Netherton Syndrome (NS) is a rare genodermatosis characterised by a triad of ichthyosiform erythroderma, an atopic diathesis, and trichorrhexis invaginata, for which no effective management is currently approved in Australia. Dupilumab has demonstrated considerable effectiveness in the treatment of atopic conditions in the paediatric population. We conducted a literature review to identify trends in disease aspects and their responsiveness to dupilumab treatment, with only four reports having follow-up beyond 12 months. To address this gap and provide insights into the long-term trajectory of dupilumab treatment in this population, we report two cases of NS treated with dupilumab over 20 and 25 months. This paper demonstrates that dupilumab may be a relatively safe and potentially effective option for targeting Th2-mediated inflammation though its overall sustained effectiveness may be variable.

This eight-year retrospective cohort study of 285 patients with primary cutaneous malignant melanoma compared diagnostic pathways and oncological outcomes, demonstrating significantly lower mortality in patients diagnosed via teledermatology versus face-to-face appointments (5% vs. 23%; adjusted OR 8.1; p = 0.00009), despite comparable clinicopathological features. Sentinel lymph node biopsy positivity was independently associated with significantly higher odds of mortality (adjusted OR 13.9; p = 0.02), confirming its continued prognostic value in guiding adjuvant therapy selection.

Perineal nodular induration, also called Cyclist's nodule, is an uncommon, benign pseudotumour of the perineal soft tissues that arises almost exclusively in individuals who engage in prolonged saddle-based sports, most notably road cycling. It is thought to result from chronic mechanical microtrauma-pressure, vibration, and shear-transmitted between the ischial tuberosities and a hard saddle. Management includes prolonged rest from cycling, bike-fit and behavioural modification, intralesional corticosteroid injection, or surgical excision for refractory disease.

Sézary syndrome (SS) is a rare cutaneous T-cell lymphoma associated with increased risks of opportunistic and atypical infections. This report presents two patients with SS and concurrent non-tuberculosis mycobacterial cutaneous infections. Although rare, difficult to diagnose and challenging to treat, these cases highlight the importance of considering atypical infectious causes in patients with SS.

Although external genital cutaneous sarcoidosis is rare, it can closely resemble lichen sclerosus (LS) and delay diagnosis. We report a case of a 69-year-old woman with long-standing vulvar symptoms and LS-like pallor of the labia minora and clitoris. Biopsy showed non-caseating granulomas with negative infection stains, consistent with vulvar sarcoidosis. This case supports the need for early biopsy in cases of persistent or atypical vulvar pallor and highlights sarcoidosis as an uncommon but important LS-mimic.

Primary cutaneous gamma-delta T-cell lymphoma (PCGDTCL) is a rare cytotoxic lymphoma with considerable clinicopathological heterogeneity. We report three patients with unusual presentations, including a TCR-silent phenotype with spontaneous regression followed by rapid progression, a granulomatous variant with a prolonged indolent course, and a lupus panniculitis-like form. Molecular studies demonstrated persistent clonal disease and identified recurrent alterations involving TET2, STAT3, CDKN2A, MAPK1, PDCD1 and TNFAIP3, with acquisition of additional mutations during disease evolution. These cases expand the recognized spectrum of PCGDTCL and highlight the importance of integrating clinicopathological and molecular findings in diagnostically challenging presentations.