Background: Onychomycosis may cause nail discoloration, thickening, nail bed separation, and other serious complications. For some cases, oral antifungal treatment is not tolerable because of its potential side effects and drug interactions. Laser therapy is considered as an alternative treatment, owing to the features of simple and effective, with only minor potential side effects. This EBCR was made to collect and appraise studies regarding the effectiveness of laser therapy for onychomycosis, and to suggest laser as an alternative treatment. Methods: Literature searching strategy was performed using Pubmed and Cochrane Library database to address the clinical problem. Keywords used were “laser” AND “onychomycosis”. Results: Seventy-nine articles were obtained from the search strategy procedure. After selection based on exclusion and inclusion criteria, and full-text availability, four relevant articles remained. Discussion: The study by Xu et al. was considered as the most valid study while compared to other three studies. This study used intention to treat analysis and had no loss of follow-up patients. Xu et al. compared mycological and clinical clearance rate between patients receiving laser, oral terbinafine, or combination of those two. It showed that laser therapy was less effective when compared to oral antifungal (Number Needed to Harm = 17). Conclusions: Laser has a lower level of effectiveness while compared to oral terbinafine as the current gold standard therapy for onychomycosis. However, laser therapy can still be used as an adjunctive therapy along with oral antifungal to achieve a better cure rate. More studies are needed to prove this hypothesis.

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with indication of oral vitamin D use is important to be understood, especially in association with some chronic diseases requiring long-term therapy. The effects of using oral vitamin D analogues are minimal, but hypervitaminosis D might cause uncomfortable symptoms for patients. Therefore, it is important to understand and regulate the amount of doses of oral vitamin D supplements prescribed.

Herpes zoster is often associated with neurological manifestation but less frequently associated with motoric nerve involvement. The most common motoric involvement is paresis, seen only in 1-5% of all zoster cases. This case report a 39-year-old male, with recurrent abdominal liposarcoma under chemotherapy, presented with symptoms of fever, and painful and weak right leg for 2 weeks. Vesicles eruption was seen on his right leg nine days after these symptoms occurred. Physical examination revealed groups of haemorrhagic vesicles with erythematous base on the right lower leg. Lumbosacral spine x-ray showed spondylosis with radiculopathy. Electromyography (EMG) examination revealed lower motor neuron total denervation corresponding to right L5 radix. The patient was diagnosed as herpes zoster on right L5-S1 segment, herpetic neuralgia, and segmental zoster paresis with recurrent liposarcoma under chemotherapy. He was treated with oral acyclovir 800 mg five times a day and gabapentin 300 mg twice a day. Physical therapy and rehabilitation were started concurrently. Paresis is a rare complication of herpes zoster. Radicular pain and weakness preceded the skin lesion potentially lead to misdiagnoses. The most frequent diagnosis for patient suffering pain and weakness in the extremities is spinal disorder, such as stenosis and disc herniation. EMG can be helpful to recognise motoric involvement of herpes zoster, and preclude other diagnoses.

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decades. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.