We describe the case of a woman presenting with rash and fever 3 weeks after starting oxcarbazepine. She had a convoluted, prolonged hospital course involving reactions to multiple structurally-different medications, with a variety of severe manifestations including drug rash with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and complicated with MRSA septic shock and death. This case illustrates the high risk in subjects with a drug reaction that initiated excessive T cell stimulation with subsequent reactions to multiple drugs.

Abstract: Congenital melanocytic nevi (CMN) even small-sized as well as acquired melanocytic nevi (AMN) are of common cosmetic concerns and getting rid of them remain challenging. The aim of this study is to evaluate the efficacy and safety of the ultra-pulsed CO2 laser for the treatment of melanocytic nevi. 15 male and female Libyan patients with 16 AMN and 7 CMN were treated with multiple sessions of ultra-pulsed CO2 laser at 1-month intervals. Clinical response at 6 months after final treatment was graded as poor (< 50%), moderate (50–75%), good (> 75%) and excellent where the skin of the lesion returned normal as the rest of the surrounding skin. All treated nevi showed good to excellent cosmetic outcomes after 2 or 4 treatment sessions. The post laser complication were minimal and transit except for one atrophic scar. No recurrence of pigmentation during the six months of follow-up period. Conclusion: Ultra-pulsed CO2 laser seems to be effective and associate with minimum adverse side effect in the treatment of small CMN and AMN.

Plaque psoriasis is typically localized to extensor surfaces of the skin, whereas inverse psoriasis is defined by its localization to intertriginous areas where two skin surfaces meet. It can be localized to the axillae, groin, genital area, umbilicus, postauricular area, intergluteal, antecubital and popliteal fossae.

The term granuloma annulare (GA) appropriately describes the classic type characterized by ringed erythematous plaques with histological palisaded granulomatous inflammation. However, GA now includes a range of disease. Over time, more atypical, rare types have been reported in isolated case reports or small case series. Here, we describe a unique case of generalized GA presented by two morphologically different lesions in a 52 years old diabetic man. To the best of our knowledge, this association has never been reported in the literature.

Actinic keratosis are the earliest lesions in the continuum of the development of squamous cell carcinomas and therefore should be treated. Although they may appear as unique lesions field canalization is the norm. Various modalities are used periodically throughout a patients lifetime. In an effort to address better and longer clearances combination sequential therapies including topical and mechanical treatments either prior or post photodynamic therapy have been tried. Treatment protocols should be tailored to an individual patient as a specific point of time to achieve the best results. There are a few case and anecdotal reports however there have not been controlled clinical evaluations. This is a review of possible algorithms that are used but definitive studies should be done.