Background Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin. Aims To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease. Methods A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non‐MeSH terms such as “acanthosis nigricans,” “classification,” “pathophysiology,” “diagnosis,” “treatment,” “topical drugs,” “systemic drugs,” “chemical peeling,” and “lasers” were taken into consideration. Results The pathophysiology of AN revolves around a multifactorial stimulation of proliferation of epidermal keratinocytes and dermal fibroblasts. Various types of AN include benign, obesity‐associated, syndromic, malignant, acral, unilateral, medication‐induced, and mixed‐type. Homeostasis model assessment‐insulin resistance (HOMA‐IR) is a good tool for assessment of insulin resistance. Management involves general measures (weight reduction and addressing the underlying cause, if any), topical drugs (retinoids, vitamin D analogs, and keratolytics), oral drugs (retinoids and insulin sensitizers), chemical peels (trichloroacetic acid), and lasers (Long pulsed alexandrite, fractional 1550‐nm erbium fiber, and CO2). Conclusion Acanthosis nigricans is a treatable condition; however, complete cure and disappearance of lesions are difficult to achieve. Weight reduction is the most scientific and practical management strategy. Long‐term studies and further research is warranted in the pathophysiology and treatment of this common condition.

Early recognition of vascular necrosis with specific protocol for treatment after injection necrosis with hyaluronic acid fillers improves the outcome of wound healing.

The novel coronavirus (COVID-19) has been declared a pandemic by the World Health Organization (WHO), with more than 13 000 deaths in more than 130 countries all across the globe till March 23, 2020. The global health community has to take action to slow its continued spread and reduce the ever increasing mortality. The action needs to be multipronged requiring financial, legislative, and executive action that will require participation from all segments of the society including the government and the citizens [1,2].

The use of IPL at specified parameters provides optimal therapy for the treatment of rosacea.

Background: Cosmetic surgery and esthetic procedures have become a billion dollar industry owing to the ever-growing demand of the population to stay young. The injectable treatments including fillers and botulinum toxin have become highly popular because of their quick, predictable and lasting results in the management of facial wrinkles and rejuvenation. Although these treatment modalities are relatively safe, they are associated with certain side effects. Aims:In this review, we will focus on the complications of fillers and botulinum toxin. Patients/Methods: The literature research considered published journal articles(clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review.Results: Brow ptosis and asymmetry are common adverse effects of botulinum toxin while the most common adverse effects associated with fillers are the local injection related effects manifesting as erythema, edema, pain, and ecchymosis. Conclusion:It is important that the treating physician is well verse with the various fillers and botulinum toxin complications and their management as some of the complications can be severely debilitating. K E Y W O R D Sbotulinum toxin, cosmetic surgery, filler, side effects | 571 KASSIR et Al.

has spread rapidly throughout the world, and World Health Organization (WHO) declared it a health emergency, and most recently, pandemic. 1 More than 100 countries including developed and underdeveloped ones have been affected. Public health approach and strategies may be similar in such situations around the world; however, developing and poor countries lack an adequate health care system to wage a strong attack. 2The approach of developed countries such as China and Italy to detect and isolate cases, prevent transmission, and detect susceptible hosts has been encouraging. 3 It includes quarantine, social distancing, and isolation. However, such strategy is difficult to follow in developing countries, due to lack of surveillance resources, appropriate technology, and funds. In addition, the poorer countries carry a higher risk

IntroductionOnabotulinumtoxinA (ONA; Botox, Allergan, Irvine, CA) was discovered for cosmetic use in the mid-1980s for which it was FDA approved in April 2002. AbobotulinumtoxinA (ABO; Dysport, Valeant Pharmaceuticals International, Inc, Montreal, Quebec) was FDA approved in April 2009 for therapeutic and esthetic uses. The most recent studies make a comparison between the two formulations; however, information is still lacking in comparison studies. In this study, we compare efficacy and safety of a single treatment of two preparations of botulinum toxin A in patients with moderate to severe rhytids in the glabellar and crow’s feet areas.MethodsA total of 85 patients with moderate to severe wrinkles in either the glabellar or crow’s feet area, or both, were given a single injection on day 0, with ABO and ONA injected on opposite sides of the face. Follow-up assessments were done at 2 weeks, 1 month, 3 months, 4 months, and 5 months. The study end points were onset of action, change in degree of wrinkles, patient satisfaction, duration of effect, and adverse effects.ResultsResults of onset of improvement with ABO vs. ONA in the glabellar and crow’s feet regions show higher percentage of patients with earlier onset improvement with ABO. Evaluator assessment showed ABO lasted longer after 3 months in a significant number of patients in both areas, 83% with ABO vs. 48% with ONA at 4 months in the glabellar area, and 65% with ABO vs. 47% with ONA at 4 months in the crow’s feet area.ConclusionTime to improvement showed earlier onset and longer duration of improvement in a higher percentage of individuals with ABO when compared with ONA. ABO provides a safe and effective alternative in a dose ratio of 2.5:1 and 3:1 in the glabellar and crow’s feet area, respectively.

Androgenetic alopecia (AGA) is a multifactorial disease that carries a significant psychological burden with it. Dihydrotestosterone, the main pathogenic androgen in AGA, is produced by conversion of testosterone, which is catalyzed by the 5‐alpha reductase (5‐AR) isoenzyme family. Finasteride and dutasteride are inhibitors of these enzymes. Finasteride, which is a single receptor 5‐alpha reductase inhibitor (5‐ARI), acts by blocking dihydrotestosterone (DHT). Dutasteride, a dual receptor DHT blocker, has a higher potency than its predecessor, finasteride. This review corroborates the evidence of superiority of dutasteride over finasteride, and its comparable safety profile concerning fertility, teratogenicity, neurotoxicity, and hepatotoxicity.