Nicole A. Seebacher, Michelle Wu, Sophia Chen, Gnanadarsha Sanjaya Dissanayake, Gilberto Moreno, William Ryman
Background/Objectives
Mohs micrographic surgery (MMS) is integral to skin cancer management due to its benefits in margin control and tissue conservation. In Australia, it is predominantly performed in the private setting, with Royal North Shore Hospital being the sole provider in the public system. This study presented an analysis of MMS within the Australian public health system and a review of local literature.
Methods
Conducting a retrospective chart review, we examined patients undergoing MMS between January 2018 and December 2022. Data encompassed patient demographics, tumour characteristics and surgical outcomes. Four electronic databases were searched for Australian literature on MMS.
Results
A total of 344 MMS procedures involving 299 patients were conducted at Royal North Shore Hospital. Patients averaging 66.4 years of age (range 19–92 years) predominantly presented with basal cell carcinomas (92.2%) and squamous cell carcinomas (6.4%). 98.2% of tumours were found on the head and neck, genitalia, hands, digits and below the knee. The mean [standard deviation (SD)], pre-operative tumour and defect sizes were 1.75 cm [SD 1.01] and 2.30 cm [SD 1.35] in maximum diameter, respectively. Our tumour and defect sizes were smaller compared to MMS procedures conducted in the public system 30 years ago. Review of local literature resulted in 11 relevant studies, of which 10 came from the private setting.
Conclusions
This study provided crucial insights into MMS referral patterns, utilisation and outcomes, demonstrating that the use of MMS aligns with local and international best practice.
背景/目的：莫氏显微手术（Mohs micrographic surgery， MMS）因其在边缘控制和组织保存方面的优势而成为皮肤癌治疗不可或缺的一部分。在澳大利亚，它主要在私人环境中进行，皇家北岸医院是公共系统中唯一的提供者。本研究对澳大利亚公共卫生系统中的MMS进行了分析，并对当地文献进行了回顾。方法：对2018年1月至2022年12月期间接受MMS治疗的患者进行回顾性图表回顾。数据包括患者人口统计、肿瘤特征和手术结果。在四个电子数据库中检索有关MMS的澳大利亚文献。结果：在[匿名]共进行344例MMS手术，涉及299例患者。患者平均年龄66.4岁（范围19-92岁），主要表现为基底细胞癌（92.2%）和鳞状细胞癌（6.4%）。98.2%的肿瘤位于头颈部、生殖器、手部、手指和膝盖以下。平均[标准差（SD）]，术前肿瘤和缺损的最大直径分别为1.75 cm [SD 1.01]和2.30 cm [SD 1.35]。与30年前在公共系统中进行的MMS手术相比，我们的肿瘤和缺陷尺寸更小。对当地文献的回顾得出了11项相关研究，其中10项来自私人机构。结论：本研究提供了关于MMS转诊模式、利用和结果的重要见解，表明MMS的使用符合当地和国际最佳实践。
{"title":"Mohs Micrographic Surgery in the Australian Public Health System: A Retrospective Observational Study and Review of the Australian Literature","authors":"Nicole A. Seebacher, Michelle Wu, Sophia Chen, Gnanadarsha Sanjaya Dissanayake, Gilberto Moreno, William Ryman","doi":"10.1111/ajd.14610","DOIUrl":"10.1111/ajd.14610","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>Mohs micrographic surgery (MMS) is integral to skin cancer management due to its benefits in margin control and tissue conservation. In Australia, it is predominantly performed in the private setting, with Royal North Shore Hospital being the sole provider in the public system. This study presented an analysis of MMS within the Australian public health system and a review of local literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Conducting a retrospective chart review, we examined patients undergoing MMS between January 2018 and December 2022. Data encompassed patient demographics, tumour characteristics and surgical outcomes. Four electronic databases were searched for Australian literature on MMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 344 MMS procedures involving 299 patients were conducted at Royal North Shore Hospital. Patients averaging 66.4 years of age (range 19–92 years) predominantly presented with basal cell carcinomas (92.2%) and squamous cell carcinomas (6.4%). 98.2% of tumours were found on the head and neck, genitalia, hands, digits and below the knee. The mean [standard deviation (SD)], pre-operative tumour and defect sizes were 1.75 cm [SD 1.01] and 2.30 cm [SD 1.35] in maximum diameter, respectively. Our tumour and defect sizes were smaller compared to MMS procedures conducted in the public system 30 years ago. Review of local literature resulted in 11 relevant studies, of which 10 came from the private setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provided crucial insights into MMS referral patterns, utilisation and outcomes, demonstrating that the use of MMS aligns with local and international best practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e521-e531"},"PeriodicalIF":1.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336294","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}
Han Seong Yoon, Chan Ho Na, Bong Seok Shin, Min Sung Kim, Hoon Choi
Lichen planus pigmentosus (LPP) is a rare variant of lichen planus that presents as hyperpigmented patches, most commonly in individuals with darker skin tones, and is difficult to treat effectively. We report a case of a 22-year-old Korean male with LPP who showed considerable improvement following combination therapy with trifarotene and a picosecond neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser. Considering the inherently variable clinical course of LPP and the challenges associated with its treatment, the combination of topical retinoids and picosecond Nd:YAG lasers appears to be a promising therapeutic approach.
