Pub Date : 2026-03-18DOI: 10.1001/jamadermatol.2026.0120
Elizabeth Garcia-Creighton, Nicholas A Felan, Jasmine V Hartman Budnik, Miranda G Manfre, Amy Du, Madeline M Felan, Sean P Spencer, Lucinda L Kohn, Tyler M Muffly
{"title":"Appointment Access and Waiting Times in General and Pediatric Dermatology.","authors":"Elizabeth Garcia-Creighton, Nicholas A Felan, Jasmine V Hartman Budnik, Miranda G Manfre, Amy Du, Madeline M Felan, Sean P Spencer, Lucinda L Kohn, Tyler M Muffly","doi":"10.1001/jamadermatol.2026.0120","DOIUrl":"10.1001/jamadermatol.2026.0120","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-18DOI: 10.1001/jamadermatol.2026.0155
Alexa B Kimball, Konrad T Sawicki, Lindsay Ackerman, Hermenio Lima, Evangelos J Giamarellos-Bourboulis, Tianyu Zhan, Leonidas Drogaris, Yihua Gu, Christine M Lee, Mona Akbari, David A Williams, Falk G Bechara
<p><strong>Importance: </strong>Hidradenitis suppurativa (HS) is a debilitating inflammatory skin disease with limited therapeutic options.</p><p><strong>Objective: </strong>To assess the efficacy and safety of lutikizumab, a dual-variable domain interleukin 1α/1β antagonist, for adult participants with moderate to severe HS who experienced anti-tumor necrosis factor (TNF) therapy failure.</p><p><strong>Design, setting, and participants: </strong>This phase 2, double-blind, placebo-controlled randomized clinical trial was conducted at 45 sites in 8 countries or territories (Australia, Canada, Germany, Greece, Japan, Puerto Rico, Spain, and the US) between December 28, 2021, and November 27, 2023, and included a 35-day screening period, a 16-week treatment period, and a 9-week safety follow-up. Data were analyzed in December 2023. Participants 18 years or older with a diagnosis of HS for 12 months or longer who experienced anti-TNF treatment failure were enrolled.</p><p><strong>Interventions: </strong>Eligible participants were randomized 1:1:1:1 to receive lutikizumab, 300 mg, every week; lutikizumab, 300 mg, every other week; lutikizumab, 100 mg, every other week; or placebo, every week. The trial drug was administered starting at baseline and through week 16.</p><p><strong>Main outcomes and measures: </strong>The primary end point was achieving a Hidradenitis Suppurativa Clinical Response (HiSCR 50) at week 16. The secondary efficacy objective was achieving at least a 30% reduction and at least 1-unit reduction from baseline in Patient's Global Assessment of skin pain (Numerical Rating Scale [NRS] 30) after 16 weeks of treatment among among patients with a baseline NRS 3 or greater. Additional end points included achieving HiSCR 75 and HiSCR 90, change and percentage change from baseline in draining tunnels, and change from baseline in Dermatology Life Quality Index total scores.</p><p><strong>Results: </strong>A total of 153 participants received at least 1 dose of the trial medication (94 female individuals [61.4%]; mean [range] age, 40.5 [19-75] years; 108 patients [70.6%] at Hurley stage III). At week 16, 19 (48.7%), 22 (59.5%), and 10 participants (27.0%) receiving lutikizumab, 300 mg, every week; lutikizumab, 300 mg, every other week; and lutikizumab, 100 mg, every other week, respectively, achieved HiSCR50 at week 16 compared with placebo (35.0%); posterior probabilities of positive treatment effect vs placebo were 89.3%, 98.5%, and 22.8%, respectively, using a bayesian analysis. Among participants with baseline NRS scores of 3 or greater, 10 (34.5%) who received lutikizumab, 300 mg, every other week and 8 (34.8%) who received lutikizumab, 300 mg, every week achieved an NRS30 response compared with 4 (12.9%) who received placebo. There were no deaths or treatment-emergent adverse events of neutropenia, serious hypersensitivity reactions, major adverse cardiovascular events, or opportunistic infections reported.</p><p><strong>Conclusions
