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We present a case of a patient with a history of Blau syndrome, who presented with acute onset of widespread florid painful folliculitis rash, which was resistant to the treatment with multiple courses of antibiotics in the community. Despite of the negative skin swab and negative periodic acid-schiff (PAS)stain on the skin biopsy, clinical diagnosis was fungal folliculitis and patient responded well to the course of itraconazole.

This work reports 30 cases of folliculitis decalvans (FD) in patients with dystrophic epidermolysis bullosa (DEB) among a cohort of 125 DEB patients seen between 2010 and 2021 in 2 French expert centers for the management of inherited epidermolysis bullosa. Such an association between two rare diseases cannot be fortuitous and implies a physiopathological link that we discuss in this paper. This association is a new significant fact to add to the reflexion on FD causes, suggesting that skin abnormality of DEB could act as a factor of a specific skin barrier alteration which could favor FD. Scarring alopecia with tufted folliculitis and pustules on inflamed skin at the vertex of a woman with dominant dystrophic epidermolysis bullosa.

A 43-year-old female zoologist has an occupational dermatomycosis of the face, neck and upper part of chest caused by T. mentagrophytes. It was mistakenly diagnosed and treated as "Rosacea, papulopustular subtype, ocular rosacea" for 1.5 years. Symmetrical, atypical clinical manifestations with recurrent blepharoconjunctivitis developed as a result of self-treatment using a topical steroid. The detection of cicatrizing folliculitis in the eyebrow area and an arcual peripheral edge in fresh foci on the chest helped to suspect dermatomycosis. The definitive diagnosis was made after the detection of abundant coarse septate mycelium during microscopic investigation of skin scales from foci on the face and chest with 30% KOH and an abundant growth of Trichophyton mentagrophytes during a cultural research study of skin scales, eyebrow hair and eyelashes from lesions. The use of terbinafine for 4 weeks led to the recovery of the patient.

Demodex spp. mites are external obligate parasites; they are transmitted between hosts through direct contact, and may induce several dermatological symptoms when found in large numbers. However, these symptoms may be similar to other commonly known diseases; this often leads dermatologists to neglect the pathogenic role of these mites. Therefore, a better diagnosis is recommended in order to avoid mistreatment. The aim of this study was to investigate the correlation between Demodex mites and dermatological diseases. Infestation rates in patients suffering from acne, rosacea, folliculitis, and psoriasis were compared with asymptomatic patients, along with the mites’ relation to gender, age, personal hygiene, time of year, and residency. These mites were mainly found in patients with rosacea (66.67%) followed by acne (64.41%), while they were only observed in 48.15% of asymptomatic patients, 40.00% in folliculitis, and 0.00% in psoriasis. The statistical analysis showed a significant relationship between infestation and the previously mentioned dermatological diseases (P

Eozinofilik püstüler dermatoz (EPD), kıl folliküllerinin eozinofilik infiltrasyonu ile karakterize non-infeksiyöz bir dermatozdur. İlk kez 1965 yılında Ise ve Ofuji tarafından kollar ve yüzde püstüller izlenen kadın olguda histopatolojik incelemede foliküllerin eozinofilik infiltrasyonu ve periferik kanda lökositoz saptanması üzerine tanımlanmıştır ve bu form klasik EPD olarak bilinmektedir. Yıllar içinde klasik EPD dışında immünsupresyonla ilişkili EPD (çoğunlukla HIV ile ilişkili) ve infantil EPD olmak üzere üç formu tanımlanmıştır ve bazı araştırmacılar birbirinden klinik olarak büyük farklar gösteren bu üç formun farklı birer hastalık olarak ele alınmasını önermektedir. Tanımlanmasının üzerinden elli yıldan fazla süre geçen bu nadir antiteyi gözden geçirmekteyiz., Eosinophilic pustular dermatosis (EPD) is a non-infectious dermatosis characterized by eosinophilic infiltration of hair follicles. It was first described by Ise and Ofuji in 1965 in a female case with pustules on the arms and face, and eosinophilic infiltration of the follicles and leukocytosis in the peripheral blood were detected in the histopathological examination, and this form is known as classical EPD. Over the years, apart from classical EPD, three forms of immunosuppression-related EPD (mostly HIV-related) and infantile EPD have been defined, and some researchers suggest that these three forms, which differ clinically from each other, should be considered as different diseases. We review this rare entity, more than fifty years after its description.

The prior use of external expansion has been described in the literature as a tool to allow reliable grafting of more than 200 mLs of autologous fat under general anesthesia. The purpose of this study was to determine whether breast autologous fat transfer entirely under tumescent anesthesia (BAFTEUTA) is a safe and effective technique.After institutional board approval, 22 consecutive patients were enrolled in this single-cohort, prospective study. All patients underwent preoperative expansion using manually evacuated domes. All procedures were performed under tumescent anesthesia with oral sedation.There was a median successful graft of 200 mLs. Complications were minimal and limited to occlusive folliculitis.Although the author has not reported as large graft volumes as some other authors, BAFTEUTA is a safe procedure and can have good outcomes with high levels of patient satisfaction.

Although topical drugs are the mainstay of treatment for patients with mild-to-moderate psoriasis, the developments observed in this field in the last two decades have been limited. The most commonly used drugs are still vitamin D analogues and corticosteroids, both with several limitations. The aryl hydrocarbon receptor (AhR) plays a role in the pathogenesis of psoriasis, and tapinarof, a novel, first-in-class, small molecule topical therapeutic AhR-modulating agent has been recently approved by the FDA for the topical treatment of plaque psoriasis in adults. Two large, 12-week, phase III trials, PSOARING 1 and 2, showed that 35.4%-40.2% of patients in the tapinarof 1% cream arm achieved the primary endpoint (Physician's Global Assessment [PGA] score of 0 or 1 and a decrease of ≥2-5 points at week 12) compared with 6.0%-6.3% for vehicle arm, respectively. The most common adverse effects were folliculitis, contact dermatitis, headache and pruritus. In the open label, 40-week, extension trial, PSOARING 3, the efficacy and safety results were similar, with 40.9% of patients achieving a PGA = 0 at least one time during the trial and 58.2% of patients with PGA≥2 achieved PGA = 0/1 at least once during the trial, without tachyphylaxis. There were no new safety signals, with most frequent adverse events being folliculitis, contact dermatitis, and upper respiratory tract infection. Tapinarof 1% cream has shown to be effective and to have a favorable safety profile in the treatment of psoriatic patients, representing an alternative to the current therapeutic options, increasing our armamentarium in the topical treatment of psoriasis.

