Anyone who invests their time in writing a scientific manuscript will want a decent chance of it being accepted for publication (Table I).1,2 We present practical tips to increase the chances of acceptance.

Eccrine porocarcinoma is a rare malignancy that clinically mimics other cutaneous malignancies.• Early histologic diagnosis is essential, as lymphatic metastasis is common and carries a 65% to 67% mortality rate.

To the Editor: Since the onset of the COVID-19 pandemic, >612 million cases of SARS-CoV-2 and over 6.5 million deaths have been reported. 12.6 billion vaccine doses have been administered worldwide, but we have not yet reached vaccine equity.1Mathieu E. Ritchie H. Rodés-Guirao L. et al.Coronavirus pandemic (COVID-19).https://ourworldindata.org/coronavirusDate: 2020Date accessed: November 1, 2022Google Scholar The spectrum of cutaneous findings of SARS-CoV-2 are associated with different COVID-19 severities, and in some cases can be the presenting, or only sign of infection. Characterizing cutaneous reactions to COVID-19 vaccination remains important, as booster doses are a key component to limiting COVID-19 related morbidity and mortality. In April 2020, in response to growing reports of SARS-CoV-2 cutaneous findings, the American Academy of Dermatology and the International League of Dermatological Societies COVID-19 Dermatology Registry was generated to rapidly collate SARS-CoV-2 associated dermatologic manifestations. In December 2020, the registry expanded to include COVID-19 vaccine-related reactions. Over 500 cases of SARS-CoV-2 cutaneous findings were submitted within 25 days of launch. As of September 2022, the registry has amassed 1436 reports of COVID-related and 1086 reports of vaccine–related dermatologic manifestations spanning 72 countries (Fig 1). The registry was designed in collaboration with a panel of experts in dermatology and infectious disease and hosted via REDCap's (Vanderbilt University) secure online survey platform. Data entry was restricted to healthcare providers for more accurate clinical and morphological data. Respondents were asked for case follow-up and biopsy results as available. Data requests are available for outside investigations via a data request application and reviewed by an appointed data governance group. The American Academy of Dermatology/International League of Dermatological Societies COVID-19 Dermatology Registry exemplifies collaborative efforts of the dermatologic community during the SARS-CoV-2 outbreak. Case entry led to 24 publications, including 111 authors across 19 different countries (Fig 2), and served as a training platform for 13 trainees. Registry publications led to >190 million media impressions, allowing for rapid dissemination of information to the medical field and the lay public. COVID–related dermatologic registries across the globe amassed over 8000 cases in total and contributed to data sharing across a spectrum of COVID-19 related dermatologic subjects.2Freeman E.E. Chamberlin G.C. McMahon D.E. et al.Dermatology COVID-19 registries: updates and future directions.Dermatol Clin. 2021; 39: 575-585Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar Registry data are useful specifically for hypothesis generation, not as a replacement for epidemiologic data, but as an initial method of rapid collation and harmonization of disparate real-world observations in times of novel disease outbreak when resources are low, but the need for data is high. Efficient data collection and dissemination functions as means of combatting misinformation and facilitating diagnosis in times of novel disease outbreaks. The registry will continue to gather information, particularly as the medical community continues to investigate Long COVID — its origins and impacts on the estimated millions it affects—and as vaccination and booster campaigns remain a key component in infection control.3Statistics NCfHLong COVID household pulse survey.https://www.cdc.gov/nchs/covid19/pulse/long-covid.htmDate: 2022Date accessed: November 3, 2022Google Scholar In response to World Health Organization's declaration of the spread of monkeypox (mpox) as a public health emergency, the registry expanded in August 2022, becoming the American Academy of Dermatology/International League of Dermatological Societies Dermatology COVID-19, Monkeypox (mpox), and Emerging Infections Registry.4Freeman E.E. Galvan Casas C. Prasad S. et al.The American Academy of Dermatology and International League of Dermatological Societies monkeypox registry: expanding the COVID-19 registry to emerging infections.J Am Acad Dermatol. 2022; 87: 1278-1280Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Reports of COVID-19, as well as mpox cases and cutaneous reactions to mpox/smallpox vaccines, are being accepted from healthcare providers worldwide (https://www.aad.org/monkeypoxregistry). Dr Freeman is the Principal Investigator of the AAD/ILDS Dermatology Registry for COVID-19, Monkeypox, and Emerging Infections. Dr Fox is a Board member of the AAD. Dr Lim is a Board member of the ILDS. Dr French is the President of the ILDS. Authors Strahan, Lubov, and Prasad; Dr McMahon; Author Singh; Drs Rosenbach, Desai, Thiers, and Hruza have no conflicts of interest to declare.