{"title":"Lutikizumab in Adults With Moderate to Severe Hidradenitis Suppurativa After Anti-TNF Therapy Failure: A Phase 2 Randomized Clinical Trial.","authors":"Alexa B Kimball, Konrad T Sawicki, Lindsay Ackerman, Hermenio Lima, Evangelos J Giamarellos-Bourboulis, Tianyu Zhan, Leonidas Drogaris, Yihua Gu, Christine M Lee, Mona Akbari, David A Williams, Falk G Bechara","doi":"10.1001/jamadermatol.2026.0155","DOIUrl":"10.1001/jamadermatol.2026.0155","url":null,"abstract":"<p><strong>Importance: </strong>Hidradenitis suppurativa (HS) is a debilitating inflammatory skin disease with limited therapeutic options.</p><p><strong>Objective: </strong>To assess the efficacy and safety of lutikizumab, a dual-variable domain interleukin 1α/1β antagonist, for adult participants with moderate to severe HS who experienced anti-tumor necrosis factor (TNF) therapy failure.</p><p><strong>Design, setting, and participants: </strong>This phase 2, double-blind, placebo-controlled randomized clinical trial was conducted at 45 sites in 8 countries or territories (Australia, Canada, Germany, Greece, Japan, Puerto Rico, Spain, and the US) between December 28, 2021, and November 27, 2023, and included a 35-day screening period, a 16-week treatment period, and a 9-week safety follow-up. Data were analyzed in December 2023. Participants 18 years or older with a diagnosis of HS for 12 months or longer who experienced anti-TNF treatment failure were enrolled.</p><p><strong>Interventions: </strong>Eligible participants were randomized 1:1:1:1 to receive lutikizumab, 300 mg, every week; lutikizumab, 300 mg, every other week; lutikizumab, 100 mg, every other week; or placebo, every week. The trial drug was administered starting at baseline and through week 16.</p><p><strong>Main outcomes and measures: </strong>The primary end point was achieving a Hidradenitis Suppurativa Clinical Response (HiSCR 50) at week 16. The secondary efficacy objective was achieving at least a 30% reduction and at least 1-unit reduction from baseline in Patient's Global Assessment of skin pain (Numerical Rating Scale [NRS] 30) after 16 weeks of treatment among among patients with a baseline NRS 3 or greater. Additional end points included achieving HiSCR 75 and HiSCR 90, change and percentage change from baseline in draining tunnels, and change from baseline in Dermatology Life Quality Index total scores.</p><p><strong>Results: </strong>A total of 153 participants received at least 1 dose of the trial medication (94 female individuals [61.4%]; mean [range] age, 40.5 [19-75] years; 108 patients [70.6%] at Hurley stage III). At week 16, 19 (48.7%), 22 (59.5%), and 10 participants (27.0%) receiving lutikizumab, 300 mg, every week; lutikizumab, 300 mg, every other week; and lutikizumab, 100 mg, every other week, respectively, achieved HiSCR50 at week 16 compared with placebo (35.0%); posterior probabilities of positive treatment effect vs placebo were 89.3%, 98.5%, and 22.8%, respectively, using a bayesian analysis. Among participants with baseline NRS scores of 3 or greater, 10 (34.5%) who received lutikizumab, 300 mg, every other week and 8 (34.8%) who received lutikizumab, 300 mg, every week achieved an NRS30 response compared with 4 (12.9%) who received placebo. There were no deaths or treatment-emergent adverse events of neutropenia, serious hypersensitivity reactions, major adverse cardiovascular events, or opportunistic infections reported.</p><p><strong>Conclusions ","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-18DOI: 10.1001/jamadermatol.2025.5354
Felipe Peirano, Virginia Llanos, Ashfaq A Marghoob
{"title":"Melanoma Arising in a BAP1-Inactivated Melanocytic Tumor.","authors":"Felipe Peirano, Virginia Llanos, Ashfaq A Marghoob","doi":"10.1001/jamadermatol.2025.5354","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.5354","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1001/jamadermatol.2025.6244
Xiaopo Wang
{"title":"Solitary Verrucous Plaque on the Right Pretibial Region.","authors":"Xiaopo Wang","doi":"10.1001/jamadermatol.2025.6244","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.6244","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1001/jamadermatol.2026.0083
