Syringomatous dermatitis: a myth or an existing entity?

Syringoma is rare disease that in classical variant occurs mainly on lower eyelids. In previously published researches, there is increasing evidence that eruptive syringomas must be discussed as an inflammatory dermal reaction pattern. And there was a proposal to change a name from eruptive syringoma to reactive syringomatous proliferation in appropriate cases. We conduct retrospective study on histopathological archived material to study the histopathological findings in cases of eruptive syringomas and correlate it with hypothesis that eruptive syringomas is not true adnexal neoplasms "de novo" but a hyperplastic response of the acrosyringium to an inflammatory process.According to obtained data and literature correlation, we can conclude that there is apparent diversity in eruptive syringomas. Part of cases can be calculated as neoplastic lesions arising "de novo," and another part as reactive syringomatous proliferation due to preceding cutaneous inflammatory process. Thus, term "eruptive syringoma" may be changed in appropriate cases to a "reactive syringomatous proliferation."Clinical variants of eruptive syringoma with evidence of underlying inflammatory process may be more responsive on types of treatments used for inflammatory disorders. Thus, more global clinicopathological correlative researches should be conducted and classification with terminology should be appropriately changed.

Topical niacinamide (Nicotinamide) treatment for discoid lupus erythematosus (DLE): A prospective pilot study.

BACKGROUND: Cutaneous lupus erythematosus is an umbrella term for a group of autoimmune connective tissue disorders affecting the skin. Discoid lupus erythematosus (DLE) is the chronic condition and most common form of cutaneous lupus erythematosus. AIMS: Current therapies of DLE are challenging and not completely satisfactory, highly expensive, off-label, or poorly available (like antimalarials due to COVID-19 outbreaks). Nicotinamide, also called niacinamide, is a water-soluble form of vitamin B3 (niacin). Its multiple effects let us think that nicotinamide could be a therapy for lupus-associated skin lesions. METHODS: We performed a prospective randomized double-blind clinical trial on 60 subjects diagnosed with Discoid lupus erythematosus using topical Nicotinamide 2% and 4% preparations in form of cream and gel on skin and scalp lesions. Control group was included using only cream/gel base as placebo control. RESULTS: Obtained data showed that topical Nicotinamide can be used for the treatment of DLE as adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Topical 4% Nicotinamide is superior to 2% preparation in response but associated with a higher incidence of irritation. CONCLUSION: Topical Nicotinamide can be used for the treatment of DLE as an adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Further trials with long-term therapy, follow-up period, and bigger sample sizes are required.

Pediculid: Literature Review with Case Presentation.

Introduction: ID reactions are infrequent disorders which are often misdiagnosed because they developed as acute dermatitis after days or weeks at skin locations distant from the initial inflammatory or infectious/infestations site. For now, several causes have been described to trigger such reactions which includes infection with dermatophytosis, Mycobacterium, viruses, bacteria, and parasites. Pediculid nowadays is forgotten entity in dermatology daily practice as well as major dermatology textbooks. Case Presentation: We present an illustrative case report of pediculid that is an ID reaction to Pediculosis capitis in 6 y.o. girl with acute generalized eczematous dermatitis successfully treated by elimination of pediculosis. Also, there is description of relapsing the condition with reinfestation. Discussion/Conclusion: During discussion and literature review, comprehensive description was made to the ID reaction as entity and its diagnostic criteria. In conclusion, we want to highlight that being aware of such possibility is important (especially in pediatric patients) to reach a correct diagnosis quickly and avoid unnecessary treatment and examinations.

Evaluation of safety and efficacy of topical 4% nicotinamide in treatment of psoriasis; among a representative sample of Egyptians (an analytical observational study).

To assess and evaluate the efficacy and safety of nicotinamide 4% topical formulation for the treatment of mild to moderate psoriasis. This study was conducted on 60 patients aged 18-65 years, with mild to moderate psoriasis vulgaris. Nicotinamide 4% in a cold cream base was used twice daily for 12 weeks. Nicotinamide 4% topical treatment shows satisfactory results, more in males than in females. Some patients report disturbing irritation (burning, itching, and redness) upon the usage of topical nicotinamide treatment and were advised to wash out the treated area after 1 h of cream application, which solved the issue. No other adverse effects of treatment were reported by patients during the study period. Unicentral base, a limited amount of sample size, and 12 weeks duration of therapy and follow-up period, which may not be sufficient to demonstrate the complete therapeutic properties and side effects of using nicotinamide as a long-term treatment for psoriasis. This study reveals statistically reliable evidence of the positive impact of topical 4% nicotinamide preparation used alone on the treatment of psoriasis with minimal side effects. Thus, we can conclude that topical nicotinamide preparation may be a good adjuvant to the current treatment regimens used alone or alternate currently used topical therapeutical regimens if used in combination.

Comparative study of the use of fractional CO2 laser versus the use of liquid nitrogen cryotherapy in the treatment of alopecia areata in a sample of the Egyptian population.

Alopecia areata (AA) is an autoimmune disease that is represented as patches of hair loss, fractional CO2 laser and cryotherapy are used to stimulate hair growth in patients of AA. Evaluation of fractional CO2 laser effect versus liquid nitrogen cryotherapy in the treatment of AA. Eighty patients presented with patches of AA. The first group consisted of 40 patients were treated with fractional CO2 laser, the second group also 40 patients were treated with cryotherapy. The efficacy of the treatment was statistically evaluated. A positive therapeutic response was noted in most patients by trichoscopy at the end of treatment, there was a decrease in exclamation mark hairs, yellow dots, black dots, broken hairs, and an increase in short vellus hair and circle hair of patients compared to baseline and control. No serious side effects were seen. Fractional CO2 laser and liquid nitrogen cryotherapy are considered a promising, safe, and effective treatment modality with the better result with CO2 laser.

A Rare Case of Coexisting Pediculosis Capitis and Tinea Capitis in a Healthy Adult Female.

Pediculosis capitis is a common condition caused by infestation with the human head louse, Pediculus humanus capitis, and primarily affects children in the age-group of 6-12 years. The most prominent symptom is intense scalp itching, yet moving lice or nonmoving nits may be seen on the scalp and hair. Tinea capitis, also known as scalp ringworm, is a superficial fungal infection caused by keratinophilic fungi termed dermatophytes. Tinea capitis is rare in adults, and its symptoms include hair loss, dry scaly areas, redness, and itching. We here report a case of a rare coexistence between pediculosis capitis and tinea capitis in an otherwise healthy adult female, motivating the search for a possible cause of this rare coexistence and alarming dermatologists to be aware of the modified clinical appearance of this coexistence which could be mistaken with other conditions such as cutaneous lupus erythematosus or lichen planopilaris.