BACKGROUND: Brentuximab vedotin (BV) is a targeted therapy for CD30-expressing lymphomas, including Hodgkin lymphoma (HL) and cutaneous T-cell lymphoma (CTCL). While peripheral neuropathy is the most common adverse event...BACKGROUND: Brentuximab vedotin (BV) is a targeted therapy for CD30-expressing lymphomas, including Hodgkin lymphoma (HL) and cutaneous T-cell lymphoma (CTCL). While peripheral neuropathy is the most common adverse event, BV-induced skin rashes are less frequent and not well characterized. PATIENTS AND METHODS: This study analyzed the clinical and histologic features of BV-induced skin rashes over the past 5 years, focusing on patterns and severity across lymphoma types. We retrospectively reviewed cases from the Dermatology and Hematology Departments at Bologna and Ancona Universities, and we identified 20 eligible patients (13 males, 7 females, median age 59 years) with a Naranjo score ≥ 5. Six had CTCL, and 14 had systemic lymphoma. RESULTS: Rashes appeared after a median of 3.5 BV cycles, presenting as eczematous (n = 11 patients), maculopapular (n = 3), or lichenoid (n = 6). Histology showed cytotoxic lichenoid infiltrates in lichenoid cases and spongiotic dermatitis in eczematous ones. CTCL patients experienced more severe reactions (50 % grade ≥ 3) compared to systemic lymphoma patients (36.3 %). BV was discontinued in 10 cases, while others continued with dose adjustments and corticosteroids. CONCLUSIONS: Lichenoid reactions were more common in CTCL, possibly due to BV's effects on the tumor microenvironment. Recognizing rash patterns may optimize care and minimize unnecessary treatment interruptions.
Near-infrared non-ablative fractional lasers (NAFL) are established for skin rejuvenation and scar treatment and have attracted interest for their expanding therapeutic potential. This scoping review aims to revisit and...Near-infrared non-ablative fractional lasers (NAFL) are established for skin rejuvenation and scar treatment and have attracted interest for their expanding therapeutic potential. This scoping review aims to revisit and reposition NAFL within a fluence-dependent continuum of tissue modulation, based on evidence from 27 studies of lasers operating at 1540-1570 nanometers, comprising ten molecular biology studies and 17 histological analyses. Histological data demonstrated a fluence-dependent tissue response: lower fluences preserved the stratum corneum, whereas higher fluences produced marked epidermal damage with subepidermal clefting, indicating a semi-ablative pattern. Both histological and molecular findings supported parallel spatiotemporal remodeling cascade, consisting of an initial inflammatory phase dominated by neutrophil infiltration and upregulation of heat shock proteins, interleukins, and matrix metalloproteinases; followed by a proliferative phase within 24 hours, characterized by keratinocyte bridging, re-epithelialization, and increased mitochondrial activity; and culminate in a prolonged remodeling phase (weeks 2-12), marked by collagen and elastin fibers synthesis and reorganization. By integrating evidence from molecular and histological studies, this review repositions NAFL within a fluence-dependent continuum of tissue modulation, ranging from non-ablative photothermal interactions to progressively barrier-disruptive treatment modalities. This framework holds perspectives for broadening the clinical scope, particularly for applications in laser-assisted drug delivery and skin cancer prevention.
BACKGROUND: Actinic keratoses (AKs) are common precursors to squamous cell carcinoma and pose a heightened risk in immunosuppressed patients, such as organ transplant recipients (OTRs). PATIENTS AND METHODS: This prospec...BACKGROUND: Actinic keratoses (AKs) are common precursors to squamous cell carcinoma and pose a heightened risk in immunosuppressed patients, such as organ transplant recipients (OTRs). PATIENTS AND METHODS: This prospective, monocentric, single-arm observational study investigated the safety and efficacy of topical tirbanibulin 1% ointment in treating Olsen grade 1 and 2 AKs on the face and scalp of 40 OTRs. At baseline (T0), demographic characteristics, clinical history, AKASI score, and AK count were collected. Patients applied tirbanibulin once daily for 5 consecutive days. Local skin reactions (LSRs) were evaluated on day 8 (T1), and efficacy outcomes - Actinic Keratosis Area and Severity Index (AKASI) and actinic keratosis count - were assessed on approximately day 60 (T2). RESULTS: All patients experienced mild or moderate local skin reactions (LSRs), primarily erythema and scaling, which resolved spontaneously without further intervention. By T2, the mean AKASI score decreased from 2.64 to 1.03, while the mean AK count dropped from 6.65 to 2.78; the differences were statistically significant. Notably, 52.5% of patients achieved at least 75% clearance, and 42.5% reached complete clearance. No serious adverse events or treatment discontinuations were reported. CONCLUSIONS: This study demonstrates that tirbanibulin is a safe, well-tolerated, and effective option for AK management in OTRs, addressing a critical need in this high-risk population.