Purpose Although infliximab (IFX) decreases the risk of blindness due to refractory uveitis in patients with Behcet's disease (BD), there are no standard criteria for IFX switching or withdrawal. To evaluate the effect of IFX switching in patients with BD in long-term remission, a prospective, single-arm intervention trial was conducted, switching from IFX to cyclosporine A (CYA). Study design A prospective open-label study. Methods Eligible patients met the following criteria: administration of IFX without concomitant immunosuppressants for more than 5 years with no episodes of ocular attacks, no retinal vasculitis on fluorescein fundus angiography, negative C-reactive protein in serum, and no extraocular lesions at the time of IFX withdrawal. CYA 5 mg/kg/day was administered from 6 weeks after IFX withdrawal. The primary outcome was the rate of readministration of tumor necrosis factor inhibitors at 1 year after IFX withdrawal. Results Three of 45 BD patients treated with IFX for refractory uveitis were included in the study. At 1 year after withdrawal of IFX, no patient had experienced any ocular attacks or needed readministation of IFX. However, extraocular lesions, such as recurrent oral ulcers, folliculitis, and recurrent fevers, occurred in all patients. Liver or renal dysfunction, which may have been caused by CYA, was also observed in all patients. Conclusions Although no ocular attacks were observed for at least 1 year after IFX withdrawal, this prospective study indicates that IFX withdrawal should be considered carefully, even for patients in long term remission of ocular and extraocular lesions.

Necrotizing infundibular crystalline folliculitis is a rare entity, which is a distinctive clinical and histopathological entity. Eruptive yellow waxy umbilicated folliculocentric plugs clinically correspond to pale crystalline filaments embedded in an amorphous sebum-rich material. Remarkably, only the superficial infundibular ostia remain, and the distended cavity is devoid of a follicular or sebaceous gland remnant. The pathogenesis of this enigmatic event remains to be established. The emergence of necrotizing infundibular crystalline folliculitis (NICF) as a paradoxical side effect of antitumor inhibitors epidermal growth factor receptor vascular endothelial growth factor and more recently programmed death-1 represents the expression of altered molecular pathways that underpin the pathogenesis of NICF. To explore these pathways, it is necessary to explore the hierarchy of follicular stem cells, particularly the potential role of committed infundibular stem cells that play a key role in wound healing. Committed infundibular stem cells are closely linked to the sebaceous gland stem cell axis, and this has relevance in the process of homeostatic repair of sebaceous follicles in the wake of folliculitis. The unscheduled modulation of this infundibular homeostatic sebaceous repair axis by epidermal growth factor receptor vascular endothelial growth factor, and programmed death-1 may lead to an aberrant outcome with metaplasia of infundibular keratinocytes to sebocytes. In the absence of sebaceous gland differentiation, these metaplastic infundibular sebocyte cells would lead to the consumption and loss of the infundibulum as a result of holocrine sebum production. This conceptual pathogenic pathway for NICF is constructed by incorporating recent advances in the fields of follicular stem cells, wound repair, follicular homeostasis, regulatory T cells, and molecular pathways linked to the biologicals inducing NICF.

Lack of anti-infective protection is one of the reasons for the occurrence of purulent-inflammatory diseases of the skin, soft tissues and purulent-septic complications in the postoperative period. Immunocorrective therapy is extremely relevant in surgical practice, and it can be used both for the prevention and treatment of postoperative complications. In this regard, special attention should be paid to low molecular weight fragments of peptidoglycan of cellular bacteria muramyl peptides. The study included 65 patients with purulent inflammatory diseases, of which 35 men aged 2355 years with chronic recurrent pyoderma (ostiofolliculitis, folliculitis, sycosis, furunculosis), and 30 patients aged 18 to 65 years with purulent inflammatory diseases of soft tissues, mainly abscesses and phlegmons of various localization without pronounced concomitant pathology. The examination included 26 patients with purulent-septic complications in the postoperative period. The patients included in the study were divided into 2 equal groups: 1 is the main group, in which patients received intramuscularly Polimuramil 200 mg daily for 5 days in addition to treatment; Comparison group 2, in which patients received only standard treatment. The clinical symptoms of pyoderma were assessed from day 0 to day 7, then on day 14, after 1 and 6 months of the study. Blood samples were taken from all patients for hematological and immunological studies. The timing of the appearance of granulations was monitored daily. The inclusion of Polimuramil in the complex treatment of pyoderma accelerated the regression of the main clinical manifestations of the disease and promoted the induction of stable remission. In patients with soft tissue infections, Polimuramil increased the degree of regression of the depth and area of the wound and accelerated the appearance of granulations. The clinical efficacy of Polimuramil in patients with purulent-septic complications in the postoperative period correlated with a decrease in CRP and procalcitonin levels. The study confirms the effectiveness of Polimuramil in the treatment of purulent-inflammatory diseases and purulent-septic complications in the postoperative period and its high immunomodulatory potential (8 figs, 2 tables, bibliography: 5 refs).

Chronic non-scarring scalp folliculitis is a little-known entity included within the spectrum of scalp folliculitis, a group of diseases sharing clinical features but with heterogeneity in terms of residual scarring (always absent in chronic non-scarring scalp folliculitis), microbiology, and response to antibiotics. Chronic non-scarring scalp folliculitis is most likely an inflammatory disease within the group of neutrophilic dermatoses. The recognition of the inflammatory nature of this disease may pave the way for the use of new therapies, directly targeting pathogenic molecules. Herein, we report the first case of chronic non-scarring scalp folliculitis treated by adalimumab.

The skin is the largest organ of the body that has many functions. Canine dermatology remain a challenging field that requires a variety of knowledge as dermatological problems are reported to be the most common health problem in small animal practice. Blood, skin and biopsy samples were collected from 50 dogs of different breeds and sexes. The present study is designed for identification of the different etiological agents causing skin diseases in dogs, evaluation of some hematological and biochemical parameters in diseased dogs and histopathological examination of selected cases using skin biopsy. These dogs were grouped into two groups, the first one was the control group (n=10) apparently healthy dogs and the second group (n=40) diseased dogs presented with different skin ailments where 12 out of 40 dogs were suffered from demodicosis, dermatophytosis (6 cases), pyoderma (8 cases) , mixed infection (10 cases) and canine atopic dermatitis (4 cases). Evaluation of the hematological parameters revealed presence of anemia and leukocytosis with apparent neutrophilia in dogs with pyoderma and eosinophilia in the other groups. Biochemical parameters lied within the reference range in all diseased groups. Staphylococcus spp. was the most common bacterial isolate in canine pyoderma. With respect to histopathological picture, results indicated presence of large focal area of epidermal liquefactive necrosis associated with dense neutrophils infiltration. Severe dermatitis, folliculitis, perifollicular and perivascular inflammatory cells infiltration, all these changes associated with cases of pyoderma. Demodicosis cases demonstrated as heavy mite infestation in different developmental stages in the stratum conium of the epidermis and in the follicles. Laminar orthokeratotic hyperkeratosis, vacuolated epidermal prickle cells, acanthosis and vaculation of keratinocytes of the infundibula. Dermatitis characterized by moderate to marked inflammatory infiltration. Necrosis of adnexa, folliculitis and perifollicultis were also recorded in demodecosis infected dogs. Fungal dermatosis showed pronounced laminar orthokeratotic hyperkeratosis and acanthosis. Vacuolar degeneration of keratinocytes and fungal Hyphae were seen in dermatophytosis infected dog. Ulcerative dermatitis in form of focal extensive area of epidermal necrosis and ulceration associated with inflammatory cells infiltration, acanthosis and spongiosis of prickle cell layer were noticed in mixed infection infected dogs. The most common infectious skin problems during our study were pyoderma, red mange and dermatophytosis. The predominant pathogen in pyoderma affected dogs was Staphylococcus spp. Histopathological examination was very useful in our study as they provide accurate diagnosis in a short period of time and help in clear visualization of the clinical picture.

