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Considering the complications and satisfaction rates, BCS was more efficient than NNS for acne scar treatment. Then, we suggest BCS as a good replacement for NNS.

We report two cases of lichen planus following COVID-19 vaccination in two middle-aged women, where the first patient presented with lichenplanopilaris (LPP) relapse and development of lichen planus 14 days after the second dose of AstraZeneca vaccine, and the other patient who had a previous scattered lesion of LP which extended and increased in severity after the first and second dose of Sinopharm. The suggested cause could be due to immune dysregulation and up regulation of T cell lymphocytes which was triggered after COVID-19 vaccination. What supports our hypothesis that LP had occurred due to COVID-19 vaccination, is that one of the patients responded successfully to Metronidazole. This means that the infection process after vaccination could be the cause in aggravating LP. To add, one of the suggested mechanisms for the appearance of LP or reactivation of a dormant LPP can be cytotoxic CD8 T-lymphocytes which increase the secretion of IFN-γ and IL-5 cytokines and may also result in basal keratinocytes' apoptosis leading to cutaneous manifestations.

Background: Subcision, also known as subcutaneous incisionless surgery, is a surgical intervention used to treat a variety of skin conditions including atrophic acne scars, depressed scars, cellulite, and wrinkles. Aims:We plan to prepare a review article about the indications of subcision, its adverse reactions, and pearls. Patients/Methods: We searched the literature for the information about subcision and its applications from papers published up to March 2019. The search was performed through the databases of the National Library of Medicine. Results: After a thorough review of the published papers about subcision, we finally chose to review 40 articles that had proper sample size and design to prepare this review article. Twenty-one papers were related to the application of subcision in the treatment of acne scar and other scars. Four articles were about the application of subcision to treat cellulite, and eight articles were related to other applications of subcision such as the treatment of striae or nasolabial fold. The remaining seven articles include published review papers about subcision or acne scar classification. Conclusion: Subcision seems to be effective on various skin conditions including acne scar, other depressed scars, and cellulite. It is easy to apply and inexpensive with short downtime and no significant complications. Subcision needs proper technique and adequate experience. K E Y W O R D S acne scar, cellulite, scar, subcision, wrinkle

Systemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by progressive cutaneous and internal organ fibrosis. Orofacial manifestations of systemic sclerosis are extremely disabling and treatment options are limited. In this study, we aimed to assess the safety and efficacy of autologous fat grafting in the face of patients with systemic sclerosis. We enrolled 16 SSc patients suffering from facial sclerosis and limited mouth opening capacity. Autologous fat injection ranging from 15 to 40 ml was administered per patient, based on their face morphology. The patients were evaluated at baseline and 3 months after fat injection. Evaluations included mouth opening capacity, mouth handicap in systemic sclerosis (MHISS), Rodnan skin sclerosis score, skin biophysical properties using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT), volumizing and aesthetic effects based on pre- and posttreatment photographs, possible side effects, and global patient satisfaction. Clinical assessment showed autologous fat transfer significantly improved mouth opening capacity and the MHISS and Rodnan score of patients with facial scleroderma (p value <.001). The aesthetic and/or functional results of fat injection were satisfying to about 80% of the patients. The changes in CRRT values were not significant. Our findings support the possible therapeutic role of autologous fat grafting in improving facial scleroderma both in aesthetic and in functional aspects. This trial is registered with IRCT20180209038677N1.

Patients with LPP, scored worse in ocular surface tests. This finding warrants special scrutiny for dry eye and MG dysfunction in these patients.

Urticarial vasculitis in a COVID-19 recovered patient Dear Editor, Coronavirus disease 2019 (COVID-19) typically presents with fever and respiratory symptoms, but the clinical spectrum appears to be wide. 1 Skin is rarely involved in the course of COVID-19, but its involvement may be underreported. 2 Herein, we report a case of COVID-19 who developed urticarial vasculitis after recovery. On March 24, 2020, a 64-year-old woman presented to the emergency room with fever, dry cough, dyspnea, nausea, and anorexia. The past medical history was significant for diabetes mellitus and hypertension. She was screened for COVID-19 with a low-dose chest CT scan that showed patchy parenchymal ground-glass opacities with peripheral distribution typical for COVID-19 infection. Her lab tests showed a normal WBC count without lymphopenia and elevated levels of both lactate dehydrogenase (LDH: 554 U/L) and C-reactive protein (CRP: 61 mg/l; Positive > 10). Nasopharyngeal swab reverse transcription polymerase chain reaction (RT-PCR) was positive for SARS-CoV-2. She was treated with hydroxychloroquine (200 mg BD) and azithromycin 250 mg/day for 5 days with advice to keep home quarantine, which led to a gradual improvement of the symptoms. On April 22, 2020, she presented again with weakness, malaise, anorexia recurring for the previous 1 week, and newonset generalized skin lesions. Skin lesions had appeared abruptly 48 hours before the presentation. Cutaneous examination revealed prominent periorbital