Flatt N, Kochanek C, Angela Y
… +13 more, Hassel JC, Forschner A, Gebhardt C, Mengoni M, Thoms KM, Heppt M, Kött J, Schulz C, Flatz L, Tüting T, Alter M, Schaper-Gerhardt K, Gutzmer R
BACKGROUND: Adjuvant therapy with anti-PD-1 monotherapy in melanoma is well established. However, a perioperative approach starting immunotherapy before surgery appears mechanistically more reasonable and emerging resear...BACKGROUND: Adjuvant therapy with anti-PD-1 monotherapy in melanoma is well established. However, a perioperative approach starting immunotherapy before surgery appears mechanistically more reasonable and emerging research results suggest a clinical benefit. This study aims to provide a comprehensive overview of the current use of perioperative anti-PD-1 monotherapy in Germany. PATIENTS AND METHODS: Patients with stage III melanoma who received perioperative anti-PD-1 monotherapy from April 2019 to March 2025 were included. Data from eight German skin cancer centers were retrospective collected including histological and radiological assessments. RESULTS: We identified 75 melanoma patients with perioperative anti-PD-1 monotherapy. Surgery was conducted in 75% of patients after a median of 11 weeks after therapy initiation. Pathological assessment revealed a major pathological response (MPR) in 46.5% of cases, a partial pathological response in 23.2%, and no pathological response in 30.4%. A moderate to strong correlation between radiological and pathological responses was identified. During a median follow up period of 11.6 months, melanoma recurrence was observed in 16 patients (21%). The longest recurrence-free survival was seen in the MPR group. CONCLUSIONS: Perioperative anti-PD-1 monotherapy has been implemented in routine clinical practice in German skin cancer centers. The observed outcomes are comparable to data reported from prospective studies.
BACKGROUND: Accurate assessment of lymph node (LN) involvement is crucial in cutaneous T-cell lymphoma (CTCL), but biopsy-based evaluation carries risks, limiting its use. This study aims to evaluate ultrasound effective...BACKGROUND: Accurate assessment of lymph node (LN) involvement is crucial in cutaneous T-cell lymphoma (CTCL), but biopsy-based evaluation carries risks, limiting its use. This study aims to evaluate ultrasound effectiveness in detecting malignant LN involvement and identify optimal ultrasound parameters for prediction. PATIENTS AND METHODS: A retrospective cohort study was conducted with 250 CTCL patients who underwent LN ultrasound evaluations between 2018 and 2024. Ultrasound parameters were compared with histopathological results, and receiver operating characteristic (ROC) analysis was performed to assess diagnostic accuracy. RESULTS: Ultrasound improves the detection rate of LN enlargement, from 21.6% to 57.6%. Lymphadenopathy on ultrasound was associated with higher disease staging and lower progression-free survival rates in mycosis fungoides. Key parameters, including increased short-axis diameter (p = 0.004) and loss of the echogenic hilum (p = 0.04), were significant indicators of malignant LN involvement. The combination of these two parameters in predicting malignant lymphadenopathy achieved an accuracy of 76.2%, with a sensitivity of 68.4% and a specificity of 82.6%, demonstrating superior diagnostic performance and providing valuable prognostic insights. CONCLUSIONS: Ultrasound is a reliable method for detecting malignant lymphadenopathy in CTCL, aiding clinicians in deciding whether an invasive biopsy is necessary.
Prat-Colilles E, Plana-Pla A, Vicente A
… +19 more, Baselga E, Iznardo H, Roé E, Casals-Andreu M, Sin-Soler M, Pujol-Montcusí JA, Cordellat-Martínez MDM, Soria-Gili X, Tapias-Terré MDM, Bertolin-Colilla M, Planella-Fontanillas N, Marques-Martín L, Munera-Campos M, Fabregat-Pratdepadua M, Prat-Torres CS, Ivars M, Montenegro-Morillo LF, Bielsa-Marsol I, Carrascosa-Carrillo JM
BACKGROUND AND OBJECTIVES: Atopic dermatitis (AD) has a highly variable clinical phenotype and ancestry can contribute to this heterogeneity. This study aims to identify clinical phenotypes of AD in children from diverse...BACKGROUND AND OBJECTIVES: Atopic dermatitis (AD) has a highly variable clinical phenotype and ancestry can contribute to this heterogeneity. This study aims to identify clinical phenotypes of AD in children from diverse ancestry groups, evaluate clinical outcomes and response to treatment, and define phenotypic clusters with potential relevance. PATIENTS AND METHODS: Multicenter, descriptive, observational study of patients with moderate-to-severe AD treated in eight Spanish hospitals. Patient ancestry was based on self-reported parental origin and country of birth. Phenotypic clusters were identified through analysis of demographic, clinical, and morphological variables. Systemic treatment response was assessed using validated AD scales. RESULTS: 157 children were categorized into five ancestry groups: American Indian, Asian, Black, Mixed, and White. Three phenotypic clusters were identified. Cluster 1 had varied ancestries and the highest rate of Th2 comorbidities. Cluster 2 patients were mostly Asian with a predominantly non-classic morphologies, and a higher rate of hospital admissions. Cluster 3 were mostly white with fewer Th2 comorbidities. Systemic treatments yielded differential responses across clusters. Cluster 1, slower response; Cluster 2, fastest improvement; Cluster 3, milder disease and consistent improvement. CONCLUSIONS: We propose a clinically based clustering framework to refine pediatric AD phenotypes and support individualized care across diverse ancestries.