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Context: There are several modalities of treating acne scars. The combination of microneedling and platelet-rich plasma (PRP) is a synergistic approach to treat acne scars. Aims: The aim was to compare the efficacy of microneedling alone versus microneedling with PRP in acne scars. Materials and Methods: This was a split face study conducted on 36 patients with acne scars who underwent four sessions of microneedling with PRP on right side and microneedling alone on left side at monthly interval. The total scars with subtypes and Ecchelle D’Evaluation Cliniques des Cicatrices D’Acne (ECCA) score were assessed at baseline and second, fourth, and sixth visits. Visual analog score (VAS) was evaluated by both physicians and patients. Statistical Analysis: The statistical analysis was carried out using Statistical Package for Social Sciences. Paired-t test and Wilcoxon signed rank test were used to compare the results. Results: Mean age was 23.7±3.2 years with 17 male and 19 female patients. The mean total scars on right and left sides declined from 42.14±21.15 to 25.08±14.14 and 43.28+23.08 to 27.17±15.68, respectively, with insignificant differences (P-value = 0.094). ECCA score on right and left sides declined from 88.31±32.78 to 62.92±23.68 and 89.58±32.43 to 66.25±23.89, respectively (P-value = 0.058). VAS evaluated by patient and physician showed maximum improvement at second and third visits, respectively. Conclusions: This study showed no added advantage of topical application of PRP over microneedling in acne scars.

Chronic dermatoses, such as atopic dermatitis, vitiligo, and psoriasis, can affect children. Apart from impacting the pediatric patient's quality of life, these disorders can also have a profound impact on the quality of life of their parents or closest caregivers and other family members. In an effort to better understand the relationship between parental stress and chronic dermatoses in children, we reviewed the available literature, which is scarce. Data indicate that the negative impact that chronic dermasoses in children can have on their parents is often overlooked during dermatologic consultation. Increased parental/caregiver stress can contribute to poor psychological adjustment of the parent to the child, potentially leading to a decreased level of childcare. Financial burden caused by prolonged therapy may further impact the parental care of the child. We as healthcare professionals should address parental and caregiver stress and incorporate appropriate measures to ensure optimal care of children with chronic dermatoses.

Cutaneous pili migrans and creeping eruption caused by parasitic diseases may present as a moving linear lesion in skin. The former, caused by a hair shaft or fragment embedded in the superficial skin or middle dermis, is a rare condition characterized by creeping eruption with a black line observed at the advancing end. In exceptionally rare instance, the hair grows inside the skin and burrows in the uppermost dermis, such a condition has been called “ingrown hair.” We report a 30-year-old Chinese man, who was accustomed to pull or extrude the beard hairs, with 1-year history of slowly extending black linear eruption on his right chin. Cutaneous examination revealed a 4-cm long black linear lesion beneath the skin associated with edematous erythema around and folliculitis on both ends of the lesion. After treatment with topical mupirocin ointment, the erythema and folliculitis improved and 2 hairs of the beard with hair follicles were pulled out from the skin. Two weeks later, another similar black line about 1 cm in length in the skin presented on the prior lesional area, which was pulled out by a shallow incision of the skin and was also demonstrated as a beard hair with hair follicle. The patient was diagnosed as “ingrowing hair” with multiple recurrences. The lesions recovered after the beard hairs were pulled out. No recurrence occurred in a year of follow-up. We suggest that “ingrowing hair” is better than “ingrown hair” to describe such a condition. Pulling out the involved hair and correcting the bad practice are its optimal management strategies.

Although erythroderma is a well-recognized entity in the adult age groups and has been studied by various authors, there is a paucity of studies on erythroderma in the pediatric age group. It poses a greater challenge to the dermatologist and pediatrician because of its potential life threatening nature. In a study conducted by us in a large Indian hospital to delineate the causes of neonatal and infantile erythroderma, the causes identified were infections (40%), ichthyosiform erythroderma (25%), atopic dermatitis (15%), infantile seborrheic dermatitis (10%) and unidentified (10%). In another study of childhood erythroderma, etiologically, drugs (29%) showed the highest incidence, followed equally (18%) by genodermatoses, psoriasis and staphylococcal scalded skin syndrome (SSSS). The management of childhood erythroderma is mainly supportive with correction of the hematologic, biochemical and metabolic imbalance if required. In this review, the causes of childhood erythroderma, the clinical features useful to the diagnosis and management are discussed.

