Melasma, and Vitiligo, and Warts, Oh My!

Low-dose naltrexone offers potential benefits for pruritic dermatologic conditions like Hailey-Hailey disease and lichen planus, though vivid dreams remain a common side effect. While metformin provides metabolic improvements, it fails to yield superior clinical outcomes for hidradenitis suppurativa compared to doxycycline monotherapy. Dietary interventions, such as low-salicylate diets, may assist in managing chronic urticaria, while hyperthermia combined with hydrogen peroxide serves as a viable, non-invasive home-based treatment for warts. High-induction dosing of risankizumab for psoriasis does not reliably eliminate disease recurrence, suggesting that resident memory T-cells persist despite intensive treatment. Topical tranexamic acid functions as an effective alternative to oral formulations for melasma, avoiding systemic risks while maintaining comparable efficacy. Long-term follow-up data indicates that pityriasis lichenoides chronica often persists longer than previously assumed, with methotrexate and phototherapy remaining standard therapeutic options.