Acne necrotica is a disorder of adults of obscure aetiology, featuring repeated cropping of inflammatory papulonodules which rapidly necrotise, leaving varying degrees of superficial scarring with pathological features in early lesions of a necrotising lymphocytic folliculitis. A perceived diminishing interest in this entity in recent years prompted a prospective study of patients presenting to a dermatology practice over a 3-year period to reassess the prevalence of this disorder in general dermatological patients, leading to the identification of 47 patients (35 female) with features of acne necrotica, with histopathology undertaken in atypical cases. We identified the importance of the recognition of primary lesions (1-2 mm umbilicated erythematous papules), often difficult to find in excoriated areas, as being paramount in the diagnosis both clinically and histologically in our study, which reveals a significantly more prevalent and clinically diverse disorder than featured in previous textbook and academic journal descriptions.

An association between adult scalp seborrhoeic dermatitis and cicatricial hair loss has not previously been convincingly established. This study seeks to demonstrate a unique relationship between a clinically identifiable chronic scalp dermatitis-folliculitis with the characteristic histological features of low-grade inflammatory fibrosing alopecia, resulting in a distinctive progressive cicatricial alopecia which we believe is prevalent and hitherto unrecognised, and befits the description of seborrhoeic folliculitis. The clinical, epidemiological and histopathological features of seborrhoeic folliculitis are demonstrated to establish its unique status among the disorders of adult diffuse cicatricial alopecia.

myeloma, six months into this time period, after treatment with bortezomib by her oncologist. Despite paraprotein levels remaining stable for six months following chemotherapy, the rash did not resolve. Oral montelukast 10mg daily was added and, on review three months later, the patient had complete clinical resolution of the rash and its symptoms. Blood eosinophil levels normalised to 0.26x10^9/L. Her skin remained clear with ongoing montelukast after twelve months of follow-up. CONCLUSIONEosinophilic dermatosis of haematological malignancy tends to have a long, relapsing course with symptoms that negatively affect quality of life. Despite this, treatment options have been largely disappointing to date with most resulting only partial or no response. 3 Achieving complete resolution of the rash with montelukast in this patient therefore marks significant potential for a new effective treatment option for eosinophilic dermatosis of haematological malignancy.

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We present six cases of multiple eruptive lichen planus-like keratoses (LPLK), occurring in older individuals predominately confined to previously solar exposed areas. Diagnosis was often confounded by the frequent histological reporting of 'lichenoid drug reaction' (LDR), despite many of the patients being unmedicated. We review the literature regarding eruptive LPLK and reflect on their etiology, clinical aspects, management and importantly their clinicopathological differentiation from LDR.