comparison with dermal mucinoses. Conclusion: Various cell types seem to contribute to mucin production in PCM. Using MFS, we showed that CD8+ T cells seem to be more involved in the production of mucin in FM than in dermal mucinoses, which could indicate that mucin in dermal and follicular epithelial mucinoses have different origins. [ABSTRACT FROM AUTHOR]

In our case, the presence of painless skin lesions, the distribution and evolvement of the exanthema led us favour the diagnosis of cutaneous GvHD. Due to suspicion of acute cutaneous graft-versus-host disease (GvHD), systemic immunosuppressants were increased and prednisolone 1 mg/kg BW was administered. Grade IV cutaneous GvHD (= TEN-like) is a life-threatening disease of stem cell recipients leading to detachment of the epidermis. [Extracted from the article]

Eosinophil count, eosinophilic cationic protein (ECP) and interleukin 5 (IL-5) during the treatment course (c). Within 48 h, the patient experienced a marked decrease of pruritus and after 3 weeks she was completely free of symptoms, her blood eosinophil count was zero and ECP normalized (Figs 1c and 2c). Eosinophilic cationic protein is a cytotoxic granule protein and secreted by activated eosinophils.1 Accordingly, serum levels in our patients correlate with eosinophil count over the treatment course (Fig. [Extracted from the article]

Background: The 'gold standard' for the diagnosis of melanocytic lesions is dermatopathology. Although most of the diagnostic criteria are clearly defined, the interpretation of histopathology slides may be subject to interobserver variability. Objectives: The aim of this study was to determine the variability among dermatopathologists in the interpretation of clinically difficult melanocytic lesions. Methods: This study used the database of MelaFind®, a computer-vision system for the diagnosis of melanoma. All lesions were surgically removed and sent for independent evaluation by four dermatopathologists. Agreement was calculated using kappa statistics. Results: A total of 1,249 pigmented melanocytic lesions were included. There was a substantial agreement among expert dermatopathologists: two-category kappa was 0.80 (melanoma vs. non-melanoma) and three-category kappa was 0.62 (malignant vs. borderline vs. benign melanocytic lesions). The agreement was significantly greater for patients ≥40 years (three-category kappa = 0.67) than for younger patients (kappa = 0.49). In addition, the agreement was significantly lower for patients with atypical mole syndrome (AMS) (kappa = 0.31) than for patients without AMS (kappa = 0.76). Limitations: The data were limited by the inclusion/exclusion criteria of the MelaFind® study. This might represent a selection bias. The agreement was evaluated using kappa statistics. This is a standard method for evaluating agreement among pathologists, but might be considered controversial by some statisticians. Conclusions: Expert dermatopathologists have a high level of agreement when diagnosing clinically difficult melanocytic lesions. However, even among expert dermatopathologists, the current 'gold standard' is not perfect. Our results indicate that lesions from younger patients and patients with AMS may be more problematic for the dermatopathologists, suggesting that improved diagnostic criteria are needed for such patients. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Melasma treatment remains challenging despite various laser systems available, because of potential side-effects and high recurrence rates. Objective Non-ablative fractionated photothermolysis (FP) is a promising therapeutic method, long-time results comparing treated vs. non-treated site are lacking. Methods A total of 14 patients were treated with FP in a split-face mode with standardized adjustments in three sessions (weeks 0, 3-4, 6-8, follow-up: 26-28). At each consultation, improvement was evaluated by patients and physicians. Objective assessment was performed using digital photographs and the pigment imaging tool SIAscope®. Results Melasma improvement was registered in 83% and 75% of the cases 26-28 weeks after the first treatment based on two evaluations: by patient and by physician, respectively. Digital photography and SIAscope® revealed improvement in 54% and 85% after the first, 61% and 85% after the second, 41% and 58% after the third treatment, accordingly, mostly due to reduction of the outline sharpness. Patients with lighter skin complexions revealed significant improvement ranged from slight to moderate ( P = 0.03). Postinflammatory hyperpigmentation occurred in two cases with skin types III and IV. Conclusion Non-ablative FP can be considered as a valuable treatment option with short-term improvement in terms of mild reduction and softening the edges of melasma in patients with skin types I/II, if prior topical therapies failed. Treatment of patients with skin types III+ should be critically questioned. [ABSTRACT FROM AUTHOR]

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Background The presence of at least one MC1R gene variant is associated with a reduction in age at melanoma diagnosis in families with CDKN2A mutations. Objectives To describe dermoscopic features of early melanoma in CDKN2A gene mutation-positive Spanish individuals and to evaluate the possibility of a correlation between particular dermatoscopic pattern and MC1R gene variants. Methods Patients in whom a melanoma was diagnosed during specific follow up of high-risk individuals carrying CDKN2A mutations (with familial or personal history of previous melanoma) were included in this study. The decision to remove such melanomas was taken on the basis of history, clinical and dermoscopic evaluations including total body photography and digital dermoscopy. Results Of the nine patients included in this study, three were noncarriers of the red hair MC1R polymorphism, three patients had one red hair MC1R polymorphism and three patients had two red hair MC1R polymorphisms. On dermoscopic analysis of suspect melanocytic lesions we found that the mean ± SD ABCD total dermoscopy score (TDS) was significantly higher in noncarriers of red hair MC1R polymorphisms than in carriers of two MC1R gene red hair variants (6·8 ± 0·4 vs. 4·4 ± 0·9; P = 0·014). Conclusions Early melanomas in patients with two MC1R red hair variants may be difficult to diagnose definitively by dermoscopy because, in our limited experience, they show fewer colours and structures and have a lower TDS. In such melanomas, subtle atypical vessels and other changes detected by digital image follow up may be useful to confirm the diagnosis of melanoma. An integrated approach including clinical history and dermoscopic data (also considering additional information, such as the presence of atypical vessels) should be utilized in evaluating these high-risk patients. Further studies are necessary to confirm our suggestion. [ABSTRACT FROM AUTHOR]

The article presents a study on the use of Laser-Induced Breakdown Spectroscopy (LIBS) in rapid analysis of steelmaking slags. Samples of solidified slags were examined using a multi-element approach. Parameters affecting slag analysis were considered, including laser focusing and amount of laser shots. The study found that the accuracy of LIBS depended on several factors including element content and the environment of slags.

A letter to the editor is presented on the significance of dermoscopic examination in the early diagnosis of skin cancer and the case of xeroderma pigmentosum patient presented with plantar basal cell carcinoma.