Malassezia species isolation rates were in agreement with those reported from South-west Europe. PCR-SSCP of the ITS 1 is useful for highlighting prospective clinical implications of M. globosa subtypes.

Summary Background Frontal fibrosing alopecia (FFA) has become one of the most common causes of cicatricial alopecia worldwide. However, there is a lack of clear aetiology and robust clinical trial evidence for the efficacy and safety of agents currently used for treatment. Objectives To enable data to be collected worldwide on FFA using common criteria and assessment methods. Methods A multicentre, international group of experts in hair loss was convened by email to create consensus recommendations for clinical trials. Consensus was defined at > 90% agreement on each recommended part of these guidelines. Results Standardized diagnostic criteria, severity rating, staging, and investigator and patient assessment of scalp hair loss and other clinical features of FFA were created. Conclusions These guidelines should allow the collection of reliable aggregate data on FFA and advance efforts in both clinical and basic research to close knowledge gaps in this condition.

Many single nucleotide polymorphisms (SNPs) have been described as putative risk factors for melanoma. The aim of our study was to validate the most prominent genetic risk loci in an independent Greek melanoma case-control dataset and to assess their cumulative effect solely or combined with established phenotypic risk factors on individualized risk prediction. We genotyped 59 SNPs in 800 patients and 800 controls and tested their association with melanoma using logistic regression analyses. We constructed a weighted genetic risk score (GRSGWS) based on SNPs that showed genome-wide significant (GWS) association with melanoma in previous studies and assessed their impact on risk prediction. Fifteen independent SNPs from 12 loci were significantly associated with melanoma (P < 0.05). Risk score analysis yielded an odds ratio of 1.36 per standard deviation increase of the GRSGWS (P = 1.1 × 10(-7)). Individuals in the highest 20% of the GRSGWS had a 1.88-fold increase in melanoma risk compared with those in the middle quintile. By adding the GRSGWS to a phenotypic risk model, the C-statistic increased from 0.764 to 0.775 (P = 0.007). In summary, the GRSGWS is associated with melanoma risk and achieves a modest improvement in risk prediction when added to a phenotypic risk model.

Despite brodalumad demonstrated efficacy in clinical trials, real‐world data reflecting clinical benefits in unselected patient populations treated in routine clinical practice are limited. Thus, we performed a longitudinal, retrospective, real‐world analysis assessing the long‐term clinical benefits of patients with moderate‐to‐severe psoriasis treated with brodalumab in Greece in the long term (up to 24 months). Main efficacy assessments included changes from baseline in the psoriasis area and severity index (PASI) and proportions of patients achieving at least 50%, 75%, 90% and 100% reduction from baseline in PASI scores (PASI50, PASI75, PASI90 and PASI100) at different timepoints up to 24 months. Other endpoints included changes in the dermatology life quality index (DLQI) and body surface area (BSA) involvement. Data from medical records of 180 patients with moderate‐to‐severe psoriasis treated with brodalumab for up to 24 months were assessed. Following treatment, mean [standard deviation (SD)] PASI scores were decreased across all visits compared to baseline (p < 0.001). The proportion of patients achieving PASI50, PASI75, PASI90 or PASI100 were high as early as at month 1 and consistently tended to increase over time, mainly during the first 6 months. Improvements on disease severity were further reflected by reductions from baseline on BSA scores across all visits (p < 0.001). Concurrent improvements on DLQI scores were observed across all visits (p < 0.001). This retrospective analysis provides real‐world evidence supporting the long‐term efficacy profile of brodalumab in Greek patients with moderate‐to‐severe psoriasis treated in standard clinical practice, which is characterized by a rapid onset of action generally sustained over time.

Melanin-like pigment produced in vitro and in vivo byMalassezia yeasts has not been described before. Masson-Fontana staining confirmed accumulation of black pigment on the cell walls of L-dihydroxyphenylalaline (L-DOPA)-cultured Malassezia species. Black pigment was also observed in cells and hyphae from hyperpigmented patient lesions with culture-confirmed pityriasis versicolor and seborrheic dermatitis.Melanin production, mediated by a copper-containing phenoloxidase enzyme using L-dihydroxyphenylalaline (L-DOPA) as a substrate, is a well-studied pathogenetic mechanism in fungi (9, 24), especially in species of the human pathogen Cryptococcus. Many properties related to the evasion of the host immune system (9) and antifungal drug resistance (23) have been attributed to melanin or melanin-like pigments, assessed in vitro by growth in L-DOPA agar (18) and in vivo by staining with Masson-Fontana stain, which detects melanin deposited on the cells of this basidiomycetous yeast (10).The aims of this study were (i) to assess the in vitro abilities of Malassezia yeasts to oxidize L-DOPA and produce a melanin-like pigment and (ii) to demonstrate that this pigment can be detected in yeast cells and hyphae by Masson-Fontana silver staining of skin scales from pityriasis versicolor (PV) and seborrheic dermatitis (SD) patients.We studied 53 type, reference, and clinical isolates of 11 Malassezia species (Table 1) (7,8,(20)(21)(22). The type and reference strains for this study were obtained from the Centraalbureau voor Schimmelcultures, Utrecht, The Netherlands. The clinical isolates were strains kept in the Mycology Reference Laboratory of the Hellenic National Collection of Pathogenic Fungi (HNCPF; World Data Centre on Microorganisms member type ID 2023). All Malassezia strains, the control Cryptococcus grubii strains (HNCPF 6417a and 6417b) demonstrating maximum and no melanization, respectively, and the autoch- The solidified agar surface was punctured with a standard sterile 5-mmdiameter cork borer, producing wells. In each well, 100 l of whole-cell suspensions or cells that had been aseptically mechanically disrupted by an orbital homogenizer at 100 rpm and suspended in sterile water was inoculated and incubated at 35°C for 3 and 7 days for the Cryptococcus and Malassezia strains, respectively (Fig. 1A and 2B). All plates were inspected daily for pigment production. Absence of a lipid source in the culture medium did not allow growth of Malassezia yeasts.The Masson-Fontana silver stain was employed to demonstrate melanin deposition (10) on the walls of Malassezia cells harvested from tyrosine and L-DOPA media, respectively. In order to ascertain the necessity for L-DOPA in the synthesis of melanin, cells grown in the L-DOPA-depleted medium were also tested for melanin-like pigment detection by Masson-* Corresponding author. Mailing address: Mycology Reference Laboratory,

Vismodegib, a Hedgehog (Hh) inhibitor, was recently approved for the treatment of advanced BCC showing a good efficacy rate and a relatively well-tolerated safety profile in clinical studies. In addition, a number of hedgehog inhibitors are now in Phase I and II trials of advanced BCC demonstrating encouraging results. Phase II studies with epithelial growth factor receptor inhibitors, such as cetuximab, gefitinib, panitimumab and erlotinib have been conducted in patients with advanced SCCs, used either as monotherapy or in combination with chemotherapy. However, there is still much knowledge to be gained about the treatment efficacies, optimal treatment durations, mechanisms of drug tolerance, adverse events and the ways in which these therapies influence patient outcomes and quality of life.

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Erlotinib (Tarceva, Roche) is a chemotherapeutic agent used in the management of advanced non-small cell lung cancer and other malignancies. We present the case of a patient who developed excessive eyelash growth, called trichomegaly, a rare ocular side effect of this drug.