Follicular occlusion tetrad is a symptom complex consisting of four conditions having a similar pathophysiology. It includes Hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. The exact pathogenesis of this group of disease is unknown but evidence suggests that they share the same pathological process initiated by follicular occlusion in apocrine gland bearing areas. Though each of these conditions is commonly encountered singly, follicular occlusion tetrad as a symptom complex has been rarely reported in the literature.

Cancer metastasis is quite devastating to the patient as well as the physician and may herald the onset, dissemination or recurrence of malignancy. Breast carcinoma metastasis is the most common carcinoma encountered by dermatologists and it presents in various morphological and histological forms. Here, we present two varied cases, the first being the common nodular metastasis from a previously treated intraductal carcinoma and the second, the rarer variant, carcinoma erysipeloides as a heralder of the invasion of an incompletely treated disease.

Isotretinoin does not appear to delay wound healing, and hence invasive procedures can be considered on patients on oral isotretinoin without any compromise on the outcome.

Background:Finasteride acts by reducing dihydrotestosterone levels, thereby inhibiting miniaturization of hair follicles in patients with androgenetic alopecia (AGA). Oral finasteride is associated with side effects such as decreased libido, sexual dysfunction, and gynecomastia.Aim:The aim of the following study is to assess the efficacy of maintaining hair growth with 5% topical minoxidil fortified with 0.1% finasteride in patients with AGA after initial treatment with 5% topical minoxidil and oral finasteride for two years.Materials and Methods:A retrospective assessment was done in 50 male patients aged 20-40 years with AGA. All the patients had been initially treated with topical minoxidil and oral finasteride for a period of two years, after which the oral finasteride was replaced with topical minoxidil fortified with finasteride. Five of 50 patients had discontinued the treatment for a period of 8-12 months and were then resumed with only topical minoxidil fortified with finasteride. The patients’ case sheets and photographs were reviewed by independent observers and the efficacy of minoxidil-finasteride combination was assessed.Results:Of the 45 patients who underwent a continuous treatment for AGA, 84.44% maintained a good hair density with topical minoxidil-finasteride combinatio. Of the five patients who discontinued oral finasteride for 8-12 months, four demonstrated good improvement in hair density when treatment was resumed with topical minoxidil-finasteride combination.Conclusion:Topical finasteride can be considered for hair density maintenance after initial improvement with oral finasteride, thereby obviating the indefinite use of oral finasteride.