Background Social networks have become a means for disseminating information on health‐related matters. Objective Describe the characteristics and analyze the accuracy of the dermatology content that is most often shared on the most popular social networks. Materials and methods The content most often shared on social networks (Facebook, Pinterest, Twitter, and Reddit) between March 2019 and March 2020 was analyzed using the keywords: acne, alopecia/hair loss, psoriasis, eczema, melanoma, skin cancer, rash, and rosacea. The total number of interactions, skin disease, topic, and origin was collected from each of the records. The content was analyzed and was categorized as precise, confusing, or imprecise based on the scientific evidence available. Results A total of 385 websites were included. About 44.7% of the shared content was rated as imprecise, 20% as confusing, and 35.3% as precise. The records classified as imprecise obtained a higher mean number of interactions (P < 0.05). No differences were found in terms of the level of certainty and the dermatosis studied, whereas they did exist in relation to their topic and origin (P < 0.001). Of the contents classified as imprecise, the most frequent topic and origin were "alternative medicines" and "individual opinions, articles not affiliated with health institutions, nor peer reviewed," respectively. Conclusions The majority of the contents often shared on social networks are below acceptable quality standards. Strategies are needed to discredit imprecise information and promote the dissemination of evidence‐based dermatology information.

Summary The COVID‐19 pandemic required people to confine themselves to their homes where possible, and disrupted normal hospital activities. We examine whether this lockdown generated changes in the size of the tumours. We compared the dimensions of the surgically removed malignant skin tumours from the first 150 patients treated after the confinement ended in Spain (22 May 2020) with those of the last 150 patients to receive such treatment before the confinement began (13 March 2020). Data on tumour surface area were collected from pathology reports. Overall, no significant difference was seen in the tumour sizes. However, among men, the tumours removed after confinement were significantly larger ( P < 0.05). Controversy exists over how the reduction in the number of tumours diagnosed during lockdowns might have influenced the characteristics of tumours. In this study, no overall difference was seen in the size of the tumours removed, although those removed from men after confinement were larger.

Summary Background As future healthcare professionals, nursing students will play an important role in social training and promoting healthy behaviours including protection against sunlight. However, few studies to date have focused on their knowledge and attitudes regarding sun‐related behaviour. Objective To evaluate the level of knowledge, attitudes and practices about sun protection and skin cancer among nursing students. Methods This cross‐sectional study included 200 all year nursing students from University of Vigo, located in the Vigo, Ourense and Pontevedra campus. Participants completed a validated, self‐reported questionnaire with 38 questions regarding their demographic characteristics, sun‐related behaviour, knowledge and attitudes. Results Approximately 87% of students reported experiencing sunburn last summer and 57% stated that they had sunbathed more than 15 days. Participants showed low level of sun protection behaviours, with the exception of using sunscreen (86%) and wearing sunglasses (72.5%). Knowledge about skin cancer and sun protection was considered high (rate of correct responses 87.7%, 6.14 out of 7). Moreover, positive tanning attitudes were high in the sample overall. Nursing students awarded a high value to tanned skin and showed misconceptions about sun exposure. Conclusion Although most of the students were aware of the side effects of sun exposure, their behaviours and attitudes were unsatisfactory. A high level of knowledge may not be predictive of positive practices and adequate attitudes, even among future healthcare professionals. Further guidance and educational campaigns are utmost important, particularly in a group that will be directly involved in prevention and early diagnosis of skin cancer.

Pilomatricoma is usually a single lesion. However, some patients present with more than one, a fact that has been reported in association with several systemic diseases. The aim of this analysis is to determine the prevalence of multiple pilomatricomas (MP) in our institution as well as to describe their clinical features and associated comorbidities. This is a retrospective analysis reviewing patients with a histological diagnosis of pilomatricoma registered in the database of the Pathology Department of our institution, from January 2005 to March 2017. One hundred ninety-five patients with histological criteria for pilomatricoma were registered. Fourteen (0.7%) of those patients suffered from MP. Among them, the most relevant findings were: 9 (64%) patients were women and 5 (36%) were men. The median age at diagnosis was 16 years. Seven (50%) had 2 pilomatricomas and 7 (50%) had more than 2. Two (14%) suffered from Steinert myotonic dystrophy (SMD). Regarding family background, 3 of them had relatives with pilomatricomas, one of them with pancreatic cancer, and another one with SMD. A total of 36 pilomatricomas were excised from those 14 patients with the following characteristics: The mean lesion size was 12 mm. The majority of the lesions (53%) were located on the head and neck. There was no recurrence or malignant transformation in any patient. Articles reporting on MP are scarce. We communicate 2 new familial MP without associated comorbidities. We would like to highlight that 2 of our patients with MP also developed SMD, an association previously reported. Thus, a thorough physical examination and inquiring about family history are of utmost importance for an early diagnosis of possible associated diseases.

