Lentigo maligna has occasionally been noted to have the capacity to invade and repigment grey hairs. We present a case of a 78-year-old male who presented with a patch of brown hair on the vertex of the scalp in an area...Lentigo maligna has occasionally been noted to have the capacity to invade and repigment grey hairs. We present a case of a 78-year-old male who presented with a patch of brown hair on the vertex of the scalp in an area of previously white hair. The patient had previous radiotherapy to the site as a child for the treatment of tinea capitis. Initial histology revealed a lentigo maligna in situ subtype and the patient underwent surgical excision with split thickness skin graft. An invasive component was identified on histological examination of the entire lesion. This case highlights not only the rare entity of hair repigmentation as a sign of malignancy but also highlights past scalp radiotherapy as a possible risk factor in the development of melanoma.
In Australia, population-level early skin cancer detection is limited because dermatology service capacity is insufficient to meet demand. Digital skin check models, which combine total body photography by nurse melanogr...In Australia, population-level early skin cancer detection is limited because dermatology service capacity is insufficient to meet demand. Digital skin check models, which combine total body photography by nurse melanographers with remote dermatologist review of clinical and dermoscopic images, may improve triage of suspicious lesions and prioritise access to in-person assessment. In this retrospective audit of 1577 reports, we evaluated the performance of one such service, DermScreen, as a triage tool to expedite in-person dermatologist review for suspicious lesions and to support more efficient use of limited dermatology resources by reducing unnecessary consultations and enabling more targeted biopsy decisions.
Psoriasis is a chronic inflammatory skin disease for which long-term treatment adherence is essential to achieve and maintain disease control. However, adherence remains suboptimal in routine clinical practice. While a r...Psoriasis is a chronic inflammatory skin disease for which long-term treatment adherence is essential to achieve and maintain disease control. However, adherence remains suboptimal in routine clinical practice. While a range of interventions have been developed to support adherence, variability in intervention design and outcome reporting has limited the ability to draw clear conclusions regarding their effectiveness. This systematic review aimed to evaluate interventions designed to improve treatment adherence among patients with psoriasis, to synthesise evidence on adherence outcomes as well as associated clinical and patient-reported effects. A systematic literature search was conducted across major electronic databases in accordance with PRISMA guidelines to identify studies assessing adherence-enhancing interventions in psoriasis. Twenty-six studies were included. Digital and technology-supported interventions, including mobile applications, short message service reminders and electronic monitoring-supported platforms were the most frequently evaluated and were generally associated with modest improvements in adherence when compared to usual care. Healthcare professional-led interventions such as nurse and pharmacist delivered models demonstrated potential benefits in adherence. Across studies, improvements in adherence were more consistently observed than improvements in clinical severity and quality-of-life outcomes. Substantial heterogeneity in intervention design, adherence measurement and follow-up duration precluded quantitative synthesis. This systematic review highlights the diversity of approaches used to address treatment adherence benefits. However, inconsistent effects on clinical outcomes and methodological heterogeneity underpin the need for standardised adherence measures, longer term follow-up and further evaluation of scalable, multidisciplinary adherence support strategies.
We present a case of BRAF primary cutaneous Langerhan cell histiocytosis (LCH), with corresponding circulating cell free DNA (cfDNA), which responded to treatment with dabrafenib, and simultaneously saw corresponding BRA...We present a case of BRAF primary cutaneous Langerhan cell histiocytosis (LCH), with corresponding circulating cell free DNA (cfDNA), which responded to treatment with dabrafenib, and simultaneously saw corresponding BRAF cfDNA become undetectable. A concomitant diagnosis of chronic myelomonocytic leukaemia (CMML) was suspected with identification of TP53, TET2, RAS and CBL variants identified through molecular testing on the initial skin biopsy, and CMML later confirmed on bone marrow biopsy. Whilst the link between LCH and several haematological malignancies is documented, the mechanism is still unclear. In this case, the LCH most likely developed from an already abnormal myeloid compartment and highlights the need for clinical vigilance and appropriate investigation, where effective treatments for these conditions exist.
