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Vitiligo is a common disorder of skin pigmentation resulting from autoimmune destruction of melanocytes. A variety of topical and systemic treatment options have been tried with varying success. Here we describe the case of a man with refractory vitiligo successfully treated with topical crisaborole ointment.Crisaborole ointment is a topical phosphodiesterase (PDE)-4 inhibitor recently FDA-approved for the treatment of atopic dermatitis. Previous literature has discussed the possible role of systemic PDE-4 inhibitors in vitiligo; herein, we discuss the ability of topical crisaborole to accelerate repigmentation in treatment-resistant vitiligo.

Background The use of pulse dose corticosteroid therapy (PDCT) in children for treatment of alopecia areata (AA) has been reported, but dosing regimens are not well‐established. We aim to evaluate the available literature regarding the utilization and various dosing regimens of PDCT, as well as associated side effects, in the treatment of AA in children. Methods We performed a systematic review of studies describing the use of PDCT for the treatment of AA in children. Results Eight relevant studies were identified, five of which administered the treatment intravenously (IV) and three of which administered the treatment orally. Protocols with IV administration included two studies which used IV dexamethasone at 1.5 mg/kg/day for 1–3 days monthly for a maximum of 12 cycles and three studies used IV methylprednisolone 8–30 mg/kg/day for 1–3 days monthly for a maximum of 3–10 cycles. The three protocols with oral administration included variable doses of prednisolone at variable intervals and cycle lengths, betamethasone and dexamethasone at a prednisolone equivalent of 5 mg/kg, and methylprednisolone 15 mg/kg for 3 days bimonthly for 12 cycles. In these studies, PDCT was generally well‐tolerated and resulted in improvement of the AA. Conclusion PDCT was found to be well‐tolerated with few serious side effects reported. It appears to be beneficial early in disease course, especially for those with multifocal AA.

Calciphylaxis is an uncommon disease that presents with painful ulceration and necrosis of the skin secondary to small vessel calcification and microvascular occlusion. Calciphylaxis carries a poor prognosis as the nonhealing wounds provide a port of entry for pathogens, predisposing these patients to infection and sepsis. Ulcers caused by calciphylaxis are most commonly seen in patients with end-stage renal disease (ESRD) but can also present in patients with normal electrolytes and kidney function. We report a case of a 42-year-old woman with a 10-year history of ESRD who developed rapidly progressing calciphylaxis in her legs and hand, starting three months after successful kidney transplantation. The relationship between kidney transplantation and calciphylaxis remains unclear. There are a handful of cases in which calciphylaxis has been treated by successful kidney transplant, however, other cases have been reported in which calciphylaxis developed after kidney transplantation.