Introduction: Several types of immune checkpoint inhibitors (ICIs) are approved to treat advanced melanoma, but their effectiveness has not been compared in older patients treated outside of a clinical trial. Moreover, evidence suggests that a patient's response to ICI therapy may vary by age and type of ICI. The purpose of this study was to compare survival by ICI type in older patients with melanoma and to investigate treatment effect modification by age. Materials and Methods: Using the SEER-Medicare database, we identified patients with cutaneous melanoma (2012-2015) treated with an ICI (CTLA-4, PD-1, or combination CTLA-4 + PD-1 inhibitors). Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for ICI types. We used an interaction term and stratified models to test for treatment effect modification by age. Results: Of the 1435 patients included in our analysis, 790 (55.1%) received CTLA-4 inhibitors, 512 (35.7%) received PD-1 inhibitors, and 133 (9.3%) were treated with combination ICIs. Median survival ranged from 13.4 months (95%CI: 10.7-16.3) for CTLA-4 inhibitors to 23.5 months (95%CI: 16.2-30.0) for combination ICIs. In multivariable models, the risk of death was lower with PD-1 inhibitors compared to CTLA-4 inhibitors (HR = 0.78, 95%CI: 0.68-0.89). An age*ICI type interaction term was significant (p < 0.001), and survival gains were greater the older age group (>= 80) compared to the younger group (65-79). Discussion: In a population-based setting, we identified important differences in survival by ICI type in older patients with melanoma treated with ICIs, with prolonged survival associated with PD-1 inhibitors compared to CTLA-4 inhibitors.

Background: Cutaneous reactions after COV1D-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized. Methods: We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns. Results: Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym "V-REPP" (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5). Limitations: Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence. Conclusion: Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.