{"title":"Segmental Lichen Planus Pigmentosus Successfully Treated With Picosecond Neodymium-Doped: Yttrium-Aluminium-Garnet Laser and Trifarotene in a Korean Patient","authors":"Han Seong Yoon, Chan Ho Na, Bong Seok Shin, Min Sung Kim, Hoon Choi","doi":"10.1111/ajd.14609","DOIUrl":"10.1111/ajd.14609","url":null,"abstract":"<div>\u0000 \u0000 <p>Lichen planus pigmentosus (LPP) is a rare variant of lichen planus that presents as hyperpigmented patches, most commonly in individuals with darker skin tones, and is difficult to treat effectively. We report a case of a 22-year-old Korean male with LPP who showed considerable improvement following combination therapy with trifarotene and a picosecond neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser. Considering the inherently variable clinical course of LPP and the challenges associated with its treatment, the combination of topical retinoids and picosecond Nd:YAG lasers appears to be a promising therapeutic approach.</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e565-e568"},"PeriodicalIF":1.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312152","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}
Matiar Madanchi, Riccardo Curatolo, Lorenzo S. Pelloni, Hazem A. Juratli
Sycosis barbae (SB) is a chronic, potentially scarring alopecia that primarily affects the beard. We report a unique case of refractory SB in a 31-year-old male successfully treated with bimekizumab, a dual inhibitor of interleukin (IL)-17A and IL-17F. Significant clinical improvement was observed after the second injection, with complete remission achieved after 4 months, highlighting the potential of this novel therapeutic approach for SB.
{"title":"Sycosis Barbae Treated With Bimekizumab","authors":"Matiar Madanchi, Riccardo Curatolo, Lorenzo S. Pelloni, Hazem A. Juratli","doi":"10.1111/ajd.14608","DOIUrl":"10.1111/ajd.14608","url":null,"abstract":"<p>Sycosis barbae (SB) is a chronic, potentially scarring alopecia that primarily affects the beard. We report a unique case of refractory SB in a 31-year-old male successfully treated with bimekizumab, a dual inhibitor of interleukin (IL)-17A and IL-17F. Significant clinical improvement was observed after the second injection, with complete remission achieved after 4 months, highlighting the potential of this novel therapeutic approach for SB.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"486-488"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacqueline Jiang, Susan Rossell, Diana Norris, Mei Tam, Rachael Davenport, Diana Courtney, Helen Saunders
{"title":"Association of Cognitive Flexibility With Negative Emotional States and Quality of Life in Patients With Hidradenitis Suppurativa: A Cross-Sectional Study","authors":"Jacqueline Jiang, Susan Rossell, Diana Norris, Mei Tam, Rachael Davenport, Diana Courtney, Helen Saunders","doi":"10.1111/ajd.14606","DOIUrl":"10.1111/ajd.14606","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e576-e578"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197987","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}
Daniella Kushnir-Grinbaum, Laita Bokhari, John Frewen, Anthony Moussa, Daranporn Triwongwaranat, Ragini Ghiya, Flavia Rodrigues Dias, Shin Shen Yong, Bevin Bhoyrul, Zeyad Dabbagh, Ahmed Kazmi, Adam Daunton, Jane Li, Leona Yip, Vivian Lai, Katherine York, William Cranwell, Dmitri Wall, Samantha Eisman, Rodney Sinclair
Over 5000 patients are newly diagnosed with Alopecia areata (AA) in Australia each year. AA severity varies from a single small patch to complete loss of scalp hair, body hair including eyelashes and eyebrows. Approximately 40% of affected individuals experience only a single patch and achieve spontaneous, complete and durable remission within 6 months (acute AA). A further 27% develop additional patches but still attain complete remission within 12 months (chronic AA). Chronic persistent AA (CPAA) is defined by an episode duration of > 12 months and occurs in approximately 33% of patients. Without systemic treatment, 55% of individuals with CPAA will have persistent multifocal relapsing and remitting disease, 30% will progress to alopecia totalis (AT) and 15% will ultimately develop alopecia universalis (AU). The physical disfigurement, unpredictable course, social isolation and rejection contribute to the psychological distress