Neonatal and infantile erythroderma or "the red baby" is a rare condition. It can be potentially life-threatening and requires urgent attention of the dermatologists. The causes of erythroderma in this age group are different from that in adults and distinctive, but maybe difficult to establish due to poor specificity of clinical and laboratory findings. Careful monitoring and management of the patient may improve the final outcome. In this review, the various causes of "the red baby" is discussed along with its prognosis and management.

Atopic dermatitis (AD) is a chronic, relapsing dermatitis commonly affecting children. Various epidemiologic factors and clinical patterns of the same were evaluated in 125 patients out of 418 attending the pediatric dermatology clinic over a period of 11/2 years. Of these, 26 were infants (upto 1 year of age) and 99 were children. Mean duration of the disease in the infantile group was 3 months while in the childhood group it was 6 years. In the infantile group, family history of atopy was found in 11 patients (42.3%), while in the childhood group 35 (35.35%) had family history of atopy, 7 (7.07%) had personal history of atopy and 2 (2.02%) had both personal and family history of atopy. The infantile group had more frequent facial involvement and acute type of eczema, while in the childhood type, site involvement was less specific and chronic type of eczema was more frequent. Most of the patients had mild to moderate degree of severity of the disease.

Superficial granulomatous pyoderma is an uncommon, benign, superficial variant of pyoderma gangrenosum, having granulomatous histological features and no systemic association. We describe 6 Indian patients with superficial granulomatous pyoderma. In two patients, the ulcers developed due to traumatization of an existing scar. We would like to highlight that superficial granulomatous pyoderma must be considered margins, especially if it is situated at the previous site of a surgical trauma or burn scar. Recognition and differentiation of this condition from pyoderma gangrenosum is important as many of the investigations can be avoided and the condition can be managed quite easily by early treatment with systemic corticosteroid.

Pityriasis rubra pilaris (PRP) is an uncommon idiopathic papulosqamous disorder characterized by circumscribed follicular keratosis, palmoplantar keratoderma and frequently erythroderma. Seven patients of PRP (five females and two males) in the age range of 2 to 50 years seen over a 2-year period are presented with their clinical features, triggering factors, associations and laboratory investigations. The clinical type of PRP was adult onset classical variety in three, juvenile circumscribed variety in two and adult onset atypical variety and juvenile classical variety in one each. The triggering factors were upper respiratory tract infection with nutritional deficiencies in two and folliculitis in one. The histopathology was consistent with PRP in all. Four patients were managed with oral vitamin A while one each was put on methotrexate, etretinate and topical steroids and they showed a good response. More number of cases should be studied over a longer period to substantiate the suggested immunologic mechanism of PRP.

Granuloma faciale is an uncommon dermatosis of unknown aetiology, usually characterized by a solitary reddish-brown plaque or a nodule on the face. We report an unusual case of granuloma facial where the lesions were multiple and they responded to intralesional triamcinolone injections.

The association of lichen planus with vitiligo is described in an Indian female patient and the possible underlying mechanisum responsible for their coexistence are discussed.

A 46 year old nondiabetic female presented with multiple, itchy lichenified papules localized over right lower leg. The histopathological findings were in accordance with granuloma annulare. The present case of localized popular type of granuloma annulare masquerading as a lichenified dermatosis forms a rare report.

Milia occurring in six individuals of a family is being reported for its rarity as familial occurrence. Differentiation from eruptive form of milia is being emphasized.

A case of pseudolymphomatous reaction to tick bite is being reported for its rarity. Slow removal of tick sticking to the skin is being emphasized for avoiding such reactions to tick bite.

Acrokeratoelastoidosis is an uncommon marginal keratoderma of sporadic or familial origin. We report here an interesting case of the severe from of acrokeratoelastoidosis in an elderly patient associated with severe anemia and acroosteolysis.

We report a case of pemphigus vulgaris in a 46-year-old woman who presented with scaly and crusted erosions over erythematous base associated with itching and burning mainly over the chest, submammary folds, face, abdomen and the back. Histopathology was consistent with pemphigus foliaceus. The patient responded to oral prednisolone (60 mg/day). The above findings suggest that pemphigus vulgaris showed a transition to the pemphigus foliaceus variant.

Milia en plaque, an unusual clinical variant of milia, has been reported mainly in the post-auricular area. We report a case of milia en plaque over an unusual site i.e. over the angle of the mouth present over lesions of pityriasis alba.

A 28 year old woman, presented with woody indurations of the skin over the buttocks with multiple, well defined punched out ulcers with a rim of hyper pigmentation surrounding them. She used to receive intramuscular pentazocine injections over her buttocks for recurrent abdominal pain. This is one of the few reports of pentazocine abuse resulting in cutaneous manifestations from India.