Journal of the European Academy of Dermatology and VenereologyVolume 36, Issue 1 p. e6-e9 Letter to the Editor Varicella-zoster and herpes simplex virus reactivation post-COVID-19 vaccination: a review of 40 cases in an International Dermatology Registry R.A. Fathy, R.A. Fathy Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorD.E. McMahon, D.E. McMahon orcid.org/0000-0002-3649-9208 Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorC. Lee, C. Lee Department of Dermatology, Las Vegas School of Medicine, University of Nevada, Las Vegas, NV, USASearch for more papers by this authorG.C. Chamberlin, G.C. Chamberlin Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorM. Rosenbach, M. Rosenbach Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorJ.B. Lipoff, J.B. Lipoff Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorA. Tyagi, A. Tyagi Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorS.R. Desai, S.R. Desai The University of Texas Southwestern Medical Center, Dallas, TX, USA Innovative Dermatology, Plano, TX, USASearch for more papers by this authorL.E. French, L.E. French Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USASearch for more papers by this authorH.W. Lim, H.W. Lim Department of Dermatology, Henry Ford Health System, Detroit, MI, USASearch for more papers by this authorB.H. Thiers, B.H. Thiers Department of Dermatology and Dermatologic Surgery, Medical University of SC, Charleston, SC, USASearch for more papers by this authorG.J. Hruza, G.J. Hruza Department of Dermatology, St. Louis University, St. Louis, MO, USASearch for more papers by this authorM. Fassett, M. Fassett Department of Dermatology, University of California San Francisco, San Francisco, CA, USASearch for more papers by this authorL.P. Fox, L.P. Fox Department of Dermatology, University of California San Francisco, San Francisco, CA, USASearch for more papers by this authorH.L. Greenberg, H.L. Greenberg Las Vegas Dermatology, Las Vegas, NV, USASearch for more papers by this authorK. Blumenthal, K. Blumenthal Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorE.E. Freeman, Corresponding Author E.E. Freeman [email protected] orcid.org/0000-0001-7751-9466 Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA *Correspondence: E. Freeman. E-mail: [email protected]Search for more papers by this author R.A. Fathy, R.A. Fathy Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorD.E. McMahon, D.E. McMahon orcid.org/0000-0002-3649-9208 Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorC. Lee, C. Lee Department of Dermatology, Las Vegas School of Medicine, University of Nevada, Las Vegas, NV, USASearch for more papers by this authorG.C. Chamberlin, G.C. Chamberlin Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorM. Rosenbach, M. Rosenbach Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorJ.B. Lipoff, J.B. Lipoff Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorA. Tyagi, A. Tyagi Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorS.R. Desai, S.R. Desai The University of Texas Southwestern Medical Center, Dallas, TX, USA Innovative Dermatology, Plano, TX, USASearch for more papers by this authorL.E. French, L.E. French Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USASearch for more papers by this authorH.W. Lim, H.W. Lim Department of Dermatology, Henry Ford Health System, Detroit, MI, USASearch for more papers by this authorB.H. Thiers, B.H. Thiers Department of Dermatology and Dermatologic Surgery, Medical University of SC, Charleston, SC, USASearch for more papers by this authorG.J. Hruza, G.J. Hruza Department of Dermatology, St. Louis University, St. Louis, MO, USASearch for more papers by this authorM. Fassett, M. Fassett Department of Dermatology, University of California San Francisco, San Francisco, CA, USASearch for more papers by this authorL.P. Fox, L.P. Fox Department of Dermatology, University of California San Francisco, San Francisco, CA, USASearch for more papers by this authorH.L. Greenberg, H.L. Greenberg Las Vegas Dermatology, Las Vegas, NV, USASearch for more papers by this authorK. Blumenthal, K. Blumenthal Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorE.E. Freeman, Corresponding Author E.E. Freeman [email protected] orcid.org/0000-0001-7751-9466 Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA *Correspondence: E. Freeman. E-mail: [email protected]Search for more papers by this author First published: 06 September 2021 https://doi.org/10.1111/jdv.17646Citations: 37Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1McMahon DE, Amerson E, Rosenbach M et al. Cutaneous reactions reported after moderna and pfizer COVID-19 vaccination: A Registry-Based Study of 414 Cases. J Am Acad Dermatol 2021. 10.1016/j.jaad.2021.03.092 Web of Science®Google Scholar 2Dooling K, Harpaz R, Radford K et al. The clinical and laboratory diagnosis of Herpes Zoster: how good is it? Open Forum Infectious Diseases. 2016; 3( suppl_1). Oxford University Press, p. 243. 10.1093/ofid/ofw172.110 Google Scholar 3Harbecke R, Oxman MN, Arnold BA et al. A real-time PCR assay to identify and discriminate among wild-type and vaccine strains of varicella-zoster virus and herpes simplex virus in clinical specimens, and comparison with the clinical diagnoses. J Med Virol 2009; 81(7): 1310–1322. 10.1002/jmv.21506 CASPubMedWeb of Science®Google Scholar 4Rodríguez-Jiménez P, Chicharro P, Cabrera LM et al. Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: Report of 5 cases. J Am Acad Dermatol Case Rep 2021; 12: 58–59. Google Scholar 5Lee C, Cotter D, Basa J, Greenberg HL. Post COVID-19 vaccine related shingles cases seen at the Las Vegas dermatology clinic and sent to us via social media. J Cosmet Dermatol 2021; 20, 1960–1964. 10.1111/jocd.14210 PubMedWeb of Science®Google Scholar 6Furer V, Zisman D, Kibari A, Rimar D, Paran Y, Elkayam O. Herpes zoster following BNT162b2 mRNA COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: a case series. Rheumatology 2021. doi: 10.1093/rheumatology/keab345 10.1093/rheumatology/keab345 Web of Science®Google Scholar 7Alpalhão M, Filipe P. Herpes Zoster following SARS-CoV-2 vaccination–a series of 4 cases. J Eur Acad Dermatol Venereol 2021. 10.1111/jdv.17555 PubMedWeb of Science®Google Scholar 8Walter R, Hartmann K, Fleisch F, Reinhart WH, Kuhn M. Reactivation of herpesvirus infections after vaccinations? Lancet 1999; 353(9155): 810. 10.1016/S0140-6736(99)00623-6 CASPubMedWeb of Science®Google Scholar 9Blumenthal KG, Saff RR, Freeman EE. Delayed large local reactions to mRNA Vaccines. Reply. N Engl J Med 2021; 384(24): e98. 10.1056/NEJMc2104751 PubMedWeb of Science®Google Scholar 10Siddiqui MS, Hasnain N. Varicella-Zoster Virus Reactivation amid the COVID-19 pandemic-Do we need to be vigilant? A mini review. J Clin Med Kaz 2020; 6(60): 40–43. 10.23950/jcmk/9267 Google Scholar Citing Literature Volume36, Issue1January 2022Pages e6-e9 This article also appears in:JEADV COVID-19 articles ReferencesRelatedInformation

