Australasian Journal of Dermatology最新文献

We describe four cases of iron extravasation injuries presenting to a dermatology clinic, where compression applied post-infusion appeared to reduce or prevent cutaneous siderosis. In each case, distinct patterns of hyperpigmentation were observed, with areas of compression from bandages or dressings showing reduced staining. Iron extravasation, a complication of intravenous iron therapy, can cause permanent cosmetic damage and distress. Current treatment options for reversing staining are limited, costly and require multiple sessions. This case series suggests that compression may be a simple, safe and effective measure to minimise cutaneous siderosis and improve patient outcomes.

Folliculitis decalvans (FD) and Tufted Hair Folliculitis (THF) present with recurrent episodes of follicular inflammation, pustules and crusting, predominantly of the scalp, leading to scarring alopecia. With no specific or optimal treatment available, FD/THF is difficult to treat and significantly impacts patients' quality of life. As new treatments have been reported for FD/THF management in recent years, we conducted a systematic review aiming to identify the types of treatments used in FD/THF, their effect, duration of effect (DoE), impact on patients' quality of life and any adverse effects impacting treatment. Registered with PROSPERO (CRD42023459898), we used PRISMA and SWiM guidelines, and Joanna Briggs Institute Critical Appraisal tools. We found 113 articles involving 728 patients, reporting on 2041 treatment episodes for 246 different treatments. Reported treatment effects were assessed, and descriptive statistics were used to calculate the median DoE for each. A mean age of 38.3 years with predominantly male (3.3:1) and Fitzpatrick I-IV skin type (85.2%) was noted. Reported treatments included systemic and topical antibiotics, corticosteroids, retinoids and ciclosporin, as well as biologic agents, photodynamic therapy, laser therapies, topical calcineurin inhibitors, radiation therapy, surgical procedures, platelet-rich-plasma injections, botulinum toxin A injections, Manuka honey and Ayurvedic treatments with leech therapy. Although limitations exist due to GRADE level of evidence being low to very low, our findings suggest systemic antibiotic monotherapy may not be as beneficial as previously reported. Combination therapy with systemic antibiotics, topical, local and/or other systemic agents may provide the best outcome and longest DoE for FD/THF patients, with a greater role for biologic agents and laser therapy in their management.

Radiation therapy has undergone unprecedented advances over the past four decades, both in the understanding of radiobiologic effects and in the technical features of external beam delivery. The extent and scope of these changes have largely remained unappreciated outside the specialty of radiation oncology. The net effect of these advances has been improved dosimetry whereby radiotherapy can more evenly target a planned tissue volume while sparing normal tissues. The term dosimetry describes the evenness (homogeneity) and sharpness (conformality) of photon irradiation. Improved efficacy and safety are now reliably deliverable, prompting a need for a general re-appraisal of the place of modern radiotherapy across the spectrum of skin cancer management. Improved techniques are now widely available for the treatment of high-risk or extensive skin cancers, multiple in-field tumours and severe skin field cancerization. Specialised techniques in development include the use of extended radiation field techniques for micrometastatic disease in lymphatic corridors and harnessing the immune stimulatory potential of radiotherapy, especially in conjunction with immunotherapy and targeted therapies. This review aims to provide a summary of these changes for the non-radiation oncologist. The major advances in radiotherapy most relevant to skin cancer will be discussed along with the evidence for several emerging new applications in cancer management.

Lichen planus pigmentosus (LPP) is a rare variant of lichen planus that presents as hyperpigmented patches, most commonly in individuals with darker skin tones, and is difficult to treat effectively. We report a case of a 22-year-old Korean male with LPP who showed considerable improvement following combination therapy with trifarotene and a picosecond neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser. Considering the inherently variable clinical course of LPP and the challenges associated with its treatment, the combination of topical retinoids and picosecond Nd:YAG lasers appears to be a promising therapeutic approach.