A newsletter that delivers the latest in dermatology research directly to you.
One Hundred and twentieth issue
october 14th, 2026
Melanoma Prevention Among Children of Melanoma Survivors: A Randomized Clinical Trial
JAMA Dermatology
JAMA Dermatology
Melanoma: the unexpected family heirloom
Children of melanoma survivors have approximately twice the lifetime melanoma risk of the general population, yet many remain inconsistently protected from UV exposure. This randomized clinical trial assigned 364 melanoma survivor-child dyads to the 4-week family, lifestyles, actions, and risk education (FLARE) telehealth intervention or an active telehealth education control and evaluated sunburn, sun-protective behaviors, and tanning.
What did they find?
Main Takeaway: The family-based FLARE intervention improved several sun-protective behaviors; however, these changes did not translate into a sustained advantage in reducing sunburn compared with active education.
Children of melanoma survivors have approximately twice the lifetime melanoma risk of the general population, yet many remain inconsistently protected from UV exposure. This randomized clinical trial assigned 364 melanoma survivor-child dyads to the 4-week family, lifestyles, actions, and risk education (FLARE) telehealth intervention or an active telehealth education control and evaluated sunburn, sun-protective behaviors, and tanning.
What did they find?
- FLARE did not significantly reduce child sunburn over time compared with the active education control
- At the first postintervention assessment, FLARE participants reported 0.17 fewer sunburns than controls (P = .01).
- FLARE produced greater improvements in overall sun-protective behaviors through the second assessment (P < .001).
- 77.2% of FLARE participants and 71.3% of controls reported no recent sunburn by the second assessment.
Main Takeaway: The family-based FLARE intervention improved several sun-protective behaviors; however, these changes did not translate into a sustained advantage in reducing sunburn compared with active education.
Improved detection of lentigo maligna with AI-assisted dermoscopy: A reader study in facial pigmented lesions
JAAD
JAAD
The hardest call in facial dermoscopy just got a little easier to make with AI.
Lentigo maligna (LM) is hard to distinguish from benign facial lesions because chronically sun-damaged skin produces overlapping clinical and dermoscopic features. Missed LM can progress to invasive melanoma, while overcalling drives unnecessary biopsies of benign lesions in cosmetically sensitive areas. This retrospective study at Ankara University developed an Xception-based convolutional neural network for facial pigmented lesions and tested whether its malignancy score improves dermatology-resident diagnostic performance.
What did they find?
Main Takeaway: AI-assisted dermoscopy improves resident recognition of lentigo maligna, supporting its role as an adjunct and training tool. However, the retrospective, single-population, dermoscopy-only, resident-only design warrants prospective, multicenter, multimodal validation (including experienced dermatologists) before routine clinical adoption.
Lentigo maligna (LM) is hard to distinguish from benign facial lesions because chronically sun-damaged skin produces overlapping clinical and dermoscopic features. Missed LM can progress to invasive melanoma, while overcalling drives unnecessary biopsies of benign lesions in cosmetically sensitive areas. This retrospective study at Ankara University developed an Xception-based convolutional neural network for facial pigmented lesions and tested whether its malignancy score improves dermatology-resident diagnostic performance.
What did they find?
- The model was built on 722 lesions (894 dermoscopic images), including 190 LM, and achieved 84.2% ± 2.5% accuracy, 90.0% ± 11.5% sensitivity, and 81.9% ± 1.2% specificity for malignant vs benign.
- In a reader study of 26 residents, AI assistance raised accuracy from 64.9% to 74.0% (P<.0001), with Cohen’s kappa improving from 0.47 to 0.61.
- The largest gain was for LM (61.5% to 78.0%, +16.5%), versus gains of 5.8% and 4.8% for pigmented actinic keratosis (+5.8%) and solar lentigo/seborrheic keratosis (+4.8%), and all four training years improved.
- AI corrected 302 incorrect decisions while inducing 63 errors, a net gain of 239, though residents with AI (74.0%) still fell short of the model alone (84.2%).
Main Takeaway: AI-assisted dermoscopy improves resident recognition of lentigo maligna, supporting its role as an adjunct and training tool. However, the retrospective, single-population, dermoscopy-only, resident-only design warrants prospective, multicenter, multimodal validation (including experienced dermatologists) before routine clinical adoption.
Not quite the representation we were looking for…
Children with alopecia often experience significant psychosocial challenges, and portrayals of hair loss in animated films may influence their perceptions of themselves and others. In this study, researchers reviewed 139 full-length films from Disney, Pixar, DreamWorks, and Studio Ghibli. They identified 177 characters with dermatologist-confirmed alopecia, whose traits were rated by five independent reviewers.
What did they find?
Main Takeaway: Animated films often portray male-pattern hair loss as a sign of wisdom and authority while portraying alopecia in women and children as villainous or comedic. Because children develop lasting social perceptions early in life, more balanced and inclusive representation is essential to reducing stigma.