Introduction: Immune checkpoint inhibitors (ICIs) have dramatically changed the treatment landscape for advanced melanoma, but their use in older patients remains understudied. An age-related decline in immune function is of concern when treating older patients because host immune factors can influence clinical outcomes with immunotherapy. Therefore, we aimed to evaluate the effectiveness of ICIs in patients 65 years and older. Methods: Using the SEER-Medicare data, we evaluated survival by first systemic treatment type in a retrospective cohort study of patients aged 65 years and older who were diagnosed with stage IV cutaneous melanoma between 2012 and 2015. Cox proportional hazards regression was used to estimate hazard ratios (HR) and their corresponding 95% confidence intervals. Results: A total of 541 patients were included in this study. Median survival differed significantly between groups (p < 0.0001) and was longest in patients treated with PD-1 inhibitors (34.0 months), followed by CTLA-4 inhibitors (16.8 months), targeted therapy (9.7 months), chemotherapy (7.1 months), and no systemic therapy (3.6 months). The ICI survival benefit persisted after adjusting for age, sex, comorbidities, M stage, the presence of brain metastases, and evaluation at an NCI-designated cancer center. Hazard ratios comparing ICIs to no systemic therapy were 0.35 (95% CI: 0.24-0.52) for PD-1 inhibitors and 0.48 (95% CI: 0.37-0.63) for CTLA-4 inhibitors. We did not observe a difference in ICI effectiveness by age group (65-74 vs >= 75). Conclusions: In a nationally representative cohort of patients with advanced melanoma, ICI therapy delivered in a real world setting significantly improved survival in patients aged 65 years and older. (c) 2020 Elsevier Ltd. All rights reserved.

BACKGROUND:Cutaneous reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but are not well characterized. OBJECTIVE:To evaluate the morphology and timing of cutaneous reactions after mRNA COVID-19 vaccines. METHODS:A provider-facing registry-based study collected cases of cutaneous manifestations after COVID-19 vaccination. RESULTS:From December 2020 to February 2021, we recorded 414 cutaneous reactions to mRNA COVID-19 vaccines from Moderna (83%) and Pfizer (17%). Delayed large local reactions were most common, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. Forty-three percent of patients with first-dose reactions experienced second-dose recurrence. Additional less common reactions included pernio/chilblains, cosmetic filler reactions, zoster, herpes simplex flares, and pityriasis rosea-like reactions. LIMITATIONS:Registry analysis does not measure incidence. Morphologic misclassification is possible. CONCLUSIONS:We report a spectrum of cutaneous reactions after mRNA COVID-19 vaccines. We observed some dermatologic reactions to Moderna and Pfizer vaccines that mimicked SARS-CoV-2 infection itself, such as pernio/chilblains. Most patients with first-dose reactions did not have a second-dose reaction and serious adverse events did not develop in any of the patients in the registry after the first or second dose. Our data support that cutaneous reactions to COVID-19 vaccination are generally minor and self-limited, and should not discourage vaccination.

