Five years out from stage IV melanoma, two in five are still carrying the treatment

The edition in brief

A German-led survey of 296 people surviving more than five years after stage IV melanoma, recruited across 40 centres in Austria, Germany and Switzerland, found about 40 per cent reporting persistent treatment-related adverse events and about 40 per cent scoring above the distress threshold. Cognitive deficits after cerebral radiotherapy and lymphoedema after surgery were the commonest complaints; persistent systemic-therapy toxicity was associated with raised distress (OR 1.99, P = .025). Around 23 per cent reported financial constraints, 44 per cent of retirees had retired early because of melanoma, and of those aged 65 or under still working, half had reduced their hours. The authors argue for dedicated survivorship programmes with validated screening and vocational, financial and psychological support. A GRADE-based Saudi national guideline update for moderate-to-severe plaque psoriasis issues 27 recommendations and 4 good-practice statements, strongly recommending PASI 90 rather than PASI 75 as the treatment target, biologics across IL-17, IL-23, IL-12/23 and TNF-alpha classes for adults, and early biologic initiation in children with etanercept, secukinumab, ixekizumab and adalimumab named as preferred. A JAAD continuing-education review sets out the cardiometabolic effects of systemic dermatological treatments — retinoids, anthracyclines, antifungals, oral minoxidil, methotrexate, phototherapy and colchicine — with monitoring recommendations. And a post-hoc analysis of the CASCADE prevention trial shows that asking a caregiver whether a clinician has diagnosed eczema identifies atopic dermatitis in under-twos better than a symptom questionnaire does, with sensitivity 71.6 per cent and specificity 93.2 per cent at 24 months.