Ellie Medcalf, Deonna M Ackermann, Jake T W Williams, Robin M Turner, David Espinoza, Zhuohan Wu, Adrian Fann, Priti Kharel, Monika Janda, Anne E Cust, Les Irwig, Jolyn K Hersch, Donald Low, Cynthia Low, Pascale Guitera, Linda K Martin, H Peter Soyer, Anthony Azzi, Alister Lilleyman, Helena Rosengren, Victoria Mar, Michelle Y Mcrae, Amanda Glanz, Helena Collgros, Jon D Emery, Peter Murchie, Rachael L Morton, Peter Ferguson, Catriona McLean, Katy J L Bell
<p><strong>Importance: </strong>The MEL-SELF randomized clinical trial (RCT) evaluated patient-led surveillance as an alternative model of follow-up. The baseline characteristics of participants provide insights into current unmet clinical needs of this population.</p><p><strong>Objective: </strong>To describe the baseline characteristics of people screened for and randomized to the MEL-SELF RCT, and those potentially eligible but not randomized.</p><p><strong>Design, setting, and participants: </strong>Baseline data from the RCT's recruitment processes, from December 2021 to June 2024, were analyzed. Data were collected from dermatologist- and general practitioner-led skin cancer clinics in Australia, and included adults previously treated for early-stage melanoma (by American Joint Committee on Cancer Staging Manual [AJCC, 0-II]) attending routinely scheduled clinics, with a skin self-examination (SSE) partner, and a smartphone. Analysis took place between August 2025 and December 2025.</p><p><strong>Interventions: </strong>Participants were invited to participate in the MEL-SELF trial with randomization (1:1) to patient-led surveillance (usual care plus reminders to perform SSE, mobile dermatoscope, teledermatologist assessment, fast-tracked unscheduled clinic visits) or clinician-led surveillance (usual care) for 12 months.</p><p><strong>Main outcomes/measures: </strong>The main outcomes were enrollment; active run-in and allocation results, sociodemographic and clinical characteristics; SSE knowledge, attitudes, and practice (frequency and thoroughness); and psychological measures including fear of cancer recurrence (FCR) at baseline.</p><p><strong>Results: </strong>Of 1226 patients screened and potentially eligible, 504 were randomized to patient-led (n = 251) or clinician-led (n = 253) surveillance. Overall, 295 were female individuals (59%) and 209 were male individuals (41%), most were aged 50 years and older (mean [SD] age, 56.0 [11.6] years) and had a highest substage of melanoma in situ (245 [49%]) or IA (217 [43%]). SSE practice varied substantially, ranging from no SSE in the previous 12 months (103 [20%]) to weekly or monthly SSE (160 [32%]). A high proportion (232 [46%]) reported clinically significant levels of FCR, which was associated with being female, younger age, and higher depression, anxiety, and stress scores. FCR was associated with a higher perceived lifetime risk of melanoma, but not with participants' actual calculated risk of a subsequent new primary melanoma (OR, 1.00; 95% CI, 0.99-1.01). Characteristics were similar between the trial population and potentially eligible patients who completed the baseline questionnaire but were not randomized (n = 225).</p><p><strong>Conclusions: </strong>This secondary analysis of baseline characteristics in the MEL-SELF trial indicates suboptimal SSE practice and clinically significant levels of FCR. Future reports will evaluate comparative effects of patient-led surveillance on h
{"title":"Characteristics of Participants Screened and Randomized to the Melanoma Self Surveillance Trial.","authors":"Ellie Medcalf, Deonna M Ackermann, Jake T W Williams, Robin M Turner, David Espinoza, Zhuohan Wu, Adrian Fann, Priti Kharel, Monika Janda, Anne E Cust, Les Irwig, Jolyn K Hersch, Donald Low, Cynthia Low, Pascale Guitera, Linda K Martin, H Peter Soyer, Anthony Azzi, Alister Lilleyman, Helena Rosengren, Victoria Mar, Michelle Y Mcrae, Amanda Glanz, Helena Collgros, Jon D Emery, Peter Murchie, Rachael L Morton, Peter Ferguson, Catriona McLean, Katy J L Bell","doi":"10.1001/jamadermatol.2026.0083","DOIUrl":"10.1001/jamadermatol.2026.0083","url":null,"abstract":"<p><strong>Importance: </strong>The MEL-SELF randomized clinical trial (RCT) evaluated patient-led surveillance as an alternative model of follow-up. The baseline characteristics of participants provide insights into current unmet clinical needs of this population.