Sir, Vitiligo is an acquired depigmenting skin disorder characterized by localized loss of skin pigment, secondary to multifactorial melanocyte damage. Most patients are adequately managed by medical means, except some who remain resistant to all non-surgical treatment modalities. The only effective treatment in this sub-set of patients is surgical replacement of damaged melanocytes. Punch grafting is an established treatment modality for stable vitiligo (more than one year) or in patients unresponsive to conventional therapies. 1 However, relatively common complications such as cobble stoning, keloid formation, variegated appearance and peripheral halo have raised concerns among dermatologists regarding its acceptability. To overcome this complication, we attempted pinhole ablation using ultra pulse CO 2 laser.

Venous lakes (VLs) are fairly common vascular lesions caused by dilatation of the localized vessels on sun-damaged skin. They are usually asymptomatic; however treatment is opted to improve psychological distress caused by cosmetic disfigurement and occasionally to prevent bleeding. Multiple treatment modalities such as cryosurgery, carbon dioxide laser, pulse dye laser, sclerotherapy, and electrocoagulation have been mentioned in literatures with varying degrees of success and specific complications. Hereby, we present a case of a 40-year-old female with VL on upper eyelid treated successfully with surgical excision with better cosmesis.

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Lobular capillary hemangioma (LCH) or pyogenic granuloma is a benign vascular tumor seen in children and adults, with a propensity to bleed profusely. Diagnosis can be made on the basis of sudden onset, rapid growth, history of trauma, and recurrent bleeding, though histopathological evidence is confirmatory. As these tumors do not usually regress spontaneously and have a high rate of recurrence, full-thickness surgical excision is a good option, especially in areas of low tension, such as the eyelids, as it offers satisfactory results with good aesthetic outcome and low chances of recurrence. Here, we report two cases of LCH over the upper eyelids, which were treated by full-thickness elliptical excision.