Combining platelet rich plasma with ablative laser for post acne scars: A review.

Background Acne scars are one of the most common sequelae of inflammatory acne. It commonly affects adolescents and young adults and hence is associated with significant psychological morbidity. It is historically resistant to oral as well as surgical modalities. In the last two decades, ablative lasers (fractional or otherwise) have proven to be effective in management of acne scars. Some studies have proven the efficacy of platelet rich plasma in reducing the adverse effects and improving the efficacy of lasers. Objective Review of the studies combining platelet rich plasma with ablative laser for post acne scars. Methods A literature review of the MEDLINE database for studies evaluating the combination of ablative lasers with platelet rich plasma was performed. Only studies with higher levels of evidence (randomised controlled trials and comparative studies) were included in this review. Results Adding intradermal platelet rich plasma to fractional ablative lasers in the management of post acne scars increases clinical efficacy, reduces downtime as well as frequency and duration of ablative lasers related adverse effects. The efficacy of topical platelet rich plasma is less as compared to intradermal platelet rich plasma. Limitations The studies analysed are heterogeneous in nature with varied protocols and duration of follow up. Conclusions It is recommended to combine the ablative lasers with intradermal platelet rich plasma for better clinical response and reduce adverse effects as well as downtime.

Current understanding of frictional dermatoses: A review.

Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as 'a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.' The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms 'frictional dermatitis,' 'friction and skin,' 'dermatoses and culture,' 'clothing dermatitis,' 'friction melanosis,' 'PPE induced dermatoses in COVID-19 era,' etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.

Undiagnosed purpura: a case of autoerythrocyte sensitization syndrome associated with dermatitis artefacta and pseudo-ainhum.

A 23-year-old young woman presented with recurrent episodes of painful bruising along with linear erosions on the accessible areas of the body of nine years duration with a pseudo-ainhum of her left nipple for the past three months. Her case history included repeated visits to various physicians at different centers and an extensive investigative profile. A diagnosis of autoerythrocyte sensitization was made on the basis of the clinical history, dermatological examination complemented by a positive autoerythrocyte sensitization test, psychiatric evaluation and absence of any organic cause for her ailment. She was placed on psychiatric management and has remained symptom-free after six months follow-up. The case is reported for its rarity, as well as for the association of autoerythrocyte sensitization syndrome with frank dermatitis artefacta and pseudo-ainhum, which to the best of our knowledge has not yet been reported in the literature.

Reiter's disease in a six-year-old girl.

Reiter's syndrome has characteristically been described in young males and presents with a triad of urethritis, conjunctivitis and arthritis. Reiter's syndrome has been known to affect children, although they usually do not manifest with the typical triad. Only a few such cases have been reported and these have described males predominantly. A case of a six-year-old girl who presented with watery diarrhea, redness of eyes and joint pains followed by skin involvement is reported. She was managed with topical salicylic acid and hydrocortisone, and oral aspirin and showed complete resolution of her clinical features in three weeks.

Relapsing linear acantholytic dermatosis in a four-year-old boy.

Linear acantholytic dermatoses are a spectrum of cutaneous disorders that form a subset of linear dermatoses with distinct clinical features and histopathologically show acantholysis. The lesions may be zosteriform or follow the lines of Blaschko. This report describes a four-year-old boy who, on a follow up of two years, exhibited a relapsing acantholytic dermatosis along the lines of Blaschko. Histopathology of a representative lesion revealed epidermal acantholysis with multiple acantholytic keratinocytes with in the prickle cell layer and an absence of corp ronds and grains, consistent with features of Hailey-Hailey disease. This, to our knowledge, is the third case of relapsing linear acantholytic dermatosis reported.