Basosquamous carcinoma (BSC) remains a histologically and clinically challenging entity, with emerging data supporting the efficacy of vismodegib even in the presence of squamous differentiation. Our commentary builds on a retrospective analysis showing a 94.4% response rate to vismodegib in locally advanced BSC and integrates findings from our national UK survey study on the management of BSC which highlighted variability in classification, surgical margins, and treatment approaches. Together, these contributions underscore the urgent need for consensus guidelines, standardised diagnostic criteria, and prospective studies to optimise management of BSC.

Ex vivo confocal microscopy (EVCM) rapidly images tissues at near-histopathological resolution, bypassing time-consuming tissue processing required for conventional histopathology evaluation. This device can benefit centers without histopathology laboratories, however, tissues must be transported in a preservative to maintain tissue integrity; formalin is a readily available tissue preservative. We have shown that formalin has no adverse effect on tissue imaging and diagnosis using an EVCM device.

Cannabinoid agonists, particularly those binding to cannabinoid receptor 2 (CB2), offer promising results for patients with inflammatory skin diseases like dermatomyositis, as they can modulate inflammatory cytokines without the unwanted psychoactive side effects associated with cannabinoid compounds. Phase 2 clinical trials to selective CB2 agonists have shown good safety and efficacy data compared to placebo, although further data remains to be seen in current phase 3 trials. Our case highlights the benefits of a complex treatment resistant case of dermatomyositis who benefited greatly from an equivalent cannabinoid agonist.

We present an unusual case of ulceration associated with diffuse dermal angiomatosis of the abdomen. Dermatologists should be aware of the use of topical glyceryl trinitrate spray to successfully resolve the ulceration associated with diffuse dermal angiomatosis, particularly where surgical intervention may be unsuitable.

This ethical dilemma examines a case in which a 16-year-old patient, deemed Gillick competent, wishes to start isotretinoin for severe acne despite her parents’ objections. The conflict highlights the tension between respecting a minor’s informed autonomy and parental authority in medical decision-making. The discussion focuses on balancing beneficence, non-maleficence, and autonomy, offering strategies for clinicians to navigate such complex scenarios.

Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder. While PRP has been reported following various vaccinations, its association with the Shingrix vaccine has not been documented. Here, we present the first two reported cases of PRP following Shingrix vaccination.

There are currently no guidelines on the management of severely dysplastic naevi (SDN) in the UK or internationally. There is generally consensus for re-excision of SDN with positive margins, however there is variation in clinical practice of completely excised SDN. We carried out a retrospective observational study reviewing the management of severely dysplastic naevi across two NHS Trusts over a 5 year period. Our results demonstrate a considerable variation in practice between two trusts and potential overtreatment of completely excised SDN. This therefore highlights the need for consensus evidence-based guidelines to standardise care for patients with SDN.

Here we report a case of giant bullous pilomatrixoma arising on the left supraclavicular fossa of a sixteen-year-old girl. This presented as an asymptomatic 6.5cm x 4cm pink-red, non-pulsatile raised bulla with a bizarre, irregular and well-demarcated outline. Histology showed an admixture of cell types consisting of monotonous basophilic epithelial cells, and collections of ghost cells lacking viable nuclei, with a surrounding giant cell reaction consistent with a pilomatrixoma.

Despite its limitations, our pilot study presents the first proof of principle that topical T3 can indeed promote hair growth (i.e., prolong anagen) and can stimulate the intrafollicular production of a potent hair growth factor (FGF7/KGF) in intact human scalp skin ex vivo, i.e. directly in the human target organ. We also show that the simple, clinically relevant vehicle we have developed and tested here facilitates topical HF-targeting THs delivery through an intact epidermal barrier.

Anti-Ki/SL antibodies are most commonly found in systemic lupus erythematosus patients, they show broader relevance to systemic sclerosis and dermatomyositis. We developed in-house ELISA for anti-Ki/SL antibodies which are not included in lineblot.