The edition · Dermatology
Lichen planus carries a site-matched cancer risk worth a follow-up plan
A Danish nationwide cohort links oral and genital lichen planus to cancers at the same sites, while a review narrows antibiotic prophylaxis in skin surgery and a family sun-protection trial misses its main target.
The edition in brief
Today's dermatology edition opens on antibiotic stewardship. A JAAD continuing-education review restates that excisional and Mohs surgery are clean procedures with low infection rates, that systemic prophylaxis belongs to defined high-risk patients and sites, and that plain petrolatum is enough for most clean wounds. A US randomised trial of 364 parent-child pairs, in which the parent had survived melanoma, found a telehealth family programme improved children's sun-protective behaviour but did not reduce sunburn over time compared with general education. An expert Delphi panel on pseudofolliculitis barbae agreed 40 statements, putting change in shaving practice first and supporting laser hair removal, with no agreement on isotretinoin, peels or multiblade razors. The pearl covers examining the mouth and genitals in every patient with lichen planus. The edition closes on a Danish register study of 35,845 people with lichen planus: compared with the general population, women had about seven times the expected rate of oral cavity cancer and 2.6 times that of vulval cancer, with risk concentrated at the site of the lichen planus. Absolute 20-year risks stayed around 1% or less, which argues for targeted follow-up rather than alarm.
Antibiotic prophylaxis in skin surgery: a narrow list, not a habit
Most skin surgery needs no antibiotics; reserve prophylaxis for defined high-risk patients and use petrolatum, not topical antibiotics, on clean wounds.
Family sun-protection programme changed habits but not sunburn
When seeing a melanoma survivor, ask about their children's sun protection and plan repeated reinforcement, as one-off education did not reduce sunburn.
Pseudofolliculitis barbae: experts agree to change the shave first
Treat pseudofolliculitis barbae by changing the shave first, adding topical treatment and considering laser hair removal for persistent disease.
Look in the mouth and at the genitals in every case of lichen planus
In every patient with lichen planus, ask about and examine the mouth and genitals, and document any erosive disease.
Lichen planus: cancer risk follows the site of disease
Plan site-matched follow-up for oral and genital lichen planus and biopsy any persistent change, while explaining that absolute risk stays low.
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