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Laser hair removal (LHR) has been established as a safe and efficient method for eliminating unwanted hair. This study aimed to investigate the frequency of LHR complications and assess the contributing factors. During one year, 16,900 patients undergoing LHR therapy were evaluated for complications. For each case, two external controls were selected (matched based on age, sex, Fitzpatrick skin type (FST) III-IV, and the treated anatomical region). To assess the impact of anatomical region on complication occurrence, each patient was used as their internal control if another area was treated during the same session. GEE analysis was used for statistical analysis.The incidence of LHR complications was calculated to be 0.69%. The most common complications were petechia, purpura, and ecchymosis (31.66%) followed by pigmentation changes (20.0%). LHR complications were most commonly observed in the lower limbs (32.0%), face and neck (23.3%), and genitalia and thighs (22.3%), respectively. Possible risk factors were younger age (OR = 0.74, P-value ≤ 0.001), operating LHR in the head and neck (OR = 5.8, P-value = 0.022), utilization of the alexandrite laser (OR = 2.32, P-value = 0.011), and fluence in the Alexandrite laser (OR = 3.47, P-value = 0.003).Overall, the results of this study indicate that LHR is generally a safe method for removing unwanted hair. However, factors such as younger age, treatment of the facial area, and use of the alexandrite laser especially with higher fluence levels in patients with FST III-IV were identified as potential risk factors.

BACKGROUND: Lidocaine/prilocaine (EMLA) cream is a local anesthetic that is applied to the skin or mucosa during painful therapeutic procedures with few reported side effects.
METHODS: Here, we report the use of dermatoscopy to identify a case of erythema with purpura, a rare side effect, after the application of 5% EMLA cream.
CONCLUSIONS: We conclude that erythema with purpura is caused by irritation and toxicity associated with EMLA, but the specific mechanism by which the toxic substance affects skin blood vessels is unclear. In response to this situation and for cosmetic needs, we recommend tranexamic acid, in addition to routine therapy, to prevent changes in pigmentation in patients with dermatitis.

A unique dermatopathology incident arose after administration of the mRNA-1273 SARS-CoV-2 (Moderna) vaccine. Specifically, a transient purpuric interface dermatitis occurred 5 days post-second vaccine with the presentation of erythematous papules with erythema multiforme-type findings. A patient developed purpuric interface dermatitis with micro-vesiculation post-vaccination which ultimately resolved without sequelae.

Infective endocarditis (IE) can present with a variety of signs and symptoms, including skin lesions. The few papers describing a relationship between IE and vasculitis are split between IE being able to mimic vasculitis and between IE indeed being associated with a vasculitis involving the skin, kidney, gastrointestinal tract, or peripheral nerves. It is important for clinicians to distinguish between an isolated vasculitis, infective endocarditis, and IE-associated vasculitis because the treatments and outcomes are different. We report a case of a patient with a history of intravenous (IV) drug use who initially presented with chest pain, was started on vancomycin following diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) IE, left against medical advice (AMA), and then returned to the hospital due to development of a purpuric rash. We contend that while he did not have a skin biopsy due to time delay, his symmetrically distributed purpura was consistent with cutaneous vasculitis. His symptoms, including his rash and an acute kidney injury (AKI), improved with antibiotics to treat the endocarditis.

Idiopathic thrombocytopenic purpura (ITP) presents challenges in management, particularly in cases refractory to corticosteroids. Thrombopoietin receptor (TPO-R) agonists, such as eltrombopag, offer alternative therapeutic options. We report a case of a 72-year-old South Asian male with steroid-refractory chronic ITP who achieved a favorable response with biweekly eltrombopag dosing. Platelet response was comparable to daily dosing, suggesting the efficacy of less frequent administration schedules. This approach may enhance patient adherence and reduce treatment-related financial burdens. Biweekly eltrombopag dosing presents a promising alternative for chronic ITP management, warranting further investigation.

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