Lupus erythematosus is an autoimmune condition that can present in both cutaneous and systemic forms, with discoid lupus erythematosus (DLE) being the most prevalent type of chronic cutaneous lupus. Although the ophiasis pattern is well documented in alopecia areata, we present a rare case of DLE exhibiting this pattern in a 51-year-old Saudi female patient with a complex medical history, including systemic lupus erythematosus (SLE). This case underscores the importance of recognizing atypical presentations of DLE, which can lead to misdiagnosis and delays in treatment. We aim to enhance awareness among dermatologists regarding the diverse manifestations of DLE and encourage further investigation into such rare patterns.

Syphilitic alopecia (SA) and ocular syphilis (OS) are rare manifestations of syphilis, typically reported together in immunocompromised patients. We present a unique case of mixed-pattern, essential, SA of the scalp and OS in the form of anterior uveitis in an otherwise immunocompetent, HIV-negative, 46-year-old female. Briefly, the patient initially presented with sudden-onset scalp hair loss that was initially diagnosed as atypical alopecia areata but failed to respond to typical alopecia areata-directed therapy. Concurrently, the patient developed ocular and neurologic symptoms, and the diagnosis of syphilis was rendered based on the constellation of clinical findings and cerebrospinal fluid/serologic testing. Syphilis-directed therapy resulted in the reversal of ocular and neurologic symptoms, as well as rapid scalp hair regrowth. This case highlights the importance of considering diagnosis of syphilis in the differential diagnosis for atypical alopecia.

Paradoxical psoriasis is a rare but increasingly recognized adverse effect of anti-tumor necrosis factor-α (TNF-α) therapy, characterized by the onset or exacerbation of psoriatic lesions in patients treated for other immune-mediated conditions. We report the case of a 47-year-old woman with chronic plaque psoriasis who developed severe generalized pustular psoriasis (GPP) after six months of treatment with an adalimumab biosimilar. Given the extent and severity of the eruption and following inadequate response to previous conventional therapies, the patient was treated with brodalumab, an interleukin-17 receptor A (IL-17RA) inhibitor. Rapid and complete remission of both pustular and plaque psoriasis was achieved and maintained for over 60 weeks. This case supports the efficacy of IL-17 pathway blockade in managing paradoxical GPP and highlights the importance of prompt recognition and appropriate therapeutic switching in severe biologic-induced psoriasis.

This study explores the single nucleotide polymorphism (SNP) variants rs2304365 and rs4074067 in the ST18 gene and their relationship with clinical manifestations of pemphigus vulgaris (PV) in Vietnamese patients. A case series was conducted with PV patients treated from March to October 2023 at the Ho Chi Minh City Hospital of Dermato-Venereology (Vietnam). Clinical data and patient histories were documented. Blood samples (2 mL) were analyzed for SNP variants rs2304365 and rs4074067 using Sanger sequencing at the Biomedical Research Center, Pham Ngoc Thach University of Medicine. Among 34 patients, two alleles, C and T, were identified in both SNPs. For rs2304365, allele C accounted for 91.2% and T for 8.8%. In rs4074067, allele C constituted 88.2% and T 11.8%. Patients carrying the T allele in rs2304365 exhibited moderate to severe disease. Additionally, the T allele in either SNP was associated with higher Pemphigus Disease Area Index (PDAI) scores compared to the C allele. SNP variants rs2304365 and rs4074067 in the ST18 gene may influence disease severity in PV among Vietnamese patients, underscoring the need for further research into their role in personalized treatment strategies.

Acne vulgaris is a common inflammatory dermatosis and the most prevalent disorder of the pilosebaceous unit. It primarily affects the face and has an estimated global prevalence of about 9.4%. Many patients treated for acne vulgaris experience symptoms of anxiety, depression, and social withdrawal, often accompanied by feelings such as anger. This can be particularly exacerbated when dermatological treatment fails to have the expected effect. Given the significant psychosocial effects of the aforementioned dermatosis, early intervention is crucial. The survey was conducted between September 2023 and July 2024. The participants were patients at a cosmetology and aesthetic medicine clinic in Katowice, Poland. The Teenagers’ Quality of Life Index (T-QoL) and Rosenberg Self-Esteem Scale (RSES) were used to conduct the survey. The study confirmed the significant impact of acne vulgaris on psycho-social aspects in women of different ages. Acne significantly lowers self-esteem and negatively affects the sufferers’ perception of themselves and their appearance. The impact was shown to be more severe in a group of women over 27 years of age, who exhibited lower self-esteem compared to the younger group. Women with acne often feel the need to hide skin lesions and pay a lot of attention to their appearance, which can lead to reduced quality of life and emotional disturbances. A significant number of women have disturbed self-esteem and negative beliefs about themselves, which may be related to current beauty canons and social pressure for an unblemished appearance.The study underscores the need for a holistic approach to female patients with acne vulgaris, considering both medical and psychological aspects, in order to effectively treat and improve psychological well-being.