Down syndrome (DS) is the most common chromosomal condition and affects many organs including the skin. Dermatologists are an integral part of the DS care team. This is a review of both common and rare dermatologic conditions in DS. We provide practical strategies for a successful dermatology interview and examination. We explore the downstream effects of trisomy of chromosome 21, in particular on the immune system, and how these insights may enhance our pathophysiologic understanding of their cutaneous conditions.

BACKGROUND/OBJECTIVES Trisomy 21 has known associated clinical phenotypes, including skin and soft tissue concerns. However, the overall prevalence and types of findings are largely unclear. METHODS A retrospective review of children with trisomy 21 and one or more dermatologic diagnoses, seen from 1/1/1994 to 7/1/2016, was performed to record dermatologic diagnoses. If one or more diagnoses were confirmed, further data were collected, including demographics, medical specialty, referrals to dermatology, treatment, complications, and follow-up. RESULTS One hundred and seventy-four patients with a diagnosis of trisomy 21 aged 18 years or younger were confirmed to have one or more dermatologic diagnoses. In a total of 479 dermatologic diagnoses, superficial mycoses (12%), skin and soft tissue infections (10%), dermatitis (8%), and folliculitis (8%) were most common. Diagnoses were most commonly made as an outpatient (91%) and by general pediatrics (45%) or dermatology (25%). A significant difference (P

Eosinophilic pustular folliculitis of infancy is a sterile, inflammatory dermatosis that mainly affects children younger than 36 months. The underlying physiopathologic mechanism is unclear. Clinical diagnosis is challenging, and a skin biopsy may be necessary. The literature data are sometimes contradictory, and a histologic series of eosinophilic pustular folliculitis of infancy cases has not been previously published.

Necrotizing infundibular crystalline folliculitis (NICF) is a rare distinct entity that was introduced in 1999. It typically presents with numerous eruptive waxy papules on the forehead and/or the upper back in adults in their fifth to seventh decade of life. The pathogenesis is unknown to date, but yeast and bacterial infection of the follicular ostia seems to contribute to the development. More recently, NICF has occasionally been observed as a side effect of targeted antitumoral therapy. Histopathologically, NICF is characterized by dilated follicular ostia filled with pale filamentous and birefringent material enclosed by parakeratotic columns of the epidermis and accompanied by a mild superficial inflammatory infiltrate of the dermis. This case report is about a 58-year-old male patient presenting with multiple eruptive keratotic papules on his forehead. Histopathology revealed all classic features of NICF. The case represents a classic example of NICF and is compared with previously published cases that are comprehensively summarized in this article.

Cohort studies on the use of retinoids for hidradenitis suppurativa (HS) have yielded contradicting results. As the clinical presentation of HS is heterogeneous, with different predilection sites and hallmark features, it can be hypothesized that HS phenotypes are associated with the effectiveness of specific retinoid treatments.The aim of this study was to evaluate the drug survival of oral retinoids in the treatment of HS and to establish predictors for longer treatment duration.A retrospective, dual-center study was conducted in the Netherlands in adult HS patients treated with oral retinoids between 2011 and 2021. Drug survival analyses were performed through Kaplan-Meier survival curves. Additionally, Cox regression models were used to determine predictors for a longer drug survival.In total, 102 patients were included. Overall drug survival of (low-dose) isotretinoin (n = 66) at 12 and 24 months was 44.2% and 15.5%, respectively. Termination of treatment was mostly due to ineffectiveness (26%). Presence of widespread comedones (p = 0.03) and the use of concomitant systemic medication (p = 0.04) were associated with a prolonged treatment duration. For acitretin (n = 36), the overall drug survival was 42.0% at 12 months and 37.4% at 24 months, and was also predominantly determined by ineffectiveness (28%). Interestingly, the scarring folliculitis phenotype (p 0.05) was associated with prolonged drug survival time for acitretin treatment relative to the regular phenotype.Comparable drug survival rates at 12 months for isotretinoin and acitretin were found. HS patients with widespread comedones and the scarring folliculitis phenotype could benefit from treatment with isotretinoin or acitretin, respectively.

We report a case of a 59-year-old man presenting with a widespread follicular-based papular rash with a several-month history of myalgias, lymphadenopathy, fatigue, and weight loss who was diagnosed with acute syphilitic folliculitis by tissue biopsy analysis with immunohistochemical demonstration of spirochetes in hair follicle epithelium. Serologic analysis also showed evidence of Treponema sp. infection. Owing to the rising number of syphilis cases in the last decade, it is important to recognize classic cutaneous findings of syphilis in addition to unusual presentations such as syphilitic folliculitis.

The dermoscopic features of rosacea have already been reported. However, the current findings are incomplete, and little is known about phymatous rosacea. Hence, this study aimed to summarize and compare the dermoscopic features and patterns of three rosacea subtypes (erythematotelangiectatic [ETR], papulopustular [PPR], and phymatous [PHR]) in the Chinese Han population and to evaluate whether these features differ with patients' genders, ages, and durations.Dermoscopic images of 87 rosacea patients were collected in non-polarized and polarized dermoscopy contact modes at 20-fold magnification. Dermoscopic features, including vessels, scales, follicular findings, and other structures, were summarized and evaluated.The reticular linear vessels and red diffuse structureless areas of ETR were distinctive. For PPR, red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules were typical dermoscopic criteria. The common dermoscopic features of PHR were: orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines. The following features statistically differed among the three rosacea subtypes: reticular linear vessels ( P 0.001), unspecific linear vessels ( P = 0.005), linear vessels with branches ( P 0.001), yellow scales ( P = 0.001), follicular plugs ( P 0.001), perifollicular white color ( P 0.001), red diffuse structureless areas ( P = 0.022), orange diffuse structureless areas ( P 0.001), red focal structureless areas ( P = 0.002), orange focal structureless areas ( P = 0.003), white lines ( P 0.001), follicular pustules ( P 0.001), and black vellus hairs ( P 0.001).The dermoscopic patterns of ETR are red diffuse structureless areas and reticular linear vessels. For PPR, the pattern comprehends combinations of red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules. Meanwhile, PHR is characterized by remarkable orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines.

