Subclinical atherosclerosis in patients with hidradenitis suppurativa treated with TNF inhibitors.

BACKGROUND: Hidradenitis suppurativa (HS) is an independent risk factor for the development of subclinical atherosclerosis. Tumour necrosis factor (TNF) inhibitors are effective for the treatment of recalcitrant moderate-to-severe HS. However, the effect of treatment with TNF inhibitors on subclinical atherosclerosis in HS patients has not been previously investigated. OBJECTIVES: In this study, we aimed to assess changes in biochemical parameters (fasting blood glucose and lipid levels) and carotid intima-media thickness (CIMT) values in Hurley stage II and III HS patients undergoing treatment with TNF inhibitors. METHODS: This was a single center prospective study including 30 patients with Hurley stage II and III HS and 30 healthy controls (HCs). Baseline values of biochemical parameters and CIMT were compared to the values recorded after at least 6 months of TNF inhibitor therapy. RESULTS: CIMT values of the HS patients significantly exceeded those of HCs (for right p = 0.011 and for left p = 0.017). After at least 6 months of TNF inhibitor therapy, there was a statistically significant decrease in fasting blood glucose (p = 0.001), whereas total cholesterol levels significantly increased (p = 0.001). CIMT values also significantly increased (for right p = 0.02 and for left p = 0.01). STUDY LIMITATIONS AND CONCLUSIONS: Small sample size is limitation of the current study. Our study shows that patients with Hurley stage II and III HS undergoing TNF inhibitor therapy are under risk for progression of subclinical atherosclerosis.

Dermoscopic findings in a case of multiple subungual fibromas.

Periungual and subungual fibromas, also known as Koenen tumors, are diagnostic findings of tuberous sclerosis. The clinical appearance and histological features that characterize ungual fibromas are well defined. However, dermoscopic findings of these benign tumors have not been reported previously. Here we report a rare presentation of multiple subungual fibromas of all fingers in a developmentally delayed patient with tuberous sclerosis along with the dermoscopic features of the ungual tumors.

Efficacy of focused radiofrequency with ultrasound in body contouring: A study of 64 patients.

BACKGROUND: Energy-based devices are increasingly used for noninvasive body contouring. Our aim was to investigate the clinical efficacy of combined radiofrequency and ultrasound device for reduction in body circumference in various body parts. AIMS: The aim of our study was to investigate the clinical efficacy of combined focused radiofrequency and ultrasound device for reduction in body circumference in various body parts. We aimed to report objective measurements in terms of circumference reduction and patient satisfaction scores. METHODS: We retrospectively analyzed data of 64 patients who were treated with focused radiofrequency and ultrasound device during August 2017-December 2019. All patients had received 4 sessions at one-week interval. Body circumference measurements were done before treatment and one month after the last session. Patients were also asked to score their satisfaction with the result of treatment on a scale of 1 to 5. RESULTS: Abdomen was treated in 40 patients, thighs in 18 patients, and arms in 7 patients. One patient had received treatments to both abdomen and thighs. Circumference measurements in all body parts differed significantly between baseline and one month after the 4th session. Patients were satisfied with the result of treatment (score: 4.48 ± 0.66). No adverse events were noted. CONCLUSIONS: Focused radiofrequency and ultrasound combination is a safe and effective treatment modality for body contouring. Patients should be informed about moderate degrees of improvement.

Treatment of alopecia areata with 2940-nm fractional erbium:yttrium-aluminum-garnet laser.

Various laser therapies have been used for the treatment of alopecia areata (AA). Enhanced hair regrowth was reported with the use of ablative fractional 2940-nm erbium:yttrium-aluminum-garnet (Er:YAG) laser in a murine model. However, clinical effectiveness of fractional Er:YAG laser for hair disorders has not been investigated in human studies. The aim of our study was to assess the effectiveness of 2940-nm fractional Er:YAG laser in the treatment of chronic AA that is unresponsive to conventional therapies. Twenty-five AA patients underwent three sessions, each 4 to 6 weeks apart, of fractional Er:YAG laser. Clinical evaluation was done at baseline and 1 month post-treatment (follow-up) by photographic assessment. Subjective evaluation by patient satisfaction score was also performed. Photographic evaluation of the patients revealed a mean percent change in SALT score of 17.4 ± 3.5% at follow-up. A total of 16 patients who were treated for patchy AA of the scalp showed 27.8 ± 31.3% regrowth. Five patients who were treated for AA of the beard had 39 ± 34.2% regrowth. Fractional Er:YAG laser might be a therapeutic alternative for patients with patchy AA of the scalp and beard that is unresponsive to conventional therapies.