Developed within the last few decades, microneedles (MNs) have only recently seen wide-scale use among the general population, especially in the area of cosmetics. With the FDA only starting to regulate microneedling devices and the many new microneedling products that enter the modern global market, it is of utmost importance to establish the safety profile and reasonable expectations of the microneedling practice and its products. In our review of current literature, the authors searched the keyword Bmicroneedle^with the following terms: Bsafety^, Bside effect^, Btoxicology^, Badverse effect^, Badverse event^, Binfection^, Bdermatitis^, Bgranuloma^, Bscarring^, and Bhyperpigmentation^. Despite wide-scale implementation of MNs, we are likely only beginning to understand the potential of MNs as a medical and consumer product, and we should, therefore, be aware of any potential adverse events associated with the product.

The pediatric melanoma population is not well described, and current guidelines for their management are not well defined. Our study aims to identify this population, treatment modalities, and outcomes using a national population-based database. We reviewed the Surveillance, Epidemiology, and End Results database (2004–2008). Patients ≤21 years old with melanoma were included and grouped into ≤12 years of age, 13 to 18 years, and 19 to 21 years. Clinical characteristics were analyzed across the groups. A total of 1255 patients were included: 52.7 per cent were 19 to 21 years of age, 36.3 per cent were 13 to 18 years of age, and 11.0 per cent were ≤12 years of age. The 19- to 21-year-olds had the highest proportion of stage I (50.5%) versus ≤12 years of age (31.9%); the ≤12-year-olds had the highest proportion of stage IV (3.6%) versus 19 to 21 years of age (0.9%), P < 0.001. The 19- to 21-year-olds had the highest proportion receiving wide local excisions only (34.8%) versus ≤12 years of age (26.4%); the ≤12-year-olds had the highest proportion of patients without any surgeries (16.0%) versus 13 to 18 years of age (9.4%), P = 0.169. On adjusted analysis, the 19- to 21-year-olds had worse survival compared with ≤12 years of age (hazard ratio: 5.26, P = 0.017, 95% confidence interval 1.34–20.65). Disparities were found in the ≤12-year-old melanoma population, as they had later stage melanomas, less invasive surgery, and lower survival. Clearer prognostic factors are needed to better elucidate their management.

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There are at least 15 factors that influence the ability of chemicals to penetrate the skin. Substantivity is yet another factor and allows penetrants to remain on and in skin for many days. As many skin pathologies involve stratum corneum and require multiple dosing of topicals, understanding substantivity mechanisms may provide insight for topical dosing strategies. Substantivity is also of importance in the development of other consumer products that necessitate adherence to skin, including sunscreens, insect repellents, and cosmetics. Furthermore, while stratum corneum adherence may delay percutaneous penetration, reducing the risk of systemic toxicity, excessive substantivity may play a role in the toxic accumulation of harmful penetrants. Continued research in this area may offer insight into dermatotoxicology and dermatopharmacology.