important dermatology research questions. For example, high-quality clinical trial evidence on the benefits (or lack of benefits) of immunomodulatory drugs such as systemic corticosteroids, intravenous immunoglobulins, tumour necrosis factor blocker biologics and ciclosporin as treatments for toxic epidermal necrolysis is urgently needed. This can only be achieved through a coordinated national or international clinical trial to assess these repurposed drugs, owing to the low prevalence of this rare but devastating disease. Clinical research into genodermatoses could benefit from coordinated efforts to set up national and international registries to inform the planning, conduct and recruitment of patients with rare genetic skin diseases into future clinical trials. The British Association of Dermatologists (BAD) Dermatology and Genetic Medicine group, along with Dr Zamiri (chief investigator leading the Genetic Skin Disease in Scotland study; REC reference: 16/ES/0094), and dermatologists and academics across the UK are working tirelessly towards achieving this goal. While new legislation and relaxation of regulatory barriers may prove invaluable to enhancing research volume, we must also be vigilant to less scientifically robust studies emerging. Ultimately, with increased collaboration, data sharing and open access publishing (e.g. the newly launched BAD online

1064-nm Q-switched Nd: YAG (neodymium-doped yttrium-aluminium-garnet) laser is widely used for the treatment of Nevus of Ota but multiple treatments are necessary for clinical improvement. Superficial chemical peeling using Modified Jessner's solution has been used for the treatment of facial pigmentation but repetitive chemical peeling can cause irritation and post-inflammatory hyperpigmentation. In this series, we evaluated seven patients who were treated with a combination of 1064-nm Q-switched Nd: YAG laser and Modified Jessner's peel for eight sessions with 85.7% patients showing more than 50% reduction in pigmentation. The added therapeutic benefit of the combination helped to achieve a significant reduction in pigmentation faster with a lesser number of sessions and reduced cost.

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SDRIFE (symmetrical drug related intertriginous and flexural exanthem) is a benign self-limiting adverse drug reaction (ADR) primarily affecting the intertriginous, gluteal and flexural regions symmetrically in the absence of systemic involvement. It is considered to be a variant of baboon syndrome. Pathogenesis is poorly understood but is thought to be result of a delayed hypersensitivity response after exposure to the drug. Commonly implicated drugs are beta-lactam antibiotics. With the rising incidence of dermatophytosis in the Indian subcontinent, the use of oral anti fungals has become rampant. SDRIFE due to itraconazole has been rarely reported in literature. We hereby present a series of 12 patients presenting with SDRIFE due to itraconazole, which is by far the largest reported in existing literature. This case series highlights the importance of identifying these cutaneous adverse drug reactions in a setting where itraconazole is commonly being used.

Amyloidosis is primarily extracellular deposition of insoluble polymeric protein fibrils in tissues and organs. About 25 percent of patients with primary systemic amyloidosis have associated skin lesions in the form of papules, plaques or nodules. Dermoscopy of these skin lesions reveals characteristic glomerular vessels on a red to pink background. Here we present unique dermoscopic features of cutaneous lesions in a case of primary systemic amyloidosis.