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Striae distensae (SD), also known as stretch marks, are common skin lesions causing significant psychological stress and cosmetic disfigurement. They are common to be seen during pregnancy, rapid weight change, puberty, many other pathological conditions including Cushing disease, anorexia nervosa, even excessive use of certain drugs. Clinically, they appear as either red raised linear bands known as striae rubrae (SR) or white depressed atrophic bands known as striae alba (SA). They were first described histopathologically in 1889. Many theories have been established to explain the etiopathogenesis of SD, yet the exact mechanism is still unclear. Also, many treatment modalities have been applied to reach maximum efficacy with the least side effects. This review article aims to optimize the most recent and accepted concepts on etiopathogenesis and pathophysiology of SD which may help in finding the best lines of management with the most satisfactory outcomes.

Introduction For elderly, pruritus is considered the most common complaint in outpatient clinic. Pruritus occurs in association with primary skin disorders and can also be caused by many diseases and drugs. The aim of the work was to study clinical and laboratory characteristics of elderly patients with pruritus in Sohag, Egypt. Patients and Methods A cross-sectional study was conducted on 225 patients aged ≥60 years of both sexes complaining of pruritus and 160 age- and sex-matched patient group complaining of non-pruritic dermatological diseases. CBC, ESR, renal function tests, serology for HBV and HCV and blood glucose levels were done routinely in all patients (both groups). Skin biopsy was done in some selected cases. Results The mean duration of pruritus was 4.23 ± 4.9 months and was generalized in 73.8% of cases with moderate severity in 35.1% with winter exacerbation in 20%. Dermatological causes of pruritus were detected in 54.2%, followed by systemic causes in 29.8%. Eczema was the most common skin cause of senile itching in 33.7%, while renal diseases were the most common systemic cause in 46.2%. Conclusion Senile pruritus is a common problem in elderly. Early and proper management is mandatory to improve their quality of life.

Background: Chronic telogen effluvium is characterised by diffuse loss of hair of the scalp. One of the emerging lines of treatment is platelet-rich plasma. However, not much of published data exist. Aims: A pilot study was conducted on chronic telogen effluvium patients to evaluate the efficacy and safety of platelet-rich plasma, and to compare two different methods of platelet-rich plasma preparation. Methods: The study included 30 female patients with chronic telogen effluvium. Patients were randomised into three groups: Group (1): Special platelet-rich plasma tubes centrifuged at 3500 rpm; Group (2): Ordinary laboratory tubes centrifuged at 1000 rpm; Group (3): Normal saline as a placebo. Patients' evaluation was done with visual analog scale, hair pull test, trichoscopy, photos, satisfaction questionnaire, and safety. All patients received four monthly sessions. Patients were evaluated one month and three months after the last session. Results: The hair pull test,visual analogue scale, and patient satisfaction results showed a statistically significant difference between group 1 vs. group 3 and group 2 vs.group 3 at one and three months after the sessions, while there was no difference between group1 vs. group 2. Trichoscopy results (baseline, one and three months after treatment) showed a significant increase in hair density and thickness in the frontal area, temporal area, and the vertex in groups 1 and 2 only. There was no statistically significant difference between the three groups with regards to side effects. Limitations: The sample size was small with ten patients in each group. Furthermore, the follow-up of patients was for only three months. Conclusions: Platelet-rich plasma could be considered as a promising therapy for patients with chronic telogen effluvium with an excellent safety profile. The ordinary laboratory low-cost tubes might be a reliable alternative to the expensive special platelet-rich plasma kits tubes. The trial registry number is PACTR202006539654415.

Background: Diagnosis of mycosis fungoides (MF) and its mimickers is a major diagnostic challenge in era of Dermatopathology. Objective: To draw a diagnostic stepwise approach to minimize this challenge focusing on the benign (unusual) mimickers of infectious etiology. Patients/methods: This retrospective study included 94 paraffin blocks of patients with clinical suspicious of MF or its mimickers, during the period from Jan 2019-July 2021. The hematoxylin and eosin (H&E) stained sections and their associated clinical presentations were reviewed. Ancillary studies were performed upon the preliminary clinical diagnosis of each case. Deeper serial sections with selected special stains were done for benign mimickers. Primary (CD3/CD4/CD7/CD68) and secondary (CD20/CD8/CD30) panels of immunohistochemistry (IHC) markers were performed for most of the cases. Results: A wide spectrum of MF mimickers was identified, our cases were categorized into 3 groups: the first is classic MF ( 24) and its variants (5), the second is benign mimickers [subgrouped into infectious (31) & non infectious (21)] and the third is heterogeneous group; (other lymphomas/parapsoriasis) (13). A suggested stepwise diagnostic approach with selected IHC panels characterizes each group. Conclusion:A constellation of diagnostic clinical data, diagnostic histopathological clues and the suggested stepwise approach minimize the misdiagnosis of classic MF and conclusively identify the infectious mimickers.

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