Malassezia folliculitis (MF) is a humid-favoured fungal skin disease caused by Malassezia species. Inaccurate treatments, changes in skin flora and disease exacerbation are often occurred due to oversights in the diagnosis. Several diagnostic methods are established for MF.To identify clinico-laboratory findings of Malassezia folliculitis in Indonesia.The study was conducted from January 2014 to December 2018 in seven referral teaching hospitals. Medical records of MF-diagnosed patients were obtained and analysed using the binomial test, chi-square test and Cohen's Kappa coefficient in SPSS 26.0.A total of 353 cases of MF were identified in seven referral teaching hospitals in Indonesia, 66.3% of which were males and 33.7% were females, dominated by the 17-25 years old group (44.5%). Itchy sensation (83.9%) was a major subjective complaint. Lesions were majorly found on the trunk-chest, back and shoulder (68.3%), while the clinical manifestation are mostly follicular papule-pustular lesions (62.1%). Patients were 87.4% positive by KOH examination (modified Jacinto Jamora's criteria) and 69.1% positive by Wood's lamp. Generally, sex, age, subjective complaint, lesion location, clinical manifestation and both examinations were statistically significant (p .001). A significant relationship between all the clinical criteria of the patients in the KOH especially the clinical manifestation was significantly related to Wood's lamp. The Cohen's Kappa assessment suggested that there was an agreement between KOH and Wood's lamp (κ = -0.272, p .001).The clinical symptoms of Malassezia folliculitis are dominated by pruritus, papulopustular follicular lesions on the trunk and the presence of spore load.

Seventy-seven strains of

International audience; No abstract available

The case of a pregnant woman with erythematous papules and pruritic pustules, located on the buttocks and trunk, predominantly over the linea nigra, is described. Histopathological analysis showed the presence of perivascular infiltrate consisting mainly of lymphocytes, in addition to a hair follicle permeated by an inflammatory infiltrate consisting predominantly of neutrophils, leading to the destruction of the pilosebaceous unit. Pruritic folliculitis of pregnancy is the rarest of the specific dermatoses of the gestational period. Its occurs more frequently in the 2nd and 3rd trimesters of pregnancy. It is a benign, self-limited dermatosis of unknown etiology, which shows spontaneous regression after delivery. There are no reports of increased maternal-fetal morbidity and mortality.

International audience; Background & aims: Secondary to tumour necrosis factor-alpha induced protein 3 (TNFAIP3) mutations, A20 haploinsufficiency (HA20) is a recently described autoinflammatory disease with clinical features similar to those of Behçet's and Crohn's diseases but with a constantly expanding clinical spectrum. Here, we describe HA20 liver involvement in three new patients from the same family.Methods: We retrospectively assessed clinical, biological and/or histological findings for eight patients over three generations of the same family with heterozygous mutations in the TNFAIP3 gene (c.259C > T, p.Arg87*).Results: The eight patients exhibited the following: aphthous ulcers (8/8, bipolar in 7), autoimmune features (6/8, including 5 with definitive autoimmune disease diagnoses, ie, type I diabetes, Hashimoto thyroiditis, pernicious anaemia, and/or 5 with antinuclear antibodies ≥320), pustulosis/folliculitis (5/8), abdominal pain (4/8), arthralgia (3/8), enlarged cervical lymph nodes (3/8) and pericarditis (1/8). In addition, three patients (twin sisters and their grandmother aged 23 and 70 years, respectively) exhibited persistent mild hepatic cytolysis associated with splenomegaly (n = 3), hepatomegaly (n = 1) and/or liver atrophy (n = 1) on echography. We could not detect any other causes of chronic liver diseases. Liver biopsies from three patients displayed hepatic fibrosis, hepatocyte injury and/or CD4+ /CD8+ T lymphocyte infiltration, and patterns of inflammatory cells and NLRP3 or NF-κB immunostaining differed from the predominant neutrophil infiltration observed in skin or some digestive tract biopsies.Conclusions: This study reinforces the dual involvement of innate and adaptive immunity in HA20 according to both acute and chronic injury and the organ involved and widens its clinical spectrum to include chronic hepatic involvement.

Background Descriptions of cutaneous findings associated with COVID-19 have not been consistently accompanied by histopathology or confirmatory testing for SARS-CoV-2. Objective To describe and classify the cutaneous findings with supporting histopathology of confirmed COVID-19 inpatients. Methods We included consecutive inpatients with a confirmed diagnosis of COVID-19 for whom a dermatology consult was requested. A skin biopsy was performed in all cases. Skin findings were classified as being compatible with a cutaneous manifestation of COVID-19 or as representing a distinct clinical entity. Results Twenty-eight patients were studied in whom thirty-one dermatologic diagnoses were made. Twenty-two of the dermatoses were compatible with a cutaneous manifestation of COVID-19; nine entities were not associated with infection by SARS-CoV-2. The most common COVID-19-associated pattern was an exanthematous presentation. In four patients, a new pattern was observed, characterized by discrete papules with varied histopathological findings including a case of neutrophilic eccrine hidradenitis. No cases of pernio-like lesions were identified. Skin findings not associated with COVID-19 represented 29% of diagnoses and included Malassezia folliculitis, tinea, miliaria, and contact dermatitis. Limitations There is no gold-standard test to distinguish between viral exanthems and drug reactions. Conclusion A histopathological study is critical before attributing skin findings to a manifestation of COVID-19.

BACKGROUND Infantile eosinophilic pustular folliculitis (I-EPF) is a rare disease characterized by pruritic vesicles and sterile pustules on the erythematous surface of the scalp and facial localization, usually seen in the neonatal period. It is essential to show the presence of dense eosinophils in the diagnosis of pustules. Histopathological examination of the hair follicles by eosinophils infiltration is determined. AIM Here, we reported a 5-month-old baby boy diagnosed infantile eosinophilic pustular folliculitis. PATIENT A 5-month-old baby boy was consulted to our polyclinic by his family because of pustules on the scalp, face, and neck developing in two week after birth. In dermatological examination, the pustular lesions of 1-2 mm in diameter on the scalp, face, and neck on an erythematous background were determined. RESULTS There was no growth in the culture taken from the pustule. In the laboratory tests of the patient; upon detection of eosinophilia in the hemogram. The eosinophil count at the patient's first admission was 1.48 K/μl. (0.05 0.50). Eosinophil count was 0.02 K/μl after treatment. It was decreased. The patient was evaluated for other pustular dermatoses. In the differential diagnosis of the patient; causing bacterial/non-bacterial pustulosis were included. Bacterial culture was negative. CONCLUSION Eosinophilic folliculitis defines as a group of papulopustular diseases with unknown etiology characterized histologically by eosinophilic infiltrates. First, Ofuji reported a female patient with recurrent follicular pustules and peripheral eosinophilia as a variant of folliculitis in 1965. Its etiopathogenesis is not clearly known. In the differential diagnosis of EPF includes the other pustular lesions of the newborn such as erythematoxicum neonatarum, transient neonatal pustular dermatosis, infantile acropustulosis, scabies, dermatophytosis, and langerhans cell histiocytosis. Treatment options includes topical corticosteroids and calcineurin inhibitors, antihistamines, systemic antibacterial and anti-inflammatory agents, and dapson.

Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad, which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. It occurs with perifolliculitis of the scalp, dermal abscesses, sinus tract development, and secondary scarring alopecia. HS, sometimes known as acne inversa, is a chronic relapsing inflammatory disease afflicting apocrine gland-rich areas of the body with painful nodules and abscesses, sinus tracts, and scarring. Given the overlap between the clinical features and the pathogenesis of DC and HS, it would be more appropriate to consider these conditions as two different localizations of the same disease rather than two different pathologies, being a follicular occlusion disease occurring on the scalp and on the apocrine gland-rich areas of the body.

Granulomatous and pyogranulomatous skin lesions in dogs are clinically heterogeneous diseases with different treatment outcomes. Sometimes for long-term management in dogs that exhibit severe symptoms of immune-mediated cutaneous lesions, long-term administration of immunosuppressive agents is required, although these agents have some unwanted side effects. On the other hand, the effectiveness of these medications may not be desirable in some patients. So, the use of alternative and complementary agents with remarkable efficacy and less unwanted side effects can be valuable and interesting for long-term management of the lesions. In the present study, a 7-year-old female mixed dog was presented with an acute onset of severe and generalized asymmetrical nonpruritic and scaly cutaneous lesions that led to erythema and ulcers. Clinical signs and histopathological studies as well as other laboratory tests failed to demonstrate any etiological agent, and the patient was diagnosed with idiopathic interstitial pyogranulomatous/granulomatous dermatitis and folliculitis. No remarkable improvement was observed following prednisolone administration for 2 weeks. Surprisingly, the clinical signs completely alleviated after 3 weeks of cyclosporine and 1 month of omega 3 oil administration. The dog was followed up for 4 years. The patient was completely dependent on omega 3 oil, as the lesions recurred whenever the treatment with omega 3 was discontinued. In conclusion, it appears that omega 3 fatty acid was effective for the long-term successful management of an idiopathic interstitial pyogranulomatous/granulomatous dermatitis and folliculitis without other parenteral administration in a dog.

Celulite dissecante e foliculite decalvante podem apresentar, em estágios iniciais, quadro clínico semelhante. Este artigo apresenta os achados ecográficos da celulite dissecante que auxiliam no diagnóstico e na abordagem terapêutica. A ecografia não se substitui à observação, tricoscopia e histopatologia mas pode ajudar ao diagnóstico. Em fase activa, observam-se lesões ovóides de bordos relativamente bem definidos, não encapsuladas, com conteúdo hipoecogénico que comunica com a derme através dos bulbos dilatados de folículos pilosos. Permite distinção com foliculite decalvante, com quisto de triquilema (no caso de lesão única ou poucas lesões) e ao permitir avaliar a inflamação quando combinado com Doppler a cores, poderia servir para monitorizar o controlo da inflamação e a resposta terapêutica. Os autores compartilham 2 casos clínicos ilustrativos, sendo apresentada uma revisão da literatura sobre o tema.

INTRODUCTION Pityrosporum folliculitis (PF) is a common skin condition that can be easily misdiagnosed, especially by non-dermatologists. While the initial diagnosis is often made clinically, skin microscopy may help to confirm the same. However, there is scant literature regarding the clinical epidemiology of PF. To our knowledge, in Singapore, only one prior epidemiological study was performed in 1987. Through the present study, we aimed to provide an update regarding the epidemiology, diagnosis and treatment of patients with PF in Singapore. METHODS We performed a retrospective review of patients with clinical presentations compatible with PF who presented to the dermatology clinic at the National University Hospital, Singapore, between 1 January 2011 and 31 December 2015. The medical records of patients identified as having clinical presentations that resembled PF were reviewed via written and electronic databases. Information regarding the demographics and clinical presentation of the patients was collected. RESULTS Of the 375 patients identified, 214 (57.1%) were confirmed as having PF based on Gram-stain microscopy. Most (35.0%) of these 214 patients were aged between 21 and 30 years, with a male-to-female ratio of 3:1. The lesions predominantly occurred on the trunk and the back. The majority of patients presented with symptoms that lasted more than one month. 128 (59.8%) patients received oral antifungal treatment, whereas 82 (38.3%) patients were treated with topical antifungal treatment alone. CONCLUSION A typical Singapore patient with PF is a young man aged 21–30 years, with erythematous follicular papules or pustules over the trunk and the back.

Objective: To present only skin lesions in the abdominal wall that we detected in morbidly obese patients and to examine them in the light of the literature. Material and Method: Patients who applied to the general surgery outpatient clinic for bariatric surgery and who also had dermatological complaints and were referred to the dermatology outpatient clinic with the detection of skin-related complaints were retrospectively evaluated in terms of age and breast skin findings. Normal skin findings were separated into intertrigo, chronic recurrent folliculitis, eczemas, acanthosis nigricans and striae. Results: A total of 60 obese female patients were included in the study. The mean age of the patients was 32.4 ± 8.8 years (19-53), and the mean body mass index was 42.6 ± 2.4 (40-49). Normal skin findings were present in 28.3% of the patients (17 patients). The most common finding was striae, and 60% (36 patients) had it. Then respectively, intertrigo was detected in 14 patients (23%), chronic recurrent folliculitis in 12 patients (20%), eczema in 5 patients (8.3%), and acanthosis nigricans in 2 patients (3.3%). Conclusion: The most common findings on the abdominal wall skin of obese individuals are striae and intertrigo, and similar findings have been found in many studies in the literature.

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic skin inflammatory disease characterized by relapsing folliculitis and painful, fluctuant abscesses, sinus tracts, and scars. The treatment of PCAS is challenging and clinical practice varies a lot, and how to choose the best treatment for PCAS is a real problem for clinicians. We reviewed articles providing treatment options for patients with PCAS in different databases. Dermatologists may find this review helpful to meet the challenges of PCAS management, but there is still a lack of authoritative guidelines. In the future, more robust randomized control trials are needed to determine the best treatment for PCAS.

Current guidelines for the use of systemic antimicrobials for the treatment of superficial bacterial folliculitis in dogs include the recommendation that the disease be treated for a minimum of 3 weeks and for at least 1 week beyond clinical resolution. With increasing antimicrobial resistance being noted for bacteria involved in this condition, as well as the increased use of evidence-based medicine, this dogma needs to be reevaluated.

