Lentigo maligna (LM) and LM melanoma (LMM) predominantly arise on chronically sun-damaged head and neck skin and are often considered biologically uniform across facial locations. Whether invasive potential varies by anatomical subsite remains unclear. We aimed to evaluate the association between predefined head and neck subsites and invasive phenotype in LM and LMM. In this retrospective cohort study, 134 patients with histopathologically confirmed LM and LMM were analyzed. Head and neck lesions were stratified a priori into scalp, nose, ear, periocular region, other facial areas, and neck. Multivariable linear and logistic regression models assessed associations between anatomical subsite, Breslow thickness, and invasive disease, adjusting for age and sex. Among 118 head and neck lesions, 50% were invasive. Anatomical subsite was independently associated with invasive disease (p = 0.0025), with auricular lesions demonstrating the highest frequency of invasion and nasal and periocular lesions showing significantly lower odds. Among invasive LMM, nasal lesions also demonstrated significantly lower Breslow thickness compared with auricular lesions in adjusted analysis (p = 0.026). To conclude, head and neck LM and LMM demonstrated significant anatomical differences in invasive presentation. These findings suggest that anatomical subsite may influence the likelihood of invasive disease and support greater anatomical consideration during clinical evaluation.

Pressure ulcer (PU) typically arises as a chronic cutaneous ulcer stemming from a complex interplay of factors. However, the underlying mechanisms of this condition remain unclear. The aim of this study was to identify inflammatory biomarkers in patients with PU. In this study, PU and normal tissues were collected from 24 patients with PU. An exploratory Olink Inflammation Panel analysis was performed to identify candidate differentially expressed proteins (DEPs) between PU and normal tissue samples from 16 of the 24 patients with PU. A total of 16 candidate DEPs were identified using an unadjusted p < 0.05 threshold between the two groups. Among them, CCL17 had the largest fold change and diagnostic potential with an optimal AUC value (0.75). In addition, CCL17, ANGPT1, FASLG, and VEGFA demonstrated high clinical relevance in the patients with PU. Immunohistochemistry and western blotting using PU tissues obtained from the remaining 8 patients confirmed the decreased expression of CCL17 in PU tissues. In conclusion, CCL17 is a novel potential biomarker for PU pathogenesis and prognosis.

Chronic spontaneous urticaria (CSU) is monitored mainly with patient-reported outcomes, whereas objective biomarkers that reflect disease status remain limited. This prospective observational cohort study included 55 adults with antihistamine-refractory CSU who initiated omalizumab as part of routine clinical care and 30 healthy controls for baseline oxidative stress comparisons. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were measured at baseline and month 6, and at month 12 in patients requiring treatment escalation. Disease control, disease activity, and quality of life were assessed using validated instruments. Unadjusted baseline TOS and OSI were lower in patients than in controls, but these differences were attenuated and were no longer statistically significant after adjustment for age, sex, and BMI (log-TOS: β = -0.297, p = 0.115; log-OSI: β = -0.310, p = 0.102). Month-6 OSI was higher in uncontrolled than controlled patients [0.274 (0.162-0.382) vs. 0.135 (0.100-0.245) AU, p = 0.010] and remained associated with uncontrolled disease after adjustment for baseline OSI, BMI, CRP, total IgE, and angioedema presence (β = 0.572, p = 0.030). Within-person change in OSI correlated inversely with change in UCT (rho = -0.596, p < 0.001), whereas its association with change in CU-Q2oL did not reach statistical significance (rho = 0.264, p = 0.053). In the 15-patient escalation subgroup, OSI did not change significantly over time (Friedman p = 0.074). These exploratory findings indicate that on-treatment OSI was associated with concurrent disease control and that within-person OSI change paralleled change in UCT. Incremental value beyond validated patient-reported outcomes, predictive performance, and treatment-guiding value was not established.

Infantile hemangioma (IH) is the most common vascular tumor in infants. Clinical and perinatal data from Japanese hospital-based studies are limited. We performed a questionnaire-based case-control study to describe the clinical characteristics of IH and evaluate the factors associated with IH. The study included 150 children with IH and 150 pediatric dermatological controls without IH who visited our hospital. IH was diagnosed by direct dermatological examination in all cases, and questionnaires were administered during hospital visits. The clinical characteristics of children with IH were summarized. Background factors were compared between groups, and factors associated with IH were analyzed using multivariable logistic regression after multiple imputation to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Among 150 children with IH, 124 (82.7%) had a single lesion, and 26 (17.3%) had multiple lesions. The most frequent lesion sites were the head and neck (n = 64), trunk (n = 51), and upper extremities (n = 39). Children with IH had lower birth weights than controls (2904 ± 474 vs. 3007 ± 391 g; p = 0.041). However, low birth weight (< 2500 g) was not associated with IH after adjustment (aOR 1.65 [95% CI 0.69-3.94]; p = 0.263). Firstborn children were more frequent in the IH group than in the control group (82/150 [54.7%] vs. 63/149 [42.3%]; p = 0.030). In the multivariable analysis, firstborn status remained associated with IH after adjustment (aOR 1.82 [95% CI 1.03-3.20]; p = 0.039). In this Japanese hospital-based case-control study, firstborn status was associated with IH after adjusting for maternal, perinatal, and socioeconomic factors. Although children with IH had a lower mean birth weight than controls, low birth weight (< 2500 g) was not associated with IH in the adjusted model.