BACKGROUND: Biologic therapies have transformed the management of inflammatory dermatologic conditions, including atopic dermatitis, psoriasis, hidradenitis suppurativa, and chronic spontaneous urticaria. However, studie...BACKGROUND: Biologic therapies have transformed the management of inflammatory dermatologic conditions, including atopic dermatitis, psoriasis, hidradenitis suppurativa, and chronic spontaneous urticaria. However, studies in Australia and abroad highlight reduced uptake in regional areas, underscoring the need to address inequities in access. METHOD(S): A retrospective audit was performed of adult patients prescribed Pharmaceutical Benefits Scheme (PBS) subsidised biologics for severe atopic dermatitis, chronic plaque psoriasis, hidradenitis suppurativa, or chronic spontaneous urticaria between 1 January 2022 and 31 July 2025. Complete biologic treatment histories were collected for all identified patients, including prescriptions initiated before or continuing after the study period. RESULTS: A total of 372 patients received PBS-subsidised biologic medications for severe atopic dermatitis (42.7%), chronic spontaneous urticaria (25.8%), chronic plaque psoriasis (22.0%), and hidradenitis suppurativa (9.4%). Approximately 17% of all patients lived in regional/remote areas (Modified Monash Model [MMM] 3-5). Dupilumab (n = 159) and omalizumab (n = 96) were the most commonly prescribed first-line biologics overall. While wait times for appointments and biologic initiation were comparable across rurality classifications (median 72-77 days to first appointment, 226-304 days to first biologic), patients from MMM 3-5 regions faced significantly higher costs per appointment (MMM 3-5 $110, MMM 2 $53 and MMM 1 $36). CONCLUSIONS: This study highlights regional disparities in biologic therapy access within an Australian tertiary dermatology service. Addressing these inequities is vital to achieving equitable and sustainable dermatologic care.
This cross-sectional survey of 127 hospital outpatients assessed sun exposure behaviours and photoprotection practices. Photoprotection was inconsistent and often sub-optimal, including among high-risk individuals. Findi...This cross-sectional survey of 127 hospital outpatients assessed sun exposure behaviours and photoprotection practices. Photoprotection was inconsistent and often sub-optimal, including among high-risk individuals. Findings highlight the need for improved patient education and targeted counselling to promote comprehensive, guideline-based photoprotection.
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting over 200 million people globally. Emerging IL-4Rα-targeted monoclonal antibodies have demonstrated strong efficacy and safety in clinical trials, wa...Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting over 200 million people globally. Emerging IL-4Rα-targeted monoclonal antibodies have demonstrated strong efficacy and safety in clinical trials, warranting comparison with dupilumab, the current systemic standard. This meta-analysis synthesises available evidence on their efficacy and safety. PubMed, Embase and Cochrane Library were systematically searched in April 2025 for randomised controlled trials (RCTs) comparing IL-4Rα-targeting monoclonal antibodies versus placebo in moderate-to-severe AD, with EASI-75 as the primary outcome. Non-RCTs and trials using concomitant corticosteroids were excluded. Risk of bias was assessed using the Cochrane RoB-2 tool. Analyses were performed in R (v4.5.0), with heterogeneity evaluated by Cochran Q and I statistics. Nineteen RCTs comprising 4465 patients met inclusion criteria. At week 16, IL-4Rα inhibitors showed sustained efficacy across EASI-50/75/90, IGA 0/1 and pruritus reduction. Dupilumab remained the most validated agent, with durable effects, low heterogeneity and favourable safety. Among novel biologics, stapokibart and rademikibart demonstrated the most promising results, achieving superior EASI-90 and ≥ 4-point PP-NRS responses: stapokibart (OR 4.94; 95% CI 3.20-7.61) and rademikibart (OR 4.61; 95% CI 1.68-12.65), though the latter showed higher odds of adverse events. Other agents (MG-K10, GR1802, 611, AK120) provided encouraging but limited data. IL-4Rα inhibitors represent effective and safe therapies for moderate-to-severe AD. Dupilumab remains the reference standard, while stapokibart and rademikibart emerge as promising next-generation options. Further large, long-term, head-to-head RCTs are warranted to confirm their comparative performance. PROSPERO Registration: CRD420251129343.