This study aimed to investigate the side effects of silicone gel sheet (Lady Care®) and evaluate its prophylactic efficacy in preventing abnormal scarring. Sixty women who underwent caesarean section were recruited from September 2016 to September 2017 in this prospective study. Lady Care® was applied from the 2nd to the 6th postoperative months. Side effects of Lady Care® were evaluated through medical examinations and questionnaires. A plastic surgeon diagnosed abnormal scarring. Pruritus was diagnosed in 25 (47.2%) patients; folliculitis, four (7.5%); dry skin, four (7.5%); contact dermatitis, three (5.7%); wound infection, two (3.8%); and epidermolysis, one (1.9%), albeit with mild severity. Following Lady Care® application, no abnormal scarring and mild hypertrophic scarring was observed in 32 (64.0%) and 18 (36.0%) patients respectively. Of seven patients with pre-existing hypertrophic scars, only two showed hypertrophic scarring after Lady Care® application. Our findings support the safety and prophylactic efficacy of Lady Care®.Impact StatementWhat is already known on this subject? The incidence of abnormal scarring, i.e. keloid or hypertrophic scar formation after caesarean section (CS) is reported to be ∼41%. Abnormal or excessive scar formation can lead to functional limitations, pruritus, pain and cosmetic issues. Studies have also shown a prophylactic effect of the application of silicone materials against the development of hypertrophic and keloid scars, though prohibitive cost and lack of adhesiveness of such gel sheets are known factors limiting their usage.What the results of this study add? The new silicone gel sheet 'Lady Care®' has strong adhesive properties and is consequently not easily peeled off. Furthermore, it is easy to use and economically efficient.What the implications are of these findings for clinical practice and/or further research? This is the first clinical trial on the application of Lady Care® silicone gel sheet for the prevention of CS scarring. Our findings support the safety and prophylactic efficacy of Lady Care®.

Background Metastatic non-small cell lung cancer (NSCLC) often requires a multimodal treatment including chemotherapy, targeted therapy and radiotherapy. In addition to this, many patients take supportive drugs. Since only scarce data on possible interactions between radiotherapy and pharmaceutical or herbal drugs exist, description of clinical cases is of special interest. Case report A patient with stage IV NSCLC was treated with docetaxel/ramucirumab followed by radiotherapy for brain and bone metastases while taking several other over-the-counter drugs (OTCs) including topical St. John’s wort skin oil. Results A 63-year-old female patient with stage IV NSCLC presented with 11 asymptomatic brain metastases and a painful osteolytic bone metastasis in the 12th thoracic vertebral body (T12). Four weeks before the start of palliative whole-brain radiotherapy and bone irradiation of T12, she was administered a combination of docetaxel and ramucirumab. At an administered dose of 24 Gy, the patient presented with severe folliculitis capitis, while skin examination over the thoracolumbar spine was unremarkable although skin dose was similar. After thorough questioning, the patient reported using a herbal skin oil that contained St. John’s wort for scalp care only, but not for skin care of her back during radiotherapy. After stopping the topical application of the skin oil, folliculitis improved with a course of systemic and topical antibiotics within 10 days, though the healing process was prolonged and included desquamation and hyperpigmentation. Conclusion St. John’s wort seems to be a significant radiosensitizer for photon radiotherapy and can cause severe skin toxicity even though the literature lacks data on this interaction. As an OTC, it is easily accessible and often used by oncological patients due to antidepressant and local antimicrobial and pain-relieving effects.

Purpose of review Pseudomonas aeruginosa is an opportunistic pathogen with considerable morbidity and mortality, particularly in vulnerable hosts. Skin manifestations are common, either representing local inoculation or secondary skin seeding following bloodstream infections. As patients with various predisposing conditions are expanding, we sought to review the most recent published evidence regarding epidemiology, risk factors and diagnosis of skin manifestations of P. aeruginosa. Recent findings New data exist on epidemiology and diagnosis of skin infections; systemic infections are impacted by multidrug-resistance issues and host immune status. Summary Green nail syndrome, toe web infection, hot tub folliculitis, hot hand-foot infection and external otitis are the most common infections originating from the skin per se. Local treatments are the cornerstone and prognosis is favorable in immunocompetent hosts. Ecthyma gangrenosum and P. aeruginosa subcutaneous nodules are usually associated with bloodstream infections and occur primarily in immunocompromised hosts. Necrotizing skin and soft tissue infections occur in diabetic, alcoholic and immunocompromised patients; management requires a multidisciplinary team with surgical approach. Burn wound infections may also be challenging, requiring a specialized team. In all the four latter types of P. aeruginosa skin infections portending significant morbidity and mortality, systemic antibiotics are an integral part of the treatment.

To evaluate the demographics, clinical aspects, and major organ involvement of patients with late-onset Behçet's syndrome (BS) in a tertiary center in China.We conducted a cross-sectional study of consecutive BS patients in Huadong Hospital of Fudan University from September 2012 to January 2020. We compared clinical variables between patients with disease onset before and after 40 years of age. The relative risks (RRs) of clinical variables were calculated between the two age groups. Moreover, a hierarchical cluster analysis was conducted according to 29 variables to determine homogeneous subgroups in patients with late-onset BS.We enrolled 152 late-onset BS patients, with a median age at onset of 47 years (interquartile range, IQR: 43-52 years). There is a higher prevalence of intestinal ulcers in late-onset BS than in early-onset BS (RR 1.47), but a lower prevalence of ocular involvements (RR 0.54) and folliculitis (RR 0.46). Female sex was associated with genital ulcers, erythema nodosum, and arthritis. Four clusters (C1-C4) were formed. C1 (n = 71), the largest cluster, was defined as the mucocutaneous group, C2 (n = 20) as the arthritis group, C3 (n = 39) as the gastrointestinal group, in which all patients presented with intestinal lesions, and five cases with esophageal ulcers. In C4 (n = 22), showing a mixture of uveitis and vascular lesions, 15 patients presented with uveitis and 8 had vascular lesions, and 1 case had central nervous system lesions.Four phenotype clusters were identified. Patients with skin lesions comprised the largest cluster, while gastrointestinal, panuveitis, and cardiovascular clusters are the most commonly involved organs in late-onset BS patients. Key Points • Our analysis demonstrated the phenotype discrepancy between early and late onset groups. • Four phenotype clusters were identified, with gastrointestinal, panuveitis and cardiovascular clusters representing commonly involved organs.

