Dermatologic TherapyEarly View e15493 LETTER Topical Timolol for ingrown nail post-avulsion refractory wound Dharmendra Dineshchandra Dave, Dharmendra Dineshchandra Dave Consultant Dermatologist at Dave Skin & Laser Clinic, Patan, IndiaSearch for more papers by this authorAyman Abdelmaksoud, Corresponding Author Ayman Abdelmaksoud behcet.behcet@yahoo.com orcid.org/0000-0003-4848-959X Mansoura Dermatology, Venereology and Leprology Hospital, Mansoura, Egypt Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy Correspondence Ayman Abdelmaksoud, Mansoura Dermatology, Venereology and Leprology Hospital, Mansoura, Egypt. Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy, Email: behcet.behcet@yahoo.comSearch for more papers by this authorUwe Wollina, Uwe Wollina orcid.org/0000-0001-5933-2913 Department of Dermatology and Allergology, StädtischesKlinikum Dresden, Academic Teaching Hospital, Dresden, GermanySearch for more papers by this authorSelami Aykut Temiz, Selami Aykut Temiz orcid.org/0000-0003-4878-0045 Necmettin Erbakan University Meram Medical Faculty, Department of Dermatology, Konya, TurkeySearch for more papers by this authorMichelangelo Vestita, Michelangelo Vestita orcid.org/0000-0002-2203-0353 Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USASearch for more papers by this author Dharmendra Dineshchandra Dave, Dharmendra Dineshchandra Dave Consultant Dermatologist at Dave Skin & Laser Clinic, Patan, IndiaSearch for more papers by this authorAyman Abdelmaksoud, Corresponding Author Ayman Abdelmaksoud behcet.behcet@yahoo.com orcid.org/0000-0003-4848-959X Mansoura Dermatology, Venereology and Leprology Hospital, Mansoura, Egypt Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy Correspondence Ayman Abdelmaksoud, Mansoura Dermatology, Venereology and Leprology Hospital, Mansoura, Egypt. Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy, Email: behcet.behcet@yahoo.comSearch for more papers by this authorUwe Wollina, Uwe Wollina orcid.org/0000-0001-5933-2913 Department of Dermatology and Allergology, StädtischesKlinikum Dresden, Academic Teaching Hospital, Dresden, GermanySearch for more papers by this authorSelami Aykut Temiz, Selami Aykut Temiz orcid.org/0000-0003-4878-0045 Necmettin Erbakan University Meram Medical Faculty, Department of Dermatology, Konya, TurkeySearch for more papers by this authorMichelangelo Vestita, Michelangelo Vestita orcid.org/0000-0002-2203-0353 Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USASearch for more papers by this author First published: 05 April 2022 https://doi.org/10.1111/dth.15493Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issuee15493 RelatedInformation

Isotretinoin is a first-generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti-inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date-unlimited PubMed search, from inception till December 2019, using the following search terms: "low-dose isotretinoin" and "dermatology," "isotretinoin and safety," "isotretinoin, off-label uses," "isotretinoin and male fertility," "isotretinoin, iPLEDGE system," aiming to deliver a therapeutic update relevant to clinical practice. All English-language articles were considered with no limitation based on the articles' type. Low-dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

Warts constitute the most frequently observed dermatological manifestations of human papillomavirus (HPV). Although an extensive range of treatments exist for local warts, there is no specific therapy based on high-quality evidence of notable treatment success or high cure rate, or minimal adverse effects. Recalcitrant warts are, therefore, a common therapeutic problem. This case series refer to 14 immunocompetent patients with recalcitrant warts, who experienced full resolution of their warty lesions when treated with addition of low dose isotretinoin, in a dose of 0.1-0.2 mg/kg/day, for a 3-month course, with no significant adverse effects. Long-term remission was noted for up to 3 years with no signs of active lesions. Low dose isotretinoin should be in the priority of the treatment options of recalcitrant warts, alone or in combination.