attributable to AA. A wide range of topical, intralesional and systemic agents used to treat AA were evaluated in the 2018 Australian expert consensus statement. In 2020, the international Alopecia Areata Consensus of Experts (ACE) publication stated that if reimbursed, Janus Kinase inhibitors (JAKi's) would be an ideal systemic treatment for adults with AA. TGA approval of baricitinib in 2023 and ritlecitinib in 2024 for severe AA is the first step on the pathway for these systemic medications to be reimbursed on the Australian Government Pharmaceutical Benefits Scheme (PBS). Reimbursement would significantly transform the Australian therapeutic landscape for AA. The purpose of this 2025 Update on the Australian Expert Consensus Statement on the treatment of chronic, moderate to severe AA is to augment the 2018 treatment algorithm to include these TGA-approved medications and to address indications for initiation, continuation and dose titration of systemic JAKi treatment, appropriate choice of agent, satisfactory outcome measures and to provide guidance on when to discontinue successful or unsuccessful treatment.
{"title":"Systemic Treatment of Moderate to Severe Alopecia Areata in Adults: Updated Australian Expert Consensus Statement","authors":"Daniella Kushnir-Grinbaum, Laita Bokhari, John Frewen, Anthony Moussa, Daranporn Triwongwaranat, Ragini Ghiya, Flavia Rodrigues Dias, Shin Shen Yong, Bevin Bhoyrul, Zeyad Dabbagh, Ahmed Kazmi, Adam Daunton, Jane Li, Leona Yip, Vivian Lai, Katherine York, William Cranwell, Dmitri Wall, Samantha Eisman, Rodney Sinclair","doi":"10.1111/ajd.14597","DOIUrl":"10.1111/ajd.14597","url":null,"abstract":"<p>Over 5000 patients are newly diagnosed with Alopecia areata (AA) in Australia each year. AA severity varies from a single small patch to complete loss of scalp hair, body hair including eyelashes and eyebrows. Approximately 40% of affected individuals experience only a single patch and achieve spontaneous, complete and durable remission within 6 months (acute AA). A further 27% develop additional patches but still attain complete remission within 12 months (chronic AA). Chronic persistent AA (CPAA) is defined by an episode duration of > 12 months and occurs in approximately 33% of patients. Without systemic treatment, 55% of individuals with CPAA will have persistent multifocal relapsing and remitting disease, 30% will progress to alopecia totalis (AT) and 15% will ultimately develop alopecia universalis (AU). The physical disfigurement, unpredictable course, social isolation and rejection contribute to the psychological distress attributable to AA. A wide range of topical, intralesional and systemic agents used to treat AA were evaluated in the 2018 Australian expert consensus statement. In 2020, the international Alopecia Areata Consensus of Experts (ACE) publication stated that if reimbursed, Janus Kinase inhibitors (JAKi's) would be an ideal systemic treatment for adults with AA. TGA approval of baricitinib in 2023 and ritlecitinib in 2024 for severe AA is the first step on the pathway for these systemic medications to be reimbursed on the Australian Government Pharmaceutical Benefits Scheme (PBS). Reimbursement would significantly transform the Australian therapeutic landscape for AA. The purpose of this 2025 Update on the Australian Expert Consensus Statement on the treatment of chronic, moderate to severe AA is to augment the 2018 treatment algorithm to include these TGA-approved medications and to address indications for initiation, continuation and dose titration of systemic JAKi treatment, appropriate choice of agent, satisfactory outcome measures and to provide guidance on when to discontinue successful or unsuccessful treatment.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e444-e460"},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nested melanoma, a relatively new subtype of melanoma first reported in 2012, is characterised by neoplastic cells organised into nests. We present a unique case of yellow nested melanoma, detailing its clinical, dermoscopic, RCM, and, for the first time to our knowledge, LC-OCT features. Alongside a comprehensive review of the literature, our findings challenge the traditional associations with advanced age and sun-damaged skin, advocating for the term ‘nested melanoma’ to better reflect its characteristics.