</p><p><strong>Objective: </strong>To describe the baseline characteristics of people screened for and randomized to the MEL-SELF RCT, and those potentially eligible but not randomized.</p><p><strong>Design, setting, and participants: </strong>Baseline data from the RCT's recruitment processes, from December 2021 to June 2024, were analyzed. Data were collected from dermatologist- and general practitioner-led skin cancer clinics in Australia, and included adults previously treated for early-stage melanoma (by American Joint Committee on Cancer Staging Manual [AJCC, 0-II]) attending routinely scheduled clinics, with a skin self-examination (SSE) partner, and a smartphone. Analysis took place between August 2025 and December 2025.</p><p><strong>Interventions: </strong>Participants were invited to participate in the MEL-SELF trial with randomization (1:1) to patient-led surveillance (usual care plus reminders to perform SSE, mobile dermatoscope, teledermatologist assessment, fast-tracked unscheduled clinic visits) or clinician-led surveillance (usual care) for 12 months.</p><p><strong>Main outcomes/measures: </strong>The main outcomes were enrollment; active run-in and allocation results, sociodemographic and clinical characteristics; SSE knowledge, attitudes, and practice (frequency and thoroughness); and psychological measures including fear of cancer recurrence (FCR) at baseline.</p><p><strong>Results: </strong>Of 1226 patients screened and potentially eligible, 504 were randomized to patient-led (n = 251) or clinician-led (n = 253) surveillance. Overall, 295 were female individuals (59%) and 209 were male individuals (41%), most were aged 50 years and older (mean [SD] age, 56.0 [11.6] years) and had a highest substage of melanoma in situ (245 [49%]) or IA (217 [43%]). SSE practice varied substantially, ranging from no SSE in the previous 12 months (103 [20%]) to weekly or monthly SSE (160 [32%]). A high proportion (232 [46%]) reported clinically significant levels of FCR, which was associated with being female, younger age, and higher depression, anxiety, and stress scores. FCR was associated with a higher perceived lifetime risk of melanoma, but not with participants' actual calculated risk of a subsequent new primary melanoma (OR, 1.00; 95% CI, 0.99-1.01). Characteristics were similar between the trial population and potentially eligible patients who completed the baseline questionnaire but were not randomized (n = 225).</p><p><strong>Conclusions: </strong>This secondary analysis of baseline characteristics in the MEL-SELF trial indicates suboptimal SSE practice and clinically significant levels of FCR. Future reports will evaluate comparative effects of patient-led surveillance on h","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1001/jamadermatol.2025.6123
Yukako Watanabe, Takuya Kawamura, Ken Muramatsu, Ken Natsuga, Hideyuki Ujiie
{"title":"Successful Treatment of Granulomatous Dermatitis With Topical Delgocitinib.","authors":"Yukako Watanabe, Takuya Kawamura, Ken Muramatsu, Ken Natsuga, Hideyuki Ujiie","doi":"10.1001/jamadermatol.2025.6123","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.6123","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1001/jamadermatol.2026.0071
Chidimma J Okwara, T Austin Black, Priscilla L Haff, Helena M Nammour, Roland Bassett, John Das, Justin H Qian, Hayden P Schandua, Anthony J Teixeira, Nadeen Gonna, Areebah S Ahmad, Chidi M Okoro, David P Farris, Kelly C Nelson, Hung Q Doan
Importance: Acral lentiginous melanoma (ALM) is a rare but aggressive melanoma subtype. Distinguishing ALM from acral nevi remains difficult, underscoring the need for reliable dermoscopic criteria.
Objective: To systematically evaluate dermoscopic patterns that differentiate ALM from benign acral nevi.
