Multiclass Classification of Pigmented Skin Lesions Using a Multimodal Large Language Model.

Background: Pigmented skin lesions span benign to malignant entities that often appear similar on standard clinical photographs, complicating accurate diagnosis without specialized imaging. Recently, multimodal large language models (MMLLMs) have attracted attention as image-based diagnostic aids and hold promise as decision-support tools in resource-limited settings where dermoscopy may be unavailable.

Objectives: This study aimed to determine whether a fine-tuned MMLLM can accurately classify eight common pigmented skin conditions using only clinical photographs, thereby providing a non-dermoscopic diagnostic support tool.

Japanese Dermatological Association Guidelines: Clinical Questions of Guidelines for Extramammary Paget Disease 2025.

Extramammary Paget disease (EMPD) is a rare malignancy that primarily arises in apocrine gland-bearing areas such as the genital, perianal, and axillary regions. The clinical and biological heterogeneity of EMPD, together with a lack of evidence from large-scale studies, has made it difficult to establish standardized approaches to diagnosis and treatment. To address these issues, the 2025 Japanese Guidelines for the Management of EMPD were developed, providing evidence-based recommendations tailored to the healthcare context in Japan.

Prognosis of a deep excision margin within or beyond subcutaneous fat for invasive acral melanoma of the sole: A multi-institutional retrospective study.

Background: Preservation of plantar subcutaneous fat is crucial for cushioning in the surgical treatment of acral melanoma of the sole. However, no studies exist on the relationship between deep margins and prognosis. We aimed to retrospectively compare the prognoses of different deep margins (within or beyond the subcutaneous fat) in patients with invasive acral melanoma of the sole who underwent wide local excision.

Deep Learning-Based Classification System for Facial Pigmented Lesions to Aid Laser Treatment Decisions.

The accurate diagnosis of facial pigmented lesions is essential for selecting appropriate treatment strategies and improving patient outcomes. Deep learning algorithms, particularly convolutional neural networks (CNNs), have shown promise in classifying skin lesions but have been underutilized in differentiating facial pigmented lesions, particularly in the context of laser treatment planning. The aim of this study is to develop and evaluate deep learning models using transfer learning to differentiate among five types of facial pigmented lesions and compare their diagnostic accuracy with that of expert and non-expert dermatologists.

Comparing 2 cm vs. 1 cm surgical margins in acral melanoma of the sole with Breslow thickness greater than 2 mm: A multicenter retrospective study of 336 Japanese patients.

Introduction: Multiple randomized trials comparing wide local excision (WLE) with different peripheral margins have established recommended peripheral margins according to Breslow thickness (BT) in the National Comprehensive Cancer Network (NCCN) Guidelines. However, these clinical trials included only a small number of patients with acral melanoma (AM). Therefore, we aimed to compare the prognosis of different WLE peripheral margin cohorts with invasive sole AM.

Hemoglobin Concentrations and Prevalence of Anemia During Pregnancy: Results from the Brazilian Maternal and Child Nutrition Consortium.

Background: Anemia is common among pregnant women from low- and middle-income countries, but national estimates are scarce.

Objectives: We aimed to assess hemoglobin (Hb) concentrations and the anemia prevalence in Brazil.

Methods: Data included 12,287 pregnant women aged 15-49 y and 17,967 measurements from 7 studies (2007-2014) participating in the Brazilian Maternal and Child Nutrition Consortium.

Adjuvant Anti-PD-1 Monotherapy Versus Observation for Stage III Acral Melanoma of the Sole: A Multicenter Retrospective Study in Japanese Patients.

Purpose: Adjuvant anti-PD-1 (adj PD-1) antibodies are extensively used to improve survival in patients with resected melanoma. Clinical trials on adj PD-1 antibodies have revealed significant improvements in recurrence-free survival (RFS); however, few of these trials have included patients with acral melanoma (AM).

Methods: Clinical data were retrospectively collected from Japanese patients who underwent resection of stage III sole AM between 2014 and 2021.

Single-cell profiling of acral melanoma infiltrating lymphocytes reveals a suppressive tumor microenvironment.

Acral lentiginous melanoma (ALM) is the most common melanoma subtype in non-Caucasians. Despite advances in cancer immunotherapy, current immune checkpoint inhibitors remain unsatisfactory for ALM. Hence, we conducted comprehensive immune profiling using single-cell phenotyping with reactivity screening of the T cell receptors of tumor-infiltrating T lymphocytes (TILs) in ALM.

Extramammary Paget's disease treated with of anti-programmed cell death protein 1 therapy after docetaxel therapy failure.

Extramammary Paget's disease (EMPD) is a rare skin cancer with no standard treatment for advanced-stage disease. Although docetaxel-based chemotherapy is common, no standard treatment exists. Pembrolizumab is approved for solid tumors with a high tumor mutation burden (TMB) and/or high microsatellite instability, and nivolumab was approved in Japan in February 2024 for unresectable advanced or recurrent epithelial skin malignancies.

Distinct induction pathways of heat shock protein 27 in human keratinocytes: Heat stimulation or capsaicin through phosphorylation of heat shock factor 1 at serine 326 and/or suppression of ΔNp63.

Epidermal keratinocytes, forming the outermost layer of the human body, serve as a crucial barrier against diverse external stressors such as ultraviolet radiation. Proper keratinocyte differentiation and effective responses to external stimuli are pivotal for maintaining barrier integrity. Heat is one such stimulus that triggers the synthesis of heat shock proteins (HSPs) when cells are exposed to temperatures above 42 °C.

Malignant testicular unclassified sex cord stromal tumor: a case report.

Background: Most testicular tumors are germ cell tumors; sex cord stromal tumors are infrequent, accounting for only 3-5% of testicular tumors. Unclassified sex cord stromal tumors are extremely rare. Generally, 10% of sex cord stromal tumors are malignant.

Difference in immunohistochemical findings among anti-PD-L1 antibodies and their relationships with CD4+ and CD8+ T cells in Japanese melanoma patients.

Background: The immunohistochemical evaluation of programmed death ligand 1 (PD-L1) is important for selecting treatments. Several antibodies are available for such evaluations, but data regarding the differences in the antibodies' positivity are limited in melanoma, particularly the acral and mucosal types. We investigated the differences in melanoma tissues' PD-L1 expression among the commonly used PD-L1 antibodies and then evaluated the relationship between PD-L1+ tumor cells and tumor-infiltrating lymphocytes (TILs).