Adolescence is a time of great psychological and physical change. In the UK, girls enter puberty around the age of 10 years with a median age of menarche of 12.9 years; thereafter, it may be several years before regular menstrual cycles are established. Variations in the type and the frequency of periods may create anxiety regarding ill health or serious underlying disorders. With the increase in childhood obesity and subsequent polycystic ovary syndrome, there is a greater awareness and presentation of girls with disorders of menstruation. This review focuses on normal variations of menses and common pathological causes of menstrual problems, including amenorrhoea, dysmenorrhoea and menorrhagia. Further consideration is given to the variations of presentation of polycystic ovary syndrome. It provides a guide to evaluate the various symptoms, investigations and management options.

IMPORTANCE Hidradenitis suppurativa (HS) disproportionately affects women of childbearing potential. There is a paucity of data regarding the HS disease course during pregnancy and in the postpartum period.OBJECTIVE To explore the HS disease course during pregnancy and in the postpartum period. DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort study was conducted on patients in the Henry Ford Health System, Detroit, Michigan-a large, academic, urban referral center.

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BACKGROUND Keloids have been assessed by numerous methods and severity indices resulting in a lack of standardization across published research. OBJECTIVE This study aims to evaluate published keloid randomized controlled trials (RCTs) and identify the need for a gold standard of assessment. METHODS and MATERIALS PubMed, MEDLINE, and Embase were searched for human RCTs on keloid treatment during a 10-year period. Eligible studies were English language RCTs reporting disease severity outcome measures after keloid treatments. RESULTS A total of 40 disease outcome measures were used in 41 included RCTs. Twenty-four (59%) of the included studies used more than one disease severity scale. The most frequently used outcome measures were the Vancouver Scar Scale (34%) (n = 14), followed by serial photography (24%) (n = 10). These were followed by adverse events and complications (20%) (n = 8), Visual Analogue Scale (12%) (n = 5), keloid dimensions (12%) (n = 5), and Patient and Observer Scar Assessment Scale (10%) (n = 4). Only one study reported quality of life outcomes. CONCLUSION There is wide variation in keloid outcome measures in the published literature. A standardized method of assessment should be implemented to reduce the disparities between studies and to better be able to compare the numerous treatment modalities.

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side-effects and/or fear of relapse remained stable during patients' follow-up. Unexpectedly, the TABQOL scores measured at the time of inclusion of the population of prevalent patients, and at month 6 in incident cases, were not significantly different between patients taking topical corticosteroids, oral prednisone and/or immunomodulators, or immunosuppressants (P = 0Á96 and P = 0Á56, respectively). Overall, this large multicentre study provides evidence that the ABQOL score is a robust tool, sensitive to change, that assesses quality of life in patients with autoimmune bullous disease. As in many other diseases, quality-of-life questionnaires in autoimmune bullous dermatoses are poorly correlated with OSS, even in patients with high disease activity at the time of diagnosis. The close correlations between ABQOL and both DLQI and Skindex raise the question of its advantage over these scores. We have not been able to show its superiority in patients with mucosal damage. TABQOL is not sensitive to change. Unexpectedly, it does not seem to be correlated with the type of treatment.

Solar urticaria (SU) is an uncommon photodermatosis that presents with sensitivity to ultraviolet (UV) or visible light which triggers urticarial lesions. Treatment of SU is a challenge and usually involves antihistamines and photoprotection as a first-line treatment. Phototherapy regimens are recommended if these first-line treatments fail to control the disease. Induction of tolerance by phototherapy (UV hardening) has been commonly described as a treatment modality. UVA1 has deeper penetration to the dermis than UVA or NB-UVB; its use in SU has not been previously reported.We present 3 patients with SU who were successfully treated with UVA1.