Androgenetic alopecia (AGA) is the commonest type of alopecia affecting over half of men and women. Only two drugs have been approved so far (minoxidil and finasteride), and hair transplant is the other treatment alternative. Low-level laser therapy (LLLT) has been claimed to be a new safe devise-based modality for stimulating hair growth in men and women in AGA. Searches of PubMed and Google Scholar were carried out using keywords alopecia, hair loss, and LLLT. Fifteen studies were found to be strongly relevant and were analyzed. Studies have shown that LLLT stimulated hair growth in both men and women. Studies with largest randomized controlled trials demonstrated statistically significant hair regrowth by terminal hair count in both males and females. One study also showed that LLLT and minoxidil had similar efficacy in hair growth and that combination therapy was even more effective. LLLT represents a non-invasive, safe, and potentially effective treatment option for patients with AGA who do not respond or are not tolerant to standard treatment of AGA. Moreover, combining LLLT with topical minoxidil solution and oral finasteride may act synergistic to enhance hair regrowth. However, the level of evidence of the studies is still low and hence more controlled large studies are needed.

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Background: Auricular keloids that occur after ear piercing or other traumas can challenge surgeons as recurrence is frequent; there has been no consensus about the best management protocol. Surgical excision combined with perioperative corticosteroid injections is frequently used as first-line therapy, but recurrent auricular keloids are usually shifted to a combination of radiotherapy and surgical excision. Objectives: The objective is to evaluate the rate of recurrence when recurrent auricular keloids are treated with surgical excision with perioperative corticosteroid injections. Materials and Methods: Between February 2017 and January 2020, 41 patients (52 auricles) with recurrent auricular keloids were treated by extralesional keloid excision combined with five corticosteroid steroid injections (two preoperative, one intraoperative, and two postoperative doses). Recurrence was recorded if the surgical scar showed hypertrophy or started to rise above the level of the margins. Results: The mean postoperative follow-up was 13.04 months (ranging from 6 to 24 months). Recurrence was recorded in five auricles (9.6%) during the follow-up period. Conclusion: Perioperative corticosteroid injections combined with surgical excision of auricular keloids are still a valid option in recurrent cases, and it is a useful choice when radiotherapy facilities are limited.

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Platelet-rich blood concentrates have been used to accelerate healing process in wounds and in bones since many decades worldwide. Platelet-rich fibrin (PRF) is a relatively new and established therapy, utilizing platelets and leucocytes trapped in fibrin matrix, for the treatment of non-healing ulcers and wounds. Many large series are available in this subject to prove its efficacy. Our patient, a known case of eczema, had applied slaked lime (calcium hydroxide) over an eczematous lesion on right leg and surrounding area, after which he developed deep wound with extensive erythema and blisters initially, which healed with necrosis due to patient’s neglect, in about 2 weeks. On presentation to us, the lesion had undergone necrosis and hence decision to debride the lesion was taken. After debridement, a large defect was created, which we tried treating conservatively using PRF therapy primarily, followed by pressure dressing. High dose vitamin C was given orally. The patient required antibiotics intermittently. The patient responded well to this protocol and the wound defect was closed within a few weeks.

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Background: Multiple viral warts represent a frustrating challenge for both patients and physicians. Management is difficult, primarily due to recalcitrance to standard therapy and high recurrence rates. Recently, intralesional antigen immunotherapy has shown promising efficacy in the treatment of warts. Objective: The aim of our study was to compare efficacy and safety of intralesional PPD versus measles, mumps, and rubella (MMR) vaccine in the management of multiple warts. Materials and Methods: One hundred and five patients having multiple warts were randomly divided into group A (PPD), group B (MMR) and group C (normal saline), with 35 patients in each group. In each group, the largest wart was injected intralesionally with 0.1 mL of vaccine at 2 weeks interval until complete clearance or for a maximum of 8 weeks. Results: Out of 105 patients enrolled in the study, 27, 25, and 21 patients completed the study in group A, group B, and group C, respectively. Rest were lost to follow up due to various reasons such as pain and long treatment duration. Complete clearance was seen in 14 patients (51.85%) in group A, 14 patients (56%) in group B, and 0 patients in group C. Partial clearance was seen in four patients (14.81%) in group A, four patients (16%) in group B, and three (14.28%) patients in group C. Nine patients (33.33%) in group A, seven patients (28%) in group B and 18 (85.71%) patients in group C did not respond to immunotherapy. Conclusions: Intralesional immunotherapy by both vaccines is a promising, effective, and safe treatment modality with MMR having slight edge.

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Background: Cutaneous warts are common benign skin lesions caused by human papillomavirus. Various treatment options are available for these but immunotherapy is becoming more and more popular over the past few years. It stimulates cell-mediated immunity causing clearance of warts. Aims and Objectives: The aim is to determine the role of intralesional vitamin D3 in the treatment of warts. Materials and Methods: Consecutive patients with verruca vulgaris attending OPD were included. Around two to three warts were injected first with 0.2 mL of lignocaine (20 mg/mL). After a few minutes, the same warts were injected with 0.2 mL (4 U) of vitamin D3 (15 mg/mL). The injections were given2 weeks apart for a maximum of six sessions, and the patient was followed up 3 months after the last injection. Results: A total of 41 patients of cutaneous warts completed the study. Complete clearance was seen in 27 (65.85%) patients, partial response was seen in 11 (26.83%) patients, and three patients (7.32%) showed no response at all. The mean number of injections required for complete response was four. Recurrence was seen in two patients (4.88%) and one patient had keloid formation at the sight of injection. Limitation: This is a small sample sized study and lacks a control group. Conclusion: Intralesional vitamin D3 is an effective treatment option for common warts.

