We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Dermatology |

Highlights FREE

JAMA Dermatol. 2015;151(10):1047. doi:10.1001/jamadermatol.2014.2941.
Text Size: A A A
Published online


Vulvar lichen sclerosus (VLS) is an uncommon skin disease that is sometimes complicated by vulvar squamous neoplasia (VSN). Current guidelines of care advocate use of superpotent topical corticosteroids (TSCs) as first-line treatment to achieve remission. Less is known about maintenance therapy for VLS. In this prospective longitudinal cohort study, Lee et al demonstrate that individualized preventive TCS regimens, with potency titrated to objective disease severity, reduced symptoms, scarring, and risk of VSN. Few cases of reversible cutaneous atrophy were observed.

Basal cell carcinoma (BCC) is the most common human cancer. Diagnosis is primarily via clinical evaluation, with definitive diagnosis via biopsy and histopathologic evaluation. Diagnostic optical technologies offer the possibility of rapid, pain-free, and noninvasive light-based histopathologic examination. Most current in vivo optical imaging devices rely on variations in refractive indices, leading to low-contrast images that may prove difficult to interpret. Multiphoton microscopy (MPM) introduces additional degrees of contrast by taking advantage of endogenous fluorophores in the skin. In this small pilot study, Balu et al demonstrate that in vivo MPM imaging can provide label-free contrast to reveal several characteristic features of BCC.

In Denmark, the incidence of malignant melanoma (MM) has doubled during the past 25 years. In this descriptive analysis of the official national Danish Melanoma Group database, Helvind et al demonstrate that the incidence, mortality, and characteristics over time of the MM population in Denmark correspond with findings of similar studies worldwide. Incidence of MM increased, with a relative increase in in situ tumors, indicating that secondary interventions such as screening were effective. A persisting increase in male mortality and incidence of MMs suggests that this increase is not due solely to overdiagnosis and diagnostic drift, and that primary interventions need to be intensified.

Cutaneous leiomyomas are smooth-muscle tumors that commonly arise from the arrector pili muscle. Among affected individuals, 92% experience pain associated with these lesions, but the mechanism of this pain is poorly understood. Some data suggest that nerve conduction pathways could be targeted to minimize leiomyoma-associated pain. In this randomized trial, Naik et al demonstrate that intralesional botulinum toxin was associated with improvement in skin-related quality of life, even though pain at rest and pain severity improvements were not statistically significant.

BRAF inhibitors have revolutionized the treatment of stage IV metastatic melanoma. The MEK inhibitor trametinib dimethyl sulfoxide has also shown a survival benefit in the same population. In this retrospective cohort study, Carlos et al compare the cutaneous toxic effects of BRAF inhibitor monotherapy with BRAF inhibitor–trametinib combination therapy (CombiDT). Cutaneous squamous cell carcinoma was the most concerning cutaneous toxic effect related to BRAF inhibitor monotherapy. CombiDT therapy had an improved profile of cutaneous toxic effects, although continuous dermatologic assessments should be provided for all patients receiving these treatments.





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.