Dupilumab, a monoclonal antibody targeting the IL-4/13 signaling pathway, effectively treats moderate-to-severe atopic dermatitis (AD). Common side effects include injection site reactions, conjunctivitis, and respiratory infections. We report the case of a 28-year-old woman with severe AD involving the periocular and chin regions, genital areas, arms, and legs (Eczema Area and Severity Index [EASI]: 24, itch Visual Analog Scale [VAS]: 8) who showed significant improvement after initiating dupilumab therapy. However, following ketoprofen intake for headache relief, she developed a lupus-like erythematous macu-lopapular rash on the periocular and malar regions. Immunological tests (antinuclear antibody [ANA] and extractable nuclear antigen [ENA]) and photopatch testing ruled out autoimmune or allergic causes. Dupilumab was stopped, and treatment with oral prednisone and cetirizine led to complete resolution. This case highlights a potential drug interaction between dupilumab and ketoprofen, emphasizing the need for awareness of paradoxical facial erythema reactions in patients undergoing dupilumab therapy.

Dear Editor, Pityriasis lichenoides (PL) is an inflammatory skin disease of unknown etiology. The clinical spectrum of pityriasis lichenoides encompasses febrile ulcer-necrotic Mucha-Habermann disease (FUMHD), pityriasis lichenoides et varioliformis acuta (PLEVA), and pityriasis lichenoides chronica (PLC). Phototherapy is an effective and well-tolerated modality that is often successful for persistent PL or resistant to topical treatments. [...].

Petrified ear is a rare clinical entity characterized by the progressive hardening of normal, flexible auricular cartilage, leading to partial or complete auricular stiffness. In many cases, it provides a valuable clinical clue that allows the clinician to detect endocrinopathies (particularly Addison’s disease) in a patient who has not received a diagnosis. We present the first documented case of petrified ears, which resulted in the diagnosis of both secondary hypoadrenalism and growth hormone deficiency (GHD). Additionally, we review the relevant literature. Petrified ear syndrome is probably an underreported clinical manifestation of other systemic disorders. It may, at times, serve as a valuable and simple clinical clue to suspect underlying endocrinopathies even in the absence of typical features.

Genital warts (GWs) are the most common sexually transmitted infections worldwide, caused by the human papillomavirus (HPV). In adults, the primary mode of transmission is through sexual contact, whereas in children, it can occur through skin-to-skin or skin-to-mucosa contact and be sexual or non-sexual. The increasing prevalence of GWs in children has renewed the interest in therapeutic management, which still presents a unique challenge, being influenced by many variables, including size, quantity, and location of warts, as well as the presence of comorbidities. Photodynamic therapy (PDT) has already shown encouraging results in treating viral warts in adult patients, but its use is still not standardized in the pediatric population. On this topic, we report the case of an otherwise healthy 5-year-old child affected by GWs, successfully treated with three sessions of PDT with 10% 5-aminolaevulinic acid (ALA) at one-month intervals. Our case is paradigmatic of the potential of PDT to treat difficult lesions in a pediatric setting.

Hyaluronic acid fillers are widely employed for aesthetic procedures but can lead to vascular complications, including rare instances of arterial occlusion. We report a case of columellar artery occlusion following a nasal filler injection in a 30-year-old woman. The patient initially presented with subtle symptoms, including persistent rhinorrhoea and an unusual sensation of cold air. Rhinoscopy revealed full-thickness necrosis of the anterior nasal septum, likely due to compression or embolization of the septal branch of the superior labial artery; prompt treatment with hyaluronidase, aspirin, and topical antibiotics resulted in complete resolution. A literature review identified only one similar case, emphasizing this complication's rarity and potential underreporting. This case underscores the importance of early recognition and intervention in filler-induced vascular events.