Vitiligo is quite a common hypopigmentary disorder, which may affect both children and adults with important psychological effects due to the well-known leopard skin-like appearance. Even if asymptomatic and not life threatening, vitiligo has to be increasingly studied and treated. Hitherto, the efficacy of topical methotrexate in treatment of vitiligo has not been reported. We herein reporting our preliminary observation on the promising efficacy of topical methotrexate in one patient with stable vitiligo. The patient applied topical methotrexate 1% gel twice daily for 12weeks. Significant improvement of the lesion with no local or systemic side effects were noted during the course of therapy. We propose that this well-tolerated drug can be used for vitiligo therapy; however, further investigations should be performed to ascertain the exact topically effective dose.

Dermatologic TherapyVolume 31, Issue 5 e12630 Therapeutic Hotline: Letters Glycolic acid cream for treatment of molluscum contagiosum Dharmendra Dave, Dharmendra Dave Consultant Dermatologist at Dave Skin & Laser Clinic, Patan, IndiaSearch for more papers by this authorAyman Abdelmaksoud, Corresponding Author Ayman Abdelmaksoud behcet.behcet@yahoo.com orcid.org/0000-0003-4848-959X Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt Correspondence Ayman Abdelmaksoud, MSc, 5-Amien Alsamanoudy Street, from Abdelsalam Aaref Street, Mansoura, Egypt. Email: behcet.behcet@yahoo.comSearch for more papers by this author Dharmendra Dave, Dharmendra Dave Consultant Dermatologist at Dave Skin & Laser Clinic, Patan, IndiaSearch for more papers by this authorAyman Abdelmaksoud, Corresponding Author Ayman Abdelmaksoud behcet.behcet@yahoo.com orcid.org/0000-0003-4848-959X Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt Correspondence Ayman Abdelmaksoud, MSc, 5-Amien Alsamanoudy Street, from Abdelsalam Aaref Street, Mansoura, Egypt. Email: behcet.behcet@yahoo.comSearch for more papers by this author First published: 28 August 2018 https://doi.org/10.1111/dth.12630Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume31, Issue5September/October 2018e12630 RelatedInformation

Dear Editor, A 14-year-old girl, Fitzpatrick III photo skin type, presented with a 5-month history of disfiguring pigmented chickenpox scarring. She had deep, atrophic, monomorphic, boxcar like scars with associated hyperpigmentation. In addition she had polymorphic papulopustular lesions consistent with acne vulgaris. The therapeutic plan was to first treat her acne vulgaris and then to treat her facial scarring (post-acne and post-varicella). She was commenced on isotretinoin 20 mg alternate day. Three months later, there was significant improvement of her acne lesions. Surprisingly, the post-varicella scars were also dramatically improved, with reduction in the hyperpigmentation. Two subsequent patients (photo type III, IV) with post-varicella pigmented scars, consented to a trial of isotretinoin 20 mg (every other day) and 10 mg (every other day), with moderate to excellent response after 1–3 months (Figure 1 and 2). None of the patients had received any cosmetic therapy or over-the-counter preparations for their pigmented post-varicella scars. Table 1 summarizes the cases. Chickenpox (varicella) is a self-limited disease with postinflammatory scarring (Leung & Kao, 1999). These scars are generally atrophic and may be associated with hyperpigmentation. Hyperpigmentation may be problematic in the darker skin types. Patients with facial scars suffer from considerable impairment of social life (Agarwal et al., 2013). Post-varicella atrophic scars have been reported to occur in up to 18% of patients in various studies (Jezek, Hardjotanojo,, & Rangaraj, 1981). There is a paucity of information in the medical literature on the treatment of atrophic chickenpox scars (Agarwal et al., 2013). Oral isotretinoin has been proven to be highly effective in the treatment of all forms and grades of acne vulgaris, even in lower doses (Lee et al., 2011). Yoon et al., observed that acne and acne scars can be treated more effectively by concomitant use of an infrared fractional laser with low-dose isotretinoin with no aggravation of the scars(Yoon et al., 2014). The anti-inflammatory and immunomodulatory properties of isotretinoin have found its use in disorders other than acne (Rademaker, 2013). Trifirò and Norbiato studied 10 patients