A massive mandibular keloid with severe infection: What is your treatment?

A case report of massive mandibular keloid with severe infection induced by acne achieved resolution of skin lesions after combined treatment with surgery and high concentration single-dose 5-aminolevulinic acid photodynamic therapy (5-ALA PDT). The patient achieved satisfactory effects, after receiving combined treatment with radiotherapy, secondary healing, intralesional injection of glucocorticoids, and other treatments. The scar didn't exhibit growth in a follow-up check after a year. This case provides evidence that photodynamic therapy is effective in the treatment of massive mandibular keloid with severe infection.

Doxycycline Combined with NB-UVB Phototherapy for Acquired Reactive Perforating Collagenosis.

BACKGROUND: Acquired reactive perforating collagenosis is a rare skin disease characterized by the discharge of collagen fibers through the epidermis. There is no standard treatment for this disease currently. Here, we report a case of ARPC that has been successfully treated and cured. CASE DESCRIPTION: A 32-year-old man developed severe itching papules on his torso and limbs for 3 months. Skin lesions were keratotic papules scattered on the limbs and trunk, with a diameter of 3 to 12 mm. Some lesions had umbilical recesses and the shape of a crater with positive isomorphic reactions. The patient scratched his severe itching lesions which merged into large ones. This patient had histories of hypertension and dilated cardiomyopathy with mild congestive heart failure. The clinical presentation and histopathology of skin lesions met Faver's diagnostic criteria for ARPC. TREATMENT: Oral Doxycycline 100mg/d, NB-UVB phototherapy 3 times a week with initial dose 400mJ/cm2, gradually increased to 1200mJ/cm2(total cumulative dose 16700J/cm2). OUTCOMES: After a week of treatment, the patient's itching symptoms were significantly reduced and stopped presenting any new skin lesions. Most of the lesions healed in 6 weeks of treatment. LESSONS: Doxycycline combined with NB-UVB may be an effective treatment for ARPC.