The increasing number of living cutaneous melanoma patients and the increased risk of developing a second primary tumour incited us to analyse the clinical characteristics of cutaneous melanoma and define the frequency, site, and type of second primary cancers in cutaneous melanoma patients. We collected data on patients who visited the Department of Dermatology at the Radboud University Nijmegen Medical Centre and were newly diagnosed with cutaneous melanoma or metastasis of melanoma with unknown primary localization between 2002 and 2006. A total of 194 cases were included; eleven patients developed a subsequent melanoma, 24 had at least one basal cell carcinoma, three had at least one squamous cell carcinoma, and 21 patients had a second non-cutaneous primary malignancy. In conclusion, 48 patients developed a subsequent malignancy. As nonmelanoma skin cancer is the most frequent second malignancy, our results subscribe to the necessity of follow-up by a dermatologist.

Haike M. J. van der Velden

Michelle M. van Rossum

Willeke A. M. Blokx

Jan B. M. Boezeman

Marie-Jeanne P. Gerritsen

Clinical Characteristics of Cutaneous Melanoma and Second Primary Malignancies in a Dutch Hospital-Based Cohort of Cutaneous Melanoma Patients

<i>Background.</i> The clinical presentation of desmoplastic melanoma is often challenging. We report the experience of the Melanoma Unit of Spedali Civili University Hospital of Brescia, Italy. <i>Method.</i> Study subjects were drawn from 1770 patients with histologica confirmed melanoma. Within this group, desmoplastic melanoma developed in 5 patients. For each diagnosed melanoma, histological characteristics, treatment, and outcomes were evaluated. <i>Results.</i> Of the 5 patients described in this study, 2 were males and 3 females. The average age was 62.4 years ranging from 56 to 68 years. Breslow thickness ranged from 2.1 to 12&#x2009;mm with a mean thickness of 5.8&#x2009;mm. Primary treatment of 5 patients included a wide local excision of their primary lesions. <i>Conclusions.</i> Desmoplastic melanoma is a rare neoplasm which clinically may mimic other tumours or cutaneous infiltrate of uncertain significance. The diagnosis is hiastopathological and radical resection is necessary.

A. M. Manganoni

C. Farisoglio

S. Bassissi

D. Braga

F. Facchetti

M. Ungari

P. G. Calzavara-Pinton

Desmoplastic Melanoma: Report of 5 Cases

Assessment of the 
                  severity of atopic dermatitis (AD) is necessary 
                  to evaluate the disease process. This study 
                  evaluates and validates the TIS in children with 
                  AD presenting in general practice. Independent  
                  investigators determined the severity of AD 
                  using the TIS and the objective SCORAD. The 
                  interobserver agreement for the TIS and SCORAD 
                  was calculated, as was the correlation between 
                  TIS and SCORAD. The mean time to assess the TIS 
                  was less than one minute. A moderate-to-good 
                  agreement between the observers was found for 
                  the TIS (<svg     style="vertical-align:-0.1638pt;width:64.675003px;" id="M1" height="11.225" version="1.1" viewBox="0 0 64.675003 11.225" width="64.675003"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.963)"><path id="x1D705" d="M484 406q0 -21 -22 -38q-10 -7 -18 -1q-15 11 -30 11q-30 0 -77.5 -37t-74.5 -67l79 -168q11 -23 19.5 -34.5t13 -14t10.5 -2.5q9 0 30 17.5t40 42.5l17 -23q-31 -45 -57.5 -69.5t-40.5 -29.5t-31 -5q-18 0 -32 13.5t-35 55.5q-34 71 -69 160q-36 -32 -59 -56&#xA;q-12 -27 -36 -158q-44 -7 -77 -15l-5 7l82 349q6 25 -2 25q-16 0 -72 -41l-14 22q44 41 89 69.5t66 28.5q19 0 19 -32q0 -16 -6 -43l-35 -160l146 143q94 92 136 92q20 0 33 -12t13 -30z" /></g><g transform="matrix(.017,-0,0,-.017,13.39,10.963)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,28.093,10.963)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,36.253,10.963)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,40.129,10.963)"><path id="x36" d="M137 343l67 33q37 17 63 17q79 0 129.5 -53t50.5 -131q0 -92 -58 -156.5t-147 -64.5t-147 68t-58 182q0 63 17 119t43 95.5t61.5 72t69 52t67.5 31.5q62 22 128 33l6 -32q-56 -11 -108 -35q-149 -71 -184 -231zM227 337q-47 0 -95 -27q-6 -23 -6 -70q0 -93 36 -155.5&#xA;t96 -62.5q53 0 78 45.5t25 105.5q0 68 -35 116t-99 48z" /></g><g transform="matrix(.017,-0,0,-.017,48.288,10.963)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,56.447,10.963)"><path id="x34" d="M456 178h-96v-72q0 -51 12.5 -62.5t72.5 -16.5v-27h-256v27q65 5 78 17t13 62v72h-260v28q182 271 300 426h40v-407h96v-47zM280 225v295h-2q-107 -148 -196 -295h198z" /></g>

