As a result of many years of research, the intricate cellular mechanisms of burn injury are slowly becoming clear. Yet, knowledge of these cellular mechanisms and a multitude of resulting studies have often failed to translate into improved clinical treatment for burn injuries. Perhaps the most valuable information to date is the years of clinical experience and observations in the management and treatment of patients, which has contributed to a gradual improvement in reported outcomes of mortality. This review provides a discussion of the cellular mechanisms and pathways involved in burn injury, resultant systemic effects on organ systems, current management and treatment, and potential therapies that we may see implemented in the future.

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BACKGROUND Solid organ transplant recipients (SOTRs) are at an increased risk of epithelial malignancies, mainly squamous cell carcinoma, and its precursor lesions such as actinic keratoses, warts, and porokeratosis, which may respond to retinoid therapy. OBJECTIVE To review the published evidence on the efficacy and safety of topical and systemic retinoids for the treatment and prophylaxis of malignant and premalignant conditions that mostly afflict SOTRs. MATERIALS AND METHODS Systematic review of the literature to summarize the level of evidence and grade of recommendation for retinoid therapy with emphasis in the SOTR population. RESULTS Acitretin has the highest strength of recommendation (Grade A) for prophylaxis of nonmelanoma skin cancer (NMSC) and treatment and prophylaxis of actinic keratoses in SOTR. In nonimmunosuppressed patients, acitretin and isotretinoin have a Grade B recommendation for treatment of recalcitrant warts. Topical retinoids have not shown efficacy in preventing NMSC in immunocompetent patients. CONCLUSION Retinoids constitute a highly efficacious alternative for the management of the most common conditions that affect SOTRs. Acitretin has the most robust evidence for chemoprophylaxis in SOTRs. Knowledge about the specific indications and expected side effects of topical and systemic retinoids may help optimize their therapeutic potential.

Melanocytic matricoma is a very rare adnexal tumor that recapitulates the anagen hair follicle bulb. Few cases of malignant melanocytic matricoma have been reported, thus criteria for malignant potential have not been previously reviewed. We report a case of an 81 year old male that was originally diagnosed as atypical melanocytic matricoma. The site was re-excised with a small focus of residual tumor, but all margins were negative. The re-excision site healed without complication. However, two years after the original biopsy, a new 8 mm firm nodule appeared at the re-excision site, which was subsequently diagnosed as malignant melanocytic matricoma (MMM). In the following paper we will report a new case of MMM and review potential criteria that could be used in the future to establish malignant potential.

Prolidase deficiency is a rare autosomal recessive disorder characterized by cutaneous ulcers, facial dysmorphism, recurrent infections, and intellectual disability. We report a unique case of a 6‐year‐old boy with prolidase deficiency and Crohn's disease who presented with lower extremity ulcers. Cutaneous ulcers due to prolidase deficiency are historically resistant to treatment, and we report success with the novel use of topical tacrolimus.

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Treatment of recalcitrant warts in solid organ transplant recipients (SOTR) can pose a therapeutic challenge for dermatologists. Successful treatment of recalcitrant warts can serve as secondary prevention for skin cancer in those with chronic immunosuppression. Given the heterogeneity of associated comorbid conditions in SOTR, clinical trials are difficult to conduct in this high‐risk population, therefore, our clinical practice is mostly driven by observed responses from studies in immunocompetent patients or from case reports of immunocompromised patients. The combination of systemic retinoids and candida immunotherapy likely provide the most effective treatment for recalcitrant warts in SOTR. However, many SOTR have chronic renal insufficiency and are not candidates for acitretin therapy. We provide two cases of recalcitrant warts in SOTR successfully treated with isotretinoin in the setting of impaired renal function.

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by relapsing eczematous rash with severe pruritus and recurrent infection. Topical emollients and immune‐modulators (e.g., corticosteroids and calcineurin inhibitor) are first‐line therapies for acute flares. In severe refractory cases, systemic immunosuppression may be required. Increased incidence of AD has been documented in heart‐transplant children who receive their transplant or thymectomy before the age of 1 year. The treatment of these patients remains a conundrum for dermatologists. We present a case report of a chronically immunosuppressed transplant patient with severe AD treated with dupilumab and in remission for over 2 years with minimal side effects. We will also discuss impact of transplant immunosuppression in the pathogenesis of AD.