Central centrifugal cicatricial alopecia (CCCA) is the most common form of primary cicatricial alopecia in women of African descent but has rarely been reported from other parts of the world. It is also rarely reported in the Philippines hence there is a need to investigate this condition. Distinguishing this from other scarring alopecia is important to be able to give the proper treatment and intervention. A 28-year-old Filipino male presented at an outpatient dermatology clinic in the Philippines with a two-years history of erythematous bump with bald spot on the vertex area of the scalp associated with 8/10 itch and 2-4/10 tenderness. He denied any burning or decrease in sensation on the affected area as well as previous history of bald spot or trauma to the scalp. He did not notice any similar lesion on other parts of the body. There is no family history of alopecia. There were no history of hair treatments or hair dye use, however admits to occasional application of hair gel and use of a cap. Clinical, trichoscopy, and histologic findings confirmed the diagnosis of CCCA. There are no clear guidelines that exist for the management of CCCA. However, early intervention reduces the chance of disease progression. The use of anti-inflammatory therapy is considered the first-line treatment such as topical steroids or intralesional triamcinolone acetonide.

Human ; Male ; Adult: 25-44 Yrs Old

A 45-year-old man has a 3-year history of a recurrent and painful blistering eruption affecting the oral mucosa and the flexural areas. Biopsy and direct immunofluorescence results were consistent with pemphigus vulgaris (PV).
Patient underwent the following treatment phases: phase 1 (control), high dosages of glucocorticosteriod to achieve initial control of the acute disease; phase 2 (consolidation), constant dosage until most lesions are healed and itching ceases; and phase 3 (maintenance), glucocorticosteroid dosage gradually tapered.
Presently, with the patient's substantial cumulative glucocorticosteroid dosage, he is worried with the complications associated with it such as: osteoporosis, adrenal suppression, cataracts, diabetes, and predisposition to infection.
He did an internet search and found articles regarding the use of dapsone in pemphigus vulgaris. He would like to know if this may be a good first-line steroid-sparing medication.

Human ; Male ; Middle Aged ; Acute Disease ; Biopsy ; Cataract ; Dapsone ; Diabetes Mellitus ; Fluorescent Antibody Technique, Direct ; Humans ; Internet ; Mouth Mucosa ; Osteoporosis ; Pemphigus ; Pruritus ; Ranunculaceae