BACKGROUND:Sebaceous carcinoma (SC) of the eyelid is a rare, aggressive malignancy associated with high rates of recurrence, metastasis, and tumor-related mortality.OBJECTIVE:Provide a collective analysis of clinical presentations, management techniques, and outcomes, and compare outcomes of common treatment methods.METHODS AND MATERIALS:Observational studies reporting management and outcomes of SC of the eyelid were included. Patient and clinical data were extracted, and meta-analysis of proportions was performed.RESULTS:One thousand three hundred thirty-three subjects were included with a mean age of 65.2 years and 803 (60.2%) women. Of 647 initial diagnoses reported, 277 (42.8%) were correct, and the mean diagnostic delay was 14.7 months (range 8.5-34.8). The tumor location was reported in 1,246 subjects and involved the upper eyelid in 780 (62.6%), lower eyelid in 409 (32.8%), and 57 (4.8%) involved both. Overall rates of recurrence, metastasis, and tumor-related mortality were 15.9%, 12.1%, and 6.2%, respectively. There were no statistically significant differences in wide local excision (WLE) versus Mohs micrographic surgery (MMS) outcomes.CONCLUSION:Sebaceous carcinoma of the eyelid is more common in women, on the upper eyelid, and is frequently misdiagnosed initially. Rate of recurrence, metastasis, and tumor-related mortality were similar in subjects managed with WLE versus MMS.

There have been increasing reports of dermatologic manifestations of COVID-19. The first case series of dermatologic manifestations included 18 Italian patients with erythematous, urticarial, and vesicular rashes, often on the trunk.1 Other reports include drug hypersensitivity,2 urticaria,2 a petechial rash mimicking dengue,3 and acro-ischemia.4

Even though the fatality rate from skin cancers is low, evidence from a few cohort studies has raised the possibility that people with a personal history of skin cancer may have a higher all-cause mortality rate compared with those without a personal history of skin cancer. The purpose of the present study was to investigate the potential links between a personal history or family history of skin cancer and all-cause and cancer-specific mortality A prospective cohort (n = 8,622) was assembled within the NHANES I follow-up study. Cox Proportional Hazard Regression analysis was used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association for personal and family history of skin cancer and all-cause and cancer-specific mortality. After adjustment for several potential confounding variables, a personal history of skin cancer was associated with decreased risk for all-cause mortality (HR 0.72, 95% CI 0.61–0.85), whereas the results for cancer-specific mortality were consistent with a null association (HR 0.97, 95% CI 0.74–1.27). A family history of skin cancer was not significantly associated with all-cause mortality (HR 0.97, 95% CI 0.76–1.24) or cancer-specific mortality (HR 0.69, 95% CI 0.38–1.24). The results of the present study do not support the hypothesis that a personal history or family history of skin cancer is associated with an increased risk of all-cause or cancer-specific mortality. The high prevalence of skin cancer adds to the public health significance of this question, providing a strong rationale for further research to resolve this question.

Background: Increasing evidence suggests pernio-like lesions are cutaneous manifestations of coronavirus infectious disease 2019 (COVID-19). Objective: To describe clinical and pathologic findings of pernio-like lesions in patients with confirmed or suspected COVID-19. Methods: An international dermatology registry was circulated to health care providers worldwide through the American Academy of Dermatology, International League of Dermatologic Societies, and other organizations. Results: We documented 505 patients with dermatologic manifestations associated with COVID-19, including 318 (63%) with pernio-like lesions. Patients with pernio-like lesions were generally young and healthy, with relatively mild COVID-19. Of 318 patients with confirmed or suspected COVID-19 by providers, 23 (7%) were laboratory-confirmed COVID-19 positive, and 20 others (6%) were close contacts of patients with confirmed COVID-19. Given current testing criteria, many patients lacked COVID-19 testing access. For 55% of patients, pernio-like lesions were their only symptom. In patients with other COVID-19 symptoms, pernio-like lesions typically appeared after other symptoms. Pernio-like lesions lasted a median of 14 days (interquartile range, 10-21 days). Limitations: A case series cannot estimate population-level incidence or prevalence. In addition, there may be confirmation bias in reporting. We cannot exclude an epiphenomenon. Conclusions: Pernio-like skin changes of the feet and hands, without another explanation, may suggest COVID-19 infection and should prompt confirmatory testing.

