Non-melanoma skin cancers (NMSCs), which include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (AK), are the most common cancer diseases in the Caucasian race. If diagnosed late and improperly treated, BCC and SCC can become locally advanced and metastasize. Malignant melanoma (MM) is less frequent but more lethal than NMSC. Given the individual and social burdens of skin cancers, performing an adequate prevention is needed. Ultraviolet (UV) ray exposure is one of the main risk factors for skin cancer. Thus, the first-choice prevention strategy is represented by photoprotection that can be both topical and systemic. The latter consists of the oral administration of molecules which protect human skin against the damaging effects of UV rays, acting through antioxidant, anti-inflammatory, or immunomodulator mechanisms. Although several compounds are commonly used for photoprotection, only a few molecules have demonstrated their effectiveness in clinical trials and have been included in international guidelines for NMSC prevention (i.e., nicotinamide and retinoids). Moreover, none of them have been demonstrated as able to prevent MM. Clinical and preclinical data regarding the most common compounds used for systemic photoprotection are reported in this review, with a focus on the main mechanisms involved in their photoprotective properties.

Background/Objectives: Psoriasis is a chronic inflammatory skin disease that may have a significant impact on patients’ quality of life. Alongside clinical scores, treatment goals include improvements in patients’ quality of life, divided into its social, working and psychosocial life aspects. Indeed, psychological impairment should always be considered in the management of moderate-to-severe psoriasis. Tildrakizumab, an anti-IL-23, is approved for the management of moderate-to-severe psoriasis. Both clinical trials and real-life studies show its efficacy and safety; however, no studies have evaluated how tildrakizumab may improve different domains of quality of life, including physical, psychological, and social aspects of patients’ quality of life. The objective was to evaluate the effectiveness of tildrakizumab in the management of moderate-to-severe psoriasis, focusing on the impact on all domains of patients’ quality of life. Methods: A 28-week multicenter, real-life, retrospective study was performed enrolling patients affected by moderate-to-severe psoriasis undergoing treatment with tildrakizumab. PASI and DLQI were evaluated at each follow-up (W16, W28). A sub-analysis of each DLQI question evaluated different domains of quality of life, including physical, psychological, and social aspects of patients’ quality-of-life. Results: A total of 62 patients were enrolled. At week 28, 97.1%, 85.7%, and 54.3% of patients achieved PASI75, PASI90, and PASI100, respectively. DLQI showed a significant reduction from baseline (20.3 ± 5.5) to week 28 (0.9 ± 2.2, p < 0.0001), with up to 82.9% achieving DLQI < 1. Sub-analysis of each question (Q1–Q10) showed a reduction in the value of each answer from baseline to week 28. Conclusions: The results confirm tildrakizumab as an effective and safe treatment in real life, positively affecting all domains of quality of life, with significant impact already appreciable at week 16 of follow-up.

Citation: Gualdi G, Ariasi C, Amerio P, Galdo G, Calzavara-Pinton P, Licata G. Inflammatory Linear Verrucous Epidermal Nevus Assessment With in Vivo Reflectance Confocal Microscopy: An Easy Option to Consider. Dermatol Pract Concept. 2023;13(2):e2023107. DOI: https://doi.org/10.5826/dpc.1302a107 Accepted: October 21, 2023; Published: April 2023 Copyright: ©2023 Gualdi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding author: Gaetano Licata, MD, Department of Dermatology, University of Brescia, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy. Phone: +393276215976 E-mail gaetano.licata89@gmail.com Keywords : inflammatory linear verrucous epidermal nevus, confocal microcopy, child, non-invasive technology This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Dermoscopy is widely used for the diagnosis of skin cancers and it increases the accuracy of basal cell carcinoma (BCC) detection. The dermoscopic criteria of BCC have recently been updated and they can be divided into three categories: vascular, pigment-related, and nonvascular/nonpigmentrelated. The objective of our multicentre retrospective study was to report the validity of a new dermoscopic pigment-related feature utilized to detect pigmented BCC (pBCC) (i.e., brown homogeneous blotches (BHB)). Cases of pBCC were collected from the databases of IDI-IRCCS of Rome and from three Italian private dermatology centres. BHB were defined as the presence of circumscribed areas of brown homogeneous pigmentation which are devoid of any dermoscopic specific arrangement (net, fat fingers, etc.) and of other internal dermoscopic structures, except for occasional vascular ones, such as arborizing vessels or globules/dots. Controls included melanocytic and non-melanocytic lesions. We examined images of 270 pigmented lesions (female 145; 51.8%) including 90 histopathological proven pBCC and 180 control cases (i.e., 90 melanocytic and 90 non-melanocytic lesions). BHB were present in 61 cases of 90 pBCC. These results showed a sensibility of 67.8 and a specificity of 93.3 with a positive predictive value of 83.6, negative predictive value of 85.3, posLR 10.2, negLR 0.3; OR 29.4, P value<0.001. Our multicentre retrospective study showed that the BHB may represent a new dermoscopic criterion for the diagnosis of pBCC.

This case was presented at the on-line telepathology meeting on the ADOI platform held on October 19^th 2022 by Dr Luongo.