BackgroundMelasma is chronic, acquired hypermelanosis that commonly appears on sun‐exposed areas of the skin. Although it is asymptomatic, it can significantly affect patients’ psychosocial and emotional well‐being, ultimately reducing their quality of life. This study aimed to assess the factors associated with quality of life and treatment practices among melasma patients in Nepal.MethodsA hospital‐based cross‐sectional study was conducted among 174 melasma patients visiting Nepal Skin Hospital, Kathmandu, from March to August 2023. The Melasma Area and Severity Index (MASI) score and the Melasma Quality of Life (MELASQoL) scale were used to evaluate melasma severity and quality of life, respectively. Statistical analyses included descriptive statistics, independent t‐tests, one‐way ANOVA, and multiple linear regression to identify factors associated with quality of life among women with melasma.ResultsThe mean (±SD) MELASQoL score was 51.89. Most participants reported feeling frustrated (81.5%), embarrassed (78.8%), depressed (95.40%), and less productive (83.9%) due to melasma. Female gender, illiteracy, both current and previous OCP use, women with multiple pregnancies, lighter skin Types (III and IV), longer disease duration, and moderate MASI scores were significantly associated with higher MELASQoL values (p < 0.05). Sunscreen (97.7%) was the most prescribed treatment, followed by tranexamic acid (78.7%), hydroquinone (76.4%), antioxidants (71.3%), and chemical peels (69.0%).ConclusionMelasma has a significant psychosocial impact on affected individuals in Nepal. Disease severity, use of oral contraceptive pills, number of pregnancies, disease duration, education, and skin type significantly influenced quality of life. The strong association between disease severity and MELASQoL underscores the importance of integrating psychosocial assessment into clinical management. Sunscreen followed by tranexamic acid, hydroquinone, antioxidants, chemical peels, multivitamins, and retinoids was the predominant treatment approaches.

IntroductionFixed pigmented erythema (FPE) is a common toxidermia characterized by the appearance of one or more annular, erythematous and hyperpigmented spots, following the systemic administration of a drug. The main aim of this study was to describe the epidemiological and clinical aspects of fixed pigmented erythema at the Departmental University Hospital Center Borgou/Alibori (DUHC‐B/A) from 2009 to 2022.MethodsThis was a descriptive cross‐sectional study with retrospective data collection, based on the records of patients seen in the Dermatology‐Venerology Unit for FPE. Initially, all files bearing the diagnosis of toxidermia were identified; then, those with the diagnosis of FPE with usable data were retained. Data were entered using EpiData 3.1 and analyzed using EpiData Analysis.ResultsSixty‐four patients were enrolled during the study period. The prevalence of FPE was 0.73%, with a male predominance. The most common drug identified was cotrimoxazole, followed by paracetamol and quinine. Over half of the patients (52.9%) were self‐medicating.ConclusionAlthough FPE occurs rarely, it remains the most frequent toxidermia at the DUHC‐B/A. It can be severe in its generalized bullous form. Avoiding the practice of self‐medication could help reduce its prevalence.

Prurigo pigmentosa (PP) is a rare inflammatory dermatosis first described in 1971 by Nagashima, classically predominantly affecting young women, particularly those of East Asian descent. Clinically, PP presents with pruritic, erythematous papules, which eventually form a reticulated pattern and resolve into post‐inflammatory hyperpigmentation. The exact pathogenesis of PP remains unclear, but it is frequently linked to ketosis‐inducing conditions, including strict dieting, fasting, and metabolic changes, such as those observed in diabetic ketoacidosis or anorexia nervosa. In recent years, PP has been increasingly reported in patients undergoing bariatric surgery, likely due to the rapid weight loss and subsequent ketosis that often follow these procedures. This review aims to take a closer and deeper look at the emerging connection between PP and bariatric surgery, particularly laparoscopic sleeve gastrectomy.