BACKGROUND We have observed an increasing number of patients referred to the Scottish Photobiology Service (SPS), who were later diagnosed with actinic folliculitis (AF) and had positive phototesting results. Treatment options for AF are limited, with only a few reports in the literature. The use of prophylactic narrowband ultraviolet B (NB-UVB) phototherapy for AF has not previously been described, and we report on this for the first time. AIM To analyse the clinical characteristics, phototesting results and responses to treatment for patients with AF diagnosed by the SPS. METHODS We undertook a retrospective review over 10 years of all case notes of patients who were assessed and diagnosed with AF through the SPS, based at the Photobiology Unit, Dundee, UK. RESULTS All 10 patients were women. Mean age of onset was 25 years and mean time to referral for investigation was 7 years. The commonest site involved was the face, with the main clinical feature being monomorphic pustules appearing after sunlight exposure. The eruption could be provoked with iterative doses of broadband UVA irradiation in five patients. All patients were offered photoprotective advice and prophylactic NB-UVB phototherapy. Five patients proceeded with phototherapy; four of these completed the desensitization course and all four reported either a delay in symptom onset or total prevention of rash induction, with complete efficacy of desensitization maintained for 3 years in one patient. CONCLUSION We demonstrate the successful use of UVA provocation testing as a diagnostic tool in AF. Additionally, we recommend the use of prophylactic NB-UVB phototherapy in AF as an effective and well-tolerated approach.

Introduction: Prolonged and tightly use of face masks has been identified as cause for skin damage during the COVID-19 pandemic. Case series presentation: We evaluated patients seen in the outpatient clinic between March and May 2020, during the lockdown period, focusing on skin damage related to the use of face masks. We aimed to highlight the major impact of routine usage of face masks on the skin of individuals of different ages and professions. Contact dermatitis was prevalent, but we also recorded many cases of outbreak of seborrheic dermatitis, acne, rosacea, perioral dermatitis, atopic dermatitis, folliculitis, as well as neurotic excoriations caused by anxiety, tinea, and impetigo. We also observed a delay in the diagnosis of benign and malignant tumors. Conclusions: The most important step should be the assessment of dermatologic pathology related to the use of face masks. They say a picture is worth a thousand words. So take off the face mask, and look at the skin!

A Hidradenite Supurativa (HS), também chamada de Hidrosadenite, Acne Inversa ou Doença de Verneuil é uma doença inflamatória crônica, recorrente, estigmatizante e debilitante. Sua etiopatogênese envolve oclusão folicular e fatores genéticos, ambientais e imunológicos, podendo ocorrer isolada ou simultaneamente em diversas regiões do corpo. As características iniciais da HS são comumente equivocadas com furunculoses, carbúnculos e foliculites, levando a um atraso no diagnóstico e no agravamento das lesões, na necessidade de intensificar a terapêutica medicamentosa e muitas vezes, o afastamento das atividades laborais. O objetivo deste trabalho é inserir o Esteticista Cosmetólogo em equipe multidisciplinar para o tratamento aos portadores de HS, oferecendo técnicas terapêuticas alternativas complementares às medicamentosas e de controle evolutivo da doença. Para tanto, intensificar a abordagem do tema nos cursos de formação do Técnico em Estética e nas graduações de Esteticista Cosmetólogo. Por ser uma doença ainda sem cura, e os tratamentos disponíveis são muitas vezes ineficazes, portanto é de fundamental importância novas estratégias terapêuticas que possam contribuir significativamente para o aumento da qualidade de vida dos portadores de HS.

Background: Obesity is a global epidemic. Obesity is associated with a number of dermatoses, including acanthosis nigricans, skin tag, keratosis pilaris, hyperandrogenism and hirsutism, striae distensae, and adiposis dolorosa. Objective: To elucidate the various skin changes in obesity and to determine if it is considered as an obesity marker. Methodology: 100 patients, aged 18 years or above satisfying the inclusion and exclusion criteria were drawn for a period of 18 months. Results: Out of 100 patients 54% were female, in their third and fourth decade. By occupation most of the females were housewives (40%) and the majority of males were farmers (14%). Type 2 diabetes mellitus was the most common systemic illness (24%). Pseudoacanthosis nigricans was the most prevalent skin change. 51% of patients had skin tags. 48% had striae distensae as a skin change. 10.86% male and 14.81% female patients had stasis dermatitis, 6% had leg venulectasias and 2% had leg ulcer. 26% had plantar hyperkeratosis. 41% of our patients had one or other types of fungal infections. Bacterial infections were detected in 15% cases, folliculitis being the commonest. Conclusion: Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. The dermatoses that showed a statistically significant relationship with obesity were Pseudo acanthosis nigricans, Skin tag, Striae, Plantar hyperkeratosis and Fungal infections. Prevention of obesity is important to prevent these dermatoses and dermatologists must work with primary care physicians and patients to reduce the harmful effects of obesity on the skin.

Pseudolymphomatous folliculitis (PLF) is a subtype of cutaneous pseudolymphoma that is recognized as an independent disease. PLF is characterized by dermal lymphocytic infiltration surrounding an irregular hyperplastic pilosebaceous unit (i.e., activated pilosebaceous unit). An interstitial distribution of CD1a-positive cells is regarded as an important feature of PLF, especially in distinguishing it from primary cutaneous marginal zone lymphoma (PCMZL), which is associated with a peripheral concentration of CD1a-positive cells. We undertook a clinicopathological investigation of PLF, with a reassessment of CD1a immunohistochemistry. We defined diagnostic criteria for PLF based on past studies and consequently identified 79 cases. In addition, we collected 32 cases of PCMZL and performed detailed clinical, pathological, and immunohistochemical investigations using antibodies to CD3, CD20, and CD1a. We found an interstitial concentration of CD1a-positive cells in 90.2% of PLF and 34.5% of PCMZL cases. The peripheral concentration of CD1a-positive cells was seen in 9.8% of PLF and 34.5% of PCMZL cases. In both diseases, CD1a-positive cells appeared in T-cell nests (88.5% in PLF and 92.9% in PCMZL) but were absent in B-cell nests (0% in both groups). All 79 cases of PLF showed activated pilosebaceous units while 22 of the 32 PCMZL cases displayed pilosebaceous units, although none of these were activated. In summary, regarding the distribution patterns of CD1a-positive cells as a diagnostic feature in distinguishing between PLF and PCMZL is somewhat inconclusive. To differentiate PLF and PCMZL, determining the presence or absence of activated pilosebaceous units is essential.

