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Background: Nodular melanoma (NM) is more likely to be fatal compared with other melanoma subtypes, an effect attributed to its greater Breslow thickness., Methods: Clinicopathological features of NM and superficial spreading melanoma (SSM) diagnosed in 17 centers in Europe (n = 15), the United States, and Australia between 2006 and 2015, were analyzed by multivariable logistic regression analysis, with emphasis on thin (T1 ≤ 1.0 mm) melanomas. Cox analysis assessed melanoma-specific survival. All statistical tests were two sided., Results: In all, 20 132 melanomas (NM: 5062, SSM: 15 070) were included. Compared with T1 SSM, T1 NM was less likely to have regression (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.29 to 0.72) or nevus remnants histologically (OR = 0.60, 95% CI = 0.42 to 0.85), and more likely to have mitoses (OR = 1.97, 95% CI = 1.33 to 2.93) and regional metastasis (OR = 1.77, 95% CI = 1.02 to 3.05). T1 NM had a higher mitotic rate than T1 SSM (adjusted geometric mean = 2.2, 95% CI = 1.9 to 2.5 vs 1.6, 95% CI = 1.5 to 1.7 per mm2, P < .001). Cox multivariable analysis showed a higher risk for melanoma-specific death for NM compared with SSM for T1 (HR = 2.10, 95% CI = 1.24 to 3.56) and T2 melanomas (HR = 1.30, 95% CI = 1.01 to 1.68), and after accounting for center heterogeneity, the difference was statistically significant only for T1 (HR = 2.20, 95% CI = 1.28 to 3.78). The NM subtype did not confer increased risk within each stratum (among localized tumors or cases with regional metastasis)., Conclusions: T1 NM (compared with T1 SSM) was associated with a constellation of aggressive characteristics that may confer a worse prognosis. Our results indicate NM is a high-risk melanoma subtype that should be considered for inclusion in future prognostic classifications of melanoma., (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Herpes labialis (HL) is a common and benign disease. However, frequent episodes can impair quality of life (QoL) and impact healthcare consumption. The aim of this survey was to understand patients' profiles, behavior, treatment and quality of life, using web-based questionnaires administered in the USA and in France. A total of 1002 and 1005 patients completed it, respectively. Self-diagnosis of HL is usually made at the very start of the prodromal phase. In the USA, 41% of patients seek medical advice at some point and they are often prescribed a topical antiviral drug (AVD) associated with an over-the-counter drug. Those who treat HL by themselves purchase mainly non-antiviral topical drugs. In France, the treatment is almost identical (topical AVD) whether patients seek medical advice (32%) or not. In both countries, patients with 6 or more annual episodes often go to the doctor and use systemic AVD. Continuous treatment is prescribed to 55% and 35% of patients with at least 4 annual episodes, in the USA and France respectively. Sick leaves are delivered to 33% and 14% of patients, respectively. QoL is significantly impaired in a majority of patients, all the more so when HL episodes are more frequent.

Background: Adapalene is a new chemical entity that exhibits tretinoin-like activities in the terminal differentiation process., Objective: We evaluated a dose range effect of two concentrations of adapalene gel as acne treatment and compared adapalene 0.1% gel with tretinoin 0.025% gel in the treatment of acne patients in two large multicenter studies., Methods: Multicenter, investigator-masked, parallel group studies including 89 acne patients in the dose range study and 591 patients in the concurrent controlled studies were conducted., Results: Adapalene gel 0.1% was significantly more effective in treating acne lesions than 0.03% adapalene gel. Adapalene gel 0.1% was significantly more effective than 0.025% or tretinoin gel in one study and of the same effectiveness in the other study. Adapalene gel was always better tolerated than tretinoin gel., Conclusion: Adapalene 0.1% gel is a safe and effective treatment of acne vulgaris.