A review of melasma treatment focusing on laser and light devices.

Melasma is a pigmentary disorder of unclear etiology with numerous treatment options and high recurrence rates. Laser and light therapies may be utilized cautiously as second- or third-line options for recalcitrant melasma, but low-energy settings are preferred due to the risk of postinflammatory hyperpigmentation and melasma stimulation. Commonly used lasers include the low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser, nonablative fractionated lasers, and intense pulsed light. Strict sun protection, concomitant use of bleaching agents, and maintenance treatments are necessary. A variety of other treatments that may also help to improve results are now being more widely adopted, including oral tranexamic acid, pulsed dye laser, antioxidants, and laser-assisted drug delivery.

Delusional tinea: a novel subtype of delusional parasitosis.

Delusions of parasitosis is one of the more complex management problems encountered in the dermatology clinic. The difficulty mainly arises from the fact that a psychiatric disease is responsible for the cutaneous pathology. Typically, patients complain of "parasites" or other crawling bugs on their skin. The delusion and its presentation are surprisingly consistent from patient to patient and effective management requires incorporation of psychiatric principles. In this report, we present a rare case of delusion in which the perpetrator was believed to be a "fungus."