Rhinophyma is a benign condition characterized by a large, bulbous nose with prominent pores. It is commonly associated with untreated cases of rosacea. The disease can carry a substantial psychological impact that causes patients to seek advice about how to improve their physical appearance. Many treatment options are available for rhinophyma, but there is no standard treatment protocol. Here, we describe the case of a 65-year-old man with a large rhinophyma that caused him cosmetic and psychosocial embarrassment. The condition was treated by surgical excision and bipolar electrocautery. No complications occurred after the procedures, and healing was completed 2 weeks later by secondary intention and reepithelialization. A simple surgical removal using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be considered as a good treatment option for rhinophyma, as it results in an excellent cosmetic outcome and has short recovery time.

Callus due to dermatophagia has rarely been reported in dermatology literature. Patients with this disorder usually present with skin damage, bleeding, blistering and discoloration, especially around the fingernails. Moreover, the presence of callus on the dorsum of proximal phalanges has also rarely described in the literature of PubMed, Google Scholar and Research Gate. We hereby describe a 16-year-old boy with bilateral calluses, on the dorsal aspects of the proximal phalanges of the forefingers. General physical examination revealed that the patient had a mental illness and a habit of biting his fingers at the affected sites for two years. We performed this report to emphasize the importance of the relationship between dermatophagia and calluses presenting on the dorsum of the proximal phalanges of the fingers as calluses are most often located on the feet and knuckles of the hands. Therefore, any patient experiencing a similar lesion to the one in our case needs a proper history taken and assessment of mental state to exclude associated psychiatric comorbidity.

Context:Treatment of resistant alopecia areata (AA) can be very challenging and include many options with variable efficacy and safety profiles. The 308-nm excimer lamp has been claimed to offer an effective alternative without significant risks, though there exists a lack of guidelines in this setting.Aims:This study aimed to evaluate the efficacy and safety of the 308-nm excimer lamp in treating resistant AA in Iraqi patients.Settings and Design:A prospective interventional study.Subjects and Methods:Eighteen patients with multiple AA were enrolled in this study. All patients were treated with a 308-nm monochromatic excimer lamp, in two sessions per week for 12 weeks. The efficacy of this modality was evaluated using two methods, namely the Severity of Alopecia Tool (SALT) score and digital photographs which were taken at four points (baseline, 4 weeks, 8 weeks, and 12 weeks). The safety of the equipment was evaluated by the objective recording of adverse reactions and patient satisfaction. Follow-up continued for 6 months after treatment to assess the level of recurrence.Statistical Analysis Used:SPSS software version 23.Results:There was a statistically significant decrease in the SALT score from the baseline (range 11–30; mean 20.33 ± standard deviation [SD] 4.78) to 12 weeks (range 2–24; mean 9.11 ± SD 5.41) (P < 0.001). The overall response rate was 100%, and successful (>50%) regrowth of hair was seen in 55.5% of patients (n = 10). Younger patients responded to the treatment more than the older age group (P < 0.05). No significant side effects were recorded.Conclusions:The results suggest that 308-nm excimer light has a significant effect on resistant cases of multiple AA, with considerable safety and tolerability.

The Koebner phenomenon is the appearance of isomorphic pathologic lesions in traumatized but otherwise normal skin of patients who have cutaneous disorders. These new lesions are clinically and histologically identical to those in the diseased skin. Psoriasis, lichen planus, and vitiligo appear to display the true type of isomorphic response of Koenbner [1]. Herein, I describe a case of lichen planus arising through the Koebner phenomenon in the areas traumatized by Hijama.

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