Children with alopecia often experience significant psychosocial challenges, and portrayals of hair loss in animated films may influence their perceptions of themselves and others. In this study, researchers reviewed 139 full-length films from Disney, Pixar, DreamWorks, and Studio Ghibli. They identified 177 characters with dermatologist-confirmed alopecia, whose traits were rated by five independent reviewers.
What did they find?
- Characters with alopecia were overwhelmingly male (94.9%) and adult (94.9%) and most often peripheral characters (48.6%, p < 0.001). Androgenetic alopecia was the most common subtype (53.7%).
- These characters were more likely to be portrayed as intelligent than unintelligent (55.9% vs. 4.5%, p < 0.001), as leaders rather than followers (36.2% vs. 23.7%, p = 0.015), and as heroes rather than villains (34.5% vs. 23.7%, p = 0.035).
- In contrast, women with alopecia were more likely to be depicted as villainous, frightening, and slow-moving (50% each).
- Child characters with alopecia were often depicted as clumsy (43%) and accident-prone (29%).
Main Takeaway: Animated films often portray male-pattern hair loss as a sign of wisdom and authority while portraying alopecia in women and children as villainous or comedic. Because children develop lasting social perceptions early in life, more balanced and inclusive representation is essential to reducing stigma.
Basal cell carcinosarcoma with an osteosarcomatous component: a case report supporting the diagnostic utility of SATB2 and TRAP immunostaining with a literature review of 22 cases
DermPath
DermPath
Even tumors can have an identity crisis.
Cutaneous carcinosarcoma is a rare biphasic tumor with malignant epithelial and mesenchymal components. When the carcinoma is basal cell carcinoma (BCC), it is termed basal cell carcinosarcoma (BCCS), and the sarcomatous part can be homologous (e.g., pleomorphic dermal sarcoma) or heterologous (osteo-, chondro-, or rhabdomyosarcoma). This case report describes a 91-year-old woman with a rapidly enlarging, ulcerated cheek nodule, characterizes the tumor with SATB2 and TRAP immunostaining, and reviews all reported cases of BCCS with an osteosarcomatous component.
What did they find?
Cutaneous carcinosarcoma is a rare biphasic tumor with malignant epithelial and mesenchymal components. When the carcinoma is basal cell carcinoma (BCC), it is termed basal cell carcinosarcoma (BCCS), and the sarcomatous part can be homologous (e.g., pleomorphic dermal sarcoma) or heterologous (osteo-, chondro-, or rhabdomyosarcoma). This case report describes a 91-year-old woman with a rapidly enlarging, ulcerated cheek nodule, characterizes the tumor with SATB2 and TRAP immunostaining, and reviews all reported cases of BCCS with an osteosarcomatous component.
What did they find?
- The case presented as an ulcerated erythematous cheek nodule that enlarged over 1 month and grew to 25 × 30 mm in the month before excision (3-mm margin); dermoscopy showed unstructured whitish/reddish areas with telangiectasias. Margins were negative, and there was no recurrence at 2 months.
- Histopathology of the presented case showed 2 distinct epithelial and mesenchymal components in an approximate 1:2 ratio, with gradual continuity and intermingling tumor cells in the transitional zone.
- The epithelial component consisted of atypical basaloid nests with peripheral palisading and cleft formation; the mesenchymal component consisted of atypical spindle- to oval-shaped cells with prominent nucleoli and frequent mitoses. <5% of the sarcomatous area contained osteoclast-like multinucleated giant cells and lace-like osteoid matrix.
- SATB2 was strongly expressed in nuclei of sarcomatous cells immediately adjacent to osteoid, and TRAP was expressed primarily in the multinucleated giant cells.
- Literature review identified 21 prior cases plus this case (22 total), with a median age of 82 years (mean 79.4, range 53–93), presenting primarily on sun-exposed sites (16/22, 72.7%), with all head and neck lesions ≤2.5 cm. No lymph nodes or distant metastasis was observed in any case. Local recurrence was observed in 1 case.
Sometimes the brightest idea in the OR might be dimming the lights.
Mohs surgeons work at close distances under intense surgical lighting, potentially exposing their eyes to reflected light that contributes to eye strain and visual fatigue. Since there is limited quantitative data on eye-level exposure to reflected surgical lighting, this experimental study was conducted using a calibrated digital lux meter positioned at the surgeon’s eye level in a simulated Mohs surgical setup to measure reflected illuminance at three working distances, two lamp orientations, two drape colors, and three simulated skin tone categories.
What did they find?
Main Takeaway: Simple, low-cost changes, including using blue drapes, positioning the surgical lamp behind the surgeon, and increasing working distance when clinically feasible, may help reduce reflected light exposure during Mohs surgery. Overall, these strategies could improve surgeon comfort and occupational eye health.
