Melanoma, an aggressive skin cancer, requires timely diagnostics for improved patient outcomes. The ABCDE criteria-assessing asymmetry, borders, color, diameter, and evolution-serve as foundational guidelines for early d...Melanoma, an aggressive skin cancer, requires timely diagnostics for improved patient outcomes. The ABCDE criteria-assessing asymmetry, borders, color, diameter, and evolution-serve as foundational guidelines for early detection. Non-invasive tools like dermoscopy, total body photography, and advanced imaging techniques enhance visualization of skin lesions, while artificial intelligence-driven algorithms improve diagnostic accuracy. Despite these advancements, biopsy remains the gold standard for definitive diagnosis. This multifaceted approach highlights the need for integrating traditional methods with innovative technologies to optimize melanoma evaluation and management, ultimately leading to better patient outcomes.
Dermoscopy is a non-invasive diagnostic tool used to examine skin lesions, significantly enhancing the accuracy of diagnosis, particularly for pigmented lesions. This article provides updates on key diagnostic algorithms...Dermoscopy is a non-invasive diagnostic tool used to examine skin lesions, significantly enhancing the accuracy of diagnosis, particularly for pigmented lesions. This article provides updates on key diagnostic algorithms of pigmented lesions over the past decade, such as the ABCDE rule, 7-point checklist, and the ASAP algorithm. It also highlights new diagnostic features, including patterns specific to malignant melanoma, melanocytic nevi, and pigmented basal cell carcinoma.
The American Cancer Society estimates that nearly 105,000 new cases of invasive melanoma of the skin and over 107,000 new cases of melanoma in situ will be diagnosed in the United States in 2025. In this same year, over...The American Cancer Society estimates that nearly 105,000 new cases of invasive melanoma of the skin and over 107,000 new cases of melanoma in situ will be diagnosed in the United States in 2025. In this same year, over 8,400 deaths from melanoma of the skin are predicted. Among non-Hispanic white individuals, the overall lifetime risk of developing invasive melanoma is 1-in-29 for male individuals and 1-in-40 for female individuals. Among this population, overall 5 year survival rates have improved from 82% in 1975 to 1997 to 94% in 2014 to 2020. As expected, disease that is only local at diagnosis confers an excellent greater than 99% 5 year survival, whereas melanoma that has metastasized regionally or distant confers only a 75% or 35% 5 year survival, respectively.
Melanoma is a malignant skin tumor with increasing global incidence, driven by factors like UV exposure and genetic predisposition. Early detection is critical, with markers such as atypical nevi and lentigo maligna indi...Melanoma is a malignant skin tumor with increasing global incidence, driven by factors like UV exposure and genetic predisposition. Early detection is critical, with markers such as atypical nevi and lentigo maligna indicating potential melanoma progression. Genetic mutations (eg, CDKN2A, NRAS) influence melanoma risk and tumor behavior, aiding risk assessment and targeted treatments. Dermoscopic and histologic tools, including the ABCDE criteria and biomarkers like S100B, improve diagnostic accuracy. Timely intervention, along with advancements in genetic testing, dermoscopy, and AI-assisted tools, are essential for reducing melanoma's morbidity and mortality. Regular surveillance for high-risk individuals is crucial for early identification and treatment.
Melanoma is one of the leading causes of skin cancer deaths and is driven by ultraviolet (UV) radiation and subsequent DNA damage. Although studies on sunscreen's effectiveness in preventing melanoma are inconsistent and...Melanoma is one of the leading causes of skin cancer deaths and is driven by ultraviolet (UV) radiation and subsequent DNA damage. Although studies on sunscreen's effectiveness in preventing melanoma are inconsistent and limited, the available high-quality data suggest that sunscreen use can reduce melanoma incidence. Challenges include increased sun exposure with sunscreen use, poor sunscreen application, and limited UVA protection of sunscreens. Current guidelines recommend broad-spectrum sunscreens with sun protection factor greater than 30, regular reapplication, and additional sun-protective measures. Ongoing research is essential to better understand melanoma and refine prevention strategies.
Melanoma continues to be an important public health issue, both inside and outside the United States. As the rates of new melanoma cases has been steadily increasing, it is important to recognize and understand risk fact...Melanoma continues to be an important public health issue, both inside and outside the United States. As the rates of new melanoma cases has been steadily increasing, it is important to recognize and understand risk factors, both endogenous and exogenous, as early detection of this malignancy can change prognosis. Recognition and improved understanding will allow us to better develop public education programs, increase awareness, change risk behaviors, and subsequently lower incidence and mortality from melanoma in the future.
