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Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) characterized by subcutaneous infiltration of pleomorphic T-cells of the α/β phenotype rarely affects children. Development of hemophagocytic syndrome (HPS) leads to a poor prognosis with this otherwise indolent lymphoma. We report a case of SPTCL in a 5-year-old child complicated by HPS treated successfully with combination chemotherapy. We discuss the potential pitfalls in reaching an early diagnosis and challenges in its management. Previously reported cases of SPTCL with HPS in children are briefly reviewed.

Summary Background Noncultured extracted hair follicle outer root sheath cell suspension (NC‐EHF‐ORS‐CS) is an upcoming surgical technique to treat stable vitiligo. Conventionally it employs trypsin to tap the hair follicle (HF) reservoir for autologous melanocytes and their precursors for transplantation. However, a perifollicular dermal sheath composed of type 1 collagen encases the target ‘bulge’ region of the HF. Adding collagenase type 1 would digest the ORS, facilitating better release of cells. Aim To compare the repigmentation achieved using trypsin and a combination of collagenase plus trypsin, respectively, with dermabrasion alone, and to compare cell counts, viability and composition of both suspensions. Methods This was a randomized, double‐blind, comparative, therapeutic trial, conducted as a pilot study on 22 patients with stable vitiligo. Three similar patches were randomized into three parallel treatment arms [(A) trypsin plus collagenase, (B) trypsin alone and (C) dermabrasion with vehicle alone]. Each patient’s HF sample was divided and digested by the two methods, and transplanted as suspensions onto dermabraded patches, while a third dermabraded patch received the vehicle only. Suspensions were sent for laboratory analysis. Repigmentation was assessed over a follow‐up of 6 months. Results There was a significant increase in cell yield and comparable viability when collagenase was added. Immunohistochemical and flow cytometry studies showed a nonsignificant increase in HMB45+ melanocytes and their precursor stem cells in group A. This trend was reflected clinically in the extent of repigmentation [group A (33.22%) > B (24.31%) > C (16.59%); P = 0.13]. Adding collagenase induced significantly higher repigmentation than dermabrasion alone (P < 0.05). Conclusions Incorporating collagenase type I into the conventional NC‐EHF‐ORS‐CS technique resulted in enhanced retrieval of pigment‐forming cells and subsequently improved repigmentation in vitiligo.

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Background: Monopolar radiofrequency (MRF) for facial rejuvenation works by diffusely heating the dermis and subdermal fibro-septal network. Immediate collagen contraction and long-term neo-collagenesis produce antiaging effects. Aim:To lift and repose drooping fat planes along their vectors of descent to restore natural, youthful contours using MRF and to objectively measure, quantify, and analyze the antiaging effects of MRF on the backdrop of functional facial anatomy. Methods:This was a prospective study on 30 subjects aged 25-65 years who underwent three sessions of MRF (Exilis, BTL Aesthetics) with a modified protocol at weekly intervals. Clinical evaluation at baseline and 4 weeks after the final session was done according to the global drooping and wrinkles classification and scoring system (GDWCSS) and statistically evaluated. Two patients were analyzed with Ultrasound and Vectra-H1 imaging for change in subcutaneous fat depth and volume over different facial areas, respectively.Results: There was improvement in all parameters (volume alteration and wrinkles) of the GDWCSS, of which improvement in cases that had baseline severe (grade-4) temporal fat loss, malar fat loss, periorbital hollowing, and puffiness was statistically significant. The results of imaging supported the clinical findings. Conclusion:Monopolar radiofrequency targets facial collagen as deep as the facial fat, thereby achieving "reversal" of the grooves and bulges of aging with volume redistribution and favorable "remolding" of fat pads. The result is simultaneous skin tightening, lifting and contouring in manner that is natural, regenerative, and corrective. Given its versatility, efficacy, safety, and tolerability, it is emerging as a powerplayer in the dermatologist's antiaging armamentarium.