Vitiligo is a chronic autoimmune skin disorder whose diagnosis is often psychologically upsetting. The efficacy of the available therapies, including topical corticosteroids and topical calcineurin inhibitors, has historically been limited and the management of vitiligo is still challenging. As vitiligo is a chronic disease limited to the skin, topical rather than systemic therapies may be preferable (especially among patients with localised lesions) to avoid the long‐term side‐effects of the latter. A topical formulation of ruxolitinib, a selective JAK1/2 inhibitor, has recently been approved in the United States for the treatment of non‐segmental vitiligo in patients aged >12 years based on data from the phase III TRuE‐V1 and TRuE‐V2 clinical trials. The aim of this review is to describe the current evidence concerning the efficacy and safety of topical ruxolitinib in the treatment of vitiligo, and discuss issues regarding its use in younger children and pregnant or breastfeeding women, as well as the duration and durability of treatment. The promising results obtained so far suggest that 1.5% ruxolitinib cream is an effective means of treating vitiligo.

Cutaneous melanoma is the most severe form of skin cancer. The incidence of the disease has been increasing in the last decades, largely due to increased ultraviolet radiation exposure. A comprehensive understanding of the complex biological processes involved in melanoma development and progression is essential for advancing patient care. Improvement in surveillance strategies, widespread use of sentinel lymph node biopsy, and breakthroughs in systemic therapy have all contributed considerably to enhancing patient outcomes and survival. Rapid advancements in melanoma management are expected to continue, particularly through innovations in molecular biology and genetics. These emerging technologies aim to enhance diagnostic accuracy, predict disease progression, and improve prognosis. Staying informed about these evolving developments is essential for professionals dealing with melanoma patients. This narrative review provides a comprehensive overview of the current state of cutaneous melanoma, covering fundamental areas, such as histopathology, genetics, epidemiology, diagnosis, and staging. It provides a foundation to enhance understanding of current treatment approaches and the principles behind emerging technologies. This review also highlights future directions in melanoma care, including improvements in neoadjuvant therapy, use of artificial intelligence-based algorithms, use of molecular biomarkers to improve diagnosis and prognosis, and development of personalized neoantigen mRNA vaccines. Ultimately, this review aims to support clinicians in understanding the current landscape and anticipated innovations in melanoma management to improve clinical decision-making.

Scabies is a highly contagious parasitic dermatosis caused by the mite Sarcoptes scabiei var. hominis, affecting over 200 million individuals globally and imposing a significant health burden. Traditionally linked to low socioeconomic status and overcrowding, its prevalence is rising globally, especially among urban and institutional settings. Beyond its cutaneous manifestations, secondary bacterial complications contribute to significant morbidity, particularly in endemic areas. Advances in non-invasive imaging techniques including ultraviolet dermoscopy, reflectance confocal microscopy and line-field confocal optical coherence tomography, have improved diagnostic accuracy, while molecular assays show promise for enhanced sensitivity. Conventional diagnostics remain dependent on clinical evaluation and microscopic identification of mites, eggs, or scybala. First-line treatment involves topical and systemic therapies, and topical permethrin, benzyl benzoate, and oral ivermectin are commonly recommended in international guidelines. Emerging drug resistance has prompted research toward optimizing drug regimens and novel therapies, including moxidectin and combination treatments. Outbreaks of scabies in institutional settings, as well as endemic disease in those with limited resources, demonstrate the importance of coordinated public health efforts in the form of early case detection, simultaneous treatment of contacts and other environmental control measures. In this review, we present an updated and thorough description of scabies, covering the relevant epidemiology, clinical picture and the new diagnostic methods. In summary, by combining new updates and essential unanswered questions, this review describes the current dilemma and covers the latest data in the field.

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease belonging to the group of neutrophilic dermatoses. The pathogenesis of PG involves a predisposing genetic background that facilitates a dysregulated innate and adaptive immune response, with an imbalance between pro-inflammatory and anti-inflammatory mediators, leading to neutrophil-driven inflammatory damage. Several immunosuppressants and immunomodulatory drugs are currently available for the treatment of PG, in combination with topical therapies, wound management and pain control strategies. Systemic corticosteroids and cyclosporine remain the first-line treatment options with the best evidence. However, in recent years, the rise of knowledge about different pathogenic mechanisms has led to a significant increase in studies attesting the efficacy and safety of biologic therapies including, among others, antagonists of tumour necrosis factor (TNF)-α and interleukin (IL)-23, becoming the drug of choice in specific clinical setting. Similarly, different small molecules such as JAK-STAT (Janus kinase/signal transducer and activator of transcription) inhibitors are showing promising results for the treatment of PG. We review established and emerging pathogenesis-driven treatments, also providing a therapeutic algorithm and informing future directions in the management of PG.

Background: Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. Objectives: To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. Methods: This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. Results: Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months–18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0–14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0–19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01–88.99). Conclusions: We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.