Background/Objectives: Psoriasis is a chronic inflammatory skin disease increasingly linked to psychiatric and behavioral comorbidities, including depression, anxiety, and substance use disorders. Shared inflammatory pathways, including elevated IL-6, TNF-α, and IL-17, may link psoriasis with psychiatric disorders such as depression and anxiety. The bidirectional interaction between systemic inflammation and mental health may exacerbate the disease burden and affect treatment outcomes. The objective of this study was to determine the prevalence of psychiatric and behavioral comorbidities in patients with psoriasis and to explore potential demographic and clinical correlations. Assessing these correlations contributes to a better understanding of the mental health status of psoriasis patients, potentially influencing both therapeutic efficacy and quality of life. Methods: We conducted a cross-sectional observational study on 316 patients with clinically and histopathologically confirmed psoriasis, evaluated between January 2021 and March 2025 at the Clinical Railway Hospital in Iași, Romania. Psychiatric and behavioral comorbidities were assessed through clinical interviews, medical record reviews, and standardized tools including AUDIT-C, Fagerström Test for Nicotine Dependence, and the Binge Eating Scale. Psoriasis severity was evaluated using the Psoriasis Area and Severity Index (PASI). Results: Of 316 participants, 88 (27.8%) had psychiatric/behavioral comorbidities. The most frequent conditions were tobacco use disorder (11.1% overall; 39.8% among comorbid patients), alcohol use disorder (9.2%; 32.9%), binge eating (7.9%; 28.4%), anxiety (6.3%; 22.7%), and depression (4.1%; 14.8%). Additional diagnoses included personality disorders, dementia, PTSD, and sleep disorders. Conclusions: Psychiatric and behavioral comorbidities, particularly substance use disorders, are relatively common in patients with psoriasis. These findings support the need for regular mental health screening and integrated care approaches in psoriasis management.

Background and Objectives: Psoriasis and atopic dermatitis (AD) are immune-mediated inflammatory diseases traditionally viewed as distinct. However, a subset of patients may present with overlapping features, leading to diagnostic and therapeutic challenges. This study aims to characterize the clinical, histopathological, and therapeutic features of patients with psoriasis–AD overlap. Materials and Methods: A retrospective review was conducted on patients diagnosed with both psoriasis vulgaris and AD between January 2021 and October 2024 at a single tertiary dermatology center. Inclusion required histopathological confirmation of psoriasis and a clinical diagnosis of AD based on Hanifin and Rajka criteria. Clinical features, histopathology, treatment history, and 6-month outcomes were analyzed. Results: Out of 469 patients screened, 24 (5.1%) had both conditions. Psoriasis preceded AD in 91.6% of cases. Most patients had intrinsic AD subtypes and moderate-to-severe diseases. Palmoplantar involvement was present in 66.6%, often refractory to biologics alone. Histological overlap complicated diagnosis, with repeated biopsies required in 58.3% of cases. Patients with dual diseases often required combination therapy, and JAK inhibitors showed favorable outcomes in refractory cases. Conclusions: Psoriasis–AD overlap represents a distinct clinical entity requiring individualized diagnosis and management. Recognition of this phenotype is critical for optimizing therapeutic outcomes.

Background/Objectives: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder with a recognized potential for malignant transformation. While histopathological examination remains the diagnostic gold standard, mucoscopy has emerged as a valuable non-invasive tool for assessing striae patterns, vascular features, and pigmentary alterations. This study aimed to evaluate the mucoscopic characteristics of OLP across different oral mucosal sites and to compare them with other inflammatory oral conditions, assessing their diagnostic relevance. Methods: A retrospective comparative study was conducted on 106 patients, including 33 with histopathologically confirmed OLP and 73 with other inflammatory oral conditions (pemphigus vulgaris, chronic cheilitis, hyperplastic oral candidiasis, leukoplakia, squamous cell carcinoma, pachyonychia congenita, morsicatio buccarum). Mucoscopic evaluation focused on the buccal mucosa, vermilion, and lingual mucosa. Features assessed included background color, white striae patterns, vascular morphology, the presence of erosions, and other features like blunting of the lingual papillae and scales on the vermilion. Statistical analysis was carried out using SPSS 29.0. Results: Reticular striae were highly specific to OLP, particularly on the buccal mucosa (90.9%, p < 0.001). Leukoplakia-like lesions were most prevalent on the lingual mucosa and significantly associated with dotted (p = 0.027) and looped vessels (p = 0.002). Erosions correlated significantly with both dotted (p < 0.001) and linear vessels (p = 0.011), especially in lingual and vermilion lesions. In comparison, control group lesions displayed significantly more globular structures (p < 0.001), veil-like patterns (p < 0.001), and diffuse vascular distributions (p = 0.018), particularly in cheilitis and candidiasis cases. Conclusions: Mucoscopy reveals distinct site-specific patterns in OLP, supporting its role as a non-invasive diagnostic aid. Comparative analysis highlights its utility in differentiating OLP from other inflammatory oral conditions and in identifying lesions with features suggestive of malignant potential. These findings support the integration of mucoscopy into routine clinical practice and warrant further validation through larger, prospective studies.