{"title":"Yellow Nested Melanoma: Line-Field Confocal Optical Coherence Tomography and Literature Review","authors":"Luca Bettolini, Vincenzo Maione, Andrea Carugno, Zeno Fratton, Enzo Errichetti, Mariachiara Arisi, Nicola Zerbinati, Iacopo Ghini, Stefano Bighetti","doi":"10.1111/ajd.14604","DOIUrl":"10.1111/ajd.14604","url":null,"abstract":"<p>Nested melanoma, a relatively new subtype of melanoma first reported in 2012, is characterised by neoplastic cells organised into nests. We present a unique case of yellow nested melanoma, detailing its clinical, dermoscopic, RCM, and, for the first time to our knowledge, LC-OCT features. Alongside a comprehensive review of the literature, our findings challenge the traditional associations with advanced age and sun-damaged skin, advocating for the term ‘nested melanoma’ to better reflect its characteristics.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"479-485"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hansa Sharma, Maria Celia B. Hughes, Danielle Gavanescu, B. Mark Smithers, Kiarash Khosrotehrani, Lena von Schuckmann
<p>Melanoma is a potentially aggressive skin cancer, and the determinants of its prognosis are yet to be fully understood [<span>1</span>]. Several studies have found type 2 diabetes mellitus (T2DM), a chronic metabolic disorder, to be linked to an increased risk of melanoma onset, thicker and/or ulcerated tumours, and an increased risk of recurrence, though some studies have shown conflicting results [<span>2-4</span>].</p><p>Our prospective cohort study recruited 700 eligible patients aged over 16 with newly diagnosed T1b–T4b (using AJCC 8th edition) cutaneous melanoma from various public and private healthcare facilities in Queensland, Australia between 2010 and 2014. We defined ‘high-risk’ melanoma as T1b and above, > 0.8 mm or < 0.8 mm with ulceration. Patients found with macroscopic lymph node metastasis or distant metastatic disease within 30 days of diagnosis were excluded. Further details of the study have been published previously [<span>4</span>]. This study was approved by the respective ethics committees.</p><p>A baseline questionnaire collected information on participants' age, sex, body mass index (BMI) [<span>5</span>], diabetes status, smoking status, statin usage in the preceding 5 years, and socioeconomic status (SES; calculated using the Socio-Economic Index for Areas [SEIFA] [<span>6</span>]). Tumour thickness and ulceration were extracted from the participants' histopathology reports. Recurrence data was obtained during follow-up, from hospital records and from the Queensland Cancer Registry. Multiple recurrences within 30 days were considered one event and assigned the earliest date of recurrence. Follow-up times were calculated as the number of months from the date of diagnosis to the date of first recurrence, death, last communication/withdrawal, or 84 months, whichever came first.</p><p>Tumour thickness was grouped as thinner (≤ 2.0 mm) and thicker (> 2.0 mm). Patient's socioeconomic status was categorised as lower (deciles 1–6) or higher (deciles 7–10), using the Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) [<span>6</span>]. Univariable chi-squared tests (<i>p</i> < 0.05) were used to describe patient and tumour characteristics with diabetes status. We used logistic regression and Cox proportional hazards to associate diabetes status with tumour thickness and 7-year recurrence, respectively. We adjusted for age, sex, presence of ulceration, smoking status, statin use, and tumour thickness (where relevant). Sub-group analyses were conducted using SES and BMI. Adherence to proportionality was verified using a Kolmogorov-type supremum test. Participants who were recurrence-free and alive (<i>n</i> = 460), died without having a recurrence (<i>n</i> = 44), or were lost to follow-up (<i>n</i> = 17) by 7 years were censored. All analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC).</p><p>Of the 700 study participants, 94 (13%) had a diagnosis of T2DM at the time of mel