Introduction: Malassezia are normal resident flora in humans and are opportunistic in nature. Superficial infections caused by Malassezia include pityriasis versicolor, pityriasis capitis (dandruff), seborrheic dermatitis and folliculitis. Though the manifestations due to Malassezia are trivial, chronicity and recurrence of lesions are associated with social embarrassment and decreased self-esteem. Aims and Objectives: The primary aim of the study was to detect the prevalence of Malassezia among superficial skin and scalp lesions. It also aims to compare Wood’s lamp examination, KOH mount examination and culture for the diagnosis of Malassezia and study the percentage of various species of Malassezia responsible for superficial infections of skin and scalp. Materials and Methods: One hundred samples collected from patients attending the Dermatology outpatient room with superficial infections of skin and scalp. Patients attending Dermatology outpatient room with complaints of hypopigmented / hyperpigmented / erythematous, scaly skin patches and patients attending Dermatology OP with complaints of itchy / non itchy scaly flakes of scalp (dandruff) were included in the study. Results: Among the 100 samples, 77% were Wood’s lamp positive, 64% were KOH positive and 59% yielded growth of Malassezia in culture. Overall prevalence of Malassezia in our study was 59%. In our study, M. globosa was the commonest species (57.62%) followed by M. furfur and M. sympodialis. Conclusion: Prevalence of Malassezia was 59% in our study. Wood’s lamp examination and KOH mount showed more positivity than culture. M. globosa was the most common species in the study. Wood’s lamp and KOH mount can be used for diagnosis of Malassezia in resource poor settings. But culture and speciation should be performed wherever possible to avoid treatment failure and recurrences. Keywords: Culture, Malassezia, Potassium hydroxide mount, Skin scrapings, Wood’s lamp.

Management of inflammatory complications of chronic granulomatous disease (CGD) is challenging. The aim of this study was to assess safety, with a focus on infections, and effectiveness of tumor necrosis factor alpha (TNF-α) blockers in CGD patients. A retrospective, single-center cohort study of CGD patients treated by anti-TNF-α agents at Necker-Enfants Malades University Hospital (Paris, France) and registered at the French National Reference Center for Primary Immunodeficiencies (CEREDIH). Between 2006 and 2019, 14 (X-linked: n = 10, 71.4%; autosomal-recessive: n = 4, 28.6%) CGD patients with gastrointestinal (n = 12, 85.7%), pulmonary (n = 10, 71.4%), cutaneous (n = 3, 21.4%), and/or genitourinary (n = 2, 14.3%) inflammatory manifestations received one or more doses of infliximab because of steroid-dependent (n = 7, 50%), refractory (n = 4, 28.6%) inflammatory disease or as first-line drug (n = 2, 14.3%; missing data, n = 1). All patients received adequate antimicrobial prophylaxis. Infliximab achieved complete (n = 2, 14.3%) or partial (n = 9, 64.3%) response in 11 (78.6%) patients. Seven (50%) patients were switched to adalimumab. During anti-TNF-α treatment, 11 infections (pneumonia, adenitis, invasive candidiasis, each n = 2; intra-abdominal abscess, bacteremic salmonellosis, Pseudomonas aeruginosa–related folliculitis, cat-scratch disease, proven pulmonary mucormycosis, each n = 1) occurred in 7 (50%) patients. All infectious complications had a favorable outcome. Anti-TNF-α treatment was definitively stopped because of infection in two patients. Nine (64.3%) patients finally underwent hematopoietic stem cell transplantation. No death occurred during follow-up. Anti-TNF-α treatment could improve the outcome of severe inflammatory complications in CGD patients, but increases their risk of infections. We suggest that anti-TNF-α treatment might be of short-term benefit in selected CGD patients with severe inflammatory complications awaiting hematopoietic stem cell transplantation.

Introduction: Facial hair transplantation has been increasingly requested by patients and used to improve appearance and highlight masculine features with natural results. Herein we describe our experience in facial hair transplantation, its pre-surgical assessment, the technique used, the subsequent follow-up, and possible complications. Methods: A pre-operative evaluation was carried out to assess the recipient and donor areas. The follicular unit excision (FUE) technique was used to extract the follicular units (FUs) from the donor areas, which could be the occipital region and the beard itself. FUs of 1- and 2-hair follicles were implanted with the help of implanters. Possible complications included post-inflammatory hyperpigmentation, incorrect placement in the direction or angle of the FUs, or folliculitis in the implanted area. Conclusion: Currently, hair transplantation to the facial area has very good results when performed by physicians with good training and experience in the technique.

Nowadays, dermoscopy (dermatoscopy) or epiluminescence microscopy is known as a bridge between clinical and histopathological examinations to help us by improving the diagnosis accuracy of skin diseases. A common red fox with history of severe itching and skin disorders was referred to the Veterinary Teaching Hospital of Lorestan University . After clinical examination, blood sample was collected and dermoscopic images as well as skin biopsy sections were taken and evaluated. In some dermoscopic images of the lateral thorax and dorsal parts of body skin and coat, local alopecia, acute inflammation, erythema, and reddish can be seen. Ectoparasites were identified as Rhipicephalus bursa, Musca domestica eggs, and lice nits. Also, histopathology examination showed folliculitis, moderate follicular hyperplasia with mononuclear cellular infiltrates, and numerous mites in the hair follicles of the dermis. Cigarette-shaped mites in hair follicles were identified as Demodex canis using the real-time polymerase chain reaction (RT-PCR) method. The present study indicated dermoscopy alongside histopathology may represent as valuable techniques for the dermatological examination of the wildlife animals like red foxes, so our finding highlighted the value of monitoring the wildlife health condition by using noninvasive methods.

Transverse sectioning of skin biopsy specimens has revolutionised assessment of human alopecia by demonstration of every hair in each specimen, allowing quantitative evaluation of follicular activity. Since only vertical sectioning is performed routinely in veterinary laboratories, we aimed to determine whether transverse sectioning was a valuable technique in assessment of canine alopecia. Paired vertical and transverse sections of biopsy specimens from 31 alopecic dogs were examined independently in triplicate in random order and blinded to previous diagnosis using a standard check-list proforma. Assessments of key features (follicular activity [anagen/telogen], infundibular hyperkeratosis, sebaceous gland abnormalities, pigment clumping, dermal inflammation) by each sectioning method were compared. In the 31 cases, (atrophic [n = 13], dysplastic [n = 12], inflammatory diseases [n = 6]), follicular inactivity scores (median, [lower-upper quartile]) in transverse sections significantly exceeded those in vertical sections (transverse 4 [3-5], vertical 3 [2-4]). Agreement between the two sectioning planes was moderate for infundibular hyperkeratosis (kappa = 0.5210) and dermal inflammation (0.4351), fair for sebaceous gland abnormalities (0.3966) and pigment clumping (0.2197), but slight for follicular activity (0.1041). Vertical sectioning demonstrated diagnostically important epidermal pathology (n = 2) and dermal thinning (n = 3) whereas transverse sectioning enhanced assessment of hair growth phase (n = 11), follicular structure and architecture (n = 11), and focal luminal or mural folliculitides (n = 3). Transverse sectioning confers significant benefits and complements traditional vertical sectioning in the histological assessment of canine hair follicle diseases, particularly when subtle abnormalities comprise distorted compound follicle architecture, hair cycle arrest or when relatively few adnexal structures are affected. [Abstract copyright: © 2020 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.]