		
	
</svg> or  0.464), or SCORAD (<svg     style="vertical-align:-0.20474pt;width:64.675003px;" id="M2" height="11.275" version="1.1" viewBox="0 0 64.675003 11.275" width="64.675003"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.962)"><use xlink:href="#x1D705"/></g><g transform="matrix(.017,-0,0,-.017,13.39,10.962)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.093,10.962)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,36.253,10.962)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,40.129,10.962)"><use xlink:href="#x36"/></g><g transform="matrix(.017,-0,0,-.017,48.288,10.962)"><path id="x39" d="M244 635q90 0 143 -72t53 -177q0 -133 -65 -229.5t-171 -139.5q-79 -32 -140 -32l-5 30q109 18 185 91t101 186l-68 -36q-29 -16 -60 -16q-79 0 -129 51.5t-50 130.5q0 80 57 146.5t149 66.5zM228 602q-52 0 -78 -45.5t-26 -98.5q0 -69 36.5 -115.5t97.5 -46.5&#xA;q53 0 90 28q4 31 4 66q0 51 -9.5 95.5t-39 80.5t-75.5 36z" /></g><g transform="matrix(.017,-0,0,-.017,56.447,10.962)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g>

		
	
</svg> or 0.700). There was an excellent correlation between TIS and SCORAD (<svg     style="vertical-align:-3.3907pt;width:105.2125px;" id="M3" height="15.1375" version="1.1" viewBox="0 0 105.2125 15.1375" width="105.2125"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><path id="x1D45F" d="M393 379q-9 -16 -28 -29q-15 -10 -23 -2q-19 19 -36 19q-21 0 -52 -38q-57 -72 -82 -126l-40 -197q-23 -3 -75 -18l-7 7q49 196 74 335q7 43 -2 43q-7 0 -30 -14.5t-47 -37.5l-16 23q37 42 82 73t67 31q41 0 15 -113l-11 -50h4q41 71 85 117t77 46q29 0 45 -26&#xA;q13 -21 0 -43z" /></g>

			<g transform="matrix(.012,-0,0,-.012,7.238,14.938)"><path id="x1D460" d="M352 391q0 -31 -27 -44q-14 -7 -24 6q-39 48 -84 48q-23 0 -39.5 -15t-16.5 -40q0 -43 73 -90q49 -32 70 -58t21 -57q0 -58 -62 -105.5t-129 -47.5q-40 0 -75.5 25t-35.5 52q0 28 32 46q7 4 15 3t11 -6q19 -31 48.5 -50.5t54.5 -19.5q34 0 54 19.5t20 42.5q0 43 -65 81&#xA;q-97 56 -97 123q0 50 51 96q19 17 58 32.5t62 15.5q37 0 61 -18t24 -39z" /></g>

