ABSTRACT Background Amelanotic melanoma (AM) is a subset of melanoma with little to no pigment that can masquerade as a benign condition, and is associated with delayed diagnosis, greater Breslow depth, higher tumour stage, and lower survival than pigmented melanoma. Objectives To evaluate the impact of an educational video on patients’ ability and confidence to identify AM. Methods In this single‐centre pre‐/post‐intervention survey, 107 patients at the UT Southwestern dermatology clinics (August 2022–July 2023) completed a survey and knowledge quiz on three melanomas, two benign nevi, and one AM, validated by two dermatologists. They identified each photo as 'benign mole' or 'melanoma'. Participants then viewed an instructional video and repeated the quiz. Data were analysed with paired t‐tests and McNemar tests, with exploratory Firth‐penalised multivariable logistic regression of demographic predictors. Results Most participants self‐identified as female (61.68%), aged 55–74 years (56.08%), and non‐Hispanic white (96.26%). After the video, average confidence improved by 1.06 points (95% CI, 0.90–1.22; p < 0.0001) on a 5‐point scale and average correct identifications increased by 0.76 points (95% CI, 0.56–0.96; p < 0.0001). Correct AM identification rose from 52.34% ( n = 56; 95% CI, 43.0–61.6) to 95.33% ( n = 102; 95% CI, 89.5–98.0; < 0.0001). No demographic factor independently predicted post‐video correct identification of AM. Limitations This single‐group study lacked a control group and reused the same images before and after the video, so improvement may reflect familiarity rather than new recognition skill. Participants were drawn from a single, older, non‐Hispanic white clinic population, and the exploratory demographic subgroup analysis was underpowered. Conclusions An educational video was associated with substantial short‐term improvement in patients’ confidence and accuracy in identifying AM.
ABSTRACT We report typical cases of biopsy confirmed granuloma annulare occurring on irradiated skin in the context of breast cancer in three women in their seventies. The lesions appeared immediately after start of irradiation in one patient, 4 and 15 months after the end of radiation treatment in the other two. The lesions eventually spread elsewhere on the body in two patients. Similar to morphea, which is a well‐known side effect of irradiation, we believe that radiotherapy can induce tissue damage, leading to dermal inflammation ultimately responsible for the emergence of granuloma annulare.
ABSTRACT Background Cutaneous T‐cell lymphoma (CTCL) is a rare and heterogeneous group of skin‐homing lymphomas with a largely unknown pathogenesis. Staphylococcus aureus (S. aureus) colonization has been implicated in exacerbating CTCL, particularly in advanced stages. Objectives This study assessed the prevalence of S. aureus colonization in CTCL through a systematic review and meta‐analysis, exploring the association with disease stage and evaluating the effect of antibiotic therapy. Methods We conducted a systematic review and meta‐analysis according to the PRISMA guidelines. The databases PubMed, Embase, Cochrane Library and Web of Science were searched in April 2024. Studies containing data on the association between S. aureus and CTCL were included. We calculated the pooled point prevalence of S. aureus and MRSA and the odds ratio (OR) of infection and disease stage. Secondary, the occurrence of colonization in lesional versus non‐lesional skin and effects of decolonization with antibiotics were reviewed. Results Thirteen studies were included. The pooled point prevalence of S. aureus and MRSA was 39.84% (26.72%–54.61%, I2 = 93%, p < 0.01) and 30.43% (9.38%–64.88%, I2 = 81%, p < 0.01). The pooled point OR of systemic bacterial infection and disease‐stage was estimated to 1.36 (0.74; 2.522, I2 = 20%, p = 0.29). Furthermore, a higher abundance of S. aureus was found in lesional skin compared to non‐lesional skin and a partial or complete response in body surface area (BSA) was observed after antibiotic‐induced eradication of culture‐proven S. aureus colonization. Conclusions S. aureus colonization is common in CTCL patients, with increased presence in lesional skin. Despite no significant association between infection and disease stage, there was a tendency for higher occurrence of S. aureus in lesional skin. Antibiotic therapy may reduce disease activity, but the temporary effects of antibiotics and the rising challenge of MRSA emphasize the need for non‐antibiotic treatment approaches to manage CTCL effectively. Trial Registration: PROSPERO ID: CRD42024535240.
