Journal of the American Academy of Dermatology最新文献

Many dermatologic and systemic disorders present with oral manifestations. Early diagnosis and treatment can improve patient outcomes. Medical, dermatology, and dentistry training in disorders of the oral mucosa is significantly lacking and has created a practice gap in diagnosing and treating oral mucosal disorders. Disorders of the oral mucosa fall under the purview of dermatology. It is the responsibility of dermatologists to incorporate oral examinations into the "complete" dermatologic exam to help bridge this gap. Part I of this two-part CME series reviews normal oral anatomy, provides a step-by-step dermatologic oral examination guide, and provides guidance in the performance of oral biopsies.

Frontal Fibrosing Alopecia (FFA) poses a distinct dermatological challenge with epithelial-mesenchymal transition (EMT) at its core, driving follicular cell transformation and fibrotic changes. Genetic studies highlight significant associations, while environmental triggers, such as implicated cosmetic products (sunblock, personal hair care products, and moisturizers), introduce complexity. Managing FFA proves daunting due to its chronic and unpredictable nature. Treatment strategies, including combination therapies including hydroxychloroquine, dutasteride, topical and intralesional steroids, and topical tacrolimus, offer hope in stabilizing the condition. Monitoring the disease progression may be challenging as no established guidelines exist, however, imaging techniques may offer help in the future.

Traditionally, dermatological education emphasizes hair, skin and nails in its curriculum. There is a practice gap with regard to knowledge of normal oral mucosa variants, performance of the oral examination, and competence in diagnosing and treating oral mucosal disorders. The oral mucosa falls within the purview of dermatology. It is the responsibility of dermatologists, along with oral medicine specialists, to help bridge this practice gap. The purpose of this Part II manuscript is to provide differential diagnoses for common oral mucosal conditions based on sites of involvement. We have provided an Oral Dermatoses Map which illustrates key oral conditions and their associated anatomical areas of involvement.

This review article focuses on acral lentiginous melanoma (ALM), a rare cutaneous malignancy and the least common subtype of cutaneous malignant melanoma (CMM). ALM exhibits distinct characteristics, such as low overall mutation rates and increased chromosomal alterations. It is associated with worse prognosis, more advanced disease, and lower survival rates compared to other CMM subtypes. The incidence of ALM varies globally, with higher rates in non-white populations, particularly affecting Black, Hispanic, and Asian individuals. Racial disparities may be attributed to a lack of awareness, biological/genetic differences, cultural values, and socioeconomic status. The etiology of ALM remains unknown, but studies suggest a limited impact of UV radiation, potential links to trauma and stress, and a unique tumor immune microenvironment. Diagnostic challenges include varied clinical presentations, with specific biopsy techniques recommended. Clinical research on ALM lacks representation from diverse populations, ultimately limiting its translatability. Understanding the molecular landscape and clinical aspects of ALM will be crucial for improved diagnosis, treatment, and addressing health disparities. LEARNING OBJECTIVES: After completing this learning activity, participants should be able to discuss the epidemiology, etiology, mutational landscape, tumor microenvironment, and clinical presentation of acral lentiginous melanoma (ALM). Moreover, participants should also be able to describe the important racial disparities observed in ALM.

This comprehensive review navigates the clinical management and challenges of acral lentiginous melanoma (ALM), including staging, surgical interventions, and systemic therapies. Multimodality treatment and clinical trials are recommended for advanced cases.