The article lists the main methods for diagnosing demodicosis. A study was carried out to compare two methods to determine the Demodex mites light microscopy of skin scrapings and confocal laser scanning in vivo microscopy. The advantage of the latter method for diagnosing demodicosis in patients with acne and rosacea is proved.

Introduction: Acrofacial vitiligo being cosmetically disfiguring, can affect patients self-esteem, employability and interaction with society. The resistant nature if this form of vitiligo adds to angerand disillusionment in the affected individual. The defiant form in addition to its unstable nature necessitates the further study on acrofacial vitiligo. Objectives: To determine the clinical morphology with respect to stability of Vitiligo. Materials and Methods: A cross sectional study was done over a period of one year comprising of patients with acro-facial vitiligo. Relevant investigations including histopathology and patch test were done wherever necessary. Results: A total of 191 cases of acrofacial vitiligo were included in the study. Among stable acral vitiligo (59.48%), ill-defined margins were seen in 84.61% and dorsum was the commonestsite (23.57%). Among unstable Vitiligo, joint was predominantly involved (27.03%). Conclusion: Being prone for injuries, acrofacial areas are unstable. Well defined margins do not strike to the stability of acral vitiligo and signs of activity can be seen even in stable vitiligo. Hence unlike vitiligo of other areas, where well defined margins can be a marker of stable Vitiligo, margins may not be a scale for defining the stability of acral Vitiligo. Involvement of bony prominences could indicate unstable course and least involvement of proximal area of the phalanges may indicate its unstable nature.

Metal allergy was found with severe types of alopecia areata (AA) at the rate of 69.9% and the elimination of metal allergens from dental metals, cooking instruments lead to satisfactory hair regrowth and prevention of severe relapse of AA for the period of in average four years and four months at the rate of 75.5%. The cooperation of dentists for analysis of dental metals, removing allergic alloys and replacing to ceramics were needed. Another causation of AA was type I and IV allergy to house dust mite (HDM). This type has been called atopic alopecia historically. There is enough evidence that HDM is the main causation of atopic dermatitis (AD). Severe and intractable AD could be cured by the mite fauna investigation by methylene blue agar (MBA) method, followed by environmental improvement to decrease mites to less than 50/m2 everywhere in the home. The same solution was applied to treat severe atopic alopecia cases, which were cured at the rate of 58.3%, and the longest record of confirmed period of cure was five years. When six years or more elapsed after the onset of AA, any kind of treatment was not successful, because biopsy of the scalp revealed the disappearance of hair follicles, which was replaced by dermal fibrosis. Therefore, the treatment of AA should start quickly, investigating allergy to metals and HDM.

Systemic antibiotic treatments for an extended period of time have greater potential for adverse effects. Acne keloidalis nuchae is a chronic disorder characterized by inflammation and scarring. The management approach for acne keloidalis nuchae includes antibiotic regimen durations consisting largely on clinical expertise. This case reports a 27-year-old male who developed bloody diarrhea and diagnosed with Crohn’s disease after more than 9 months of antibiotics, minocycline and sulfamethoxazoletrimethoprim. By writing this up, new evidence is provided for the association between these two specific antibiotics and Crohn’s development, while highlighting the need for cautious attention during acne keloidalis nuchae management. Clinicians should be aware that antibiotics may contribute to the pathogenesis of inflammatory bowel disease and careful consideration should be given to this development in treatment regimens.

Mutual exchanges between specific and non-specific antibody molecules on receptors on the surface of mast cells should take place after an accumulation of non-specific antibodies in the patients’ bodies. These exchanges will bring about decompositions of combinations of mast cells and specific antibodies. These decompositions equal eliminations of causes of allergic diseases.