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Background Basal cell carcinoma with large subclinical extension (BCC-LSE) is a tumour whose extensive spread becomes apparent during Mohs surgery histopathology review. Not recognizing BCC-LSE preoperatively may result in a greater number of Mohs layers and in larger than anticipated postoperative defects. Objective To evaluate the characteristics of BCC-LSE. Methods This retrospective study reviewed BCC treated with Mohs surgery at a single academic surgical centre between March 2007 and February 2012. A total of 2044 cases met the criteria of BCC-LSE, which was defined as a lesion requiring at least three Mohs stages and a final surgical margin (difference between preoperative and postoperative measurements in either vertical or horizontal dimensions) of ≥1 cm. Results In adjusted multivariable analysis, male sex (P = 0.05), Fitzpatrick skin type I (P = 0.002), history of prior BCC (P = 0.003) and subtypes of basosquamous, metatypical, micronodular, infiltrative, morpheaform and sclerosing (P = 0.005) remained significant BCC-LSE predictors. Conclusions Demographic factors, including personal history of BCC, skin type, anatomic location, gender and age, in addition to tumour histologic subtype assessed through incisional biopsy, can help predict occurrence of BCC-LSE and assist physicians in optimizing preoperative assessment of surgical time and complexity.

Postinflammatory hyperpigmentation (PIH) is a common consequence following cutaneous inflammation in dark-skinned individuals with Fitzpatrick skin phototypes (SPTs) III–VI. The exact pathogenesis of this condition is unknown, but is believed to be an integral part of the normal response of the skin to inflammatory stimuli. PIH can last from months to years and may significantly impair quality of life of affected individuals. The primary treatment of PIH is prevention and treatment of the underlying inflammatory condition. In addition to prevention, there are a variety of medication and procedures used to treat PIH. Although topical skin-depigmenting agents remain the treatment of choice for PIH, lasers and light sources may be an effective adjunctive therapy or alternative for treatment failures. When treating PIH, any treatment options selected should be optimized and utilized carefully because the treatments itself may worsen the PIH.

Background A low fluence, high repetition rate 810 nm diode laser using constant motion technique has been recently introduced with advantages of less treatment discomfort and fewer side effects compared with traditional laser hair removal. Objective To compare hair reduction and side effects of low fluence high repetition rate 810 nm diode with high fluence low repetition rate 1064 nm Nd:YAG lasers. Methods Forty-nine subjects were randomly received five monthly treatments with diode laser on one side of their axilla and long-pulsed Nd:YAG laser on the other side. Hair count was recorded at baseline, 1- and 6-month follow-up visits. Results Percentage of axillary hair reduction at 1-month follow-up visit after receiving diode and Nd:YAG laser treatment were 71.0% and 82.3%, respectively, and at 6-month follow-up were 35.7% and 54.2%, respectively. There were significant differences in hair reduction between both laser systems at 1- and 6-month follow-ups (P