Data sources: Embase, PubMed, Web of Science, MEDLINE, and the Cochrane Library were searched from January 1970 through March 2023 using controlled vocabulary (MeSH and Emtree) and natural language terms associated with acral melanoma, nevi, and diagnostic techniques. Searches were limited to English-language and human studies. Data analysis was conducted on November 1, 2024.
Data extraction and synthesis: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, reviewers independently extracted study data. Pooled proportions and prevalence differences were assessed using random-effects models.
Main outcomes and measures: The main outcome was the prevalence of dermoscopic features, including parallel ridge, parallel furrow, latticelike, multicomponent, and other pigmentation patterns, with pooled differences between ALM and nevi.
Results: Forty-one studies were included, comprising 8845 acral nevi (from 35 studies) and 801 ALMs (from 18 studies). The parallel ridge pattern was the most sensitive and specific feature for ALM (79.6% [95% CI, 71.4%-87.8%] vs 0.6% [95% CI, 0.3%-0.9%] in nevi; pooled difference, -77.3%; 95% CI, -85.0% to -69.6%; P < .001). Multicomponent structures were also significantly associated with ALM (45.8% [95% CI, 19.3%-72.2%] vs 5.0% [95% CI, 3.7%-6.2%] in nevi; pooled difference, -38.5%; 95% CI, -65.7% to -11.2%; P = .01). Conversely, parallel furrow (51.8% [95% CI, 46.7%-56.8%] in nevi vs 8.9% [95% CI, 5.3%-12.5%] in ALM; pooled difference, 41.3%; 95% CI, 33.1%-49.5%; P < .001) and latticelike patterns (13.0% [95% CI, 10.6%-15.5%] in nevi vs 2.7% [95% CI, 1.0%-4.5%] in ALM; pooled difference, 8.9%; 95% CI, 4.2%-13.6%; P < .001) were significantly more common in nevi. Other features, including fibrillar, homogeneous, globular, reticular, other, and nontypical patterns, showed inconsistent or nonsignificant associations.
Conclusions and relevance: While the parallel ridge and parallel furrow patterns remain key diagnostic indicators of ALM and benign acral lesions, this systematic review and meta-analysis establishes the additional diagnostic significance of multicomponent and latticelike features. Nearly 20% of ALM lacked the parallel ridge pattern, demonstrating the need for new specific features for melanoma diagnosis. These findings provide evidence-based benchmarks to potentially improve diagnostic accuracy, guide dermoscopy training, and enhance early detection of ALM.
重要性：肢端色素性黑色素瘤（ALM）是一种罕见但侵袭性的黑色素瘤亚型。区分ALM和肢端痣仍然很困难，强调需要可靠的皮肤镜标准。目的：系统地评价皮肤镜下鉴别ALM与良性肢端痣的特征。数据来源：Embase、PubMed、Web of Science、MEDLINE和Cochrane Library从1970年1月到2023年3月，使用控制词汇（MeSH和Emtree）和与肢端黑色素瘤、痣和诊断技术相关的自然语言术语进行检索。搜索仅限于英语和人类研究。数据分析时间为2024年11月1日。数据提取和综合：根据系统评价和荟萃分析（PRISMA）指南的首选报告项目，审稿人独立提取研究数据。采用随机效应模型评估合并比例和患病率差异。主要结果和测量方法：主要结果是皮肤镜特征的患病率，包括平行脊状、平行沟状、格状、多成分和其他色素沉着模式，以及ALM和痣之间的综合差异。结果：纳入41项研究，包括8845例肢端痣（来自35项研究）和801例ALMs（来自18项研究）。平行脊型是ALM最敏感和特异的特征（79.6% [95% CI, 71.4%-87.8%] vs 0.6% [95% CI, 0.3%-0.9%]）；合并差异为-77.3%;95% CI, -85.0%至-69.6%；P结论和相关性：虽然平行脊型和平行沟型仍然是ALM和良性肢端病变的关键诊断指标，但本系统回顾和荟萃分析确立了多成分和格状特征的额外诊断意义。近20%的ALM缺乏平行脊型，这表明需要新的特异性特征来诊断黑色素瘤。这些发现提供了基于证据的基准，以潜在地提高诊断准确性，指导皮肤镜检查培训，并加强ALM的早期发现。
