Trichotemnomania is a rare, underrecognized obsessive-compulsive disorder characterized by repetitive cutting of hair. Its clinical presentation may mimic other hair disorders, often leading to misdiagnosis and unnecessary treatments. We report the case of a 25-year-old man presenting with scalp hair thinning. Trichoscopy revealed areas of miniaturized hairs with heterogeneous shaft diameters, consistent with androgenetic alopecia, adjacent to irregular patches of uniformly short hairs with blunt ends, suggestive of mechanical trimming. Detailed history-taking confirmed the coexistence of trichotemnomania, supported by the patient's report of recurrent and deliberate use of a razor to cut his hair.

Keywords: Alopecia; Hair Diseases; Obsessive-Compulsive Disorder

Mohs micrographic surgery is the preferred technique for the treatment of skin cancers involving the lip region. Reconstruction of surgical defects in this area is particularly complex, requiring preservation of anatomical structures, respect for cosmetic subunits, and maintenance of function whenever possible. This study describes 4 cases of lip surgical defects managed with different reconstructive techniques: mucosal rotation flaps, double V-Y advancement flaps, and O-Z rotation flaps. The choice of technique was individualized according to the location and size of the defect, aiming to achieve symmetry, preserve oral sphincter function, and obtain satisfactory aesthetic outcomes.

Keywords: Surgical Flaps; Mohs Surgery; Lip

Reconstruction of the malar region poses a surgical challenge due to its aesthetic relevance and the need to preserve function. We report the case of a 75-year-old man with bilateral basal cell carcinomas of the medial malar region. After tumor excision, reconstruction was performed using advancement flaps: a McGregor flap on the right side and a Burow flap on the left side. Advancement flaps proved effective owing to their simplicity, favorable tissue mobility, and adaptability to facial aesthetic units. The patient had an uneventful postoperative course, achieving satisfactory functional and aesthetic outcomes, highlighting the value of these flaps in facial reconstruction.

Keywords: Surgical Flaps; Basal Cell Carcinoma; Surgical Oncology; Dermatology; Face

Chronic paronychia is an inflammatory condition of the proximal nail fold, often associated with prolonged exposure to moisture and irritant substances. Surgical treatment is indicated in refractory cases. We report the case of a patient with involvement of all digits and an unsatisfactory response to clinical therapies. The square flap technique was employed, yielding favorable functional and aesthetic outcomes. This case highlights the efficacy of the surgical approach and underscores the importance of dermatologists' training in nail surgery techniques.

Keywords: Nails; Paronychia; Nail Diseases

Molluscum contagiosum is a common viral infection in children, usually self-limiting, but treatment of extensive or recalcitrant cases can be challenging. We report a child with refractory MC unresponsive to conventional therapies who achieved complete clearance with low-dose oral isotretinoin. This case highlights the potential of isotretinoin as a novel therapeutic approach for refractory molluscum contagiosum in children.

Keywords: Molluscum contagiosum; Isotretinoin; Child; Retinoids

BACKGROUND: Wound healing is a complex process, and various factors can disrupt this process, leading to non-healing wounds or scarring. Conventional treatments for scar management often have low efficacy and high recurrence rates. The combination of intense pulsed light (IPL) and fractional laser therapy (FLT) has emerged as a minimally invasive alternative with promising results. The goal of this study was to evaluate the safety and efficacy of combined IPL + FLT therapy and to manage pathological scars.
METHODS: This study followed PRISMA guidelines. Systematic searches were performed in PubMed, ProQuest, Scopus, and the Cochrane Library up to December 2025. Studies involving patients with pathological scars treated using combination IPL and FLT were included.
RESULTS: Five studies met the eligibility criteria, comprising 3 randomized controlled trials, 1 retrospective cohort study, and 1 case series, totaling 288 patients. Across all studies, combination therapy produced significant reductions in POSAS, MSS, and VSS scores in hypertrophic and postoperative scars. One study reported significantly higher patient satisfaction rates (p<0.05). Adverse effects were minimal, primarily mild transient erythema.
CONCLUSION: Combined FLT and IPL safely enhance scar appearance, with low adverse effect rates, offering an effective and minimally invasive therapeutic option.

Keywords: Keloid; Cicatrix, Hypertrophic; Laser Therapy; Intense Pulsed Light Therapy

Cutaneous metastases (CMs) are uncommon manifestations of systemic malignancies, usually indicating poor prognosis. Breast cancer, lung cancer, and melanoma are the main primary tumors associated with CMs. Lesions may mimic several dermatological conditions, which makes diagnosis challenging. Clinical history, histopathology, and immunohistochemistry are essential for confirmation. Management depends on the primary tumor and may include adjuvant therapies tailored to cutaneous involvement. This study reports a case of a patient with CM from a primary pulmonary carcinoma, initially suspected to be a fibroepithelioma of Pinkus, highlighting the importance of differential diagnosis and complementary examinations in clinical practice.

