Sarcoidosis and sarcoid‐like reactions (SLRs) may develop in association with various malignancies, as well as in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs). We aimed to perform a narrative review with regard to the development of ICIs‐associated sarcoidosis or SLRs, and to discuss the corresponding diagnostic and therapeutic challenges raised in this scenario. Apropos of a melanoma patient developing SLRs while treated with ipilimumab and nivolumab, we searched for clinically evident, ICIs‐associated sarcoidosis or SLRs in the English literature. We recorded the oncologic characteristics, including type of malignancy and type of ICI, the phenotypic characteristics of sarcoidosis/SLRs, as well as the impact on immunotherapy. Including our patient, we identified 80 ICIs‐associated sarcoidosis or SLRs cases. Both sexes were equally affected (40 F/40 M) and the most common malignancy was melanoma (65/80, 81.3%). Concerning the oncologic treatment, there was a predilection for pembrolizumab (23/80, 28.7%), followed by the ipilimumab/nivolumab combination (21/80, 26.3%), ipilimumab (18/80, 22.5%), nivolumab (16/80, 20.0%). Although in the majority of the cases (52/80, 65.0%) there was no need for systemic prednisolone for the management of sarcoidosis, a significant proportion of patients finally discontinued ICIs treatment (44/80, 55.0%). Phenotypically, sarcoidosis and SLRs highly imitate oncologic progression posing diagnostic difficulties. A therapeutic dilemma is also raised when there is a need for systemic prednisolone, since the latter may jeopardize the therapeutic efficacy of immunotherapy. Sarcoidosis and SLRs, though rare, can present in oncologic patients treated with ICIs. Clinicians should be aware of this possibility and the related diagnostic and therapeutic challenges they have to face in this scenario.

Immune checkpoint inhibitors (CPIs) are targeted molecules that modulate the immune system, assist with self-tolerance, and minimize collateral tissue damage when immune responses are activated. Although they are characterized by a favorable risk/benefit ratio, immune checkpoint blockade has been associated with a new subset of autoimmune-like toxicities, named immune-related adverse events (irAE). Dermatologic reactions are among the most prevalent irAE triggered by CPIs. In a majority of cases they are self-limiting and readily manageable. However, it is not uncommon that they result in severe skin involvement and impairment of patients’ quality of life. Awareness of the spectrum of cutaneous irAEs is mandatory for every clinician involved in the management of oncologic patients. The role of the dermatologists is essential because early recognition and appropriate management of skin toxicity may prevent dose modifications and discontinuation of CPIs. The latter is particularly relevant, considering that recent data suggest favorable oncologic response in patients developing irAEs.

Solitary trichoepithelioma (TE) is a rare, benign tumor of follicular origin that in certain cases is difficult to differentiate from basal cell carcinoma (BCC). We report the case of an 8-year-old girl with a pale pink, soft lesion on the neck. The clinical image of the lesion was equivocal, while some dermoscopic findings—blue-gray globules and arborizing vessels—could not exclude the presence of BCC from the differential diagnosis, although that would have been a very unlikely case considering the age of the patient. The histopathologic examination established the diagnosis of TE. Given the occasion of this challenging case we try to list the key clinical, dermoscopic and histopathological characteristics of TE and BCC in order to elucidate the differential diagnosis of these two entities.

Background Cutaneous immune-related adverse events (irAEs) represent the most frequent toxicities induced by immune checkpoint inhibitors (ICIs). Objectives To investigate clinical associations of cutaneous toxicities induced by different ICI therapies. Methods This was a multicentre retrospective international cohort study of patients with cancer who developed cutaneous irAEs under ICI therapy. Analysis was performed of the rates and basic characteristics of all cutaneous toxicities, and identification of any associations was performed using univariate and multivariate models. Results In total, 762 patients were included, who developed 993 cutaneous toxicities. Forty different types of skin toxicities were identified. Psoriasis (175 patients, 23Á0%) and pruritus (171 patients, 22Á4%) were the most common toxicities, followed by macular rash (161 patients, 21Á1%) and eczematous-type reactions (150 patients, 19Á7%). Multivariate analysis showed that among

Rosacea is a chronic skin disease characterized by facial erythema and telangiectasia. Despite the fact that many hypotheses have been proposed, its etiology remains unknown. In the present review, the possible link and clinical significance of Helicobacter pylori in the pathogenesis of rosacea are being sought. A PubMed and Google Scholar search was performed using the terms “rosacea”, “H.pylori”, “gastrointestinal disorders and H.pylori”, “microorganisms and rosacea”, “pathogenesis and treatment of rosacea”, and “risk factors of rosacea”, and selected publications were studied and referenced in text. Although a possible pathogenetic link between H. pylori and rosacea is advocated by many authors, evidence is still interpreted differently by others. We conclude that further studies are needed in order to fully elucidate the pathogenesis of rosacea.

Literature data regarding the impact of pandemic on psoriasis and the relationship between psoriasis and COVID-19 outcomes are emerging. [1][2][3][4][5][6][7][8] The main aim of this study was to evaluate the impact of COVID-19 on treatment maintenance, disease course, psychosocial status, and intention to vaccinate in patients with moderate to severe psoriasis under systemic treatment (biologic agents, conventional systemic

Uveitis is an entity that should be considered when evaluating psoriasis patients with ocular complaints, even in the absence of arthritis. Anti-TNF-α monoclonal antibodies and adalimumab in particular seem to represent a promising therapeutic avenue for the treatment of refractory psoriatic uveitis. Larger randomized clinical trials are needed to confirm our conclusions.

BackgroundLimited data on immune checkpoint inhibitor (ICI)‐induced pruritus per se and efficacy of different therapeutic modalities in its management exist.ObjectiveTo study the quantitative and qualitative characteristics of ICI‐induced pruritus per se and to assess the efficacy of the therapeutic modalities usually applied.MethodsWe retrospectively reviewed the records of 91 patients who were under treatment with ICIs for any kind of neoplasia and developed pruritus during treatment.ResultsTwenty out of 91 individuals (22.0%) with ICI‐induced pruritus had pruritus as the only symptom, while 71/91 (78.0%) presented with pruritus coexisting with an additional cutaneous toxicity. Pruritus was treated with antihistamines (18/20, 90.0%) and/or topical regimens, as first‐line choice. In resistant cases, as a second therapeutic intervention, narrow‐band UVB (NBUVB), oral steroids and GABA analogs were added (70.0%). Statistical analysis revealed a significant difference in mean pruritus Numerical Rating Scale (NRS) scores between baseline and sequential visits. Moreover, subgroup analysis revealed a significant reduction in mean NRS scores in those treated with phototherapy.LimitationsRetrospective design, low number of patients and survivorship bias.ConclusionPruritus per se was present in a substantial portion of our cohort (22.0%). Our study confirms the efficacy of current treatment strategies and suggests NBUVB as a potential steroid‐sparing therapeutic alternative.