Mohs surgeons work at close distances under intense surgical lighting, potentially exposing their eyes to reflected light that contributes to eye strain and visual fatigue. Since there is limited quantitative data on eye-level exposure to reflected surgical lighting, this experimental study was conducted using a calibrated digital lux meter positioned at the surgeon’s eye level in a simulated Mohs surgical setup to measure reflected illuminance at three working distances, two lamp orientations, two drape colors, and three simulated skin tone categories.
What did they find?
- Working distance matters, since reflected illuminance was approximately 1.5- 2x higher at 14 inches than at 20 inches and up to 2- 3x higher than at 26 inches.
- Drape color makes a difference, with white surgical drapes producing a higher reflected illuminance than blue drapes, suggesting that darker drapes may reduce ocular light exposure.
- Lamp positioning is modifiable, and positioning the surgical lamp behind the surgeon reduced reflected light exposure compared with perpendicular positioning.
Main Takeaway: Simple, low-cost changes, including using blue drapes, positioning the surgical lamp behind the surgeon, and increasing working distance when clinically feasible, may help reduce reflected light exposure during Mohs surgery. Overall, these strategies could improve surgeon comfort and occupational eye health.
Treatment efficacy for androgenetic alopecia (hair loss): combination therapy of clinical low-level laser (light) therapy and proprietary hair growth serum: a pilot study
JCD
JCD
The future of hair restoration is bright!
Androgenetic alopecia is a non-scarring, patterned hair loss impacting up to 50% of men and women by age 50. There are several options with varying efficacy, including low-level laser light therapy (LLLT), topical medications (such as minoxidil), and topical serums (e.g., U.SK Skin Savers Hair Growth serum). This prospective pilot case series explores the impact of a combination of LLLT and U.SK serum in patients >18.
What did they find?
Main Takeaway: The findings of this study demonstrate an improvement in hair count, density, and terminal hair to vellus hair ratio following 3 months of LLLT and U.SK serum; however, none were statistically significant.
Androgenetic alopecia is a non-scarring, patterned hair loss impacting up to 50% of men and women by age 50. There are several options with varying efficacy, including low-level laser light therapy (LLLT), topical medications (such as minoxidil), and topical serums (e.g., U.SK Skin Savers Hair Growth serum). This prospective pilot case series explores the impact of a combination of LLLT and U.SK serum in patients >18.
What did they find?
- Mean hair count/cm2 increased from 110.00 prior to treatment to 138.00 after treatment, representing a 25.45% increase (p = 0.342).
- Mean terminal to vellus hair ratio increased from 19.59 to 24.33, a 24.51% increase (p = 0.641).
- Mean hair count/follicular unit increased from 1.21 to 1.73, a 42.27% increase (p = 0.206).
Main Takeaway: The findings of this study demonstrate an improvement in hair count, density, and terminal hair to vellus hair ratio following 3 months of LLLT and U.SK serum; however, none were statistically significant.
Some AD patients don’t know JAK!
Atopic dermatitis (AD) is associated with several allergic and nonallergic conditions. Racial disparities may also influence disease burden and access to treatment. This TriNetX-based study compared comorbidities, treatment patterns, and health care utilization in 76,654 Black and 76,654 White adults with AD after propensity-score matching.
What did they find?
Main Takeaway: There are race-associated differences in IBD comorbidity and treatment patterns among Black and White patients with AD, including fewer prescriptions of ruxolitinib and increased prescriptions of glucocorticoids among Black patients.
Atopic dermatitis (AD) is associated with several allergic and nonallergic conditions. Racial disparities may also influence disease burden and access to treatment. This TriNetX-based study compared comorbidities, treatment patterns, and health care utilization in 76,654 Black and 76,654 White adults with AD after propensity-score matching.
What did they find?
- Black patients with AD had higher odds of inflammatory bowel disease, including Crohn disease (OR = 1.31, p < 0.0001) and ulcerative colitis (OR = 1.28, p < 0.001), compared with White patients.
- Most other comorbidities showed little clinically meaningful difference by race, including asthma, food allergy, systemic lupus erythematosus, alopecia areata, and vitiligo.
- White patients had greater odds of receiving ruxolitinib (OR = 1.60, 95% CI = 1.27-2.01, p < 0.0001), with smaller differences also seen for dupilumab (OR = 1.10, CI = 1.01-1.19, p = 0.02) and tacrolimus (OR = 1.10, CI = 1.03-1.18, p = 0.01).
- White patients had lower odds of receiving glucocorticoids than Black patients (OR = 0.88, CI = 0.84-0.92, p < 0.0001), while phototherapy use was similar between groups.
Main Takeaway: There are race-associated differences in IBD comorbidity and treatment patterns among Black and White patients with AD, including fewer prescriptions of ruxolitinib and increased prescriptions of glucocorticoids among Black patients.
DERMLITE Dermoscopy QUESTION OF THE WEEK
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