{"title":"Diagnostic Accuracy of Dermoscopic Features in Acral Lentiginous Melanoma: A Systematic Review and Meta-analysis.","authors":"Chidimma J Okwara, T Austin Black, Priscilla L Haff, Helena M Nammour, Roland Bassett, John Das, Justin H Qian, Hayden P Schandua, Anthony J Teixeira, Nadeen Gonna, Areebah S Ahmad, Chidi M Okoro, David P Farris, Kelly C Nelson, Hung Q Doan","doi":"10.1001/jamadermatol.2026.0071","DOIUrl":"10.1001/jamadermatol.2026.0071","url":null,"abstract":"<p><strong>Importance: </strong>Acral lentiginous melanoma (ALM) is a rare but aggressive melanoma subtype. Distinguishing ALM from acral nevi remains difficult, underscoring the need for reliable dermoscopic criteria.</p><p><strong>Objective: </strong>To systematically evaluate dermoscopic patterns that differentiate ALM from benign acral nevi.</p><p><strong>Data sources: </strong>Embase, PubMed, Web of Science, MEDLINE, and the Cochrane Library were searched from January 1970 through March 2023 using controlled vocabulary (MeSH and Emtree) and natural language terms associated with acral melanoma, nevi, and diagnostic techniques. Searches were limited to English-language and human studies. Data analysis was conducted on November 1, 2024.</p><p><strong>Data extraction and synthesis: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, reviewers independently extracted study data. Pooled proportions and prevalence differences were assessed using random-effects models.</p><p><strong>Main outcomes and measures: </strong>The main outcome was the prevalence of dermoscopic features, including parallel ridge, parallel furrow, latticelike, multicomponent, and other pigmentation patterns, with pooled differences between ALM and nevi.</p><p><strong>Results: </strong>Forty-one studies were included, comprising 8845 acral nevi (from 35 studies) and 801 ALMs (from 18 studies). The parallel ridge pattern was the most sensitive and specific feature for ALM (79.6% [95% CI, 71.4%-87.8%] vs 0.6% [95% CI, 0.3%-0.9%] in nevi; pooled difference, -77.3%; 95% CI, -85.0% to -69.6%; P < .001). Multicomponent structures were also significantly associated with ALM (45.8% [95% CI, 19.3%-72.2%] vs 5.0% [95% CI, 3.7%-6.2%] in nevi; pooled difference, -38.5%; 95% CI, -65.7% to -11.2%; P = .01). Conversely, parallel furrow (51.8% [95% CI, 46.7%-56.8%] in nevi vs 8.9% [95% CI, 5.3%-12.5%] in ALM; pooled difference, 41.3%; 95% CI, 33.1%-49.5%; P < .001) and latticelike patterns (13.0% [95% CI, 10.6%-15.5%] in nevi vs 2.7% [95% CI, 1.0%-4.5%] in ALM; pooled difference, 8.9%; 95% CI, 4.2%-13.6%; P < .001) were significantly more common in nevi. Other features, including fibrillar, homogeneous, globular, reticular, other, and nontypical patterns, showed inconsistent or nonsignificant associations.</p><p><strong>Conclusions and relevance: </strong>While the parallel ridge and parallel furrow patterns remain key diagnostic indicators of ALM and benign acral lesions, this systematic review and meta-analysis establishes the additional diagnostic significance of multicomponent and latticelike features. Nearly 20% of ALM lacked the parallel ridge pattern, demonstrating the need for new specific features for melanoma diagnosis. These findings provide evidence-based benchmarks to potentially improve diagnostic accuracy, guide dermoscopy training, and enhance early detection of ALM.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1001/jamadermatol.2026.0037
Nikolaj Holgersen, Nana Aviaaja Lippert Rosenø, Valdemar Wendelboe Nielsen, Carsten Hjorthøj, Merete Nordentoft, Amit Garg, Andrew Strunk, Jacob P Thyssen, Sandra Feodor Nilsson, Alexander Egeberg, Simon Francis Thomsen
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