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Infantile hemangiomas (IHs) are common benign lesions involving most part of the body. It can regress spontaneously but these hemangiomas should be treated early on course of evolution to prevent further complications. Different treatment options are available for its management. Topical timolol 0.5% solution available as eye drops or gel can be used as first-line therapy even in complicated IH. We have successfully treated a large complicated facial IH by using topical timolol 0.5% solution.

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Introduction: Atrophic dermatofibroma is a rare variant of dermatofibroma which is many times underdiagnosed. Case Report: We report a case report of a 29-year-old female who came to the dermatology department with black-colored lesions on the lower leg for the past 7 years. Histopathological examination revealed a non-encapsulated dermal tumor involving upper to deep reticular dermis and extending to superficial subcutis. There was epidermal hyperplasia, and at the center of the lesion a slight epidermal atrophy was present. Discussion: It is a commonly underdiagnosed variant of dermatofibroma. Histopathologically, this disorder presents as a decrease in at least 50% of the thickness of the dermis relative to the adjacent dermis. The case is rare and hence reported.

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We describe a unique method for formulating trichloroacetic acid (TCA) in different strengths with the help of a syringe.

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Bowen’s disease is an in situ squamous cell carcinoma of the skin, commonly seen in the elderly, on sun-exposed areas. Although it can occur on any site of the body, the involvement of glabrous skin is rare. Bowen’s disease of hand is very rare, only a few cases are reported and none of them is managed surgically with immediate reconstruction. Through this article, we present a case of Bowen’s disease of the palm managed by oncologically safe excision and cosmetic reconstruction by in-step graft.

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Context: As propranolol has emerged as first-line therapy for problematic infantile hemangioma, the number of non-responders and partial responders to propranolol therapy is also increasing. Aims: The study was conducted to evaluate the response of intralesional bleomycin, triamcinolone, and a combination of both as second line of treatment for the residual hemangioma following propranolol therapySettings and Design: A prospective comparative study was conducted in patients who were either non-responders or partial responders to previous propranolol treatment. Materials and Methods: The patients randomly received injection bleomycin, injection triamcinolone, and combination of both bleomycin and triamcinolone. The response to treatment was recorded clinically by using photographs. The pathological response was assessed by calculating pre-treatment and post-treatment microvessel density in biopsy of lesion from the non-cosmetic sites using immunohistochemistry. Statistical Analysis Used: χ² test was used to test the association between the variables. The utility of microvessel diameter (MVD) in terms of clinical response to the therapy was predicted by using receiver operating characteristic (ROC) curve. Results: Out of the 134 patients, 42 received bleomycin and 44 received triamcinolone and were treated with a combination of both. The overall clinical response was better in the combination group compared with the bleomycin group (P = 0.018) and triamcinolone group (P = 0.0005), respectively, after 6 months of follow-up. There was no difference in clinical response between the triamcinolone and bleomycin groups. Change in MVD correlated with the clinical response. Conclusion: The combination of bleomycin and triamcinolone is effective and safe for the treatment of residual hemangioma.

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Vitiligo involving the angle of lip is a therapeutically challenging site because of the small and delicate area, high mobility, and lack of hair follicles. Dermabrasion combined with topical 5-fluorouracil cream has shown promising results in various studies involving different sites. Here we present a novel technique of using radiofrequency cautery for abrasion of epidermis followed by application of 5-fluorouracil cream. This technique has the advantage of being simple, easy, cost-effective with less downtime. A single session can yield excellent pigmentation in small areas such as the angle of lip.

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As tinea capitis rarely affects infants, early trichoscopic diagnosis facilitates timely institution of appropriate therapy. We report a 10-month-old female presenting with mixed pattern tinea capitis and coexisting tinea faciei wherein trichoscopy showed perifollicular scaling, comma hair, corkscrew hair, and horse-shoe hair. Case 2 was a 3-month-old female with gray patch tinea capitis, corroborated by the presence of perifollicular scaling, comma hair, corkscrew hair, and prominent telangiectasia on trichoscopy. Both cases were successfully treated with tablet fluconazole (5 mg/kg) for 6–8 weeks.

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Historically, nose piercing was considered as the symbol of elegance and sometimes also associated with regional ritual. In modern civilization, there has been a decreasing trend to wear nose rings and some people demand for its closure. Herein, we report a case series of three patients who were successfully managed with full-thickness skin grafting for the closure of nose piercing site.

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Melanoma is a malignant tumor that is derived from melanocytes of the skin and other sites. Melanoma accounts for 1% to 3% of all malignancies and 1% to 2% of all cancer deaths worldwide. We are presenting a case of a 42-year-old female who presented to the surgery department with a growth over the right heel since 18 months, with a history of trauma to the site. The lesion showed rapid progression with a large mass and secondary skin ulceration and sloughing. A PET scan showed an enhancing lesion on the right heel measuring 11 mm in thickness. There was no evidence of any systemic organ or any lymph node metastasis. Surgical excision and reconstruction on the part of the heel by a local flap with sural graft with split-thickness skin grafting was done. The excised growth was sent for histopathology. The histopathological diagnosis of nodular melanoma (NM) of the heel was given. We are presenting this case for its clinical, histopathological, and surgical management.

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Keratoacanthoma (KA) is a common and distinctive cutaneous neoplasm that behaves in a benign fashion, displaying rapid growth followed by spontaneous involution. Clinical and histological examinations are essential to confirm this diagnosis, although differentiating KA from squamous cell carcinoma is often difficult. In general, complete surgical excision is a standard of care for solitary KAs; however, the conservative approach could be considered in some selected situations.We present the case of a 59-year-old female patient who presented with a KA, on a high-risk area, displaying self-involution after undergoing a biopsy. This is one of the few cases in the literature in which spontaneous resolution process was photographically documented with good cosmetic results.

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