Clinical and Experimental Dermatology最新文献

{"title":"Extramammary Paget's Disease With Bilateral Sentinel Lymph Node Biopsy: a Multicenter Study of Lymphatic Patterns and Outcomes.","authors":"Yoshiki Sakai, Eiji Nakano, Ken Horisaki, Shoichiro Mori, Yuta Kage, Dai Ogata, Shusuke Yoshikawa, Masashi Akiyama, Naoya Yamazaki, Kenjiro Namikawa","doi":"10.1093/ced/llag436","DOIUrl":"https://doi.org/10.1093/ced/llag436","url":null,"abstract":"<p><strong>Background: </strong>Extramammary Paget's disease (EMPD) can metastasize to lymph nodes or distant sites. Sentinel lymph node biopsy (SLNB) is recommended for invasive EMPD without clinical nodal involvement.</p><p><strong>Objectives: </strong>Lesions near or across the midline may show bilateral lymphatic drainage, but the clinical significance of bilateral SLNB remains unclear. This study evaluated SLN metastatic distribution and its association with clinicopathological features, lymphatic drainage patterns, and survival in patients undergoing bilateral SLNB.</p><p><strong>Methods: </strong>We retrospectively reviewed 147 patients with EMPD who underwent bilateral SLNB at three institutions between 2015 and 2025. Tumor characteristics, SLN status, recurrence, and survival outcomes were analyzed. Patients were stratified as bilateral negative, unilateral positive, or bilateral positive. Clinicopathological features, lymphatic drainage patterns, and survival outcomes, including overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS), were compared.</p><p><strong>Results: </strong>Bilateral SLN positivity was detected in eight male patients with genital nodular lesions; unilateral positivity occurred in 12 patients, and 127 were bilaterally negative. Contralateral SLNs were frequently negative despite lesions crossing the midline, although bilateral metastases developed in two patients. Four ectopic lower abdominal lesions were identified, two with irregular drainage. Patients with bilaterally negative SLNs had significantly better survival than those with SLN metastases. No significant differences in RFS or DFS were observed between the unilateral- and bilateral-positive groups.</p><p><strong>Conclusions: </strong>Bilateral SLN positivity is rare and limited to male genital cases. It was not associated with worse disease-related outcomes than unilateral positivity. Risk of bilateral metastasis appears to depend more on tumor location than intrinsic aggressiveness.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome selection and reporting transparency in ClinicalTrials.gov-registered chronic spontaneous urticaria trials: a registry-publication linkage study.","authors":"Yannan Liu, Ruhong Gao, Yongjun Peng, Wenli Ma, Fengxia Lian","doi":"10.1093/ced/llag450","DOIUrl":"https://doi.org/10.1093/ced/llag450","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria/chronic idiopathic urticaria (CSU/CIU) trials increasingly evaluate biologics and targeted mast-cell therapies. Whether ClinicalTrials.gov-registered trials consistently capture patient-centred outcomes and disseminate results in a timely and linkable manner remains uncertain.</p><p><strong>Objectives: </strong>To map registered outcome domains, patient-centred outcome breadth and reporting transparency among interventional CSU/CIU trials in ClinicalTrials.gov.</p><p><strong>Methods: </strong>ClinicalTrials.gov was searched using three CSU/CIU-related queries, yielding 486 records and 168 unique NCT registrations after deduplication. Eligible interventional trials were coded for intervention category, trial purpose and nine registered outcome domains. A descriptive 0-8 patient-centred outcome score excluded safety. A stratified sample was independently recoded by a second author. Completed or terminated trials underwent manual registry-publication linkage, with primary and secondary publications distinguished and reporting assessed at 12, 24 and 36 months after primary completion using a fixed data lock of 1 June 2026.</p><p><strong>Results: </strong>We included 128 eligible trials; 83 were completed or terminated. Disease activity/UAS7 (78.1%), itch/pruritus (65.6%) and wheals/hives (59.4%) were commonly registered, whereas urticaria control/UCT (28.1%), angioedema (30.5%), relapse/remission/rescue medication (24.2%) and explicit sleep/daily activity (7.8%) were less frequent. The mean patient-centred score was 3.37 (SD 1.98), and 20 trials (15.6%) scored at least 6. Independent second coding showed 90.4% agreement across 270 domain-level decisions. Among 83 completed/terminated trials, 32 (38.6%) had both posted results and a confirmed primary publication, whereas 15 (18.1%) had no qualifying public result identified. Any qualifying public result was available within 12, 24 and 36 months for 18.8%, 53.5% and 66.7% of trials with sufficient follow-up, respectively.