黑色素瘤是一种潜在的侵袭性皮肤癌，其预后的决定因素尚不完全清楚。一些研究发现，2型糖尿病（T2DM）是一种慢性代谢紊乱，与黑色素瘤发病风险增加、肿瘤变厚和/或溃疡以及复发风险增加有关，尽管一些研究得出了相互矛盾的结果[2-4]。我们的前瞻性队列研究招募了700名16岁以上新诊断为T1b-T4b（使用AJCC第8版）皮肤黑色素瘤的符合条件的患者，这些患者来自2010年至2014年澳大利亚昆士兰州的各种公共和私人医疗机构。我们将“高风险”黑色素瘤定义为T1b及以上，>； 0.8 mm或<； 0.8 mm伴有溃疡。排除诊断30天内发现肉眼淋巴结转移或远处转移的患者。该研究的进一步细节已于2010年发表。本研究得到了各自伦理委员会的批准。基线问卷收集了参与者的年龄、性别、体重指数（BMI）[6]、糖尿病状况、吸烟状况、过去5年他汀类药物使用情况和社会经济地位（SES；使用地区社会经济指数[SEIFA][6]计算）。从参与者的组织病理学报告中提取肿瘤厚度和溃疡。在随访期间，从医院记录和昆士兰癌症登记处获得复发数据。30天内多次复发视为一个事件，并确定最早复发日期。随访时间计算为从诊断之日至首次复发、死亡、最后一次通信/停药之日的月数，或84个月，以先到者为准。肿瘤厚度分为较薄（≤2.0 mm）和较厚（> 2.0 mm）。使用相对社会经济优势和劣势指数（IRSAD）[6]，将患者的社会经济地位分为较低（1-6分位数）或较高（7-10分位数）。单变量卡方检验（p < 0.05）用于描述糖尿病患者和肿瘤特征。我们使用logistic回归和Cox比例风险分别将糖尿病状况与肿瘤厚度和7年复发率联系起来。我们调整了年龄、性别、溃疡、吸烟状况、他汀类药物使用和肿瘤厚度（如相关）。采用SES和BMI进行亚组分析。使用kolmogorov型最大检验验证了对比例性的依从性。筛选无复发存活（n = 460）、无复发死亡（n = 44）或随访7年未随访（n = 17）的参与者。所有分析均使用SAS 9.4版（SAS Institute Inc., Cary， NC）进行。在700名研究参与者中，94名（13%）在黑色素瘤诊断时已诊断为2型糖尿病。T2DM患者多为男性（67%），肥胖（30 kg/m2） BMI(59%)，使用他汀类药物（63%），SES较低（60%）（表1）。我们发现T2DM患者和非T2DM患者诊断时患较厚黑色素瘤的可能性无显著差异（校正优势比[OR] 0.66, 95%可信区间[CI] 0.40-1.09, p = 0.10）。我们发现，较低社会经济地位的T2DM患者与非糖尿病患者相比，患较厚黑色素瘤的可能性显著降低（OR 0.49, 95% CI 0.25-0.94, p = 0.03）（表2）。假设社会经济地位较低的2型糖尿病患者比没有社会经济地位的患者更容易获得医疗保健，这一结果可能是由于在糖尿病相关的健康检查中发现了机会性病变。此外，这一结果可能是由于我们的研究中未捕获的其他健康行为或药物使用。来自大规模人群队列的进一步证据可能有助于澄清这些结果。我们发现T2DM与黑色素瘤诊断后7年复发之间没有总体上的显著关联（校正风险比[HR] 1.27, 95% CI 0.83-1.94, p = 0.27）。然而，BMI分层显示，与非糖尿病患者相比，肥胖T2DM患者在7年内复发的风险显著增加（HR 1.96, 95% CI 1.02-3.74, p = 0.04），这表明这些共病可能由于炎症增加或慢性炎症而产生潜在的叠加效应（表3）。本研究的局限性在于T2DM的诊断是自我报告的（通过医疗记录证实）。鉴于黑色素瘤和2型糖尿病的异质性，其他未被探索的临床病理因素可能促成了这些关联。我们得出结论，T2DM可能不是肿瘤厚度或复发的独立危险因素，但与BMI一起起作用。与非糖尿病患者相比，社会经济地位较低的2型糖尿病患者在诊断时更有可能有较薄的黑色素瘤。 此外，与肥胖的非糖尿病患者相比，肥胖的T2DM患者在诊断后7年内复发的风险更高。由昆士兰大学审核和批准，ID#15895。南方地铁医院和卫生服务以及QIMR伯格霍夫医学研究所伦理委员会。作者没有什么可报告的。作者声明无利益冲突。支持本研究结果的数据可根据通讯作者的合理要求提供。
{"title":"The Association Between Type 2 Diabetes Mellitus and Melanoma Prognosis in Patients With High-Risk Primaries","authors":"Hansa Sharma, Maria Celia B. Hughes, Danielle Gavanescu, B. Mark Smithers, Kiarash Khosrotehrani, Lena von Schuckmann","doi":"10.1111/ajd.14605","DOIUrl":"10.1111/ajd.14605","url":null,"abstract":"<p>Melanoma is a potentially aggressive skin cancer, and the determinants of its prognosis are yet to be fully understood [<span>1</span>]. Several studies have found type 2 diabetes mellitus (T2DM), a chronic metabolic disorder, to be linked to an increased risk of melanoma onset, thicker and/or ulcerated tumours, and an increased risk of recurrence, though some studies have shown conflicting results [<span>2-4</span>].</p><p>Our prospective cohort study recruited 700 eligible patients aged over 16 with newly diagnosed T1b–T4b (using AJCC 8th edition) cutaneous melanoma from various public and private healthcare facilities in Queensland, Australia between 2010 and 2014. We defined ‘high-risk’ melanoma as T1b and above, > 0.8 mm or < 0.8 mm with ulceration. Patients found with macroscopic lymph node metastasis or distant metastatic disease within 30 days of diagnosis were excluded. Further details of the study have been published previously [<span>4</span>]. This study was approved by the respective ethics committees.</p><p>A baseline questionnaire collected information on participants' age, sex, body mass index (BMI) [<span>5</span>], diabetes status, smoking status, statin usage in the preceding 5 years, and socioeconomic status (SES; calculated using the Socio-Economic Index for Areas [SEIFA] [<span>6</span>]). Tumour thickness and ulceration were extracted from the participants' histopathology reports. Recurrence data was obtained during follow-up, from hospital records and from the Queensland Cancer Registry. Multiple recurrences within 30 days were considered one event and assigned the earliest date of recurrence. Follow-up times were calculated as the number of months from the date of diagnosis to the date of first recurrence, death, last communication/withdrawal, or 84 months, whichever came first.