Effect of microneedling by dermaroller on acne scars: an observational study at tertiary care hospital

Background: Post acne facial scar is very distressing phenomenon. There are many treatment options like laser resurfacing, dermabrasion, microdermabrasion and non-ablative laser resurfacing but it may cause adverse effects and interference with the daily activities of the patient. Microneedling or dermaroller therapy is newer modality in management of acne scars with satisfactory improvement and no significant side effect. Objective of our study was to evaluate efficacy and safety of microneedling in the treatment of atrophic facial acne scars. Methods: Twenty-eight patients of Fitzpatrick skin type IV to V having atrophic facial acne scars and fulfilling inclusion criteria were treated with multiple sittings of microneedling (dermaroller) treatment at monthly interval. Goodman and Baron’s qualitative and quantitative acne scar grading system was used for assessment. Patients were evaluated clinically and by serial photography. Presence of any active infection, active acne, wounds, blisters, keloids, taking some medications like Accutane, antihypertensives, anticoagulants, systemic retinoids, topical retinoids, those undergoing cosmetic procedures, treatment with injecting fillers or ablative or non-ablative laser resurfacing, diabetes, collagen diseases and those who do not agree to participate in study were excluded. Results: Any change in the grading of scars after the end of treatment and follow-up period was noted. Efficacy and improvement of dermaroller treatment was assessed by Goodman and Baron’s global acne scarring system. Out of 18 patients (of total 28) with Goodman and Baron’s qualitative grade-4, 16 (88.90%) patients reduced to grade-1. 21 out of 28 patients achieved ‘excellent’ response. Adverse effects were limited to transient erythema and post inflammatory hyperpigmentation. Conclusions: Microneedling therapy seems to be simple, safe and efficacious for the management of atrophic facial acne scars

Kaposi's sarcoma: A presenting sign of HIV

Kaposi′s sarcoma (KS) is a multifocal cutaneous and extra cutaneous vascular proliferative disorder. In India, there are only a few cases of HIV-associated KS in published literature. A 26-year-old married man presented with asymptomatic elevated skin lesions over the face, trunk, both upper limbs and lower limbs with a duration of one-and-a-half months. Cutaneous examination revealed multiple violaceous papules and nodules, on the face (right upper and lower eyelids, upper lip), trunk and proximal part of both limbs. Oral cavity showed erythematous plaques, two in number, on the hard palate. Skin biopsy showed proliferation of thin walled capillaries with formation of slit like spaces, spindle cell proliferation, abundant extravasation of RBCs and moderately dense inflammatory infiltrate in the dermis. Thus a clinical diagnosis of cutaneous KS was confirmed. On testing with ELISA for HIV, the patient was for the first time diagnosed as HIV reactive. Thus KS was the presenting manifestation of HIV disease

Androgen - secreting steroid cell tumor of the ovary

Steroid cell tumors (SCTs), not otherwise specified of the ovary are rare subgroup of sex cord tumors, which account for less than 0.1% of all ovarian tumors and also that will present at any age. The majority of these tumors produce steroids with testosterone being the most common. A case of a 28-year-old woman who presented with symptoms of virilization is reported. Although SCTs are generally benign, there is a risk for malignant transformation. Surgery is the most important and hallmark treatment