It is known that when an electrical stimulus is greater than 10 kHz, our body converts this electrical energy into thermal energy, and due to this fact, one of the therapies that has been showing good results is therapeutic, capacitive, and resistive energy transfer (tecar therapy), but there is still little evidence about its action on area of aesthetics. Therefore, the objective of this study was to evaluate the safety and efficacy of tecar therapy for the reduction of localized fat and improvement of skin flaccidity in the abdomen region. A controlled clinical trial was carried out with 48 women equally divided into 2 distinct groups, with (G-1) received treatment with tecar therapy and (G-2) considered the control. Ten treatment sessions were performed once a week. The volunteers were evaluated at three different times using anthropometric data, adipometry, and ultrasound (US), in addition to histological analysis of the adipose tissue performed on one of the volunteers. In the results of the adipometry and US, a decrease was observed both in the comparison between the groups and between the baseline and the end of the treatment for the supra and infra umbilical region. In the histological analysis, it was observed that the G1 showed positive markers for moderate chronic inflammation, indicating degeneration of the adipose tissue with a large number of fibroblasts and newly formed blood vessels in the integumentary tissue. With this, it was possible to conclude that tecar therapy proved to be a safe and effective resource in the treatment of sagging skin and reduction of superficial adipose tissue. Trial Registration: ClinicalTrials.gov identifier: NCT05020054.

Keloid scars represent a complex fibroproliferative disorder characterized by abnormal wound healing and excessive collagen deposition. Central to keloid pathogenesis are dynamic fibroblast populations that undergo extensive phenotypic transitions, including heterogeneous subpopulation differentiation, enhanced migration, myofibroblast transdifferentiation, and sustained activation states. This review examines fibroblast dynamics as the central orchestrator of keloid formation, analyzing how these cells interact with keratinocytes, immune cells, endothelial cells, and melanocytes to drive pathological scarring. We focus on key signaling pathways that directly regulate fibroblast function, including TGF‐β/Smad, VEGF, Wnt, and emerging regulators such as miR‐3606‐3p that integrate multiple fibrotic cascades. Current therapeutic approaches show variable efficacy, with surgical excision alone resulting in 45%–100% recurrence rates, while combination therapies incorporating radiation, intralesional injections, and novel molecular targets achieve improved outcomes. Emerging strategies include COX‐2 inhibition for dual antiproliferative and proapoptotic effects on keloid fibroblasts, stem cell therapies, and precision medicine approaches based on molecular profiling. Through deeper understanding of fibroblast dynamics and their regulatory networks, more effective therapeutic strategies can be developed to improve patient outcomes and quality of life.

Background: Acrocyanosis is a functional peripheral vascular disorder, currently categorized under the canopy of acrosyndromes, i.e., a group of clinically similar and significantly overlapping vascular disorders involving the acral skin. The disorder might be primary or secondary, depending on the cause. Recently, there has been a remarkable surge in acrocyanosis prevalence along with the COVID-19 pandemic. Both COVID-19 infection and vaccines for COVID-19 have been affixed to the list of disorders instigating acrocyanosis. Objectives: The goal of this narrative review was to evaluate the existing literature, project acrocyanosis from the viewpoint of dermatologists in the face of the COVID-19 pandemic, and assess the need for targeted research, education, and/or clinical practice. Methods: An English literature search was conducted using PubMed and Google. All abstracts on acrocyanosis, irrespective of the article type and publication date, were retrieved and reviewed and those most relevant for the focus of this article were selected and summarized. Discussion/Results: A narrative review was carried out. There is paucity of randomized, double-blind, placebo-controlled studies on acrocyanosis in the English literature, implicating the need for targeted research. Pertinent information still relies on anecdotal observations, case reports, case series, or scarce reviews, which are dated rather old and published in vascular-oriented journals. The scarcity of published literature on acrocyanosis in dermatology-oriented journals points to the necessity of professional education and improvement of clinical diagnostic skills for dermatologists. Conclusions: Although acrocyanosis is the least known and the least studied acrosyndrome, it is increasingly more commonly confronted in the COVID-19 era. The diagnosis still largely relies on clinical findings. Accordingly, it has become a growing necessity for a dermatologist to remain updated on this peculiar disorder and be able to differentiate acrocyanosis from clinically similar cold-induced or cold-exacerbated acrosyndromes. Acrocyanosis is still misdiagnosed, underdiagnosed, underreported, and undertreated by the dermatology community.

Melasma, a pigmentary disorder that particularly affects Asian women, has been clinically proven to respond effectively to combination therapy of Q-switched lasers and tranexamic acid (TXA), especially with the advancements in laser aesthetics in recent years. However, treatment outcomes can be influenced by factors such as the wavelength and spot size of the Q-switched laser, the route of administration for TXA (including injectable, oral, or topical), as well as the dosage and duration of treatment. This article presents 13 different combination approaches from six randomized controlled trials, indicating that oral administration of TXA in combination with a 1064 nm Q-switched laser is currently the most widely used and effective treatment approach.

