Efficacy and safety of diode laser for facial hair reduction in hirsutism-a clinico-trichoscopic evaluation.

Background: Hirsutism is the presence of excessive terminal hair on androgen-dependent sites of the body. Lasers like Alexandrite, diode, and Nd:Yag lasers have been used for hair reduction with varying efficacy. Trichoscopy of hair is a simple noninvasive method of hair assessment. However, it has not been used in the assessment of diode laser hair reduction. Objectives: This study aimed to assess the efficacy and safety of diode laser hair reduction in skin color with the help of clinical and trichoscopic assessment. Materials and Methods: This prospective observational study included 73 patients of hirsutism recruited in 18-month period. All participants received sessions of 805 nm diode laser at monthly intervals up to six sessions. Clinical and trichoscopic evaluation along with photographs were obtained at each visit. Side effects, if any, were noted in every sitting. Results: All patients were females of Fitzpatrick skin types III-V. All clinical parameters showed statistically significant hair reduction when compared with baseline. Trichoscopic parameters of hair reduction like total hair count, terminal hair count, and terminal/vellus hair ratio showed reduction compared to baseline which was statistically significant (P < 0.05). The most common side effect noted in our study was pain followed by erythema and perifollicular edema. Conclusions: Diode laser is an effective and safe procedure for the reduction of unwanted facial hair, even in darker skin types. We also wish to emphasize that trichoscopy for the assessment of laser hair reduction is a recent, noninvasive, simple, and underutilized tool. No serious adverse events were noted in our study.

Efficacy of apremilast in hyperkeratotic hand and foot dermatitis: results from a randomized observer-blinded comparative study.

BACKGROUND: Hyperkeratotic hand and foot dermatitis significantly affects quality of life. Some patients respond suboptimally to topical corticosteroids and have multiple recurrences. OBJECTIVE: Our aim was to compare the efficacy and safety profile of apremilast and topical corticosteroid versus corticosteroid alone in hyperkeratotic hand and foot dermatitis. METHODS: This randomized controlled study involved 77 patients treated for 3 months. Group A (39 patients) received mometasone furoate 0.1% cream with oral apremilast 30 mg twice daily, and Group B (38 patients) received mometasone alone. They were assessed monthly using the Hand Eczema Clinical Severity Index (HECSI) and Visual Analogue Scale (VAS) scores for pruritus. Investigator Global Assessment (IGA) and Quality of Life in Hand Eczema Questionnaire (QOLHEQ) were conducted at the end of 3 months. RESULTS: The HECSI, VAS score, and QOLHEQ showed a significant decrease in both groups from baseline to the third month. Intergroup comparisons of HECSI failed to reach the significance level. When compared, patients receiving apremilast had significantly better improvement in the third month according to the Patient Global Assessment (PGA) and Investigator Global Assessment (IGA). They also had a smaller number of flares. CONCLUSION: Adding apremilast to topical corticosteroid leads to better patient and physician-perceived improvement and reduces the number of flares in hyperkeratotic hand eczema.

'Generalised Pruritus with Prurigo-Like Lesions and Generalised Lymphadenopathy: Could be an Early Diagnostic Clue for Angioimmunoblastic T-Cell Lymphoma (AITL) and/or Histoplasmosis'.

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon systemic lymphoproliferative disorder that comprises approximately one-fifth of all mature peripheral T-cell lymphomas. A broad range of cutaneous manifestations include maculopapular, papulovesicular, erythrodermic, urticarial, plaque-like and nodular, and they are mentioned in 50% of patients and may precede systemic symptoms, which include lymphadenopathy, hepatosplenomegaly and constitutional symptoms. Histoplasmosis is a common granulomatous infection worldwide caused by Histoplasma capsulatum, a dimorphic fungus. Cutaneous manifestations are reported to occur in 10% to 25% of immunosuppressed patients with disseminated histoplasmosis. Generalised pruritus as a presenting feature is rarely described in both of these entities. We report a unique case of AITL with histoplasmosis discovered during paraclinical assessment of generalised pruritus (? neurodermatitis) with prurigo-like lesions and lymphadenopathy.