Early diagnosis is essential for completely eradicating skin cancer and maximizing patients’ clinical benefits. Emerging optical imaging modalities such as reflectance confocal microscopy (RCM), optical coherence tomography (OCT), magnetic resonance imaging (MRI), near-infrared (NIR) bioimaging, positron emission tomography (PET), and their combinations provide non-invasive imaging data that may help in the early detection of cutaneous tumors and surgical planning. Hence, they seem appropriate for observing dynamic processes such as blood flow, immune cell activation, and tumor energy metabolism, which may be relevant for disease evolution. This review discusses the latest technological and methodological advances in imaging techniques that may be applied for skin cancer detection and monitoring. In the first instance, we will describe the principle and prospective clinical applications of the most commonly used imaging techniques, highlighting the challenges and opportunities of their implementation in the clinical setting. We will also highlight how imaging techniques may complement the molecular and histological approaches in sharpening the non-invasive skin characterization, laying the ground for more personalized approaches in skin cancer patients.

The skin is a complex organ that includes a wide variety of tissue types with different embryological origins

Promotes the activation of proinflammatory and prothrombotic pathways, contributing to disease progression [52,53]. The summarized in vivo studies suggest that low dose proteasome inhibitors may alleviate the clinical manifestations of APS by reducing inflammatory mediators [54,55]. These results indicate that targeting the UPS could represent a novel therapeutic strategy for controlling the inflammatory and thrombotic processes associated with this condition.Expanding the scope of autoimmune interactions, Duan et al. employed bidirectional Mendelian Randomization to elucidate causal relationships between psoriasis, psoriatic arthritis, and multiple autoimmune diseases, including systemic lupus erythematosus (SLE), Crohn's disease (CD), Hashimoto's thyroiditis (HT), rheumatoid arthritis (RA), vitiligo, and ankylosing spondylitis (AS). Their analysis revealed that CD and vitiligo increase the risk of developing psoriasis (PsO), whereas bullous pemphigoid appears to reduce it. For PsA, risk factors extended to CD, HT, RA, AS, SLE, and vitiligo. These results underscore the interconnectivity of autoimmune disorders and highlight the importance of careful monitoring for disease progression, particularly in patients presenting with coexisting autoimmune conditions. The study exemplifies how genetic epidemiology can contribute to risk stratification and early intervention strategies, guiding personalized patient management.Proteome-wide analyses complement genetic studies by identifying causal proteins that may serve as biomarkers or therapeutic targets. Similarly, in AS, a chronic immune-mediated arthritis with a not fully understood pathogenesis, primarily affecting the axial joints [56][57][58], Zhao et al. identified eight plasma proteins causally associated with disease risk, including AIF1, TNF, FKBPL, AGER, ALDH5A1, and ACOT13.Colocalization analyses confirmed these as shared causal variants, while phenome-wide assessments highlighted potential adverse effects, offering guidance for drug development.Together, these studies illustrate the power of multi-omics approaches to unravel the molecular mechanisms underlying autoimmune diseases and to support the design of targeted therapies.The role of the microbiome is emerging as a critical modifier of autoimmune pathogenesis [59][60][61][62][63][64][65][66] Coupled with mechanistic and molecular insights from the other studies, such platforms can accelerate translational research, bridging the gap between bench and bedside.Collectively, these contributions highlight a unifying theme: autoimmunity is a multidimensional process shaped by immune dysregulation, genetic predisposition, proteomic signatures, microbial interactions, and systemic consequences. Across RA, PsA, PsO, AS, and APS, the studies underscore the importance of integrating molecular, microbiological, and clinical data to contribute to risk stratification, biomarker discovery, and targeted interventions.The convergence of genetic epidemiology, proteomics, microbiome research, and advanced modelling technologies emphasize autoimmune disease not as a single organ pathology but as a networked, systemic phenomenon. Furthermore, the research presented in this issue emphasizes translational and clinical implications. Targeted immunotherapies, such as lowdose IL-2 in D2T RA, demonstrate the potential to restore immune balance with precision.Proteomic analyses identify actionable biomarkers and druggable targets in PsA and AS, paving the way for personalized therapeutics. Microbiota interventions illustrate the potential for disease prevention or modulation of progression, while organ-on-a-chip platforms provide realistic preclinical models to optimize drug development and predict adverse effects. Together, these advances signify a paradigm shift toward integrated, precision medicine approaches in autoimmune disease management.Lupus is another chronic autoimmune disease presented in our special issue. It is characterized by dysregulated immune responses leading to inflammation and immune-mediated injury that may affect various organs [67][68][69]. There are 4 original papers dedicated to lupus. Serological profile of Systemic Lupus Erythematosus (SLE) was explored by Nicola et al. and Anti-dsDNA antibodies were found to be statistically significant for both malar rash and proteinuria; anti-Ro/SSA antibodies showed an association with photosensitivity and pericarditis; additionally, association was found between anti-Ro antibodies and proteinuria, but only if anti-dsDNA antibodies were present as well. A similar study focusing on another circulatory marker, Mycinduced nuclear antigen (Mina) 53 The analysis of 26 publications revealed a lack of consensus regarding markers and criteria for assessing immune resolution but identified associations between T-cell regulatory biomarkers and clinical remission. The study highlights the potential of the "immune resolution" concept as marker of durable remissions, as well as the urgent need for methodological standardization in clinical studies.Pemphigus vulgaris, an autoimmune disease affecting the skin and mucous membranes [87][88][89][90][91], was studied by Zakrzewicz et al. and their original study focused on IgG autoantibodies directed against desmosomal adhesion proteins, (e.g. desmoglein-3 and -1) cause loss of keratinocyte adhesion. The paper shows that FcRn binding is compulsory for the pathogenicity of recombinant anti-desmoglein-3 antibodies in keratinocytes. The data suggest that the role of FcRn in autoimmune diseases is versatile and cell-type dependent. The report of Hou and Chen describes a rare case of pemphigus vegetans, a distinct form of pemphigus characterized by vegetative lesions in intertriginous areas, in which the most common autoantibodies target desmoglein 3 [92,93]. The case underscores the importance of prompt diagnosis and appropriate immunosuppressive therapy, demonstrating the effectiveness of modern...