Melanoma is a type of cutaneous malignancy responsible for thousands of deaths every year. Despite improvements in therapuetics and identification, incidence rate and the total number of associated deaths for melanoma co...Melanoma is a type of cutaneous malignancy responsible for thousands of deaths every year. Despite improvements in therapuetics and identification, incidence rate and the total number of associated deaths for melanoma continue to increase annually. Melanoma outcomes are impacted by numerous variables, and sex, age, race, socioeconomic status, and tanning bed use have been studied extensively as they relate to melanoma. Additionally, this article explores the trends in the changing melanoma incidence and mortality rates per modifiable variable and subpopulation.
Hidradenitis suppurativa (HS) is a painful, autoinflammatory condition with dramaticimpact on quality of life. As of January 1, 2024, there are 25 phase I-III clinical trials for topical and systematic medications in the...Hidradenitis suppurativa (HS) is a painful, autoinflammatory condition with dramaticimpact on quality of life. As of January 1, 2024, there are 25 phase I-III clinical trials for topical and systematic medications in the management of HS. Only three medications, adalimumab, secukinumab and bemikizumab, are currently approved by the United States Food and Drug Administration for the treatment of moderate to severe HS. In addition, 15 nonmedication-based studies are ongoing, including those for various surgical techniques, botulinum toxin, laser and light-based therapies, differing wound care methods, and a variety of complementary and alternative medicine practices for HS.
People with hidradenitis suppurativa (HS) face structural, provider-related, and patient-related barriers in accessing health care and treatments for HS. This article highlights how these barriers result in delayed diagn...People with hidradenitis suppurativa (HS) face structural, provider-related, and patient-related barriers in accessing health care and treatments for HS. This article highlights how these barriers result in delayed diagnosis, inadequate treatment, and poorer health outcomes for people with HS. It also discusses the disparities faced by minoritized and underserved communities in accessing dermatologic care, as well as the need for more efficacious treatments for HS given the current limited therapeutic options. Efforts are underway to increase HS awareness and education, improve and expand access to treatment, and build trust between people with HS and the health care community.
Hidradenitis suppurativa (HS) in children can be especially challenging to treat due to a lack of pediatric-specific data and guidelines. Management strategies for this special population are often extrapolated from the...Hidradenitis suppurativa (HS) in children can be especially challenging to treat due to a lack of pediatric-specific data and guidelines. Management strategies for this special population are often extrapolated from the adult HS literature. Many treatments, including topical agents, oral antibiotics, hormonal agents, biologics, and procedures, often utilized for adults, may also be implemented in children; however, certain age-specific considerations should be noted. Early identification and treatment of HS may help reduce the development of irreversible tissue damage and mitigate potentially devastating impacts on mental health and physical functioning.
This review provides insight into the different types of laser-based and energy-based therapies used in the treatment of hidradenitis suppurativa. It further explores the differences among some of the more commonly utili...This review provides insight into the different types of laser-based and energy-based therapies used in the treatment of hidradenitis suppurativa. It further explores the differences among some of the more commonly utilized laser modalities and the indications for their use (ie, scar treatment and hair follicle destruction).
A variety of procedures may be employed for hidradenitis suppurativa, a chronic cutaneous condition that causes abscesses, nodules, and tunnels in skinfold areas. Intralesional steroid or incision and drainage are prefer...A variety of procedures may be employed for hidradenitis suppurativa, a chronic cutaneous condition that causes abscesses, nodules, and tunnels in skinfold areas. Intralesional steroid or incision and drainage are preferred for acutely inflamed discrete lesions, while deroofing or excision may be pursued for persistent or recurrent areas. Excision and deroofing may target individual lesions or complete regions that are more widely affected. Reconstructions may be considered after excisions based on operator and patient preference. Other procedures such as botulinum toxin injection, cryoinsufflation, and electrosurgical and laser-based modifications to deroofing and excisions have also been used successfully.