</p><p><strong>Conclusions: </strong>ClinicalTrials.gov-registered CSU/CIU trials show substantial heterogeneity in patient-centred outcome coverage. Distinguishing trial purpose, primary from secondary publications and reporting opportunity over time provides a more cautious assessment of the registered evidence base and highlights opportunities for more harmonised outcome selection and clearer result dissemination.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin Oncology.","authors":"Valencia Long, Suyin Ong, Chien Sheng Tan, Shan Xian Lee","doi":"10.1093/ced/llag449","DOIUrl":"https://doi.org/10.1093/ced/llag449","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time assessment of mitotic rate in malignant melanoma by ex vivo confocal microscopy.","authors":"Daniela Hartmann, Katharina Wex, Aimée Braun, Alisa Swarlik, Lisa Buttgereit, Lara Stärr, Andreas Ohlmann, Elke C Sattler, Maximilian Deußing","doi":"10.1093/ced/llag443","DOIUrl":"https://doi.org/10.1093/ced/llag443","url":null,"abstract":"<p><strong>Background: </strong>Malignant melanoma has exhibited a significant increase in incidence over the past decade and remains the most common cause of skin cancer-related deaths. Early diagnosis and treatment are essential, as delays correlate with poorer clinical outcomes. Ex vivo confocal laser scanning microscopy (EVCM) enables intraoperative examination of fresh tissues within minutes and has shown potential for detecting morphological criteria and accurately determining Breslow thickness in melanoma.</p><p><strong>Objectives: </strong>The aim of the present pilot study was to evaluate whether EVCM can also reliably assess the mitotic rate, an important prognostic marker influencing the indication for sentinel lymph node biopsy (SLNB).</p><p><strong>Methods: </strong>40 histologically confirmed melanomas from various anatomical sites were examined using the current gold standard of histopathology and EVCM. The confocal mitotic rate (CMR) and the histopathological mitotic rate (HMR) were statistically compared. In this context, two clinically relevant groups (0 mitoses/mm2 and ≥ 1 mitosis/mm2) were defined for analysis, taking into consideration the clinically significant thresholds typically used in histopathological assessment.</p><p><strong>Results: </strong>Overall, 95.0% of melanomas were correctly assigned to the respective group. With a sensitivity of 100%, a specificity of 77.8%, a positive predictive value of 93.9% and a negative predictive value of 100%, EVCM demonstrated promising performance for detecting mitotic activity.</p><p><strong>Conclusions: </strong>These findings emphasize the potential of EVCM for reliable detection of atypical mitotic figures. Prior to clinical implementation, prospective validation in larger, multicenter cohorts involving multiple EVCM experts is required.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumour-Vascular Interface in melanomas with Breslow thickness ≥0.8 mm: A Confocal Microscopy Study.","authors":"Michela Lai, Gioia Pedroni, Martina Cavicchi, Marica Mirra, Margherita Raucci, Cinzia Ricci, Simonetta Piana, Shaniko Kaleci, Giovanni Pellacani, Caterina Longo","doi":"10.1093/ced/llag447","DOIUrl":"https://doi.org/10.1093/ced/llag447","url":null,"abstract":"<p><strong>Background: </strong>Due to the limited laser penetration depth, reflectance confocal microscopy (RCM) application in the study of thick cutaneous lesions has been limited so far.</p><p><strong>Objectives: </strong>To describe clinical, histopathological, dermoscopic and RCM features of cutaneous melanomas with Breslow thickness ≥0.8 mm, to identify possible differences among different histological subtypes, and describe new RCM features of these tumours, with a focus on their potential impact on prognosis.</p><p><strong>Methods: </strong>We conducted a retrospective, single-centre, study. We assessed the presence of a new RCM feature named \"tumour-vascular interface\" (TVI) defined as the presence of vessels adjacent to melanocytic structures. The included cases were classified according to melanoma histotype and the presence of TVI.