</p><p>Tumour thickness was grouped as thinner (≤ 2.0 mm) and thicker (> 2.0 mm). Patient's socioeconomic status was categorised as lower (deciles 1–6) or higher (deciles 7–10), using the Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) [<span>6</span>]. Univariable chi-squared tests (<i>p</i> < 0.05) were used to describe patient and tumour characteristics with diabetes status. We used logistic regression and Cox proportional hazards to associate diabetes status with tumour thickness and 7-year recurrence, respectively. We adjusted for age, sex, presence of ulceration, smoking status, statin use, and tumour thickness (where relevant). Sub-group analyses were conducted using SES and BMI. Adherence to proportionality was verified using a Kolmogorov-type supremum test. Participants who were recurrence-free and alive (<i>n</i> = 460), died without having a recurrence (<i>n</i> = 44), or were lost to follow-up (<i>n</i> = 17) by 7 years were censored. All analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC).</p><p>Of the 700 study participants, 94 (13%) had a diagnosis of T2DM at the time of mel","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e572-e575"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on: An Online Questionnaire Improves Outcomes for Children With Atopic Eczema","authors":"Deryn L. Thompson","doi":"10.1111/ajd.14602","DOIUrl":"10.1111/ajd.14602","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 7","pages":"e488-e489"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091122","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}
Yaron Gu, Deshan F. Sebaratnam, Mani Makhija, Joshua Farrell
A systemic review was completed of primary research articles reporting patient outcomes in paradoxical psoriatic alopecia in association with biologic therapy. Our search strategy identified 96 patients from 45 studies in addition to our own case. Our review indicates a higher prevalence of paradoxical psoriatic alopecia in younger female patients, most commonly secondary to TNF-alpha inhibitors. Unlike alopecia secondary to psoriasis vulgaris, a mixed inflammatory infiltrate featuring lymphocytes, plasma cells and eosinophils was observed. Remission was observed in most patients, including approximately a third of whom continued biologic therapy.
{"title":"Biologic-Induced Paradoxical Psoriatic Alopecia: A Systematic Review","authors":"Yaron Gu, Deshan F. Sebaratnam, Mani Makhija, Joshua Farrell","doi":"10.1111/ajd.14600","DOIUrl":"10.1111/ajd.14600","url":null,"abstract":"<p>A systemic review was completed of primary research articles reporting patient outcomes in paradoxical psoriatic alopecia in association with biologic therapy. Our search strategy identified 96 patients from 45 studies in addition to our own case. Our review indicates a higher prevalence of paradoxical psoriatic alopecia in younger female patients, most commonly secondary to TNF-alpha inhibitors. Unlike alopecia secondary to psoriasis vulgaris, a mixed inflammatory infiltrate featuring lymphocytes, plasma cells and eosinophils was observed. Remission was observed in most patients, including approximately a third of whom continued biologic therapy.</p><p><b>Trial Registration:</b> PROSPERO registration number: CRD42023471174</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"441-447"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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