IV metoclopramide 20mg+diphenhydramine 25mg is an effective and well-tolerated medication regimen for patients presenting to the ED with acute post-traumatic headache, though 1/3 of patients report headache relapse after ED discharge and 1/4 of patients report persistent headaches one week later.

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Melasma, a common cause for seeking dermatologic care, is a chronic condition of skin hyperpigmentation. With a poorly understood pathogenesis, and no universal cure, melasma is a challenge for many dermatologists. For decades, there has been investigation into the role of oxidative stress in melasma. In this literature review, we introduce the role of oxidative stress in melasma and discuss the function of various topical and oral antioxidant therapies for patients suffering from melasma. Numerous studies have shown efficacy of various antioxidant therapies for treatment of hyperpigmentation, and in this review, we focus primarily on those with less widespread use. Vitamin E, niacinamide, polypodium leucotomos, pycnogenol, grape seed extract, amino fruit acids, phytic acid, zinc, silymarin, Korean red ginseng powder, plant extracts, and parsley all have well‐demonstrated evidence of antioxidant properties, and these substances have been studied in the context of skin hyperpigmentation. Although there is conflicting evidence of their therapeutic efficacy, the use of these naturally occurring substances is promising for patients and medical providers seeking alternative therapeutic options.

Background Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of hair follicles characterized by recurrent, painful nodules, abscesses, and sinus tracts (“tunnels”) typically refractory to treatment. This debilitating condition results in poor quality of life due to high disease burden. Intralesional triamcinolone (ILTAC) is a standard of care for acute inflammation and drainage associated with HS; however, the optimal therapeutic dose has not been determined. We investigated the utility of high‐dose ILTAC 20 mg/ml (ILTAC‐20) or 40 mg/ml (ILTAC‐40), for inflammatory lesions of HS. Methods A retrospective chart review and telephone questionnaire included HS patients treated with high‐dose ILTAC‐20 or ILTAC‐40 between April and December 2018. Patients with Hurley stages I–III were included. Data were obtained from electronic medical records and telephone interviews. A short questionnaire pertained to satisfaction with therapy, changes of disease state, and modifications in quality of life. Results Of 54 patients interviewed, the average age was 36.9 ± 11.6 years; 36 (66.7%) were female. Forty patients (76.9%) were very satisfied (n = 19) or satisfied (n = 21) with high‐dose ILTAC therapy. Fifty patients (92.6%) demonstrated improvements in disease state, and 41 patients (75.9%) experienced enhanced quality of life. Forty‐four patients (86.3%) were amenable to additional injections of high‐dose ILTAC, if clinically indicated. No adverse effects of therapy were reported. Conclusions The majority of patients reported improvements in disease state, quality of life, and overall satisfaction after administration of high‐dose ILTAC (20–40 mg/ml). These findings support the use of high‐dose ILTAC for acute lesions of HS.