We found the Roche et al 1 article on prevailing dermatology-related topics on the rapidly growing TikTok social media (SoMe) platform informative, particularly with respect to the popularity of dermatological search terms such as #roaccuatane (57.7 million in August 2021). Zheng et al2 expatiated on this further by providing guidance on how dermatologists can navigate such platforms using hashtags (#) which Nikookam et al3 postulated as a way of providing quality educational dermatology-related content for the public and budding dermatologists alike.

Background: Postinflammatory hyperpigmentation (PIH) occurs as a result of different inflammatory dermatoses and exogenous factors in individuals with darker skin types. With current skin lightening treatments, there are concerns about irritation leading to worsening of their underlying inflammatory skin condition or worsening of PIH. Case: A 20-year-old woman with Fitzpatrick skin type (FST) V presented with facial hyperpigmented patches since childhood following an intermittent erythematous, pruritic facial rash. Skin biopsy confirmed PIH secondary to possible burnt-out morphea. Treatment with topical adapalene 0.1% gel and triple combination cream (containing hydroquinone, topical corticosteroids, and retinoids) proved unsuccessful. Treatment with cysteamine 5% cream over 4 months resulted in significant improvement with a reduction in the melanin index. Discussion: The current recommendation for first-line treatment in PIH is hydroquinone or triple combination cream containing hydroquinone, which can be associated with significant short- and long-term side effects. Cysteamine 5% cream is one of the latest cosmetic skin lightening products. It is hypothesized that cysteamine reduces melanin production by inhibiting key melanogenic enzymes required in melanogenesis. Its efficacy and tolerability have been demonstrated in two randomized controlled trials against placebo in patients with melasma. This report demonstrates a successful use of cysteamine 5% cream in a patient with chronic severe PIH.

BACKGROUND:Cetuximab improves progression-free survival (PFS) and overall survival (OS) in patients with KRAS wild type (wt) metastatic colorectal cancer (mCRC). Few data are available on factors impacting both efficacy and compliance to cetuximab treatment, which is, in combination with chemotherapy, a standard-of-care first-line treatment regimen for patients with KRAS wt mCRC. PATIENTS AND METHODS:PREMIUM is a prospective, French multicenter, observational study that recruited patients with KRAS wt mCRC scheduled to receive cetuximab, with or without first-line chemotherapy, as part of routine clinical practice, between October 28, 2009 and April 5, 2012 (ClinicalTrials.gov Identifier: NCT01756625). The main endpoints were the factors impacting on efficacy and compliance to cetuximab treatment. Predefined efficacy endpoints were PFS and safety. RESULTS:A total of 493 patients were recruited by 94 physicians. Median follow-up was 12.9 months. Median progression-free survival was 11 months [9.6-12]. In univariate analyses, ECOG performance status (PS), smoking status, primary tumor location, number of metastatic organs, metastasis resectability, surgery, folliculitis, xerosis and paronychia maximum grade, and acne preventive treatment were statistically significant. In multivariate analysis (Hazard Ratios of multivariate stepwise Cox models), ECOG PS, surgery, xerosis and folliculitis were positive prognostics factors for longer PFS. Among all patients, 69 (14%) were non-compliant. In multivariate analysis, no variables were statistically significant. The safety profile of cetuximab was consistent with previous studies. CONCLUSIONS:ECOG PS <2, surgical treatment performed, and maximum grade xerosis or folliculitis developed were predictive factors of cetuximab efficacy on KRAS wt mCRC patients. Unfortunately, we failed in identifying predictive factors for compliance in these patients.

A female infant was born with a firm mass on the right lower leg. Her bloods showed platelet and consumption coagulopathy, she required platelet transfusion (lowest platelet count was 19×109 and Fibrinogen was 0.8 g/L). Ultrasound scan showed a well-defined slightly heterogeneous soft tissue mass that measured 49 mm ×29 mm × 49 mm in keeping with a diagnosis of Rapidly Involuting Capillary Haemangioma (RICH). However, due to persistent thrombocytopenia needing further transfusions, a biopsy was performed. Histology was consistent with Kaposiform Haemangioendothelioma (KHE). KHE is a rare, locally aggressive vascular tumour that occurs in infancy. KHE may rarely involve other internal organs. The incidence is 0.07 per 1 00 000 per year and both genders are affected equally. Half of the cases present at birth and it is frequently complicated by a consumptive coagulopathy, referred to as Kasabach Merritt Syndrome (KMS) which occurs in 70% of cases. Abnormal endothelium and tumor like vasculature promote platelet adhesion, which leads to thrombocytopenia and ongoing fibrosis causes coagulopathy. Vincristine used as neo adjuvant therapy is the most popular treatment choice. It promotes endothelial apoptosis. Vincristine has a low side effect profile and it has been shown to achieve effective tumour shrinkage with resolution of thrombocytopenia. After eight weeks of treatment with Vincristine, her platelet count improved considerably and the lesion became less prominent.

BI01 Long-term mucocutaneous adverse effects of imatinib in Asian patients with chronic myeloid leukaemia K. Vinay, U. Yamanandra, S. Dogra, V. Suri, S. Kumari, A. Khadwal, G. Prakash, D. Lad, S. Varma and P. Malhotra Postgraduate Institute of Medical Education and Research, Chandigarh, India Short term mucocutaneous adverse effects are well documented with imatinib. However, studies on long-term adverse effects and in ethnic populations are lacking. Our objective was to evaluate the long-term mucocutaneous adverse effects of imatinib in patients with skin phototypes IV–VI and to study the factors predicting these adverse effects. In this crosssectional study, consenting adult patients with chronic myeloid leukaemia, on imatinib for > 250 days, were recruited. The details of imatinib treatment were retrieved from haematology clinic records. In total 438 patients who were on imatinib for a mean duration of 1820 days were recruited. A mean number of 1.42 0.98 cutaneous adverse effects were seen per patient. Melasma-like pigmentation, periorbital oedema, oral lichenoid reaction, cutaneous hypopigmentation and vesiculobullous eruptions were seen in 236 (53.9%), 81 (18.5%), 70 (16.0%), 42 (9.6%) and 12 (2.7%) patients, respectively. Cutaneous hyperpigmentation was more often seen in younger patients (P = 0.001) and women (P < 0.001). On multivariate analysis, female sex was a significant risk factor for developing cutaneous hyperpigmentation and periorbital oedema. Cutaneous hyperpigmentation and periorbital oedema are common long-term adverse effects of imatinib in patients with skin phototypes IV–VI. Female sex is a significant risk factor for development of both of these adverse effects.