Background: The therapeutic value of ultraviolet A1 (UVA1) phototherapy has been acknowledged for many years. Initially developed predominately for experimental and diagnostic purposes, it was subsequently recognised as a beneficial therapeutic modality in atopic dermatitis and localised scleroderma, and more recently a variety of sclerosing and fibrosing dermatoses, T-lymphocyte mediated disorders, both inflammatory and infiltrative, and several predominately dermal processes previously unresponsive to current therapies. Methods: We present a retrospective evaluation of outcomes and treatment tolerability in adult patients using a low dose (30 joules/cm 2), regimen administered in our private dermatologic practice, between 2006 and December 2019. Results: Major clinical groups represented include atopic dermatitis, localised and systemic sclerodermas, mycosis fungoides, urticarial dermatitis, generalised pruritus and granuloma annulare. Eightyseven patients are included in this study with 92% of all patients experiencing a beneficial result, 54% having complete and 38% partial relief of presenting signs and/or symptoms. UVA1 therapy was well tolerated, with no patients ceasing treatment due to adverse effects. Conclusions: Ultraviolet A1 is an effective and safe treatment option in many hitherto recalcitrant cutaneous conditions.

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evidence of invasion. The nasal cartilage had undergone severe atrophy from compressive effects of the lesion. The resultant defect diameter was 1.5 cm which was reconstructed with a bilobed flap and cartilage graft (Fig. 1b). In view of the benign histological characteristics from the punch biopsy and the well-encapsulated nature of the lesion, the decision was made intraoperatively not to aggressively pursue wider margins. Cheah et al in a 33 patient case series demonstrated that SCLs can have infiltrative borders and exhibit skeletal muscle infiltration (focally or extensively). 8 There was also infiltration of dermal collagen and around adnexal structures in that series. CONCLUSIONSCLs arising from the face at the nasal alar aspect are rare and presents diagnostic and management challenges, especially where excision can potentially result in larger skin defects requiring more extensive reconstruction. Available literature suggests that even if SCLs are incompletely excised from the face, recurrence rate is low. Meticulous evaluation of morphology and use of ancillary studies can assist with diagnosis of SCL and distinction from more aggressive, infiltrative mimics such as a liposarcoma.