Multimodal treatment plans are essential for effectively managing hidradenitis suppurativa (HS). To optimize patient outcomes, conventional medical and surgical treatments should be integrated with lifestyle changes and...Multimodal treatment plans are essential for effectively managing hidradenitis suppurativa (HS). To optimize patient outcomes, conventional medical and surgical treatments should be integrated with lifestyle changes and nonpharmacologic modalities. This review offers an evidence-based guide to the most studied and recommended lifestyle changes and complementary and alternative medicine (CAM) modalities for patients with HS.
Hidradenitis suppurativa (HS) wounds are complex and have unique characteristics that complicate dressing selection. Proper wound care assists with wound healing and contributes to improved quality of life. Ideal dressin...Hidradenitis suppurativa (HS) wounds are complex and have unique characteristics that complicate dressing selection. Proper wound care assists with wound healing and contributes to improved quality of life. Ideal dressings are comfortable while maintaining a wound-healing environment. Antimicrobial dressings should target dysbiosis and biofilms. Absorptive dressings are needed for control of exudate. Pain control is best achieved with nonadhesive dressings and contact layers. Agents targeting anaerobic bacteria are effective at odor reduction. Surgery may be indicated for management of refractory wounds. Overall, there is a need for increased research and education on both routine and postsurgical wound care in HS.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that may cause debilitating pain and itch. Given their physical and psychological burden, recognition and treatment of HS-associated symptoms are cri...Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that may cause debilitating pain and itch. Given their physical and psychological burden, recognition and treatment of HS-associated symptoms are critical for supporting patients with HS. The complex nature of HS pain, encompassing acute and chronic timing as well as nociceptive, neuropathic, and nociplastic character, requires a tailored treatment approach. Itch in HS, although less studied, is also a prevalent and distressing symptom. The aim of this narrative review is to apply current knowledge of HS pain and pruritus to develop a practical approach for symptomatic management in the dermatology office.
"Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a significant quality-of-life impact. In addition to the 2 drugs approved by the Food and Drug Administration for HS, adalimumab and secukinumab,..."Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a significant quality-of-life impact. In addition to the 2 drugs approved by the Food and Drug Administration for HS, adalimumab and secukinumab, several other biologic and small molecule inhibitors are used off-label or are in clinical trials. A systematic and evidence-based approach using these and other therapies-considering patient comorbidities, response to therapy, dose adjustment, and frequent troubleshooting-is required. In this article, we review the latest evidence supporting anti-inflammatory biologic and small molecule therapies for HS and provide a practical, algorithmic approach to management incorporating experience and expert opinion."
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Despite significant research efforts to discover new therapeutic molecules in recent years, antibiotics and conventional systemic therapies continue t...Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Despite significant research efforts to discover new therapeutic molecules in recent years, antibiotics and conventional systemic therapies continue to be the indispensable first-line treatments for HS. In this study, we discussed well-known topical and systemic antibiotics and widely used systemic treatments (hormone-modulating therapies, retinoids, and immunosuppressants), and their combinations. Overall, since targeted biologics are not accessible to all patients with HS due to cost, availability, or contraindications, these therapies remain important for treating mild-to-moderate HS and serve as adjunct or bridge treatments in severe cases.
Accurate assessment of disease severity and treatment response are essential in the clinical management of hidradenitis suppurativa (HS) and vital in research efforts, particularly investigations of potential therapeutic...Accurate assessment of disease severity and treatment response are essential in the clinical management of hidradenitis suppurativa (HS) and vital in research efforts, particularly investigations of potential therapeutics. Key elements of the history and physical examination can inform treatment decisions to meet the needs of each individual patient. Over time, and through diligent and purposeful research, outcome measures capable of accurately and reliably assessing treatment response suitable for both research and clinical use have been developed and refined. This review explores HS clinical assessment, existing outcome measures, and emerging tools to enable accurate assessment, improve care, and optimize treatment strategies.
Skin and gut microbiome perturbations may play a role in hidradenitis suppurativa (HS) pathogenesis. Emerging microbiome research has established the complex roles of the skin and gut microbiomes in health maintenance an...Skin and gut microbiome perturbations may play a role in hidradenitis suppurativa (HS) pathogenesis. Emerging microbiome research has established the complex roles of the skin and gut microbiomes in health maintenance and disease. Perturbations in the HS skin microbiome have been shown to correlate with HS disease severity. HS gut microbiome characterization studies point to a trend in decreased microbial diversity associated with HS. Future research efforts examining microbiome perturbations and their functional implications longitudinally and in the setting of interventions are needed to build on this foundational knowledge.