41BAP1 germline mutations predispose to a cancer predisposition syndrome that includes 42 mesothelioma, cutaneous melanoma, uveal melanoma and other cancers. This co-occurrence 43 suggests that these tumors share a common carcinogenic pathway. To evaluate this hypothesis, we 44 studied 40 Italian families with mesothelioma and/or melanoma. The probands were sequenced for 45BAP1and for the most common melanoma predisposition genes (i.e. CDKN2A, CDK4, TERT, MITF 46 and POT1) to investigate if these genes may also confer susceptibility to mesothelioma. 47In two out of six families with both mesothelioma and melanoma we identified either a germline 48 nonsense mutation (c.1153C>T, p.Arg385*) in BAP1 or a recurrent pathogenic germline mutation 49 (c.301G>T, p.Gly101Trp) in CDKN2A. 50Our study suggests that CDKN2A, in addition to BAP1, could be involved in the melanoma and 51 mesothelioma susceptibility, leading to the rare familial cancer syndromes. It also suggests that 52 these tumors share key steps that drive carcinogenesis and that other genes may be involved in 53 inherited predisposition to malignant mesothelioma and melanoma.

Low recurrence rate can be achieved when treated with MMS; it is the treatment of choice for many BCC of the head. Aggressive histopathological subtypes, critical head sites and recurrence after incomplete excision are the most important indications for MMS.

We present a 21-year-old Italian girl with an 8-year history of missed diagnosed prurigo pigmentosa (PP) successfully treated with short monotherapy with minocycline. PP is an inflammatory disease characterized by recurrent pruritic erythematous papules followed by reticular hyperpigmentation usually located on the trunk. About 300 cases of PP have been described mainly in Japan, whereas only few cases have been reported in Italy. This report shows that minocycline is rapidly effective probably through its ability to scavenge reactive oxygen species and to inhibit the chemotaxis and neutrophil function. Other than its ethnic rarity, this case is very interesting because it is the third case of PP in Caucasian patient with prepubescent onset.

Germline mutations on the CDKN2A gene, the most important known genetic factors associated with cutaneous melanomas (CMs), predispose carriers to multiple primary CMs (MPMs) with higher frequency and younger onset compared to non-carriers. Most of the largest published studies concerning clinical and histological characteristics of CMs with CDKN2A mutation carriers did not specify if the described CMs are first or subsequent to the first, and they used sporadic CMs from non-genotyped patients as controls. We conducted a single-centre observational study to compare clinical and histological CM features of 32 unrelated carriers (MUT) of 5 germline CDKN2A mutations (one of which was never previously described) compared to 100 genotyped wild-type (WT) patients. We stratified the data based on time of diagnosis, anatomical site and histological subtype of CMs, demonstrating several significant unreported differences between the two groups. MUT developed a higher number of dysplastic nevi and MPMs. We proved for the first time that anatomical distribution of CMs in MUT was independent of gender, unlike WTs. MUTs developed in situ and superficial spreading melanomas (SSMs) more frequently, with significantly higher number of SSMs on the head/neck. In MUTs, Breslow thickness was significantly lower for all invasive CMs. When CMs were stratified on the basis of the time of occurrence, statistical significance was maintained only for SSMs subsequent to the first. In WTs, Clark level was significantly higher, and ulceration was more prevalent than in MUTs. Significant differences in ulceration were observed only in SSMs. In nodular CMs, we did not find differences in terms of Breslow thickness or ulceration between WTs and MUTs. In situ CMs developed 10 years earlier in MUTs with respect to WTs, whereas no significant differences were observed in invasive CMs. In contrast to those reported previously by other authors, we did not find a difference in skin phototype.

Background/Aim: The guidelines of the British Photodermatology Group for topical treatment with psoralen and ultraviolet light (PUVA) recommend starting UVA doses between 0.2 and 0.5 J/cm², according to the phototype. Our purpose was to evaluate the therapeutic efficacy and tolerability of bath PUVA, with 8-methoxypsoralen (8-MOP), by using lower UVA doses, regardless of phototype. Methods: We compared 2 groups of patients (group 1: n = 10, group 2: n = 20) with chronic plaque-type psoriasis. Group 1 was treated with the usual starting dose and dose progression; group 2 was treated by using a lower first dose, a slower dose progression and reaching a lower maximum dose. The Psoriasis Area and Severity Index (PASI) score was assessed at the initial stages, and every month until the end of the treatment. Results: In group 1, the median baseline PASI score decreased from 15.2 to 4.5 (p < 0.005, Student’s paired t test), while in group 2, it fell from 13.7 to 4.1 (p < 0.005). No statistical difference between the groups is detectable. Severe phototoxic reactions were observed only in 2 patients of group 1. Side effects were not observed in group 2. Conclusions: Our data indicate that an aggressive bath PUVA treatment is not substantially more effective in clearing chronic plaque-type psoriasis than a milder therapeutic approach.