The GR of localized cutaneous melanomas may be a possible prognostic factor for survival. Additionally, rapid GR is associated with male patients more advanced in age at diagnosis, which suggests the need to assess new strategies for the early detection of these melanomas.

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory disease of unknown aetiology that usually occurs in the elderly. It is characterized by sterile pustules, chronic crusted erosions, cicatricial alopecia, and skin atrophy. The histopathology is nonspecific, and its pathophysiology remains undetermined, with various types of local trauma possibly acting as the triggering factor. We describe a case of EPDS in a 75-year-old female in whom there was a marked response to photodynamic therapy with methyl 5-aminolaevulinic acid.

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In humans, it is not possible to obtain experimental evidence of when a cancer begins to metastasize. The purpose of this study was to estimate the time of onset of metastatic dissemination in cutaneous melanoma using a model based on its growth rate (GR). The critical time of onset of metastatic dissemination below which no cases of fatal melanomas were seen may be described with a potential function in which this time is inversely proportional to the GR. The critical time of development beyond which a melanoma may metastasize presents great variation. This time was just 1 month for those melanomas with a fast GR, whereas it was over 5 years for those with a very slow GR. Quantitatively, the fastest-growing melanomas began metastasizing with a greater thickness than the slowest-growing melanomas. A correlation exists between the critical time of onset of metastatic potential and the GR of the melanoma. These results may well have relevance to the understanding of mechanisms of tumor dissemination and for the design of future studies on melanomas, irrespective of whether they are basic studies on biomolecular mechamisms or clinical studies.

An 8-year-old boy consulted about a 1-year asymptomatic plaque on the left dorsal side of the spine. The patient had had no previous antecedents to note and presented no injury or scratch marks in the region. Upon physical examination, we observed a 3.5 · 2.0 cm in size ovalshaped plaque that extended laterally outwards from the spine with a slight blaschkoid pattern. The surface presented a slightly raised appearance, flesh colored with lightly hyperpigmented edges ( Fig. 1a).A biopsy was performed which showed an epidermis with acanthosis and papillomatosis. The dermis and the hypodermis did not seem to be affected, however, a colloid iron stain showed diffuse blue deposits in the upper dermis between the collagen bundles. Accordingly, the patient was diagnosed with mucinous nevus. No treatment was started, and the lesion remained stable in the following months. Case 2A 14-year-old girl was seen in consultation for a two-year history of a brown lesion on her back. The lesion was largely asymptomatic, and there was no antecedent of trauma or scratching in this area. Cutaneous examination showed a solitary brownish, firm plaque, 3 cm in diameter located on the lumbosacral region ( Fig. 1b). There were no other skin or mucosal abnormalities.An incisional biopsy from the solitary plaque was performed, and the histopathologic pictures showed an acanthotic epidermis with thin, elongated rete ridges and minimal basket-weave hyperkeratosis (Fig. 2a).The striking feature was the massive deposit of mucinous material in the whole dermis that stained positive with alcian blue at pH 2.5 (Fig. 2b). With the van Gieson stain, the density of elastic fibers was shown to be slightly reduced. Masson trichrome staining failed to demonstrate collagen fiber alterations. There were no abnormalities in eccrine sweat glands.Results of laboratory studies were within normal limits. Case 3A 14-year-old girl, twin sister of the previous case, presented with a well-defined plaque in the same area similar to her sister that had appeared some months previously. 1283