Australasian Journal of Dermatology最新文献

{"title":"Radiotherapy—A Renaissance for Skin Cancer","authors":"Robert Sinclair,&nbsp;Raj Jagavkar,&nbsp;Michael Anthony Izard,&nbsp;Stephen Shumack","doi":"10.1111/ajd.14615","DOIUrl":"10.1111/ajd.14615","url":null,"abstract":"<div>\u0000 \u0000 <p>Radiation therapy has undergone unprecedented advances over the past four decades, both in the understanding of radiobiologic effects and in the technical features of external beam delivery. The extent and scope of these changes have largely remained unappreciated outside the specialty of radiation oncology. The net effect of these advances has been improved dosimetry whereby radiotherapy can more evenly target a planned tissue volume while sparing normal tissues. The term dosimetry describes the evenness (homogeneity) and sharpness (conformality) of photon irradiation. Improved efficacy and safety are now reliably deliverable, prompting a need for a general re-appraisal of the place of modern radiotherapy across the spectrum of skin cancer management. Improved techniques are now widely available for the treatment of high-risk or extensive skin cancers, multiple in-field tumours and severe skin field cancerization. Specialised techniques in development include the use of extended radiation field techniques for micrometastatic disease in lymphatic corridors and harnessing the immune stimulatory potential of radiotherapy, especially in conjunction with immunotherapy and targeted therapies. This review aims to provide a summary of these changes for the non-radiation oncologist. The major advances in radiotherapy most relevant to skin cancer will be discussed along with the evidence for several emerging new applications in cancer management.</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e501-e510"},"PeriodicalIF":1.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353403","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":"Clinical Letter: Rapidly Progressive TEN Secondary to Nivolumab and Relatlimab in a Patient With Metastatic Gastric Mucosal Melanoma","authors":"Serene Chan,&nbsp;Peter Ferguson,&nbsp;Linda Chan","doi":"10.1111/ajd.14618","DOIUrl":"10.1111/ajd.14618","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e582-e583"},"PeriodicalIF":1.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336335","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":"Mohs Micrographic Surgery in the Australian Public Health System: A Retrospective Observational Study and Review of the Australian Literature","authors":"Nicole A. Seebacher,&nbsp;Michelle Wu,&nbsp;Sophia Chen,&nbsp;Gnanadarsha Sanjaya Dissanayake,&nbsp;Gilberto Moreno,&nbsp;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}

{"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,&nbsp;Chan Ho Na,&nbsp;Bong Seok Shin,&nbsp;Min Sung Kim,&nbsp;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}

{"title":"Sycosis Barbae Treated With Bimekizumab","authors":"Matiar Madanchi,&nbsp;Riccardo Curatolo,&nbsp;Lorenzo S. Pelloni,&nbsp;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}

{"title":"Linear Subepidermal Calcified Nodule With Somatic FGFR3 Mutation","authors":"Italo Francesco Aromolo,&nbsp;Michela Brena,&nbsp;Valerio Pedrelli,&nbsp;Gianluca Tadini","doi":"10.1111/ajd.14607","DOIUrl":"10.1111/ajd.14607","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 8","pages":"e579-e581"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273583","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":"Association of Cognitive Flexibility With Negative Emotional States and Quality of Life in Patients With Hidradenitis Suppurativa: A Cross-Sectional Study","authors":"Jacqueline Jiang,&nbsp;Susan Rossell,&nbsp;Diana Norris,&nbsp;Mei Tam,&nbsp;Rachael Davenport,&nbsp;Diana Courtney,&nbsp;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}

{"title":"Systemic Treatment of Moderate to Severe Alopecia Areata in Adults: Updated Australian Expert Consensus Statement","authors":"Daniella Kushnir-Grinbaum,&nbsp;Laita Bokhari,&nbsp;John Frewen,&nbsp;Anthony Moussa,&nbsp;Daranporn Triwongwaranat,&nbsp;Ragini Ghiya,&nbsp;Flavia Rodrigues Dias,&nbsp;Shin Shen Yong,&nbsp;Bevin Bhoyrul,&nbsp;Zeyad Dabbagh,&nbsp;Ahmed Kazmi,&nbsp;Adam Daunton,&nbsp;Jane Li,&nbsp;Leona Yip,&nbsp;Vivian Lai,&nbsp;Katherine York,&nbsp;William Cranwell,&nbsp;Dmitri Wall,&nbsp;Samantha Eisman,&nbsp;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 &gt; 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}

{"title":"Yellow Nested Melanoma: Line-Field Confocal Optical Coherence Tomography and Literature Review","authors":"Luca Bettolini,&nbsp;Vincenzo Maione,&nbsp;Andrea Carugno,&nbsp;Zeno Fratton,&nbsp;Enzo Errichetti,&nbsp;Mariachiara Arisi,&nbsp;Nicola Zerbinati,&nbsp;Iacopo Ghini,&nbsp;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}

{"title":"The Association Between Type 2 Diabetes Mellitus and Melanoma Prognosis in Patients With High-Risk Primaries","authors":"Hansa Sharma,&nbsp;Maria Celia B. Hughes,&nbsp;Danielle Gavanescu,&nbsp;B. Mark Smithers,&nbsp;Kiarash Khosrotehrani,&nbsp;Lena von Schuckmann","doi":"10.1111/ajd.14605","DOIUrl":"10.1111/ajd.14605","url":null,"abstract":"&lt;p&gt;Melanoma is a potentially aggressive skin cancer, and the determinants of its prognosis are yet to be fully understood [&lt;span&gt;1&lt;/span&gt;]. 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 [&lt;span&gt;2-4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;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, &gt; 0.8 mm or &lt; 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 [&lt;span&gt;4&lt;/span&gt;]. This study was approved by the respective ethics committees.&lt;/p&gt;&lt;p&gt;A baseline questionnaire collected information on participants' age, sex, body mass index (BMI) [&lt;span&gt;5&lt;/span&gt;], diabetes status, smoking status, statin usage in the preceding 5 years, and socioeconomic status (SES; calculated using the Socio-Economic Index for Areas [SEIFA] [&lt;span&gt;6&lt;/span&gt;]). 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.&lt;/p&gt;&lt;p&gt;Tumour thickness was grouped as thinner (≤ 2.0 mm) and thicker (&gt; 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) [&lt;span&gt;6&lt;/span&gt;]. Univariable chi-squared tests (&lt;i&gt;p&lt;/i&gt; &lt; 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 (&lt;i&gt;n&lt;/i&gt; = 460), died without having a recurrence (&lt;i&gt;n&lt;/i&gt; = 44), or were lost to follow-up (&lt;i&gt;n&lt;/i&gt; = 17) by 7 years were censored. All analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC).&lt;/p&gt;&lt;p&gt;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}