PurposeDermatophytes are fungi that cause infections affecting hair, nail, and skin; in nails they cause onychomycosis, while in hair they lead to tinea capitis. Detection of dermatophytes using traditional methods, including potassium hydroxide (KOH) and culture on agar-based media leads to high rates of false-negative results. Here, we investigated more accurate diagnostic techniques, including Chicago sky blue staining and Calcofluor white fluorescent staining and compared them with traditional KOH and culture methods for the diagnosis of fungi causing onychomycosis and tinea capitis.Patients and methodsThis study was conducted using samples from 50 patients with dermatophytosis of the hair or nail. Samples were subjected to all the following laboratory investigations: KOH wet mount, culture on Sabouraud’s dextrose agar, Chicago sky blue staining, and Calcofluor white staining. The results of the new diagnostic techniques were compared with those of the traditional methods.ResultsCalcofluor white stain and Chicago sky blue stain for dermatophytosis of hair and nail are more specific and sensitive as compared to traditional diagnostic methods. KOH wet mount is simple, rapid, and inexpensive test but lacks color contrast and gave more false positive (artifacts) and false-negative results as compared to these new stain methods.ConclusionChicago sky blue and Calcofluor white staining are excellent methods for diagnosis of fungal infections, including those that cannot be confirmed using conventional methods.

Background Melasma is a common acquired symmetrically distributed hyperpigmented macules of sun‐exposed skin. Skin microneedling acts as a transdermal delivery system that facilitates the penetration of lightening agents to deeper layers of skin. Objective Clinical and dermoscopic evaluation of the efficacy and safety of topical tranexamic acid versus topical vitamin C after microneedling for melasma treatment. Patients and Methods Twenty patients with facial melasma were enrolled in a split‐face prospective, randomized uncontrolled study. The right side of the face was treated with topical tranexamic acid after dermapen microneedling, while the left side of the face was treated with topical vitamin C after dermapen microneedling. Sessions were done every 2 weeks for 6 sessions. The Hemi‐MASI score and dermoscopic examination before and after treatment were done. Results Hemi‐MASI score was reduced after treatment on both sides of the face, besides improvement of the pigmented lesions showed by dermoscopy on both sides and improvement of the vascular component on the tranexamic acid treated side. Conclusion Topical tranexamic acid or vitamin C application after dermapen microneedling was an effective and safe technique in melasma treatment with minimal side effects, and vascular component improvement by tranexamic acid.

The clinical presentation of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2 COVID‐19) varies from asymptomatic infection to a life‐threatening, multiorgan disease. One of these manifestations is telogen effluvium (TE) which is characterized by diffuse hair loss occurring in patients previously infected with SARS‐CoV‐2 and lasts ~3 months, after which excessive hair loss follows. Hair follicles are known to contain a well‐characterized niche for adult stem cells which is the bulge containing epithelial and melanocytic stem cells. Stem cells in the hair bulge, a demarcated structure within the lower permanent portion of hair follicles, can generate the interfollicular epidermis, hair follicle structures, and sebaceous glands. This study aims to evaluate autologous micrografts from scalp tissues as a therapeutic modality in the management of TE caused by COVID‐19. Twenty patients of previous COVID‐19 infection suffered from TE were included in this study for human follicle stem cells micrograft scalp treatment and they were evaluated after 3 months of treatment and after 6 months. There was significant improvement of the hair thickness and density compared with the start of the treatment and 6 months of follow‐up. Autologous micrograft of the scalp showed marked improvement in the treatment of COVID‐19 TE.

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Background: Acral subcorneal hematoma (ASH) is a dark-colored skin lesion of the palms and/or soles due to bleeding. ASH may be difficult to be clinically differentiated from acral melanocytic lesions, resulting in unnecessary biopsies. Few researches reported the importance of dermoscopy in differentiating ASH from acral melanocytic lesions. Purpose: This study aims at reporting the dermoscopic features in a series of ASH to facilitate precise diagnosis and to avoid performing unnecessary surgical techniques. Methods: Eighteen patients with ASH were studied. Dermoscopic images were obtained using a handheld dermoscope and a dermoscope-adopted phone camera. Paring test was performed on all lesions. Results: The preliminary diagnoses of the lesions were ASH in 55.6%, acral melanocytic nevi in 33.3%, and acral lentiginous melanoma in the remaining 11.1%. Dermoscopically, the lesion colors were red-black in 44.4%, black in 27.8%, and brown in the remaining 27.8%. The pigmentation patterns were homogeneous (structureless) in 55.6%, parallel ridge in 27.8%, and negative pseudonetwork in the remaining 16.6%. Over 44% of the lesions had red and/or brown globular satellites. Peripheral red lines with/without radial extensions were noticed around ASH in 55.6%. Paring led to complete removal of pigmentation in all ASH (100%), with the appearance of post-paring blood-tinged serum in 55.6%. No skin biopsies were performed. Conclusion: Although there is clinical similarity between ASH and acral melanocytic lesions, dermoscopy and paring test can facilitate a precise diagnosis and markedly decrease the need for unnecessary invasive procedures.