ABSTRACT
INTRODUCTION@#The occurrence of malignant tumors associated with leprosy has been observed, with lymphoma being the most commonly associated non-epithelial malignant tumor and may be due to the depressed immunologic surveillance. The converse where leprosy manifests in a lymphoma patient undergoing chemotherapy has also been mentioned in a few articles.@*CASE SUMMARY@#A 49-year-old female was diagnosed to have peripheral T-cell lymphoma after an initial presentation of enlarged lymph nodes, generalized asymptomatic papules and plaques on the trunk, and pancytopenia. Two weeks after initiation of chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP), her skin lesions progressed to become violaceous to slightly hyperpigmented. Further query revealed a year-long history of hypoesthesia of the lower extremities. Histopathologic examination revealed nodular histiolymphocytic infltrates surrounding blood vessels, adnexal structures, and nerves, consistent with lepromatous leprosy. Fite-Faraco stain was positive. Due to lymphoma-related pancytopenia, the patient was given monthly rifampicin, ofoxacin and minocycline (ROM) chemotherapy, alternatively. Erythema nodosum leprosum reaction developed for which clofazimine was given, resulting in improvement.@*CONCLUSION@#Leprosy is a great mimicker and dermatologists need to be adept at diagnosing skin conditions in immunocompromised patients, especially since disease course and manifestation may be modifed in this subset of patients. Leprosy must be considered when granulomatous lesions arise in lymphoma patients before ascribing them to the underlying disease. Management may also be challenging due to the comorbidities, which may limit treatment options. Careful history, clinical clues, histopathologic correlation, and prudent therapeutic approach are important tools in addressing these cases.
ABSTRACT
INTRODUCTION: There is a consistent increase in the interest and demand for non-invasive modalities toimprove facial skin laxity and rhytides. Monopolar radiofrequency is one of such non-invasive modalities.This systematic review aimed to determine the efficacy and safety of monopolar radiofrequency inimproving facial rhytides and skin laxity.METHODS: Clinical studies that assessed the efficacy of monopolar radiofrequency to address clinicallyobservable facial rhytides and skin laxity were included. Outcome measures included improvementin rhytides and skin laxity as documented by patient satisfaction scores, and investigator and third-personobserver ratings based on clinical photographs and clinical scales.RESULTS: Three studies involving 29 participants were included in this review. All studies reported 25-50% improvement in facial rhytides and skin laxity. Participants from the three studies were satisfiedwith the results. Transient erythema was reported in several patients.CONCLUSION: Monopolar radiofrequency appears to be beneficial and safe for patients with facialrhytides and skin laxity. However, the evidence is inconclusive due to problems in the methodologicalquality of each trial and the heterogeneity of the studies included in this review.