Stretch marks are one of the most common benign cutaneous lesions and encountered esthetic problems. Striae rubrae and striae albae can be differentiated on the basis of clinical appearance. Histologically, disturbances of the dermal fiber network and local expression of receptors for sexual steroids have been detected. The epidermal changes are secondary. Prevention of stretch marks using topical ointments and oils is debatable. Treatment of striae rubrae by lasers and light devices improves appearance. Microneedling and non-ablative and fractionated lasers have been used. This review provides an overview on current treatment options with a special focus on laser treatments.

Purpose: To assess the reliability and repeatability of periorbital biometric measurements using ImageJ software and to assess if the horizontal visible iris diameter (HVID) serves as a reliable scale for facial measurements. Methods: This study was a prospective, single-blind, comparative study. Two clinicians performed 12 periorbital measurements on 100 standardised face photographs. Each individual’s HVID was determined by Orbscan IIz and used as a scale for measurements using ImageJ software. All measurements were repeated using the ‘average’ HVID of the study population as a measurement scale. Intraclass correlation coefficient (ICC) and Pearson product-moment coefficient were used as statistical tests to analyse the data. Results: The range of ICC for intra- and interobserver variability was 0.79–0.99 and 0.86–0.99, respectively. Test-retest reliability ranged from 0.66–1.0 to 0.77–0.98, respectively. When average HVID of the study population was used as scale, ICC ranged from 0.83 to 0.99, and the test-retest reliability ranged from 0.83 to 0.96 and the measurements correlated well with recordings done with individual Orbscan HVID measurements. Conclusion: Periorbital biometric measurements using ImageJ software are reproducible and repeatable. Average HVID of the population as measured by Orbscan is a reliable scale for facial measurements.

Background: It is a challenge to treat acne scars and a multimodal combination approach is necessary. While fractional CO₂ lasers (FCLs) are an established treatment option, the role of platelet-rich plasma (PRP) in the treatment of acne scars is not established though it is being used extensively in other fields of medicine owing to its healing properties. We combined the two methods to assess the proposed synergistic action on acne scars. Aims and Objectives: To evaluate the effect of FCL alone vs FCL combined with PRP on the quality of acne scars. Materials and Methods: This is a left–right split-face comparison study with 30 patients with moderate-to-severe acne scars. The patients underwent three sessions of FCL and FCL + topical PRP on right and left sides of the face, respectively, at monthly intervals. Results: There was significant improvement on both sides of the face (right side, P = 0.001; left side, P = 0.0001), but the difference between the right and the left sides of the face was not statistically significant (P = 0.2891). The symptoms of redness, edema, and pain on the treated areas with laser were significantly lesser on the FCL + PRP (left) side as compared to the FCL-only (right) side. Conclusion: Both methods were effective in management of acne scars. Addition of PRP does not improve the scar quality; however, the downtime and inflammation associated with laser treatment gets significantly reduced on the PRP-treated side.

Background: Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP) is one of the concealers recently gaining popularity. Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated. Methods: Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP—angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. Ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia). SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs. Results: The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness. Conclusion: SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of thicker hair.

Accessory auricles are relatively rare malformations arising from the first branchial arch which contains skin, fat and cartilage. The treatment is usually surgical removal for the cosmetic purpose. We are sharing our experience of utilising the accessory auricle skin as full thickness graft for post.burn reconstruction of the fingers contracture of a child. Even though this type of association is rare, it is an innovative idea following Sir Harold Gilles’ principle ‘Never throw anything away’.

Background: The use of hyaluronic acid soft-tissue fillers for enhancement of lip features is a popular and minimally invasive office-based procedure used worldwide due to its relative simplicity and favorable safety profile. Materials and Methods: Hyaluronic acid was used in illustrative cases to attempt correction of congenital and acquired lip asymmetries. Results: In the cases presented, accurate and cosmetically acceptable results were attained and maintained for the duration of the product life. Conclusions: Hyaluronic acid may be used successfully when lip asymmetry is evident and is a relatively simple nonsurgical alternative.

Full-thickness skin grafts (FTSGs) are frequently used to treat patients with burn injuries and to repair defects rendered by excisional (including Mohs) surgery. The evidence for corrective laser surgery after scar formation is well established. With regard to laser treatment of FTSG, the evidence is sparse. Laser treatment after FTSG is a novel concept, with minimal literature. We present a case series, one of the first to our knowledge, of the treatment of FTSG with fractional CO₂ laser in five patients after Mohs surgery.

Introduction: Androgenetic alopecia is a common form of alopecia with multifactorial etiology. Finasteride and minoxidil are approved by the FDA for the treatment of androgenetic alopecia. Balding scalp is believed to have relative microvascular insufficiency. Blood vessels in the scalp travel through the intramuscular plane. Intramuscular injection of botulinum toxin relaxes muscles and thereby increases blood flow in balding scalp. We conducted a pilot study to evaluate the efficacy of botulinum toxin in androgenetic alopecia management. Material and Methods: The study was conducted in a tertiary care center. A total of 10 male patients with androgenetic alopecia meeting inclusion criteria of the study were included. In the scalp, 30 sites were injected with 5 U of botulinum toxin in each site. Preprocedure photograph taken and evaluation was done, which was repeated after 24 weeks. Efficacy was assessed by photography and self-assessment scoring was done by patients. Results: Of 10 patients, 8 had good to excellent response on photographic assessment. At the end of 24 weeks, 1 patient showed poor and 1 showed fair response to treatment. As per self-assessment, 7of 10 patients showed good to excellent response. Two patients had fair response and 1 patient showed poor response to treatment. Conclusion: Botulinum toxin was found to be safe and effective therapy for the management of androgenetic alopecia in this pilot study. Studies with larger sample size and randomized controlled trials are required to establish the role of botulinum toxin in the management of androgenetic alopecia.

Earlobe keloids are commonly encountered in this era where ear piercing is routine in various traditions. Various medical and surgical methods have been tried for its management. Surgically, fillet flap surgery has better acceptability worldwide. Various difficulties are faced during keloid excision, and we hereby describe few innovative modifications (use of needle, hydrodissection, pressure dressing, bolster button) using cost-effective and simple materials (needles, dynaplast, buttons) to ease the excision of keloids. These have easy adaptability and also reduce the recurrence rate of earlobe keloids.

Objective: To present the initial experience of 12 patients with burns treated with cutaneous grafts and to analyse the variables that influence their integration. Materials and Methods: We analysed data from 12 patients seen in a year in the regional hospital of high speciality of Oaxaca. Quantified variables: Age, sex, burned body surface, depth of burn, airway injury, nutritional status by CONUT index, type of graft, development of local infection and days of hospital stay. Results: We included 10 men (83%) and 2 women (17%) with median age of 28 years, median burned body surface area of 19%, depth: 75% were mixed burns and 25% were third degree; with median time between injury and application of grafts of 13 days, 1 patient presented airway injury and 50% concomitant trauma. Regarding Nutritional Status: Fifty percent had severe malnutrition, 33% moderate and 16% mild. About 67% of the grafts were meshed and 33% intact, the mean integration percentage was 80%, 25% developed local infection and the average length of hospital stay was 21 days. Conclusions: Cutaneous grafts are the definitive treatment of burns, in their integration process influence different factors, including nutritional status. The CONUT index seems to be a useful, safe and widely available tooling in the nutritional assessment of the burned patient and can be related to the percentage of integration of the grafts and the days of hospital stay.