Extra-anogenital giant cSCCs are rare but have worse outcomes compared to smaller tumors. Prompted by limited data, the authors conducted a retrospective study to gather more information about giant cSCCs to optimize clinical care. We identified seven cases of giant cSCCs from a review of cSCC cases treated in the Unit of Dermatosurgery between 2016 and 2022. Most patients were male (85.71%) with a mean age of 80.29 ± 12.22 years. UV radiation was the most common risk factor (five cases) followed by smoking (three cases) and hidradenitis suppurativa (one case). Most giant cases were located in the head area (71.4%) and the diameter of lesions ranged from 6 to 18 cm. All patients corresponded to tumor stage T3, and 42.86% of patients had lymph node metastases. Surgical excision was the treatment of choice in most cases (85.71%), while a combination of cemiplimab and RP1 was used in some cases due to the ineffectiveness of treatment or contraindications to other therapies. The authors emphasize the importance of early detection and prevention of modifiable risk factors, such as UV radiation, and a multidisciplinary approach to treatment. Other therapies, including immunotherapy, may become increasingly important.

Background/Objectives: Scabies, caused by Sarcoptes scabiei, is a recognised neglected disease of rising global burden, and increasing resistance to first-line scabicides is making treatment failure more frequent. No dermoscopic marker of cure has been validated for monitoring treatment response, so a reliable marker of active infestation is crucial. The tunnel window sign (TWS)—rounded perforations along the burrow, visible under polarised dermoscopy and ultraviolet-induced fluorescence dermoscopy (UVFD)—is a recently introduced candidate. We aimed to determine whether TWS represents a dermoscopic marker of active scabies infestation by evaluating its specificity, treatment dynamics and diagnostic performance under polarised dermoscopy and UVFD. Methods: In this single-centre observational study conducted in 2026, 33 patients with active scabies (Cohort 1; 106 burrows in 30 permethrin–ivermectin-adherent and 11 in 3 non-adherent) and 30 controls with excoriated pruritic dermatoses (Cohort 2; 150 lesions) were examined. All Cohort 1 patients were re-evaluated every 4 weeks until resolution. Paired polarised/UVFD images were re-scored by four raters (three blinded). Results: TWS was undetectable in all 30 controls with pruritic dermatoses and in all 30 post-treatment adherent patients (0/30 and 0/30, respectively). It resolved with effective treatment (undetectable from week 4; McNemar p < 0.0001), preceding pruritus resolution, and persisted in non-adherent patients until retreatment. At the burrow level, UVFD detected TWS more sensitively than polarised dermoscopy (68/106 vs. 60/106; p = 0.0078; adjusted OR 1.38, 95% CI 1.07–1.79). Inter-rater agreement was almost-perfect (Fleiss’ κ = 0.872). Conclusions: TWS behaves as a dermoscopic marker of active scabies infestation: it disappears after successful treatment, persists following treatment failure, and distinguishes active infestation from both post-treatment skin and non-scabietic pruritic dermatoses. UVFD improves its detection compared with polarised dermoscopy.

Background: Scabies is a World Health Organization–designated neglected tropical disease of rising incidence with increasingly reported treatment failure, making objective verification of cure important. Dermoscopy is well established for diagnosis, but its role in assessing treatment response has never been mapped. Objectives: To map how dermoscopy assesses treatment response in scabies—which markers, timepoints and cure definitions are applied, and how it relates to clinical and microscopic standards. Methods: A scoping review following PRISMA-ScR searched PubMed/MEDLINE, Web of Science, EBSCO and Scopus (2016–2026, English) using a two-concept strategy (scabies × dermoscopy); eligibility required baseline dermoscopy plus at least one further, separately reported dermoscopic assessment during or after therapy. Two reviewers screened independently, supplemented by citation searching. Results: Ten studies were included. The same mite structure appeared under at least four names; assessment timepoints (day 2 to beyond day 28) and cure definitions were inconsistent. Dermoscopy was the genuine object of investigation in few studies; only one used ultraviolet-induced fluorescence to track response. Conclusions: Despite the disease’s recognised importance, dermoscopic monitoring of scabies remains a declared rather than a designed research aim. No standardised marker, timepoint or cure definition exists; consensus standards analogous to the 2020 IACS diagnostic criteria are needed.

Background: Adverse reactions to tattoo pigments are increasingly recognized, yet severe systemic complications remain rare and poorly characterized. Red tattoo ink, in particular, is associated with delayed hypersensitivity reactions, but widespread manifestations affecting multiple organ systems have not been documented. This case report aims to describe an unusual constellation of erythroderma, alopecia universalis, anhidrosis, and vitiligo triggered by red tattoo ink and to highlight the diagnostic and therapeutic challenges associated with such reactions. Case presentation: This case report describes a 36-year-old Caucasian male who developed erythroderma, alopecia, anhidrosis, and vitiligo as complications of a red ink tattoo, marking a rare and previously unreported case of such extensive reactions. Four months after getting the tattoo, the patient began to develop itchy eczematous changes, which progressed to erythroderma over several months, along with alopecia universalis and anhidrosis. Results: After months of ineffective treatment with glucocorticosteroids, cyclosporine, methotrexate, and acitretin, patch tests confirmed hypersensitivity to possible components of the red tattoo ink, prompting surgical removal of the inflamed tattoo fragments. Unfortunately, aside from resolving the erythroderma, this did not improve the patient’s clinical condition, and he developed vitiligo. Only after the complete removal of the red tattoo ink from the same series that caused the sensitization and the use of immunosuppressive and immunomodulatory drugs, including JAK inhibitors, was hair growth restored and the progression of vitiligo halted, but with no effect on anhidrosis. Conclusions: This case highlights the challenges in managing systemic reactions to tattoo ink and the importance of thorough evaluation and treatment strategies.