			<g transform="matrix(.017,-0,0,-.017,17.038,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,31.741,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,39.901,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,43.777,10.862)"><path id="x37" d="M447 623l8 -12l-283 -613l-74 -10l-7 11q174 283 297 551h-216q-48 0 -62.5 -12t-33.5 -63h-29q10 60 18 148h382z" /></g><g transform="matrix(.017,-0,0,-.017,51.936,10.862)"><use xlink:href="#x35"/></g><g transform="matrix(.017,-0,0,-.017,60.095,10.862)"><use xlink:href="#x35"/></g><g transform="matrix(.017,-0,0,-.017,65.433,10.862)"><path id="x2D" d="M300 253l-14 -55h-229l14 55h229z" /></g><g transform="matrix(.017,-0,0,-.017,68.646,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,76.805,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,80.681,10.862)"><path id="x38" d="M249 635q70 0 116 -43t46 -105q0 -46 -28 -80q-22 -25 -80 -64q62 -35 97 -75t35 -99q0 -81 -63 -131t-135 -50q-83 0 -137.5 45.5t-54.5 123.5q0 52 45 95q29 28 89 64q-109 62 -109 155q0 66 50.5 115t128.5 49zM238 603q-42 0 -67.5 -31t-25.5 -72q0 -50 32.5 -79.5&#xA;t98.5 -62.5q61 48 61 124q0 59 -29.5 90t-69.5 31zM248 20q46 0 76.5 33.5t30.5 89.5q0 50 -39 85.5t-110 71.5q-81 -54 -81 -137q0 -67 35.5 -105t87.5 -38z" /></g><g transform="matrix(.017,-0,0,-.017,88.84,10.862)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g><g transform="matrix(.017,-0,0,-.017,97,10.862)"><use xlink:href="#x39"/></g>

		
	
</svg>). In conclusion, the TIS is an easy and fast method to 
score AD. Because of the moderate to good interobserver agreement 
and the high correlation with the SCORAD, we recommend the TIS to 
determine the severity of AD in general practice.

Marjolein G. Willemsen

Rosalinda W. C. van Valburg

Pauline C. Dirven-Meijer

Arnold P. Oranje

Johannes C. van der Wouden

Heleen Moed

Determining the Severity of Atopic Dermatitis in Children Presenting in General Practice: An Easy and Fast Method

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown aetiology. Clinical manifestations of PG are characterized by destructive, necrotizing, and noninfective ulceration of the skin. 20&#8211;30&#37; of cases are initiated and aggravated by minor trauma or surgery, a phenomenon named pathergy. PG is related to several autoimmune diseases including ulcerative colitis, Crohn&#39;s disease, rheumatoid arthritis, and monoclonal gammopathy. The association with Takayasu&#39;s arteritis (TA), a chronic inflammatory and stenotic disease of large and medium-sized arteries, is instead less common.
We report a case of PG associated with TA that was induced by an accident with folgoration of the skin; in this case the folgoration can be considered as an exemple of Pathergy, that is, a characteristic feature of PG.

A. G. Richetta

S. D&#39;Epiro

C. Mattozzi

S. Giancristoforo

S. Calvieri

Folgoration as an Example of Pathergy in a Patient Affected  by Pyoderma Gangrenosum  and Takayasu&#39;s Arteritis

A 35-year-old woman who developed whitish macules on trunk and limbs at 12 years of age and observed a remarkable increase of the hypopigmentated lesions after her pregnancies at ages 29 and 32 years. Because of the highly characteristic clinical aspect and the light- and electron-microscopic histopathologic findings, we diagnosed progressive macular hypomelanosis (PMH). It is a nonscaly disorder with hypopigmented macules mainly on the trunk and is more often seen in young women. In contrast to some authors assuming the presence of <i>Propionibacterium spp.</i> as a matter of principle in PMH, we report a case with no evidence for <i>Propionibacterium spp.</i>

Sven Neynaber

Christina Kirschner

Stefanie Kamann

Gerd Plewig

Michael J. Flaig

Progressive Macular Hypomelanosis: A Rarely Diagnosed Hypopigmentation in Caucasians

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<p><em>Dermatology Research and Practice</em> publishes original research articles and&nbsp;review articles related to the prevention, diagnosis, and treatment of disorders of the skin, hair, and nails.</p>


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Dermatology Research and Practice publishes original research articles and review articles related to the prevention, diagnosis, and treatment of disorders of the skin, hair, and nails.

Dermatology Research and Practice