Marie Line Chedid

To evaluate the efficacy of ablative laser therapy, compared to sham laser or topical corticosteroids, or an alternative laser treatment protocol for improving symptom burden and disease severity in women with vulvar lichen sclerosus (VLS). Systematic review and meta-analysis of RCTs. PubMed, Embase, Cochrane Library, Scopus, and Web of Science were searched for RCTs evaluating fractional ablative lasers in adult women with confirmed VLS. Primary outcomes were change in patient-reported symptom burden (visual analog scale [VAS]) and objective disease severity (LS Score, Clinical Scoring System, vulvar-appearance VAS). Mean differences and standardized mean differences were pooled using a random-effects model with restricted maximum-likelihood (REML) estimation of between-study variance and Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment of confidence intervals; heterogeneity was assessed with I²; risk of bias was assessed with Cochrane RoB 2.0. Three RCTs (151 patients) evaluating fractional CO2 laser versus sham laser, topical clobetasol propionate 0.05%, or low-dose CO2 laser were included, with follow-up of 18 to 32 weeks. Laser therapy produced a non-significant reduction in VAS total (mean difference, 1.04; 95% CI, -4.71 to 6.79; P =0.52; I²=58%) and LS severity scores (standardized mean difference, -0.27; 95% CI, -1.47 to 0.94; P =0.44; I²=65%). No adverse events were reported. Current evidence from three small, short-duration RCTs does not demonstrate a statistically significant benefit of fractional ablative laser therapy for vulvar lichen sclerosus. Larger, adequately powered trials with standardized outcomes are needed before laser therapy can be recommended as primary or adjunct treatment. PROSPERO CRD420261385742. Not applicable.

Purpose: Nasal necrosis is a rare but potentially devastating manifestation of diverse conditions, including fulminant infection, immune-mediated vasculopathy, drug toxicity, neoplasia and device-related pressure injury. Surgical intervention is often prioritized; however, a subset of patients is managed non-surgically and evidence-based guidance remains limited. The objective is to systematically synthesize non-surgical etiologies, clinical patterns, diagnostic workup, and management strategies reported in cases of nasal necrosis. Methods: A systematic search of PubMed, Scopus and ScienceDirect from inception to December 7, 2025 identified case reports and case series involving human patients with nasal skin or soft-tissue necrosis not primarily attributable to surgery or cosmetic procedures. Non-human studies, systematic reviews and non english records were excluded. Data on demographics, etiology, presentation, investigations, management and outcomes were extracted. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools. Results: Thirty-nine publications comprising 45 cases were included. Infectious etiologies were most frequent (44.4%), followed by mechanical or traumatic (20.0%), immune-mediated (13.3%), drug-induced (13.3%), neoplastic (6.7%), and congenital causes (2.2%). Isolated nasal involvement occurred in 57.8% of cases. Non-surgical management included antimicrobials, corticosteroids, immunosuppressive agents, anticoagulation, wound care, and adjunctive hyperbaric oxygen therapy, with better outcomes in cases where the underlying cause was identified early. Conclusion: Nasal necrosis represents a heterogeneous clinicopathologic endpoint in which prompt etiologic diagnosis is critical for effective, organ-preserving dermatologic management.

This review aims to highlight the diverse skin manifestations in children and adolescents with COVID induced multisystem inflammatory syndrome in children (MIS‐C). The symptoms of COVID‐19 can vary greatly in severity between different age groups. Although most children infected with SARS‐CoV‐2 experience either no symptoms or only mild symptoms, some reported cases of severely affected children with a clinical presentation similar to incomplete Kawasaki disease have led to the definition of a new condition called MIS‐C. MIS‐C can involve multiple organs, including the skin, and may pose a life‐threatening risk to affected children. Such cases highlight the need for continuous research into the possible skin manifestations associated with COVID‐19 in pediatric populations to aid in early diagnosis and prompt treatment. We conducted a search of PubMed, Scopus, and ScienceDirect databases for studies published up until October 1, 2022. Three reviewers independently examined each study, and a fourth reviewer resolved any disagreements. A narrative review of all relevant papers was conducted. We present an overview of the clinical presentation, pathophysiology, diagnosis, and treatment of the various skin manifestations in children and adolescents with COVID‐19 or MIS‐C. The skin manifestations of COVID‐19 and MIS‐C can be diverse and are frequently overlooked. It is important to conduct further research to better understand the impact of this disease on children to provide appropriate care for these at‐risk populations.