</p><p><strong>Results: </strong>A total of 197 melanomas were included and comprehensive description of their clinicopathological, dermoscopic and RCM features was provided. Most cases were superficial spreading melanomas (72.6%) and nodular melanomas (16.2%). The mean Breslow thickness was 2.3 mm (SD ±2.4; range 0.8-25). TVI was identified in 83 cases (42.1%). TVI+ cases were more frequently amelanotic/hypomelanotic (p = 0.011) and ulcerated (p= 0.093) and exhibited a higher mitotic rate (p=0.002). No significant differences in mortality rate or disease progression were observed between TVI+ and TVI- melanomas though TVI+ cases showed a trend toward higher nodal relapse rates (p=0.068).</p><p><strong>Conclusions: </strong>This study provides an in-depth analysis of clinicopathological, dermoscopic and RCM features of invasive cutaneous melanomas, suggesting a potential new application of RCM in the study of melanoma vascularization and its possible correlation with clinical behaviour.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribed insulin use in type II diabetes mellitus and skin cancer risk: A systematic review 3.","authors":"Adele Sotgiu, Girum Assefa, Lydia Tutt, Grace Baby, Zoe C Venables, Zenas Z N Yiu, Lesley E Rhodes, Iskandar Idris, Sonia Gran","doi":"10.1093/ced/llag444","DOIUrl":"https://doi.org/10.1093/ced/llag444","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sebaceous Carcinoma in England (2013-2022): A national cancer registry report on incidence, referral pathways, treatment and survival.","authors":"Mythili R Srinivasan, Birgitta van Bodegraven, Sam Cook, Neil Rajan, Zoe C Venables","doi":"10.1093/ced/llag446","DOIUrl":"https://doi.org/10.1093/ced/llag446","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upadacitinib Combined with NB-UVB for Non-Segmental Vitiligo: A Single-Center Prospective Study.","authors":"Lu Lu, Jindi Feng, Lu Yang, Huimin He, Yubin Peng, Anqi Xie, Shiyu Zhang, Yuehua Liu, Tao Wang","doi":"10.1093/ced/llag437","DOIUrl":"https://doi.org/10.1093/ced/llag437","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is a chronic autoimmune depigmenting disorder with limited therapeutic options for patients with active and refractory disease. Janus kinase (JAK) inhibitors have emerged as promising treatments, and combination therapy with phototherapy may further enhance repigmentation.</p><p><strong>Objectives: </strong>To evaluate the efficacy and safety of oral upadacitinib combined with narrowband ultraviolet B (NB-UVB) phototherapy in patients with active non-segmental vitiligo.</p><p><strong>Methods: </strong>In this prospective cohort study, adults with active non-segmental vitiligo and inadequate response to prior therapies received either oral upadacitinib (15 mg once daily) combined with NB-UVB phototherapy or NB-UVB alone for 12 weeks. The primary endpoint was achievement of ≥50% improvement in total Vitiligo Area Scoring Index (T-VASI50) at week 12. Secondary endpoints included changes in T-VASI, facial VASI (F-VASI), Vitiligo Extent Score (VES), and disease activity and improvement scores (VDAS/VDIS). Safety was assessed throughout the study.</p><p><strong>Results: </strong>A total of 38 patients were included, with 19 patients in each treatment group. At week 12, 47.4% of patients in the combination group achieved T-VASI50, compared with 5.3% in the NB-UVB monotherapy group (P = 0.0078). The combination group showed significantly greater mean percentage improvements in T-VASI (49.1%±20.3% vs 18.7%±14.3%, P < 0.01) and VES (44.6%±20.1% vs 18.6%±13.8%, P < 0.01). Superior responses were observed in truncal and non-acral extremity lesions, whereas facial outcomes did not differ significantly between groups. All adverse events were mild, and no serious adverse events were reported.</p><p><strong>Conclusions: </strong>Oral upadacitinib combined with NB-UVB phototherapy demonstrated superior short-term efficacy compared with NB-UVB alone in patients with active non-segmental vitiligo, with an acceptable safety profile. These findings support this combination as a promising therapeutic strategy and warrant further validation in larger randomized controlled trials with longer follow-up.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decades Long Granulomatous Plaque Defying Diagnosis.","authors":"Hassan A Bennakhi, Ronald Muc, Chenjing Peng","doi":"10.1093/ced/llag433","DOIUrl":"https://doi.org/10.1093/ced/llag433","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naevus comedonicus syndrome associated with unilateral thoracic deformity in an adolescent male.","authors":"Jessica Bales, Natalya Fox","doi":"10.1093/ced/llag442","DOIUrl":"https://doi.org/10.1093/ced/llag442","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}