A cheap acute-phase marker sharpens the anti-MDA5 warning in dermatomyositis

The edition in brief

Today's dermatology desk leads with a retrospective cohort in which serum amyloid A was markedly raised in dermatomyositis with rapidly progressive interstitial lung disease, mean 103.60 mg/L, and combining it with anti-MDA5 antibody gave an area under the curve of 0.950 (95% CI 0.906 to 0.995) for identifying that group. A level above 21.98 mg/L independently marked worse survival, though on very wide confidence limits. A retrospective multicentre case series of 33 patients given one or two 100,000 international unit doses of oral vitamin D for toxic erythema of chemotherapy or acute radiation dermatitis reports symptom relief in 26 of 30 within ten days, a fall in mean erythema score from 4.36 to 2.21 by day 10, no meaningful calcium change, and 73% continuing anticancer treatment without interruption. A meta-analysis of 11 case-control studies confirms MITF E318K as a moderate-penetrance melanoma allele, odds ratio 2.55 (95% CI 1.90 to 3.43), stronger in multiple primary melanoma and strongly enriched in people with more than 200 naevi. A pooled comparison of fractional carbon dioxide against erbium lasers for atrophic acne scars favours carbon dioxide for clinical response, relative risk 0.69 for erbium (95% CI 0.49 to 0.97), at the cost of more pain and about 3.7 extra days of downtime. A clinic pearl separates post-inflammatory hyperpigmentation from post-inflammatory erythema. The edition closes with a split-face trial in Fitzpatrick III to V skin showing a model-guided non-whitening laser endpoint matched clearance while cutting post-inflammatory hyperpigmentation from 22.6% to 4.8%.