Background/Objectives: Cardiovascular disease (CVD) remains one of the leading causes of death worldwide, with several well-established risk factors. Among dermatological conditions, psoriasis is a well-known contributor to cardiometabolic risk, while lichen planus (LP) remains an underexplored chronic inflammatory disorder in this context. This study aimed to comparatively assess the prevalence and clinical patterns of metabolic syndrome (MetS) components in patients with LP versus psoriasis and healthy controls, focusing on the intrinsic inflammatory burden in patients not receiving systemic therapy. We also examined whether specific clinical subtypes of LP carry distinct metabolic profiles. Methods: We conducted a cross-sectional observational study at a tertiary dermatology center between January 2020 and December 2024. A total of 236 adult patients were included: 78 with LP, 79 with psoriasis, and 79 controls with minor dermatological conditions. Demographic, clinical, and laboratory data were collected. LP subtypes (cutaneous, mucocutaneous, reticular oral, erosive oral) were evaluated using the Lichen Planus Activity Index (LPAI) and Oral Lichen Planus Clinical Index (OLP-CI); psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI). Cardiometabolic comorbidities were assessed according to established guidelines. Results: LP patients showed significantly higher prevalence of hypertension (OR 1.94, p = 0.044) and type 2 diabetes mellitus (OR 3.09, p = 0.015) compared to controls. Compared to psoriasis, LP was associated with a higher prevalence of mixed dyslipidemia (OR 3.41, p = 0.033), while psoriasis showed more abdominal obesity (OR 0.35, p = 0.003). Mucosal LP subtypes, especially erosive and reticular oral LP, were linked to elevated cardiometabolic risk. Conclusions: LP, particularly its oral subtypes, is associated with a distinct cardiometabolic risk profile comparable to or exceeding that of psoriasis. These findings support the need for systematic metabolic screening in LP patients as part of comprehensive care.

Background/Objectives: Atopic dermatitis (AD) and alopecia areata (AA) frequently coexist due to shared immune-mediated mechanisms. Treatments targeting AD, including Janus kinase (JAK) inhibitors and dupilumab, may impact AA outcomes in unpredictable ways. This study aims to evaluate the effects of advanced therapies on patients with concurrent AD and AA to inform treatment strategies. Methods: A retrospective cohort study was conducted on six patients diagnosed with both AD and AA. Treatments included systemic corticosteroids, dupilumab, and JAK inhibitors (baricitinib and upadacitinib). Outcomes were assessed at six months using the Severity of Alopecia Tool (SALT), Dermatology Life Quality Index (DLQI), and Scoring Atopic Dermatitis (SCORAD) scores. Results: Patients receiving JAK inhibitors showed significant improvements in AD and AA outcomes, with mean reductions of 95.65% in SALT scores, 91.03% in DLQI scores, and 89.57% in SCORAD scores. Dupilumab was associated with the onset or worsening of AA in two patients. Systemic corticosteroids provided short-term benefits but are unsuitable for long-term management due to safety concerns. Conclusions: JAK inhibitors are effective for managing concurrent AD and AA, offering substantial improvements in disease control and quality of life. However, dupilumab requires cautious use in patients with these comorbid conditions. Personalized treatment strategies, informed by patient-specific factors, are essential for optimizing outcomes and minimizing risks. Further research is needed to identify predictive markers and refine therapeutic approaches for this challenging population.

(1) Background: Cutaneous secondary malignant neoplasms are a growing survivorship burden after pediatric cancers and hematopoietic stem cell transplantation (HSCT), yet skin-focused surveillance remains inconsistently implemented. (2) Objective: To synthesize current molecular dermatology insights relevant to prevention, early detection, and treatment of basal cell carcinoma (BCC) in high-risk survivors, while anchoring the discussion in a detailed case of multiple BCCs after childhood acute lymphoblastic leukemia and HSCT. (3) Methods: Narrative review integrating clinical, dermoscopic, molecular, and translational data from recent high-impact studies; case retained in full. (4) Results: Radiation exposure (especially total body irradiation), prior immunosuppression, and persistent immune dysregulation synergize with ultraviolet mutagenesis to create a “field cancerization” state characterized by Hedgehog-pathway activation (Patched1/Smoothened), impaired Deoxyribonucleic Acid damage response, and stromal remodeling. Dermoscopy, when embedded in routine whole-body examinations, markedly improves accuracy for keratinocyte cancers. Chemoprevention (e.g., nicotinamide) and targeted therapies (hedgehog inhibitors; Programmed Death-1 blockade) represent key translational levers for care innovation. (5) Conclusions: Integrating structured dermatologic surveillance with molecularly informed prevention and therapy should be standard in survivorship pathways for hematopoietic stem cell transplantation/Radiotherapy-exposed patients.