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BACKGROUND Scalp arteriovenous malformations (SAVMs) are seen in young individuals and skin involvement is common in large SAVMs. They are commonly seen in younger age group too. Pre-operative embolization followed by surgical excision and hair bearing scalp reconstruction with tissue expansion are the treatment of choice. Therefore, proper selection of tissue expander for reconstruction of hair bearing scalp, seems essential. This study evaluated excision of large SAVMs with aesthetic scalp reconstruction. METHODS We described management of 10 patients of large SAVMs with cutaneous involvement. All patients underwent pre-op embolization followed by surgical excision and hair bearing scalp reconstruction with tissue expansion. RESULTS All cases of large SAVMs healed well with minor complications. CONCLUSION While complete surgical excision with extirpation of the nidus is considered as the gold standard treatment, aesthetic hair bearing scalp restoration is also of paramount importance for the patient. This is done by using scalp tissue expansion after proper selection of the expander.

<b><i>Background:</i></b> Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. <b><i>Objectives:</i></b> To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. <b><i>Methods:</i></b> This was a retrospective, multicenter study being a part of an ongoing project “Mucoscopy – an upcoming tool for oral mucosal disorders” under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. <b><i>Results:</i></b> Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. <b><i>Conclusion:</i></b> Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis.

Periumbilical perforating pseudoxanthoma elasticum (PPPXE) usually presents with well-defined periumbilical yellowish atrophic plaques with keratotic papules at the periphery. It is considered a variant of hereditary pseudoxanthoma elasticum or a localized acquired cutaneous dermatosis. The lesions usually occur in the periumbilical area in obese, multiparous women. Here, we report an additional case of periumbilical perforating pseudoxanthoma elasticum with its dermoscopic features.

Background Acanthosis nigricans (AN) is a common dermatosis that presents with hyperpigmented, velvety thick plaques over intertriginous areas. Though a number of treatment modalities including chemical peels have been used, none provide long‐term and sustained improvement. Aim and objectives Our study evaluated the efficacy and safety of regular sessions of salicylic acid‐mandelic acid peeling over axillary AN lesions, which was followed by daily application of a topical combination of glycolic acid, urea, and cetylated fat esters for maintenance of effect for 9 months. Methodology A retrospective pilot study was conducted in Indian patients (Fitzpatrick skin type 4 or 5), aged 18–50 with benign hereditary AN involving the underarms, with or without affection of other typical sites. Data were retrieved of seventeen patients with AN involving the axillae. Patients were started on combination salicylic‐mandelic acid peel given every 2 weeks for a total of 6 sessions. Maintenance was done by night application of combination cream of glycolic acid, urea, and cetylated fat esters, which was continued for 9 months after completion of peeling sessions. Lesions were evaluated every 3 months of 9 months for improvement in pigmentation and skin thickening. Results All the patients (100%) showed significant improvement in both pigmentation and thickening of lesions. In terms of improvement in skin thickening, very good improvement was seen in 41%, while 29% patients had moderate improvement. In terms of improvement in pigmentation, 35% each had very good and moderate improvement. Post peel erythema (100%) and burning sensation (90%) were the most common encountered adverse effects which lasted for only 1–2 days. Patients were followed up for another 9 months during which no relapses were seen. Conclusion Combination of keratolytic chemical peels and topical mild keratolytic application ensures better therapeutic outcome in patients of AN with long lasting effect.