Oral tetracyclines are commonly prescribed in dermatology, especially for acne. The most commonly used oral agents for acne treatment over the past several years are doxycycline and minocycline based on their overall efficacy and safety. Available for over five decades as immediate-release formulations, both of these agents exhibit broad-spectrum antibiotic activity and are primarily FDA-approved for treatment of a variety of cutaneous infections. In 2018, oral sarecycline was FDA-approved for the treatment of acne, which is the only disease state for which it was evaluated based on a narrower antibiotic spectrum of activity. This article reviews the overall antibiotic properties of commonly used oral tetracyclines with a focus on explaining the narrow spectrum of activity exhibited by sarecycline. Specifically, sarecycline has high activity against Cutibacterium acnes, the organism correlated with acne pathogenesis, as well as Staphylococci and Streptococci, with a low potential for emergence of resistant mutant bacteria based on in-vitro testing. The narrow-spectrum antibiotic designation of sarecycline relates to its negligible or low activity against many gram-negative and anaerobic bacteria. This article serves to review available data to date to assist clinicians in determining potential clinical relevance related to oral antibiotic use for acne.Kaposi sarcoma (KS) is a low-grade vascular neoplasm with four well-documented clinical types classic, African (endemic), acquired immunodeficiency syndrome (AIDS)-associated (epidemic), and iatrogenic, as well as a fifth recently described variant, men having sex with men (MSM) without human immunodeficiency virus (HIV) infection. Often distinguishable on clinical exam, KS lesions are typically found on the skin and mucosa of immunocompromised individuals, though numerous published reports have demonstrated the ability of KS to present in immunocompetent individuals. Here, we present the case of a 66-year-old, HIV-negative MSM with violaceous, non-blanching macules and patches of the medial foot referred to dermatology by his primary care physician. Histopathologic analysis revealed Kaposi sarcoma. Although this patient engaged in same-sex sexual behaviors, his HIV-negative status and otherwise lack of immunocompromise would deter many clinicians from suspecting a diagnosis of KS. Despite therapy, disease prognosis is often dependent upon stage at diagnosis. Therefore, it is important that every clinician understand the cutaneous findings associated with KS and be aware of the higher rates of KS even in HIV-seronegative MSM to facilitate prompt diagnosis and immediate treatment of this high-risk population.The term plaque morphea describes a variant of morphea (localized scleroderma) in which oval or round circumscribed areas of induration, pigmentary changes, and violaceous or erythematous halo (i.e., lilac ring) are found in the dermis and occasionally to the superficial panniculus. We report a case of 28-year-old male patient with recurrent plaque morphea who was treated with polydioxanone (PDO) mono threads and topical tacrolimus ointment. After the introduction of PDO mono threads, the patient was prescribed topical tacrolimus ointment for six months. After that six-month period, the lesions were softer to palpation and lighter in color. This was observed as a positive therapeutic response. Notably, no future recurrence was seen at one-year follow up.OBJECTIVE We sought to evaluate the efficacy and safety profile of an herbal extract combination comprising biochanin A, acetyl tetrapeptide-3, and ginseng extracts, and compare this to 3% minoxidil solution for the treatment of andogenetic alopecia (AGA). METHODS A 24-week, triple-blinded, randomized controlled study was conducted in male and female subjects (N=32) with mild to moderate AGA. All were randomized to receive twice-daily, 1mL applications of the herbal extract combination or 3% minoxidil solution. Clinical efficacy from photographic assessment and adverse reactions were evaluated. RESULTS There were thirty-two subjects (16 male, mean age 41.3±13.8 years), with AGA onset and duration of 35.5±13.6 and 6.5±5.1 years, respectively. click here The herbal extract combination demonstrated a comparable efficacy to 3% minoxidil solution. Expert panel photographic assessment observed a response to both treatments in most patients at 24 weeks, with no statistically significant difference in an increase of terminal hair counts (8.3% [P=0.009] and 8.7% [P=0.002] at 24 weeks in the herbal extract combinations and the 3% minoxidil solution groups, respectively). No local adverse reactions from the herbal extract combination were observed, but one subject developed scalp eczema after using the 3% minoxidil solution. CONCLUSION The non-significant difference in clinical efficacy and safety to 3% minoxidil solution suggests that the herbal extract combination evaluated here could potentially be an alternative treatment with for AGA. Further studies with larger groups and longer follow-up periods are recommended to verify our results.A 64 year-old Caucasian male patient with a long history of ultraviolet light exposure and multiple actinic keratoses presented with a large, erythematous, and scaly plaque on his forehead. Biopsies revealed superficial basal cell carcinoma (sBCC). Because the patient wanted the shortest possible topical regimen, his sBCC was treated with two overnight ingenol mebutate (IM) 0.05% gel applications. He tolerated the local skin reaction (LSR) well, and at approximately six weeks post-treatment, biopsies showed no evidence of sBCC. The patient was happy with the cosmetic outcome and has remained free of clinical recurrence for 18 months. Although IM gel is only FDA approved for the treatment of actinic keratosis, it has also been used off-label to treat other epithelial lesions, including basal cell carcinoma (BCC), anogenital warts, and Bowen's disease. One clinical trial, multiple case series and case reports, and now this report, have demonstrated IM's utility in treating BCC. IM treatment is therefore a promising alternative to surgery for select BCC, with major advantages, including a short treatment duration and generally favorable cosmetic outcome.