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Hats aid in reducing exposure to both direct and diffuse ultraviolet light, but hats are of mixed styles and the resultant sun-protection value is variable. Adult male patients have higher rates of skin cancer, especially of the head and neck, than other subgroups. The UK and Australia have set standards for what constitutes a sunhat, whereas no such standard exists in Ireland. We explored adult male sunhats for sale during the summer in a single urban region in the west of Ireland. All the hats available were compared with the UK standard, BS 8466:2006. Almost 90% of the hats available did not meet this standard and thus did not offer adequate sun protection. Ireland requires legislation on what constitutes a sun-hat and more availability and visibility of such hats for men to encourage the use of hats for photoprotection.

This case report describes a women in her 50s with obesity, end-stage kidney disease, and type 2 diabetes who presented with severe painful, erythematous nonhealing ulcerated skin lesions with necrotic eschars on the right lower abdomen.

We examined the sun-protection practices of 61 men attending a dermatology department in the west of Ireland. Most worked outdoors, either currently or in the past. Although most wore hats as a sun-protection measure, the majority wore baseball caps, with smaller numbers wearing other types of hats that do not offer protection to the head and neck. Use of SPF products was widespread, but often not used habitually.

Toxic epidermal necrolysis and Staphylococcal scalded skin syndrome (SSSS) are potentially life-threatening dermatological emergencies that present in a similar clinical fashion. Toxic epidermal necrolysis is typically triggered by anticonvulsant and other neurological medications and reports clindamycin inducing the disease is exceedingly rare. SSSS seldomly occurs in adult patients. We present the case of a 60-year-old male presenting with dermatological rash covering >80% his body surface. Diagnosis and therapy involved multidisciplinary contribution from medical physicians, dermatologists, microbiologists and histopathologists to provide a favourable outcome.

Background: Calciphylaxis is a rare disorder that is very unusual outside the setting of end-stage kidney disease. Case Summary: A 64-year-old woman with normal renal function presented with painful leg ulcers. She had previously received 300 000 IU of vitamin D3 followed by daily calcium and vitamin D3 supplementation. A skin biopsy was consistent with calciphylaxis, and she was treated with sodium thiosulphate infusions and wound debridement. Conclusion: Calcium and vitamin D3 supplements are widely prescribed. We report a case of calciphylaxis triggered by calcium and vitamin D3 supplementation in a patient with none of the typical risk factors. Our patient had an excellent response to treatment with sodium thiosulphate.

Summary Naevus spilus (NS) is a naevoid disorder characterized by hyperpigmented macules or papules scattered over a cafe-au-lait macule. Such cafe-au-lait macules are often present at birth, and the darker pigmented speckles of NS slowly increase in number and size over a period of several years. NS can therefore be difficult to evaluate clinically for the development of melanoma. In vivo confocal microscopy (IVCM) is a novel method that allows examination at cellular resolution of cutaneous lesions in vivo. IVCM has been shown to have twice the specificity of dermoscopy for the diagnosis of melanoma, with comparable sensitivity. It has been shown to be useful in the detection and grading of dysplastic naevi, which are recognized precursors of melanoma in some cases. In this report, we highlight that IVCM can also be used as a tool complementary to dermoscopy to identify areas of dynamic change in clinically and dermoscopically equivocal lesions. IVCM may thereby assist in the early detection of melanocytic atypia and melanoma arising in NS, in turn leading to excision of melanoma at an early stage, which is associated with a favourable outcome. We also outline some of the difficulties encountered in confocal microscopy and histology when differentiating melanoma from dysplastic naevi.

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