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An unusual presentation that underscores the importance of keeping a broad differential.

A patient presented with multiple draining abdominal lesions, describing extrusion of “foreign material.” Initial considerations included retained or migrating foreign bodies; however, histopathology revealed gouty tophi—deposits of monosodium urate crystals—confirming an atypical manifestation of Gout.

While gout classically involves peripheral joints (most notably the first metatarsophalangeal joint), chronic hyperuricemia can lead to tophaceous deposition in less common locations, including soft tissue and skin, occasionally resulting in ulceration and drainage.

A reminder that systemic diseases don’t always read the textbook—and why biopsy can be critical in atypical cases.

MedicalEducation

Eyelid heaviness and hooding can often be genetic. With the Avava laser, targeted tightening around the eye can create a more lifted, refreshed appearance.

In this before-and-after, subtle tightening of the eyelid skin gives the eye a brighter, more open look—often described as a blepharoplasty-like result without surgery. ✨

BeforeAndAfter

Headshot update

Using the Avava laser to address post children skin laxity ✨

First photo: before treatment.
Second photo: 6 weeks after.

The patient weighed the exact same on the day of the procedure and at follow-up — this result is purely from skin tightening. A beautiful, natural improvement with no weight change.

One treatment of at the 6 week mark for over all improvement of skin texture and acne scars. This laser continues to WOW me

Before and after full face rejuvenation!

Traction alopecia is hair loss caused by chronic mechanical tension on the hair follicles, commonly due to tight hairstyles such as braids, ponytails, weaves, or head coverings. It most often affects the frontal and temporal scalp. In its early stages, traction alopecia is non-scarring and potentially reversible, presenting with hair thinning, broken hairs, and perifollicular erythema.

With prolonged or repeated traction, ongoing follicular damage and inflammation can lead to cicatricial (scarring) alopecia, characterized by permanent destruction of hair follicles and replacement with fibrous tissue. Clinically, scarring alopecia presents with loss of follicular openings, smooth or shiny scalp, and possible symptoms such as itching, pain, or burning. Once scarring occurs, hair regrowth is not possible, and management focuses on preventing further progression.

Early recognition and elimination of traction are critical to prevent irreversible hair loss and the development of cicatricial alopecia. Aggressive treatment was initiated and here we are at our six month follow up.

Lip balancing perfectly done 💋
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UPDATED result at the 6 week mark. I’m blown away. Can’t wait to see the 6 month results!