ObjectiveThe risk of cardiovascular disease (CVD) is higher in patients with psoriatic arthritis (PsA) compared to the general population. Tofacitinib is an oral Janus kinase inhibitor for the treatment of PsA. Because tofacitinib increases circulating lipid levels in some patients, we evaluated CVD risk factors and major adverse cardiovascular events (MACE) in patients with active PsA receiving tofacitinib 5 or 10 mg twice daily plus conventional synthetic disease‐modifying antirheumatic drugs.MethodsData were pooled from 2 phase III studies (Efficacy and Safety of Tofacitinib in Psoriatic Arthritis [OPAL Broaden] and Tofacitinib in Patients with Psoriatic Arthritis With Inadequate Response to TNF Inhibitors [OPAL Beyond]) and 1 ongoing long‐term extension (Open‐Label Extension Study of Tofacitinib in Psoriatic Arthritis [OPAL Balance], data cutoff January 2017; database not locked). Outcomes included fasting lipid levels, blood pressure, hypertension‐related adverse events (AEs; including hypertension, high blood pressure, and increased blood pressure), and MACE.ResultsOverall, 783 tofacitinib‐treated patients were included. Percentage increases from baseline in low‐density lipoprotein cholesterol (LDL‐c) and high‐density lipoprotein cholesterol (HDL‐c) levels ranged from 9% to 14% for tofacitinib 5 mg and 10 mg at 3 and 6 months; no meaningful changes in LDL‐c:HDL‐c or total cholesterol:HDL‐c ratios were observed. Blood pressure remained stable for 24 months. Fifty‐eight patients (7.4%) had hypertension‐related AEs; none were fatal (incidence rate [IR] per 100 patient‐years 4.81 [95% confidence interval (95% CI) 3.65–6.22]). Five patients (0.6%) had MACE (IR 0.24 [95% CI 0.05–0.70]); 2 were fatal.ConclusionSerum lipid level increases at month 3 following tofacitinib treatment in PsA were consistent with observations in rheumatoid arthritis and psoriasis. The IR of hypertension‐related AEs and MACE was low; long‐term follow‐up is ongoing.

Richard Lawrence Dobson, MD, an icon of dermatology in the late 20th century, passed away on February 16, 2019, at the age of 90 (Fig 1). During his long and illustrious career, he served as president of the Society for Investigative Dermatology (1976-1977), the American Academy of Dermatology (1983-1984), and the American Board of Dermatology (1988-1989). He was one of the founders of the Journal of the American Academy of Dermatology and served as its second editor (1988-1998).

PURPOSE:Skin cancer has repeatedly been observed to be a marker of increased risk for developing an internal malignancy. The purpose of our study was to further investigate this association while also characterizing the potential role of family history of skin cancer in relation to risk for non-cutaneous malignancies.METHODS:Our study used data from 8,408 participants from the NHANES I epidemiological follow-up study. Cox-proportional hazards models were used to estimate the risk for developing an internal cancer associated with a personal history and family history of skin cancer during follow-up.RESULTS:A personal history of skin cancer was associated with significantly increased risk of developing an internal cancer in adjusted models [hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.09-1.61] but a family history of skin cancer was not associated with increased risk (HR 0.80, 95% CI 0.58-1.11).CONCLUSIONS:Consistent with prior reports, a personal history of skin cancer was associated with increase of developing internal malignancies, but this did not hold true for a family history of skin cancer. Further research is needed to understand why a personal history of skin cancer acts as a marker for increased risk for internal cancer.

Background/Aim: Keratinocyte carcinoma (KC) is a marker of increased risk of other cancer types. To assess if this association exhibits a dose-response relationship, a case-control study was carried out. Patients and Methods: This was a clinic-based study of cases with KC plus another type of cancer matched by age, race (all Caucasian), sex and histologic type to controls with KC only (n=48 matched pairs). Results: Compared with the KC only group, those with KC plus another cancer had a mean number of lesions that were 43%, 35%, and 41% greater for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and total KC, respectively. The odds ratio (OR) of developing another type of cancer increased from 1.0 to 1.09 (95% confidence interval (CI)=0.23-5.13) to 2.12 (95%CI=0.50-9.08) according to whether the patient had zero, one, or ≥two BCC lesions; for SCC, the corresponding ORs were 1.0, 1.24 (95%CI=0.48-3.24), and 1.39 (95%CI=0.29-6.61). Conclusion: A dose-response relationship seems to exist between the number of skin lesions and the risk of another type of cancer, but the lack of statistical significance weakens this evidence.

