Kimura’s disease is a rare, chronic inflammatory disorder of unknown etiology, classically presenting as painless subcutaneous nodules in the head-and-neck region, often associated with lymphadenopathy, peripheral eosinophilia, and elevated serum immunoglobulin E levels. It predominantly affects young Asian males, making its occurrence in females uncommon and diagnostically challenging. We report a rare case of recurrent Kimura’s disease in a 34-year-old woman presenting with a progressively enlarging, painless left preauricular and parotid-region mass causing significant esthetic deformity. The patient had undergone multiple surgical excisions at other centers over 3 consecutive years, with rapid and florid recurrences and a histopathological diagnosis of foreign-body giant cell reaction. Imaging evaluation suggested a benign neural tumor, further complicating the diagnostic process. Definitive diagnosis was established following complete surgical excision and detailed histopathological examination, which revealed characteristic features including florid lymphoid follicular hyperplasia with prominent germinal centers, dense eosinophilic infiltrates with microabscess formation, vascular proliferation, and stromal sclerosis, confirming Kimura’s disease. The lesion was found adherent to the parotid fascia with extensions into the gland and encasement of facial nerve branches, necessitating meticulous dissection to preserve facial nerve integrity. Postoperatively, the patient developed a transient salivary fistula. This case highlights the diagnostic complexity, atypical demographic presentation, and recurrence-prone nature of Kimura’s disease. It underscores the critical role of histopathology in diagnosis and the need for long-term follow-up and consideration of adjuvant medical therapy to reduce recurrence risk.
Securing platelet-rich fibrin (PRF) over distal wounds is difficult due to curved surfaces and mobility. We describe a simple rolled adhesive surgical tape bolster that stabilizes the PRF membrane, maintains wound contact, and provides gentle compression. This inexpensive and reproducible technique may improve PRF application in distal wounds.
Objectives: To compare the efficacy and safety of 5% topical spironolactone versus 5% topical minoxidil in adult males with androgenetic alopecia (AGA). Material and Methods: This 12-week, pilot comparative study enrolled 40 male patients (aged 18–50 years) with Hamilton–Norwood grades II–IV AGA at a tertiary center in Northern India. Participants were equally allocated ( n = 20/group) to receive either 5% topical spironolactone lotion or 5% topical minoxidil, applied twice daily. The primary outcome was the change in hair density measured by dermoscopy (×10 magnification) at baseline, 4, 8, and 12 weeks. Secondary outcomes included the physician global assessment (PGA), patient satisfaction score (PSS), and safety profile. Data were analyzed using statistical package for the social sciences version 25. Results: Forty patients completed the study (mean age 32.93 ± 6.67 years). Baseline characteristics and mean dermoscopic hair density (43.10 ± 9.84 vs. 43.35 ± 7.21; p = 0.927) were comparable between the spironolactone and minoxidil groups. At week 12, both groups showed significant improvement in hair density; mean scores increased to 51.40 ± 8.69 for spironolactone and 55.45 ± 6.31 for minoxidil ( p = 0.099). No statistically significant differences were observed in PGA (2.15 ± 0.81 vs. 2.40 ± 0.60; p = 0.275) or PSS (1.80 ± 1.01 vs. 2.05 ± 0.83; p = 0.395). Adverse events occurred in 15% of patients, primarily localized irritation and cosmetic residue, with no systemic side effects or significant differences in safety between groups. Conclusion: Both 5% topical spironolactone and 5% minoxidil are effective and well-tolerated for mild-to-moderate AGA. While minoxidil showed a trend toward higher density, spironolactone provided comparable clinical outcomes. Topical spironolactone represents a safe, effective non-systemic alternative or adjunct therapy for male patients with AGA.
Objectives: This study aims to evaluate the effectiveness and safety of combining fractional carbon dioxide (CO 2 ) laser treatment with topical corticosteroid application in the management of alopecia areata (AA). Material and Methods: This prospective uncontrolled trial was conducted at a tertiary care center on 37 patients diagnosed with AA who had not received any form of treatment for at least 2 months before the study. Results: The treatment demonstrated significant efficacy in promoting hair regrowth. After the second session, 40.62% of patients showed regrowth of vellus hair, and by the fourth session, 62.50% exhibited sparse pigmented terminal hair. By the sixth session, 43.75% achieved regrowth of terminal hair in clusters, and 34.37% achieved complete regrowth. By the eighth session, 50% of participants reached a stage where no further treatment was required, and 28.12% had complete regrowth of terminal hair. The results showed significant statistical improvements, with p = 0.0020, 0.00463, and 0.00146 after the fourth, sixth and eighth sessions, respectively. Gender differences in treatment response were observed, with male patients showing a higher early response, although this was not statistically significant. Comorbidities, including hypertension and diabetes mellitus, did not significantly alter treatment outcomes. Conclusion: The study demonstrated significant improvements in hair regrowth over the course of eight treatment sessions, with a notable proportion of patients achieving complete regrowth or satisfactory outcomes. The results suggest that this combined therapy is particularly effective for patients with localized AA.
