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Background:Expression of microRNAs (miRs) has been shown to be altered in many solid tumours and is being explored in melanoma. The malignant potential of some melanocytic lesions is difficult to predict. We hypothesised that characterisation of miR expression in borderline melanocytic proliferations would lead to the identification of a molecular profile that could be used with known prognostic factors to differentiate lesions with high malignant potential.Methods:The miR expression profile of melanocytic lesions (benign naevi, malignant melanoma and borderline melanocytic tumours) was evaluated by real-time PCR.Results:PCR analysis revealed primary cutaneous melanomas had an 8.6-fold overexpression of miR-21 and a 7.5-fold overexpression of miR-155 compared with benign naevi (P<0.0001). In situ hybridisation confirmed these results. miR-21 and miR-155 were significantly overexpressed within borderline lesions (P=0.0011 and P=0.0048, respectively). When borderline lesions were categorised by mitotic activity and Breslow thickness, miR-21 was associated with mitotic activity and miR-155 was associated with thickness (P<0.025). Among 14 patients with borderline lesions who underwent sentinel lymph node biopsy (SLNB), positive SLNB was associated with increased miR-21 and miR-155 in the primary lesion compared with lesions with a negative SLNB.Conclusion:MicroRNA expression profiles can be used to characterise atypical melanocytic lesions.

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Synopsis: Orofacial granulomatosis (OFG) is an uncommon chronic inflammatory disorder of the orofacial region. It is characterised by sub-epithelial non-caseating granulomas and has a spectrum of possible clinical manifestations ranging from subtle oral mucosal swelling to permanent disfiguring fibrous swelling of the lips and face. Etiopathogenesis is unknown. A range of systemic granulomatous disorders including Crohn's disease and sarcoidosis may cause orofacial manifestations that cannot be distinguished from those of OFG. Treatment of OFG has proven difficult and unsatisfactory, with no single therapeutic model showing consistent efficacy in reducing orofacial swelling and mucosal inflammation. Key Points:  Orofacial granulomatosis (OFG) is an uncommon granulomatous disorder of the orofacial tissues. Disease hallmarks include development of disfiguring labial and/or facial enlargement and intra-oral mucosal swelling and ulceration. Etiopathogenesis remains unknown.  Crohn's disease, sarcoidosis and a range of other systemic disorders can present orofacial features similar to those of OFG. However, a strict case definition of OFG requires the exclusion of concomitant systemic granulomatous disease.  A small subgroup of OFG patients, especially those with disease onset during childhood, will eventually develop intestinal Crohn's disease or, more rarely, sarcoidosis.  Management of OFG is challenging and not evidence-based. Prolonged anti-inflammatory and immune-modulatory systemic therapy is usually needed to obtain long-term control of severe orofacial swelling and inflammation. However intralesional corticosteroid therapy may provide notable long-term remission with no need of prolonged treatment.  The vast majority of OFG patients on therapy will eventually experience a variable degree of reduction in clinical manifestations

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