Psoriasis is a chronic, relapsing, inflammatory, immune-mediated systemic disease with mainly skin and joint manifestations. The available treatment options to cure psoriasis include topical therapy, phototherapy, and biological therapy. Biological therapy has become a promising option due to the rapid action and less adverse effects associated with its use. The newly developed biologic itolizumab is a humanized recombinant anti-CD6 monoclonal antibody of IgG1 isotype that binds to domain 1 of CD6, thereby immunomodulating human lymphocytes without interfering with the binding of CD6 to the activated leukocyte-cell adhesion molecule. In this case series, a total of 5 patients with chronic plaque psoriasis were treated with itolizumab. They exhibited a rapid PASI 75 response after 4 doses of itolizumab infusion. The patients were poor responders to methotrexate and/or cyclosporine therapy for a long time. All infusions were well tolerated by all patients with no adverse reactions or infections during the treatment period. Itolizumab can be a good option for management of psoriasis and psoriatic arthritis.

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Freckles are usually thought of as small, poorly marginated, well-circumscribed, pale brown macules present on sun-exposed skin areas in fair-complexioned individuals. However, freckles also occur in patients who have skin types IV and V, and there is a risk of prolonged depigmentation after treatment with a Q-switched laser emitting wavelengths of 532 nm. Unlike in fair-complexioned patients with light eyes and auburn hair who respond well but relapse in a matter of weeks, patients with skin type V show a permanent and satisfactory response to laser therapy. However, lower energies have to be used to prevent permanent hypopigmentation, which stands out in patients with skin of color. It is advisable to perform test spots on freckles before treating the entire face. After treatment, freckles can become of an ash white color. Test spots can be evaluated after 6 weeks. Sunscreen should be mandatory after the procedure. Additionally, freckles should be differentiated from lentigines by Wood lamp examination, where the superficial freckles get ac­centuated. Lentigines are treated using wavelengths of 1,064 nm.

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