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Background: Collision lesions as two independent and unrelated skin tumors often manifest an atypical morphology., Objective: To determine the combinations of collision skin lesions (CSLs)., Methods: Twenty-one pigmented lesion clinics in nine countries included 77 histopathologically proven CSLs in this retrospective observational study., Results: Seventy-seven CSLs from 75 patients (median age 59.8 years) were analyzed; 24.7% of CSLs were located on the head and neck area, 5.2% on the upper extremities, 48.1% on the trunk, and 11.7% on the lower extremities; 40.3% revealed a melanocytic component (median age 54.7 years), followed by 45.5% with a basal cell carcinoma (BCC) (median age 62.4 years) and 11.7% with a seborrheic keratosis (median age 64.7 years). CSLs with a BCC component were more often found on the head and neck area compared to tumors with a melanocytic component (34.3% versus 16.1%). Lesions with a melanocytic component were more often detected on the trunk compared to lesions with a BCC (64.5% versus 37.1%). Patients with CSLs with epidermal-epidermal cell combination were older than patients with epidermal-dermal cell combination (63 versus 55.2 years), were more often male than female (63% versus 43.3%), more often had the lesion on the head and neck area (32.6% versus 13.3%), and less often on the upper (2.2 % versus 10%) or lower extremities (8.7% versus 16.6%)., Conclusions: CSLs consist of a heterogeneous group of lesions of varying cell types. They are associated with advancing age and cumulative UV-exposure. CSLs manifest a complex morphology making it challenging to diagnose correctly., Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.

Introduction: Familial history of melanoma is a well-known risk factor for the disease, and 7% melanoma patients were reported to have a family history of melanoma. Data relating to the frequency and clinical and pathological characteristics of both familial and non-familial melanoma in Spain have been published, but these only include patients from specific areas of Spain and do not represent the data for the whole of Spain., Patients and Methods: An observational study conducted by the Spanish Group of Melanoma (GEM) analyzed the family history of patients diagnosed with melanoma between 2011 and 2013 in the dermatology and oncology departments., Results: In all, 1047 patients were analyzed, and 69 (6.6%) fulfilled criteria for classical familial melanoma (two or more first-degree relatives diagnosed with melanoma). Taking into account other risk factors for familial melanoma, such as multiple melanoma, pancreatic cancer in the family or second-degree relatives with melanoma, the number of patients fulfilling the criteria increased to 165 (15.8%). Using a univariate analysis, we determined that a Breslow index of less than 1 mm, negative mitosis, multiple melanoma, and a history of sunburns in childhood were more frequent in familial melanoma patients, but a multivariate analysis revealed no differences in any pathological or clinical factor between the two groups., Conclusions: Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior.

Vemurafenib is a selective BRAF kinase inhibitor recently proven to improve rates of overall and progression-free survival in patients with BRAF-V600-mutant metastatic melanoma. The most common adverse effects of this targeted therapy are arthralgia, fatigue, and cutaneous lesions, including alopecia, photosensitivity, pruritus, hand-foot skin reactions, squamous cell carcinomas, keratoacanthomas, warty dyskeratomas and verrucous keratosis. Less frequently, cases of panniculitis of varying severity have been reported in patients receiving vemurafenib. In this report, we describe a patient who developed asymptomatic nodules on her legs, with complete, spontaneous resolution, while on vemurafenib therapy. A causal relationship was considered likely because of the timing of occurrence and the absence of other potential causes after extensive assessment. Vemurafenib therapy was continued at full dosage and no recurrences were observed. We believe that management of lobular panniculitis associated with selective BRAF inhibitors should vary according to the clinical presentation, degree of systemic involvement, and presence of joint inflammation. Physicians should be aware of this emergent side effect. Treatment discontinuation should be considered on a case-by-case basis because the condition may resolve spontaneously.