Background Cardiovascular (CV) disease and cardiometabolic syndrome are common comorbidities/causes of mortality in patients (pts) with psoriatic arthritis (PsA). Tofacitinib is an oral JAK inhibitor for the treatment of PsA. Objectives To investigate changes in lipid levels and incidence of CV events in pts with PsA treated with tofacitinib in Phase (P) 3 and long-term extension (LTE) studies. Methods Data were analysed for pts who received ≥1 dose of tofacitinib 5 or 10 mg BID or placebo (PBO), integrated across 2 P3 studies (OPAL Broaden [12 months (m); NCT01877668, including adalimumab control]; OPAL Beyond [6 m; NCT01882439]) and 1 LTE study (OPAL Balance [data cut-off May 2016; ongoing, database not locked; NCT01976364]). Lipid levels were assessed throughout P3 and LTE studies; this analysis included data from the PBO-controlled period (M0–3) of P3 studies. Blood pressure, hypertension events (standardised MedDRA query [narrow]) and adjudicated (independent/blinded to treatment) major adverse cardiovascular events (MACE) are reported for all pts who received ≥1 dose of tofacitinib (pooled across doses for hypertension and MACE). Incidence rates (IR; pts with events/100 pt-years [PY]) and 95% CI are reported. Results Overall, 783 pts (776 PY of tofacitinib exposure) were included in P3 and LTE studies; treatment duration was 1–927 days. After 3 m of tofacitinib treatment in P3 studies, dose-dependent increases in lipid levels were observed with tofacitinib; minimal changes were observed with PBO, except for triglycerides (figure 1). Concurrent increases in high-density and low-density lipoprotein (HDL/LDL) and no change in the total cholesterol/HDL ratio were shown. Across P3 and LTE studies, no clinically significant changes in mean systolic or diastolic blood pressure were seen to 24 m. Hypertension events were reported in 38 (4.9%) pts: IR 4.93 [95% CI 3.49, 6.77]. Of these events, 4 led to pt discontinuation and 2 were serious adverse events. MACE were reported for 3 (0.4%) pts receiving tofacitinib (IR 0.38 [95% CI 0.08, 1.11]) and included sudden cardiac death (57 days of exposure at time of event), myocardial infarction (197 days) and ischaemic stroke (80 days). This is within the range reported in tofacitinib studies in pts with psoriasis (IR 0.24 [0.15, 0.37]; 8,759 PY of exposure) and rheumatoid arthritis (RA) (IR 0.38 [0.30, 0.47]; 21,286 PY of exposure). No dose-dependent effects on blood pressure were apparent. Conclusions In pts with PsA, the magnitude and dose dependency of increases in lipid levels to M3 were consistent with findings in tofacitinib studies in pts with psoriasis and RA. In P3 and LTE studies, no clinically significant changes were seen in blood pressure or incidence of hypertension. Incidence of MACE was within the range reported in prior tofacitinib studies in psoriasis and RA; however, the long latency of MACE requires longer-term observation. Acknowledgements Study sponsored by Pfizer Inc. Medical writing support was provided by A MacLachlan of CMC and funded by Pfizer Inc. Disclosure of Interest D. Gladman Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, Consultant for: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, C. Charles-Schoeman Grant/research support from: AbbVie, Bristol-Myers Squibb, Pfizer Inc, Consultant for: Amgen, Gilead, Pfizer Inc, Regeneron-Sanofi, I. McInnes Grant/research support from: Celgene, Janssen, Novartis, Pfizer Inc, Roche, UCB, Consultant for: AbbVie, Celgene, Janssen, Novartis, Pfizer Inc, Roche, UCB, D. Veale Grant/research support from: AbbVie, Actelion, Bristol-Myers Squibb, Janssen, MSD, Novartis, Pfizer Inc, Roche, UCB, Speakers bureau: AbbVie, Actelion, Bristol-Myers Squibb, Janssen, MSD, Novartis, Pfizer Inc, Roche, UCB, B. Thiers Consultant for: Pfizer Inc, Valeant Pharmaceuticals, D. Graham Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, C. Wang Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, T. Jones Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, R. Wolk Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, R. DeMasi Shareholder of: Pfizer Inc, Employee of: Pfizer Inc

I am excited to announce that our Academy's Board of Directors has appointed Dirk M. Elston, MD, as the next Editor of the Journal of the American Academy of Dermatology (JAAD), for a term beginning July 2018. Dr Elston has ably served JAAD as its Deputy Editor since July 2008 and has been instrumental in its success over the past 10 years.