This study shows a significant decrease in bulla formation associated with tattoo treatment when fractionated CO2 ablation is added to the picosecond Alexandrite laser, which is consistent with observations from a previous case series. This is important because decreasing extensive blistering likely results in increased patient satisfaction and willingness to return for future treatments.

Background: Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous disease. It presents as red-brown papules on the face that can resolve with scarring. LMDF is often resistant to treatment. Objective: Nonablative fractionated lasers have been used effectively to treat granulomatous disorders; however, there is little data on the treatment of LMDF with lasers. Our objective was to test a novel non-ablative fractionated laser for the treatment of recalcitrant LMDF. Results: A 24-year-old man had a one-year history of LMDF. He had been treated with various topical therapies, oral medications, and laser devices with no improvement and continued progression. We utilized a non-sequential scanning 1,565 nm nonablative fractionated laser to treat this patient. After only one treatment he had significant improvement. He has been subsequently treated five times in the past 6 months and has continued to improve. Conclusion: The novel 1,565 nm nonablative fractionated laser may be a useful tool in the treatment of granulomatous conditions such as LMDF.

High-potency TC application immediately postsclerotherapy produced no statistically significant differences in subject- and investigator-assessed AEs and clearance rates compared with placebo. Foam sclerotherapy with polidocanol is safe and effective for the treatment of lower extremity reticular veins.

A 58-year-old man with a history of hyperlipidemia and hypertension presented to the dermatology clinic with a 3-month history of a sudden onset, progressively worsening pruritic eruption involving the torso and extremities. Prior treatment included azithromycin and oral and intramuscular steroids, without improvement. Laboratory results demonstrated a serum eosinophil count of 7x10 3 /uL (normal 0-4). A 4-mm punch biopsy of the plaque on the patient's left thigh revealed a diffuse dermatitis with innumerable eosinophils with formation of "flame figures." Histologically, these findings are consistent with a diagnosis of Wells syndrome (WS). A work up for possible underlying malignancy found that the patient had underlying clear cell renal carcinoma. The eruption largely resolved following right laparoscopic nephrectomy with negative surgical margins, thus confirming the diagnosis of paraneoplastic WS. However, 2 years later the patient developed metastasis to his liver, lungs, and ribs. The patient's cancer has continued to progress despite treatment with high-dose interleukin-2, oral sunitinib, afinitor. avastin, azacytidine, and currently axitinib. Our case is the first to describe eosinophilic cellulitis arising in a patient with underlying renal cell carcinoma.

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