Atypical moles are melanocytic lesions that clinically present with asymmetry, border irregularity, color variegation, or diameter 6 mm or greater. They are more common in patients with fair skin and high cumulative sun exposure. High mole density (more than 100) and presence of atypical moles are associated with increased risk of melanoma and should prompt periodic, systematic skin examinations. The US Preventive Services Task Force recommends patient or parent counseling for individuals with fair skin who are 6 months to 24 years of age on sun protection to reduce skin cancer risk and selective counseling for adults older than 24 years with fair skin and certain risk factors. To distinguish benign moles from melanoma, clinicians should use the ugly duckling assessment and ABCDE (asymmetry, border irregularity, color unevenness, diameter 6 mm or greater, evolution) mnemonic during clinical examination, incorporating dermoscopy if appropriately trained. Biopsy is sometimes necessary to exclude melanoma. Excisional biopsy should include 1- to 3-mm circumferential margins and sufficient depth. Postbiopsy management is guided by the degree of histopathologic atypia determined by the dermatopathologist, margin involvement, and patient risk factors.

Partial hydatidiform mole (PHM) is a rare pathological subtype of gestational trophoblastic disease (GTD). Tubal pregnancy complicated with PHM is an extremely rare clinical condition with atypical preoperative manifestations, which easily leads to clinical misdiagnosis. Definitive diagnosis primarily relies on intraoperative exploration combined with postoperative histopathological and immunohistochemical verification. This study reports a case of tubal PHM in a 31-year-old nulliparous female presenting with 54 days of amenorrhea and persistent lower abdominal distending pain. Preoperative examinations revealed markedly elevated serum β-human chorionic gonadotropin (β-hCG) levels and a unilateral adnexal mixed mass. The patient underwent emergency laparoscopic left salpingectomy, and the final diagnosis of tubal PHM was confirmed by postoperative pathological examination. The patient achieved uneventful postoperative recovery, with serum β-hCG declining steadily in a logarithmic pattern and no metastatic lesions identified during follow-up. This article systematically elaborates the clinical manifestations, pathological features, diagnostic challenges, individualized treatment strategies, and standardized follow-up principles of tubal PHM, aiming to improve clinicians' awareness of differential diagnosis and standardized management of this rare disease, and provide a credible clinical reference for the diagnosis and treatment of rare ectopic gestational trophoblastic lesions.

Patients with genodermatoses, such as nevoid basal cell carcinoma syndrome, recessive dystrophic epidermolysis bullosa, familial atypical multiple mole and melanoma syndrome, xeroderma pigmentosum and ichthyosis with confetti, face a high risk of skin malignancies. While dermoscopy significantly improves diagnostic accuracy compared to clinical examination, its specificity remains limited when evaluating ambiguous lesions in these complex patients. This narrative review examines the role of reflectance confocal microscopy and line-field confocal optical coherence tomography in high-risk populations. By enabling the in vivo visualization of histologic-like features at cellular resolution, these noninvasive imaging technologies overcome the limitations of dermoscopy. The analysis of illustrative cases demonstrates that integrating these tools enhances both sensitivity and specificity, allowing for a precise differentiation between true malignancies and benign mimics. While reflectance confocal microscopy remains the standard for melanocytic criteria, line-field confocal optical coherence tomography complements it by overcoming depth limitations. Consequently, the use of combined noninvasive imaging supports a more conservative management strategy, potentially reducing the number of unnecessary excisions while ensuring the timely detection of skin cancer in patients with rare genetic syndromes.

Background: Germline CDKN2A variants are associated with Familial Atypical Mole-Malignant Melanoma (FAMMM) syndrome. This syndrome involves an increased risk of melanoma, pancreatic cancer, and, in specific populations, duodenal cancer, breast cancer, and astrocytoma. The CDKN2A (c.146T>C) variant has been found in hereditary cancer patients within the Mexican population. Furthermore, the phenotype linked to this variant in Mexico differs from that observed in other groups. This study aims to evaluate the founder effect of the CDKN2A (c.146T>C) variant through epidemiological analysis and to describe the phenotype within our population. Patients and Methods: We examined 72 Mexican patients (14 probands from distinct families, 48 relatives, and 10 nonrelated probands) carrying the CDKN2A (c.146T>C) form three hereditary cancer centers between September 2023 and September 2025. Results: Of the 72 individuals analyzed, 52 (72.22%) tested positive. A cancer diagnosis was established in 27 (37.50%) of the individuals analyzed. Breast cancer was the most common neoplasia, accounting for 19 cases (70.37%), followed by melanoma with 4 cases (14.81%) and ovarian cancer with 2 cases (7.40%). Three patients (11.11%) had two distinct primary neoplasms. Conclusions: Based on our findings and the fact that this variant has been reported nearly exclusively in the Mexican population, we conclude that it has a founder effect in this population. Additionally, the phenotype associated with this variant can vary among populations, with breast cancer being the most common carcinoma rather than melanoma among Mexican carriers, highlighting the importance of updating screening guidelines.

This article highlights current advances in melanocytic lesions and their impact on histopathologic diagnosis and patient management. Special emphasis is given to the concept of melanocytoma and the study of dysplastic nevi. Finally, the article describes the current status and possible future applications of immunohistochemistry, digital analysis, and artificial/augmented intelligence.

A pair of dizygotic (DZ) twins discordant for Turner syndrome are discussed with reference to the biological origins of the condition and the effects of discordance on the twin relationship. There is little research on how having an atypical twin influences the life events and goals of the typical twin. Next, timely reviews of research on preventing premature twin birth, a twin gestation with hydatidiform mole, an update on Feingold syndrome twins discussed in a previous issue of this journal, and qualitative monozygotic twin difference studies are presented. The final portion of this article covers human interest stories of twins that are variously entertaining and enlightening. They include identical twins who celebrated their 100th birthday together, twins in famous families, celebration of the Yorùbá twins of Nigeria, identical artistic partners, and surgical separation of a rare, conjoined twin set.