Arborescent Vascular Dilatation Mimicking Lichtenberg Figures from Lightning

The clinical presentation of arborizing vascular dilatation can resemble Lichtenberg figures from lightning. Both have a feather‐like or ferning pattern. We report an interesting case of pressure‐induced vasodilatation (PIV) caused by temporary vascular occlusion from jeans buttons.     

A Systematic Review and Meta-analysis of Randomized Controlled Trials of United States Food and Drug Administration-Approved,Home-use,Low-Level Light/Laser Therapy Devices for Pattern Hair Loss: Device Design and Technology

BackgroundLow-level light/laser therapy (LLLT) can potentially stimulate hair growth in pattern hair loss (PHL), with many available home-use LLLT devices of different designs and technology on the market. However, not all devices are cleared by the United States (US) Food and Drug Administration (FDA), with very few studies to support their efficacy.ObjectivesThis systematic review and meta-analysis aimed to investigate the effectiveness of FDA-approved LLLT devices for PHL treatment.MethodsWe included articles related to FDA-approved home-use LLLT devices on PubMed and Medline, using the FDA 510(K) Premarket Notification database and the systematic search of articles up to January 2020. The standardized mean difference (SMD) for the changes of hair density treated by LLLT versus sham devices was analyzed.ResultsOnly 32 home-use LLLT devices have been approved by the FDA as of January 2020. The meta-analysis comprised seven double-blinded, randomized, controlled trials. The overall quantitative analysis yielded a significant increase in hair density in those treated by LLLT versus sham groups (SMD: 1.27, 95% confidence interval [CI]: 0.993–1.639). The subgroup analysis demonstrated the increased hair growth in male and female subjects with both comb- and helmet-type devices. There were significant LLLT sources in the LDs alone (SMD: 1.52, 95% CI: 1.16–1.88) and the LDs combination (SMD: 0.85, 95% CI: 0.55–1.16) (p=0.043).ConclusionLLLT is potentially effective for PHL treatment. Nonetheless, the long-term follow-up study in patients with severe PHL with combined standard treatment and comparison between LLLT devices and energy sources is recommended.     

Efficacy of MAS063DP lotion vs 0.02% triamcinolone acetonide lotion in improving post‐ablative fractional CO2 laser resurfacing wound healing: a split‐face,triple‐blinded,randomized, controlled trial

Proven as effective acne scar treatment, ablative fractional carbon dioxide (AFCO₂) laser requires post‐laser wound healing care. MAS063DP is a multicomponent nonsteroidal anti‐inflammatory moisturizer for effective post‐laser treatment. This study compares the efficacy of MAS063DP and 0.02% triamcinolone acetonide (TA) lotion for post‐laser wound healing and complications. A split‐face, triple‐blinded, clinical study was performed in 16 patients, aged 20–50 years, receiving AFCO₂ on both sides of the face, with MAS063DP on one side and 0.02% TA on the other side for 7 days twice daily. Digital photography, hemoglobin, and melanin index at baseline were obtained immediately after laser treatment and then at days 3, 5, 7, and 30. Erythema, edema, crusting, adverse effects, and post‐inflammatory hyperpigmentation (PIH) were followed every visit. Sixteen patients, mean age 38.6 (8.4) years, with moderate–severe atrophic scar and skin phototype III–IV completed the study. Clinical improvement of edema, erythema, crusting, and hyperpigmentation was observed from day 3 to day 30 (P < 0.001), with no statistically significant difference in both groups. There was also no statistical difference of hemoglobin, melanin index, and texture at days 3, 5, 7, and 30. Melanin index at day 30 was significantly less than baseline in both MAS063DP and 0.02% TA. With PIH in 50% of cases, both treatments demonstrated good safety profiles and no serious adverse reactions. MAS063DP could be an effective treatment for post‐laser wound healing and complications, compatible to 0.02% TA.     

Distinctive lupus panniculitis of scalp with linear alopecia along Blaschko's lines: a review of the literature

Lupus panniculitis of the scalp (LPS) is a rare and distinctive clinical feature of lupus erythematosus panniculitis (LEP) with linear alopecia along Blaschko's lines. In this study, we investigated clinical features and treatments of LPS by literature review of articles in the English language from PubMed and SCOPUS databases up to April 2018. The following key words, “lupus panniculitis, “lupus erythematosus panniculitis”, “lupus profundus”, “head”, and “scalp”, were used. Twenty cases of LPS were identified (mean age = 26.4 [10–53] years, female: male ratio = 1:1, mean disease duration = 86.89 [8–336] weeks). The most commonly affected areas of scalp included parietal (70%), frontal (45%), temporal (40%), occipital (30%), and vertex (10%), along 70% of Blaschko's lines with morphologic lesions linear, annular, arch-shaped, and ulcer. Besides, ANA (60%) was in particular noted. Hydroxychloroquine, oral prednisolone, intralesional corticosteroid, and methotrexate were the most common treatments, with complete response after an average period of 8.08 (2–12) weeks. Systemic lupus erythematosus (SLE) was developed in four cases (20%) during follow-up, with high recurrence of 35%. We reported distinctive and rare cases of LPS.The continuing follow-up was highly recommended to avoid probable recurrence and SLE development.     

Aplasia cutis congenita with fetus papyraceus: report and review of the literature

We report a case of a 2‐week‐old white female who presented with large stellate atrophic skin defects on bilateral thighs and knees at birth. The pregnancy was complicated by the death of monozygotic twin at the 16th week of gestation. This represents aplasia cutis congenita with fetus papyraceus. This rare condition is defined as the congenital skin defect and intrauterine death of fetus with or without a stillborn fetus pressed flat by the growing twin (fetus papyraceus) at delivery time. Aplasia cutis congenita coexisting with fetus papyraceus has a distinctive and reproducible distribution pattern of bilateral symmetrical truncal, buttock, and thigh lesions related to fetal death during the late first to early second trimester. There are at least 44 reported cases of this disorder in the English literature. We discuss our case and review the literature.     

Flood‐related skin diseases: a literature review

Flood is one of the most common natural disasters, which commonly occurs in all parts of the world. The effects of the disasters considerably become enormous problems to overall public health systems. Flood‐related skin diseases are a portion of these consequences presenting with cutaneous manifestations and/or signs of systemic illnesses. We conducted a systematic literature review of research publications relating to flooding and skin diseases. The purpose of this review was to provide dermatologists as well as general practitioners with comprehensive conditions of flood‐related skin diseases and suggested treatments. Moreover, we categorized these flood‐related diseases into four groups comprising inflammatory skin diseases, skin infections, traumatic skin diseases, and other miscellaneous skin diseases in a bid to implement early interventions and educate, prevent, and efficaciously handle those skin diseases under such a catastrophic situation so that better treatment outcomes and prevention of further complications could be ultimately achieved and accomplished.