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To verify and compare the therapeutic efficacy and safety of superficial cryotherapy using dimethyl ether and propane (DMEP) mixture vs. microneedling in the treatment of mild scalp alopecia areata (AA). In a prospective randomized single‐blinded clinical trial, 80 patients with clinically evident scalp mild AA were randomly assigned into two groups of 40 patients each. Group (1) was treated by superficial cryotherapy using DMEP in three freeze–thaw cycles of 5 s each. Group (2) was treated by microneedling. Both groups were treated every 2 weeks for 6 sessions and followed up for 3 months after the last session. Patients were assessed by photographic documentation, trichoscopic evaluation, severity of alopecia tool (SALT) score, and alopecia areata symptom impact scale (AASIS). An excellent response was achieved in 15 (37.5%) of group (1) compared with 14 (35%) of group (2) patients, while a good response was achieved in 23 (57.5%) of group (1) compared with 21 (52.5%) of group (1) patients, with a statistically insignificant difference. The mean SALT score change percentage was a statistically significantly higher in group (2) patients. The mean AASIS change percentage was higher in group (1) patients, but this was a statistically insignificant. In both groups, the mean numbers of trichoscopic signs of AA significantly decreased from baseline to the end of follow‐up period. Both therapeutic modalities were well‐tolerated, with no recurrence after the follow‐up period. Both superficial cryotherapy using DMEP mixture, and microneedling are simple, effective, and safe therapeutic options for mild scalp AA, however, microneedling showed higher efficacy.

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Introduction. Superficial morphea (SM) is an uncommon entity that was described in the literature without definitive correlation to localized scleroderma (LS) or other atrophoderma diseases. Aim. To demonstrate the clinicopathological features of SM and evaluate the efficacy of different therapeutic modalities in its management. Patients and methods. A total of 28 patients with SM were studied during the period from 2010 to 2015. Clinicopathological features and therapeutic outcomes were recorded and analyzed. Results. Clinically, SM was predominant in females (71.4%) with an average onset at 33 years of age and an average duration of 15 months. It was commonly presented as asymptomatic, darkly pigmented, and multiple and slightly indurated patches. The lesions were mostly ill-defined, large-sized, and located more on the trunk. Histologically, thickening of collagen fibers was observed either localized to the papillary dermis only (38.9%) or extended into the upper reticular dermis (61.1%). Elastic fibers were generally diminished in the upper reticular dermis while the number of fibroblasts and basal melanin pigmentation were increased in the majority of cases (92.9% and 96.4%, respectively). The most commonly associated diseases were diabetes mellitus (50%) and hepatitis C virus (HCV) infection (42.8%), and their incidence was significantly higher than that in patients with LS. Excimer light showed promising effective results in the treatment of most cases (78.9%) while the response to other modalities such as topical corticosteroid alone or in combination with tacrolimus or treatment with UVA1 alone was less effective (7.1%, 23.1%, and 5%, respectively). Conclusion. Our results proposed that SM is a distinctive clinicopathological variant and not a stage in the spectrum of LS. The novel response of SM to excimer light and not for UVA1 therapy also suggests the different therapeutic outcome of SM from LS. Although SM has a significant association with DM and HCV infection, they seem not to affect the course of the disease.

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.

Background Plantar warts are common benign cutaneous lesions affecting the plantar aspects of the feet; they are caused by infection of the keratinocytes by the human papillomavirus (HPV). The effective treatment of plantar warts is still a therapeutic challenge. Aim This study aimed to assess the possible clinical efficacy and safety of the combined intralesional autologous platelet‐rich plasma (PRP) injection with local application of salicylic acid 30% solution in the treatment of multiple resistant plantar warts. Method In the present case, a 54‐year‐old immunocompetent male patient presented with multiple, bilateral resistant plantar warts. Results A complete clearance of the plantar warts was observed after three sessions of intralesional autologous PRP injections with one‐month interval, combined with twice‐daily local application of salicylic acid 30% solution between sessions. No recurrence was recorded after a nine‐month follow‐up from the last session. There were no reported side effects during or after the sessions. Conclusion The combined intralesional autologous PRP injection with topical salicylic acid is an effective, economic, and safe modality of treatment for multiple resistant plantar warts.

: Trichodynia was elucidated as a distressing, painful sensation of the scalp hair and/or the skin of the scalp that becomes more vigorous when hairs are touched without an underlying cutaneous disease and is frequently associated with hair shedding. It was often more in women than men, directly correlating with hair loss. The etiology of trichodynia is not well-known, but it may be multifactorial. Several possible hypotheses can explain the etiopathogenesis of trichodynia, including enhanced expression of neuropeptide substance P with perifollicular inflammation, psychiatric diseases, and nutritional deficiencies. Currently, there is no specific and effective therapy for trichodynia. Various available treatments included L-cystine-containing oral preparation, topical corticosteroid, low-dose antidepressant, oral propranolol, and botulinum toxin injection. This review article highlights an update of the definition, etiopathogenesis, diagnosis, and treatment of trichodynia.