Keywords: Neoplasm Metastasis; Immunohistochemistry; Lung Neoplasms

This correspondence comments on the recent article describing the transfollicular subcutaneous forehead and brow lift technique. Alopecia is a potential complication of such procedures, ranging from reversible telogen effluvium to permanent scarring forms. Although rare, hair loss can significantly affect patient satisfaction. Even minimally invasive techniques carry some risk. The transfollicular approach offers facial rejuvenation with hairline lowering, improvement of rhytids, and effective scar camouflage through preservation of anterior hair follicles. We emphasize the importance of transparent preoperative counseling and aim to enrich the discussion initiated by the original article.

Keywords: Alopecia. Dermatologic Surgical Procedures. Postoperative Cognitive Complications. Rhytidoplasty

Bednar tumor is a rare variant of dermatofibrosarcoma protuberans. A 45-year-old woman presented with a progressively enlarging bluish macule on the shoulder. Biopsy revealed a pigmented spindle cell neoplasm, with immunohistochemistry positive for CD34 and negative for S100 and SOX-10. Surgical excision with margin mapping was performed. Surgical treatment with margin control is the gold standard for the management of Bednar tumor. This technique ensures complete resection, with outcomes comparable to those of Mohs micrographic surgery. This case highlights the importance of clinical suspicion in atypical hyperpigmented skin lesions.

Keywords: Dermatofibrosarcoma; Immunohistochemistry; Dermatology

Rosacea is a chronic, multifactorial inflammatory dermatosis involving immune dysregulation, neurovascular alterations, and microbial imbalance. Overexpression of TLR2, activation of TRP channels, and increased LL-37 cathelicidin are central to its pathophysiology. Therapeutic management includes behavioral strategies, topical treatments (metronidazole, ivermectin, azelaic acid, brimonidine), systemic agents (doxycycline, isotretinoin), and procedures such as laser and intense pulsed light. A personalized, multifaceted approach combining trigger control, pharmacologic therapy, and physical interventions is crucial for reducing symptoms and improving patient quality of life.

Keywords: Rosacea; Innate immunity; Cathelicidins; Botulinum toxin type A; Tetracyclines; Technology

Malignant transformation of folliculitis decalvans (FD) into squamous cell carcinoma (SCC) is rare but relevant due to its aggressive clinical course. We report the case of a 53-year-old man, a Jehovah's Witness, with a long-standing history of FD who developed rapidly progressive metastatic scalp SCC. Due to refusal of surgery, cemiplimab monotherapy (a PD-1 inhibitor) was initiated, resulting in complete resolution of the neoplasm within 12 weeks. This case highlights the risk of malignant transformation in chronic inflammatory dermatoses and suggests cemiplimab as an effective treatment option for advanced SCC when surgical resection is not feasible.

Keywords: Carcinoma, Squamous Cell; Skin Ulcer; Alopecia; Immune Checkpoint Inhibitors; Cicatrix; Skin Neoplasms

The "negative pigment network" is a dermoscopic feature observed in melanomas, melanocytic nevi, and dermatofibromas; however, studies indicate that it is more frequently associated with melanoma. The aim of this case report is to highlight the negative pigment network as an important clue in the diagnosis of melanoma and that its presence, even in the absence of other typical dermoscopic features of melanoma, should prompt further investigation followed by biopsy to confirm the diagnosis.

Keywords: Melanoma; Dermoscopy; Diagnosis

In recent years, the demand for eco-friendly cosmetics formulated with safer and more sustainable ingredients has driven the expansion of the global market. The concept of clean beauty has evolved into a philosophy that requires transparency, safety, and sustainability throughout the production chain. This review article updates the definitions of clean beauty, differentiates natural, organic, and vegan cosmetics, and details experimental findings on endocrine disruptors present in cosmetic formulations, including in vitro and in vivo evidence.

Keywords: Cosmetics; Coloring Agents; Aquatic Environment; Allergens

Acral subcutaneous nodules pose a diagnostic challenge due to their broad differential diagnoses. We report a case of a foreign body granuloma presenting as a long-standing acral subcutaneous nodule on the thumb of a 64-year-old woman. High-frequency ultrasound revealed a homogeneous hypoechoic nodule with posterior acoustic enhancement, surrounding a central linear hyperechoic structure suggestive of a foreign body reaction. Excisional biopsy confirmed a granulomatous inflammatory process surrounding a vegetal fiber. This case highlights the value of high-frequency ultrasound as a noninvasive tool to support etiological diagnosis and guide surgical planning in chronic acral subcutaneous nodules.

Keywords: Ultrasonography; Granuloma, Foreign-Body; Epidermal Cyst