SCORring atopic dermatitis (SCORAD) is widely used to assess the severity of atopic eczema, but score systems based on the entire body may be limited in effective monitoring and intervention. It is crucial to monitor moisture levels in each affected body part, but empirical research is still lacking. The objective of this study was to analyze the levels of stratum corneum hydration (SCH) and transepidermal water loss (TEWL) in atopic dermatitis (AD) patients, focusing on the presence and location of atopic lesions at different body sites. The levels of TEWL and SCH were measured using the AF200 AquaFlux and the Corneometer, respectively, at 15 body sites. 98 children under the age of 10 were measured, including 83 AD patients and 15 in the control group. Patients were also assessed with SCORAD and for the presence of atopic lesions at each body site. 58.7% of AD patients had lesions in the antecubital fossa and popliteal fossa, with corresponding low SCH levels and high TEWL in the upper body. The differences in TEWL between the control group and AD patients were confirmed significant in the neck and antecubital fossa regions, while differences in SCH were identified in the face, antecubital fossa, and popliteal fossa regions. A higher TEWL was found among AD patients with atopic lesions in the face and ankle. This study suggests that continuous monitoring of SCH and TEWL levels at specific body sites can provide insights into identifying vulnerable body areas to AD and supplement the SCORAD system for more effective clinical intervention and prevention strategies.

Background: Tinea of vellus hair is a rare condition that is recalcitrant to treatment. It is typically caused by nonanthropophilic dermatophytes. Extant data on this disease remain scarce.Aims/Objectives: This study aimed to delineate the clinical features and treatment outcomes of patients with tinea of vellus hair and to compare the characteristics of patients infected by anthropophilic and nonanthropophilic species.Methods: A 10-year retrospective study was conducted at the Department of Dermatology in a tertiary hospital in Thailand. The study included all patients with tinea of glabrous skin involving vellus hair. Baseline characteristics, clinical data, and treatment outcomes were analyzed.Results: Of the 31 patients in the study, two-thirds of the patients (69%) had a history of using topical medications, mainly steroids and antifungals. The face and extremities were the most common locations for lesions with positive vellus hair. There were no significant differences in data between patients infected with anthropophilic and nonanthropophilic species. Most patients received oral antifungals (80.6%). There was no significant difference in the cure rate between patients who were administered oral antifungals and those who solely utilized topical antifungals. Kaplan–Meier analysis demonstrated the overall median duration to achieve a cure was 5 weeks.Conclusion: The diagnosis of tinea of vellus hair should be considered in cases of tinea of the glabrous skin in exposed areas, especially in patients with a history of topical treatments. Nonanthropophilic dermatophytes are the primary causative agents of tinea of vellus hair. Systemic antifungals with prolonged duration are recommended.

Background: Radiofrequency ablation (RFA) is an emerging technology for the effective treatment of cutaneous hemangioma and vascular malformation. However, there are few histopathological studies on the treatment of this disease with RFA.Objective: This study aimed to investigate the effect of RFA and associated histopathological changes in a cockscomb model of cutaneous hemangioma and vascular malformation.Methods: Thirty-two Leghorn chickens were randomly divided into two groups: RFA group (treated with RFA; 220 V, pulse rate: 15 ms) and control group (treated with 1 mg/mL bleomycin). At 3, 7, 14, and 28 days after treatment, histopathological changes in the cockscomb tissues were observed visually and microscopically using hematoxylin and eosin staining and Masson's trichrome staining. The rates of capillary reduction and collagen proliferation were examined.Results: The cockscomb in the RFA group developed scabs earlier than that in the bleomycin group, and the scabs were darker and more clearly defined. The RFA group showed a more severe inflammatory reaction than the bleomycin group. At 28 days, most scabs had fallen off in both groups, and the boundary was clearer in the RFA group. At 3, 7, and 14 days, the number of capillaries decreased in both groups, with a more obvious decrease in the RFA group. From Days 3 to 28, the number of capillaries in the RFA group showed a trend of gradual increase, whereas that in the bleomycin group showed a trend of gradual decrease, but there was no significant difference between the two groups at 28 days (p > 0.05). The collagenous fibers of cockscomb showed a trend of gradual increase in both groups. The collagenous fiber hyperplasia was higher in the RFA group than in the bleomycin group at 14 and 28 days (p < 0.01).Conclusion: RFA significantly reduced the capillary number and promoted tissue fibrosis. Compared with bleomycin, RFA showed a better effect and with no obvious side effects in treating a cockscomb model of cutaneous hemangioma and vascular malformation.