Incidental skin cancer diagnosed in routine dermatology consultations represents a significant proportion of the total diagnosed. This study contributes to current strategies to improve early diagnosis of cancer, by highlighting factors that can trigger or act as barriers to skin cancer detection and seeking consultation. Incidental skin cancer appears to be related to both patient and tumour characteristics, with symptoms, time of evolution, family history of skin cancer, sex and living alone being the major contributors to patients taking notice of any changes or newly appearing skin lesions.In the absence of guidelines recommending routine total-body skin examination, patient concern remains the main factor in seeking consultation regarding suspicion of skin cancer. This study explores gaps in patients' understanding of malignant skin lesions, through the factors associated with incidental skin cancer. Included patients had a confirm ed histological diagnosis of basal cell carci noma, squamous cell carcinoma or melanoma. Tumour characteristics, patient demographics and other risk factors related to the development of skin cancer were obtained from each participant. The main measure was incidental skin cancer detection, using both binary logistic regression and Chi-squared Automatic Interaction Detection (CHAID) algorithm. Of the total tumours, 26.6% were detected incidentally. The following variables: male sex, living alone, long-axis diameter, tumour location, symptoms and time of disease evolution were independent predictors of incidental skin cancer. According to the CHAID algorithm, the most significant risk factor for incidental skin cancer was the absence of symptoms at diagnosis.

Background: Alternative metrics are emerging scores to assess the impact of research beyond the academic environment.Objective: To analyse whether a correlation exists between manuscript characteristics and alternative citation metrics.

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Anetoderma is a rare skin condition marked by circum scribed areas of slack skin due to the loss of dermal elastic fibres. Based on aetiology, anetoderma can be classified into 2 forms. Primary anetoderma (PA) develops in clini cally normal skin (Schweninger-Buzzi type) or after a non-specific inflammatory process (Jadassohn-Pellizzari type), whereas secondary anetoderma arises from an ab normal reparative mechanism of well-defined preceding skin diseases (1, 2). Anetoderma has been related to different immunolo gical diseases, ranging from simple serological findings to well-defined pathologies (2). Although the connection may not be so much with systemic lupus erythematosus (SLE) as with the presence of antiphospholipid antibodies (APA) (3), patients with both conditions (anetoderma and SLE) in the absence of APA have been described (4, 5). Moreover, the pathophysiology, as well as a temporary relationship between APA, SLE development and onset of anetoderma, have not been well established. CASE REPORTA 43-year-old man presented with a 1-year history of gradually spreading, non-itching skin lesions that had appeared on his trunk and left arm. Regarding his previous medical history, he had been diagnosed with SLE 8 years previously due to the presence of erythema after sun exposure, discoid facial lesions, oral ulcers and consistent positive serology (antinuclear antibodies (ANA) >1/640 speckled pattern and anti-double-stranded antibodies (dsDNA) > 1/10). There was no history of vascular thrombosis, neurological disorders or heart valve defects. His condition had been treated with hydroxychloroquine for 3 years. Since he became asymptomatic, he had decided to drop out of the treatment and was lost to follow-up.Physical examination showed well-circumscribed, erythematous round plaques with overlying wrinkled skin and herniation phe nomenon on his left arm and upper and lower back. These lesions had developed on previously healthy skin according to the patient' medical records (Fig. 1).Laboratory studies demonstrated no abnormalities except per sistent lymphopaenia (lymphocytes <1,200/mm 3 ). Immunological studies revealed a negative extractable nuclear antigen (ENA) panel, low serum levels of C3 (80 mg/dl, normal range 88-201 mg/dl) and negative APA. Serological tests, including for HIV, syphilis and Borrelia, were also negative.A skin biopsy from a lesion on his back showed superficial and deep perivascular lymphocytic infiltrate with no thrombi detected in dermal blood vessels. Verhoeff-van Gieson staining evidenced depletion and fragmentation of elastic fibres, which was more evident in the upper dermis (Fig. 2). Direct immunofluorescence (DIF) study detected granular IgG (+++), IgM (++) and C3 (+++) deposits in the basement membrane and blood vessels of involved skin. These findings confirmed the diagnosis of anetoderma in a patient with SLE.Based on the association of anetoderma with APA, the patient was tested for APA with a 6-month periodicity. One year later, positive results for lupus anticoagulant test ...