Lights, lasers, and radiofrequency are unique sources of energy that are increasingly utilized for therapeutic and cosmetic purposes. As the indications for these tools continue to increase and their use expands beyond physicians to aestheticians, physician-extenders, and technicians, the incidence of complications has also risen. It is imperative that operators of these tools be as familiar with the management of potential complications as they are with their usage and indications. This article serves as a review of potential complications encountered with usage of lasers, lights, and radiofrequency devices in dermatology.

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The authors report 2 cases of measles demonstrating novel skin pathology that may be useful in establishing early diagnosis. Syncytial epithelial giant cells, which are characteristic of measles, were found to be present in the dermis, indicating that these cells are not specific to the lymphoid tissue and epithelia of which they are classically attributed to. The cells were not prominent, and required step sectioning to observe. These results were confirmed by electron microscopy, which showed virus capsid particles within the endoplasmic reticulum, secretory vesicles, and cytoplasm of multinucleated cells. One of the cases also demonstrated an unusual mixed infiltrate of eosinophils and fibrin thrombi, which has not been previously described. Both patients in this report recovered with supportive therapy.

Immunobiologics are used to treat patients with moderate to severe psoriasis and allow for continuous maintenance therapy for longer periods of time without the adverse effects seen with older systemic medications, such as methotrexate or cyclosporine. However, will patients stop responding to the drug if they discontinue and restart therapy? This review will examine four biologic agents currently used in the treatment of psoriasis – etanercept, adalimumab, infliximab, and ustekinumab — to determine whether patients can re-achieve comparable clinical response with intermittent therapy versus continuous therapy. While some data suggest that continuous immunologic therapy may lead to decreased efficacy over time, etanercept, adalimumab, and ustekinumab provide patients with durable response should a patient need to discontinue and reinitiate treatment. These findings may assist clinicians in selecting an appropriate agent should interruption of therapy be necessary.