This month’s news from across the specialty
What’s hot
February 1, 2026
In this monthly column, members of the DermWorld Editorial Advisory Workgroup identify exciting news from across the specialty.
Gawey et al. reviewed the current state of sunscreen regulation in the United States and the process of “sunscreen doping.” As sunscreens are regulated as OTC drugs, new UV filters are required to pass through a slow and restrictive regulatory process. It is so restrictive that since 1999, only one new filter has been approved. As a workaround to these regulatory constraints, manufacturers in the U.S. have been adding UV-absorbing ingredients as “inactive ingredients” avoiding the need for FDA approval — this is called sunscreen doping by media and consumers (doi:10.1016/j.jid.2025.07.017). Although no major safety issues have been reported from these ingredients, use of this regulatory loophole prevents formal evaluation of these chemicals and impairs informed decision making by consumers and physicians. The authors advocate for modernization of our current regulatory system by aligning more with international models with more streamlined but still rigorous approval pathways. This should allow for increased transparency and access to UV-filters.
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Dermatopathologists are well aware that distinguishing persistent and/or recurrent nevi from melanoma on histopathology may be very challenging, particularly in situations when a scar from a prior procedure or trauma is not well visualized, and/or supportive clinical history is not available. As such, the term “pseudomelanoma” has previously been used to refer to persistent/recurrent nevi.
Recently, two small studies examining Preferentially expressed Antigen in Melanoma (PRAME) immunohistochemical staining in persistent/recurrent nevi were published (J Cut Pathol. 2025. 52(12):740-2, Am J Dermatopathol. 2025. 7(11):834-9). Dougher et al. identified 14 cases from a single institution with a dermatopathology diagnosis of “persistent nevus.” The preceding biopsies for these cases were most often conventional nevi or dysplastic nevus with mild or moderate, but not severe, atypia. Out of 14 cases, 13 had absent PRAME staining and the remaining case had only weak staining, not meeting the threshold to be considered PRAME positive.
Kucharik et al. identified 22 cases of recurrent/persistent nevi which had corresponding prior diagnoses of melanocytic nevi at the same anatomic site. PRAME staining was evaluated by two dermatopathologists, and similar to Dougher et al., all of the persistent/recurrent nevi studied were interpreted to be PRAME negative.
These papers expand on the limited published data regarding PRAME expression in persistent/recurrent nevi, suggesting utility in differentiating these lesions from melanoma. One caveat to note is that characteristics of the original nevus, such as presence of severe atypia, could influence the performance of PRAME staining in this setting (Am J Dermatopathol. 2024. 46(1):21-30).
Not a clinic day (or, in fact, a regular day) goes by where I am not asked, “Should I be using topical estrogen on my face?” There has been increased attention and research on menopause and female aging. We have made great strides in the knowledge base, but we have so much farther to go.
In a recent report, researchers reviewed the safety and efficacy of the different estrogens available: estradiol (E2), estriol (E3), phytoestrogens, methyl-estradiol-propanoate (MEP), conjugated equine estrogen (CEE), and estrone 1%. They found that topical estrogens may improve certain signs of skin aging, however, none of the studies compared these estrogens against the gold standard retinoids (doi: 10.1016/j.jaad.2025.08.050). It should be noted that most of these compounds are not available in commercial pharmacies. Side effects were minimal, however, some reported breast tenderness which suggests systemic absorption. Melasma also needs to be considered.
In another review, researchers found that bioactives (which do not require a prescription) may be another reliable option to improve estrogen-deficient skin (doi: 10.1007/s13555-025-01413-2). They can be used topically and orally (nutraceuticals) to affect the dermal estrogen receptors by two separate pathways.
Both papers report small sample sizes and varied study designs. Therefore, it is challenging to make conclusions on the best recommendations. More studies are needed to assess both the long-term safety and effectiveness of the various topical products.
A recent retrospective multicenter cohort study (https://doi.org/10.1016/j.ijrobp.2025.10.007) looked at 1,267 cSCC categorized as high-risk (HRCSCC) that received adjuvant radiation therapy (ART) after confirmed negative surgical margins. Over a median follow-up time of 42.3 months, ART was associated with a 50% decreased risk of local recurrence (LR), locoregional recurrence (LRR), and nodal metastasis (NM) in fully resected HRCSCC.
In this study, consistent with prior findings, the absolute risk reduction associated with ART varied according to baseline tumor risk. When HRCSCC were stratified as ‘higher-risk’ and ‘lower-risk’ based on tumor characteristics defined in a prior study (10.1016/j.jaad.2022.03.044), higher-risk HRCSCC experienced double the reduction in LRR and NM after ART as compared to lower-risk tumors. For lower-risk HRCSCC, which experience a much smaller risk reduction after ART, the risks and potential adverse effects of ART may outweigh potential benefit.
Although prospective randomized studies are needed, this study offers valuable data on the utility of ART in fully resected HRCSCC, showing that ART results in ~50% reduction in local recurrence, locoregional recurrence, and nodal metastasis. These data help dermatologic surgeons make evidence-based recommendations for ART, as we work with our colleagues in radiation oncology to provide the highest standard of care to skin cancer patients.
More What’s Hot!
Check out more What’s Hot columns from the DermWorld Editorial Advisory Workgroup.