Vitiligo can cause a substantial psychosocial burden. However, the clinical and patient-reported features associated with impaired disease-specific quality of life (QoL) in Japanese patients remain incompletely characterized. We conducted a multicenter, cross-sectional questionnaire study to examine the associations between the Vitiligo-specific Quality-of-Life (VitiQoL) instrument and clinical variables reported by patients and physicians. A total of 255 questionnaires were collected, and 227 patients with complete VitiQoL data were included in the main analysis. The mean VitiQoL total score was 40.6 ± 22.4. Higher VitiQoL scores were associated with female sex, exposed-site involvement, and border hyperpigmentation, with scores increasing progressively with the number of involved exposed regions. VitiQoL scores showed a trend toward an inverse correlation with age. Lesion-associated symptoms were also associated with higher VitiQoL scores, whereas non-lesional skin symptoms were not. Lesion-associated symptoms were associated with physician-rated disease severity. Treatment response assessed by either patients or physicians was not associated with VitiQoL scores. In multivariable analysis, female sex, younger age, a greater number of exposed regions, and border hyperpigmentation were independently associated with higher VitiQoL scores, whereas physician-rated disease severity and lesion-associated symptoms were not. These findings highlight the multifactorial nature of QoL impairment in vitiligo and the importance of incorporating both clinical and patient-reported features into the assessment of QoL beyond repigmentation-based treatment response.

Talquetamab, a bispecific antibody, has a high efficacy in multiple myeloma (MM), with common dermatologic adverse events. We aim to describe the real-world burden of cutaneous toxicities. A retrospective study of MM patients treated with talquetamab between March 2021 and February 2026. Demographic and clinical data were extracted from electronic health records. Cutaneous, nail, and mucosal toxicities attributed to talquetamab were recorded. Of 32 patients (mean age 61.4 years; 59.4% male), 28 (87.5%) developed cutaneous adverse events. A total of 87 dermatologic events were recorded. Most frequent manifestations were exanthema (37.5% of cutaneous events), xerosis (33.3%), and palmoplantar involvement (46.9% of patients). Nail toxicity affected 75% of the cohort, predominantly onychomadesis. Mucositis affected 34.4%, with a tendency to occur earlier compared with cutaneous and nail toxicities. Dermatologic evaluation was associated with therapeutic management of adverse events (95.8% vs. 69.9%, p = 0.0098). No patient required permanent talquetamab discontinuation due to mucocutaneous toxicity. Median time to resolution was 50 days. Talquetamab is associated with a high burden of mucocutaneous toxicity. Early dermatologic assessment enables accurate diagnosis and effective management. These findings expand the clinicopathological spectrum of talquetamab toxicity and highlight the importance of interdisciplinary care.

We aimed to measure anti-nuclear matrix protein 2 antibody (anti-NXP2) titers in patients with anti-NXP2-positive idiopathic inflammatory myopathies, investigate whether these titers are associated with clinical manifestations, malignancy risk, and treatment response, and compare the clinical and serological features between anti-NXP2-positive and anti-transcriptional intermediary factor 1-γ antibody (anti-TIF1-γ)-positive dermatomyositis in order to identify practical indicators for differentiating the two subsets. We established a newly optimized in-house enzyme-linked immunosorbent assay for the quantitative measurement of anti-NXP2. After excluding two of the 34 initially identified patients with anti-NXP2 antibody reactivity, we used the assay to analyse sera from 32 patients with anti-NXP2-positive idiopathic inflammatory myopathy. Clinical correlations between anti-NXP2 titers and inflammatory indices, cardiothoracic ratio, malignancy status, and longitudinal changes after immunosuppressive therapy were examined. We developed a novel clinical scoring system to differentiate between anti-NXP2-positive and anti-TIF1-γ-positive myositis. The anti-TIF1-γ-positive patients showed a higher frequency of classic dermatomyositis skin manifestations, whereas the anti-NXP2-positive patients had significantly higher creatine kinase, aldolase, and lactate dehydrogenase levels, indicating more prominent muscle involvement. Anti-NXP2 titers correlated with erythrocyte sedimentation rate and cardiothoracic ratio and were significantly higher in patients with malignancy in the anti-NXP2-positive idiopathic inflammatory myopathy patients. Longitudinal analyses demonstrated declines in antibody titers after immunosuppressive treatment. Our scoring system, incorporating age at onset, Gottron's sign, creatine kinase, lactate dehydrogenase, and malignancy status, highly accurately distinguished between anti-NXP2-positive and anti-TIF1-γ-positive myositis. Anti-NXP2 titers reflect systemic inflammation, cardiac involvement, and malignancy risk in anti-NXP2-positive idiopathic inflammatory myopathy. The observed decline in anti-NXP2 titers after therapy suggests the potential utility of these titers as biomarkers for longitudinal disease assessment and stratifying malignancy risk.