ABSTRACT Background Mycoplasma genitalium is a sexually transmitted infection (STI) linked to urogenital symptoms, pelvic inflammatory disease, and infertility in females. However, in accordance with British Association for Sexual Health and HIV (BASHH) guidelines, it is not routinely included in STI screening panels for asymptomatic individuals attending the genitourinary clinic due to limited evidence on the utility. Objectives The aim of the study is to calculate the prevalence and risk factors for M. genitalium infection in asymptomatic patients attending the genitourinary clinic in the Isle of Man in order to determine a high‐risk population which may benefit from screening. Methods Asymptomatic individuals attending the genitourinary clinic in the Isle of Man were identified and recruited following the completion of a routine clinic questionnaire. Self‐taken vaginal swabs or first‐void urinary samples were tested using an Aptima assay, which uses transcription‐mediated amplification. Risk factors for the infection were assessed by analysing clinician‐completed histories detailing demographics and clinical characteristics. Results The total number of participants was 251 with 100% retention. The prevalence of infection was 4.38% (11/251; 95% binomial CI 2.21%–7.71%), with a higher rate of infection in those aged 30 year and younger (prevalence 7.14% (10/140; binomial 95% CI 3.48%–12.74%). Non‐statistically significant associations included female gender and non‐British ethnicity. Conclusions The prevalence of M. genitalium in asymptomatic individuals attending the genitourinary clinic is significant. M. genitalium testing those aged <= 30 years, attending genitourinary clinics using a robust assay, would be justified in this population.
ABSTRACT Background Vitiligo is an autoimmune disorder characterized by CD8+ T cell‐mediated melanocyte destruction and a pro‐inflammatory immune milieu. Despite frequent use of ultraviolet‐based phototherapy, emerging evidence suggests that vitiligo may paradoxically confer a reduced risk of skin cancer. Clarifying this association may provide insight into tumor immune surveillance and inform risk assessment in patients with vitiligo. Objectives To evaluate the association between vitiligo and the risk of melanoma and non‐melanoma skin cancers (NMSC), and to assess the potential impact of phototherapy exposure on skin cancer risk. Methods A PRISMA‐compliant systematic review and meta‐analysis searched PubMed, Scopus, Embase, and ClinicalTrials.gov through January 2026 for studies comparing skin cancer incidence in patients with vitiligo versus controls. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using Hartung‐Knapp random‐effects models, with assessment of heterogeneity and publication bias. Results Fourteen studies were included (454,307 vitiligo patients; 3,583,147 controls), of which nine were eligible for meta‐analysis. Vitiligo was associated with lower odds of melanoma (OR 0.43; 95% CI, 0.16–1.13), with consistent inverse associations across sensitivity analyses. A similar inverse trend was observed for NMSC overall (OR 0.29; 95% CI, 0.06–1.49). Squamous cell carcinoma risk was significantly reduced (OR 0.76; 95% CI 0.57–0.99; p = 0.045), while basal cell carcinoma showed a non‐significant inverse association (OR 0.54; 95% CI, 0.26–1.11). Phototherapy exposure was associated with higher point estimates for melanoma (OR 1.87; 95% CI 0.53–6.54) and NMSC (OR 1.46; 95% CI, 0.37–5.69), although neither association reached statistical significance. Funnel plots and Egger's testing did not detect publication bias. Conclusions Vitiligo was associated with lower odds of melanoma and NMSC, with a statistically significant reduction for squamous cell carcinoma. Phototherapy exposure showed higher but non‐significant point estimates. These findings provide a benchmark for baseline cancer risk in vitiligo and may inform safety monitoring of phototherapy and emerging immunomodulatory therapies. PROSPERO number: CRD42024619708.
