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In This Issue of JAMA Dermatology |

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JAMA Dermatol. 2016;152(4):361. doi:10.1001/jamadermatol.2015.3247.
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Polycystic ovary syndrome (PCOS) affects 2% to 7% of women, and many of these women experience some of the classic cutaneous findings of acne, hirsutism, and androgenic alopecia. In this retrospective cross-sectional study, Schmidt et al demonstrate that, although acne is common in women with PCOS, it did not distinguish between women suspected of having PCOS and those meeting the diagnostic criteria. Hirsutism and acanthosis nigricans were the most useful cutaneous indicators to distinguish those most at risk among a suspected PCOS population.

Metabolic syndrome is an integral part of polycystic ovary syndrome, and acne is commonly seen in this setting. In male patients, the association between insulin resistance and acne has been poorly investigated. In this cross-sectional study, Nagpal et al demonstrate that postadolescent men with acne more commonly had insulin resistance that may be a stage of prediabetes, and they may develop hyperinsulinemia or type 2 diabetes. These patients should be monitored for a prolonged time to determine whether they develop other conditions associated with insulin resistance.

Many studies have suggested that total number of nevi and atypical nevi (AN) are strongly associated with risk of melanoma. In this survey of patients with melanoma, Geller et al demonstrate that most patients with melanoma had few nevi and no AN. In younger patients, thick melanomas were commonly found in those with fewer total nevi, but more AN, suggesting that practitioners and patients should not rely on total nevus count to determine risk of melanoma. Younger patients with higher numbers of AN should be educated regarding their increased risk of thick melanoma.

Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer of the skin. Surgical removal offers an excellent prognosis in most cases, but nodal metastases and death are seen in a small number of cases. The absence of a national tumor registry for cSCC complicates the analysis of prognostic factors related to outcomes. In this meta-analysis, Thompson et al demonstrate that tumor depth is associated with the highest relative risk of local recurrence and metastasis of cSCC. Tumor diameter exceeding 20 mm was associated with the highest relative risk of disease-specific death.

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by painful, recurrent, suppurative abscesses in areas rich with apocrine sweat glands. Patients with HS carry a greater systemic inflammatory load, and HS may be associated with cardiovascular (CV) risk factors such as smoking, obesity, metabolic syndrome, and diabetes mellitus. In this population-based cohort study, Egeberg et aldemonstrate that HS was associated with a significantly increased risk of adverse CV outcomes and all-cause mortality independent of measured confounders. These results call for greater awareness of this association and for studies of its clinical consequences.





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