Dermoscopic predictors of melanoma in small-diameter melanocytic lesions
Authors of an article published in the International Journal of Dermatology aimed to identify dermoscopic features that aid in distinguishing small diameter melanomas (≤5 mm) from equivocal melanocytic nevi of the same size. In total, five dermoscopic predictors of melanoma for flat non-facial melanocytic lesions measuring ≤5 mm were found: An atypical pigment network, a blue–white veil, pseudopods, peripheral radial streaks, and the presence of more than one color. Melanomas ≤5 mm with a blue–white veil or negative pigment network were more likely to be invasive.
DermWorld Insights and Inquiries: The Venetian antithesis – Treating median canaliform nail dystrophy
The canals dermatologists confront are on the nails in the condition known as median canaliform nail dystrophy (MCND, aka MCND of Heller, median nail dystrophy [MND], or solenonychia). Clinicians need to differentiate MND from other disorders that may cause linear defects of the nail, especially the habit tic deformity. It is easier to differentiate other disorders that may display linear nail defects such as subungual tumors, digital mucous cysts, lichen planus, lichen striatus, Darier disease, and others. MCND is easy to recognize but difficult to treat. Recent reports utilizing tazarotene foam, dupilumab, and marigold offer some promise that warrant further study with appropriate trials. Keep reading!
Risk between history of rosacea and risk of BCC of the face
A retrospective JAAD study of 2,453 patients with basal cell carcinoma (BCC) showed that those with a history of rosacea were significantly less likely to have facial BCC compared with those without a history of rosacea. This association was specific to facial BCC, as no significant difference was observed when comparing BCC at other body sites. Female gender and older age were associated with a significantly increased risk of facial BCC, whereas smoking and skin color did not show a significant association. The authors suggest that a history of rosacea may be a protective factor against the development of facial BCC.
Adalimumab with methotrexate vs. adalimumab monotherapy in psoriasis patients
An article published in the Journal of the European Academy of Dermatology and Venereology investigated the long-term effectiveness and safety of adalimumab in combination with methotrexate versus adalimumab alone in the treatment of patients with psoriasis. After week 49, the combination group tended to show better drug survival and higher PASI score reduction, although the results were not significant. The rate of adverse events was higher in the combination group. According to the authors, combining methotrexate with adalimumab can enhance effectiveness at the cost of more adverse events, and drug survival remains low compared with other biologics used to treat psoriasis.
Experts break down emerging treatment options for psoriasis and what they can offer patients and physicians. Read more in DermWorld.
ChatGPT: Generating patient-facing and clinical responses for melanoma
Authors of a JAAD research letter evaluated the appropriateness, applicability to clinical care, accuracy, and comprehensibility of ChatGPT 4.0 responses to inquiries about melanoma care. Twenty-five hypothetical melanoma-related patient questions were input into ChatGPT, with generated responses evaluated by three board-certified dermatologists for appropriateness for a patient-facing informational platform, sufficiency for clinical practice, and accuracy from 1 (completely inaccurate) to 5 (completely accurate). The authors’ analysis revealed that reviewers consistently rated the accuracy of ChatGPT's responses as high (4.88/5). A majority of the responses (92%) were deemed appropriate for a patient-facing informational platform. In contrast, only 64% were unanimously considered sufficient for clinical practice.
Insufficiency was often attributed to omitted crucial details, highlighting the importance of distinguishing accuracy from sufficiency, said the authors. Additionally, according to the authors, ChatGPT’s advice to “get regular skin exams” is accurate but less specific than a physician’s recommendation for exams every three months. ChatGPT and similar models may be suitable for patient-facing informational platforms but may play a more supplemental role in clinical practice.
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