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Background: There has been a significant increase in the incidence of recurrent, resistant, and extensive dermatophyte infections worldwide recently. This menace has spurred the need for more well-designed randomized controlled trials to optimize the treatment of dermatophyte skin infections. One of the limitations in designing such studies is the limited availability of standard and validated score, to measure the severity of dermatophyte infections. Aims: To create a severity score for the evaluation of dermatophyte infections. Materials and Methods: A Delphi consensus model was used to frame a severity scoring tool for superficial dermatophyte skin infections. Fourteen experts participated in the first round and twelve experts participated in the second round. Results: Based on the expert consensus, a final scoring system proposed was: Final Severity Score (FSS) = Sum total of Body Surface Area (BSA) in hand units for each patch multiplied by the sum of the scores for pruritis (P), lichenification (L), and actively raised borders (A) for each patch (FSS = BSA in hand units x (P + E + L + A) of patch 1 + BSA in hand units x (P + E + A) of patch 2 ...etc.). For measuring hand units more accurately fractional values of 0.25 can be used (0.25 corresponding to an approximate 1/4th of a hand unit). A score of +1 will be added in case of the following - 1) Close contact/family member affected, 2) History of at least one recurrence in the previous 6 months after a course of oral antifungals, 3) History of immunosuppression (on immunosuppressive medication or having underlying immunosuppressive disease). The scores will be valid only if the patient has not used any treatment topical or systemic, for at least 2 weeks before enrolment. Conclusion: The proposed Dermatophytosis Area and Severity Index (DeASI) score will help the physicians and researchers standardize the treatment protocol for dermatophytosis, henceforth, assessing the response to therapy. This will also help to standardize the parameters of effectiveness while designing any clinical trial. [ABSTRACT FROM AUTHOR]

Byline: Dillon. Mintoff, Manas. Chatterjee, Indrashis. Podder, Alexa. Shipman, Anupam. Das The coronavirus disease of 2019 (COVID-19) pandemic has radical repercussions on every aspect of medical science, including dermatology. The [...]

Byline: Dhiraj. Kumar, Anupam. Das, Debabrata. Bandyopadhyay, Satyendra. Chowdhury, Nilay. Das, Preeti. Sharma, Amit. Kumar Background: Elderly population is vulnerable to develop a multitude of dermatological diseases, owing to comorbidities [...]

The cutaneous microflora consists of various microorganisms which interact with host epithelial cells and innate and acquired immunity. This microbial milieu and its interaction with host cells prevent the growth of pathogenic organisms and educate host immunity to fight against harmful microorganisms. The microbial composition depends on various intrinsic and extrinsic factors and an imbalance in the cutaneous microflora predisposes the individual to both infectious and non-infectious diseases. Even though probiotics have been extensively studied in various diseases, their efficacy and safety profile are still unclear. A better understanding of the cutaneous microflora is required to develop newer therapeutic targets. In this review, we describe the commensal microbiome and its variation, the current role of the cutaneous microbiome in the pathogenesis of various dermatological diseases, and their therapeutic implications. [ABSTRACT FROM AUTHOR]

Obese and overweight individuals may have a wide spectrum of cutaneous features and can have more severe manifestations of multiple dermatological conditions. There have been multiple expert opinions on the role of weight loss, in the improvement of skin conditions. There have been few studies over the past decade evaluating the effects of exercise and other modes of weight reduction on various dermatoses such as psoriasis, acne vulgaris, hidradenitis suppurativa and acanthosis nigricans. In this review, we have attempted to provide a summary of the beneficial effects of weight loss on various dermatological conditions. [ABSTRACT FROM AUTHOR]

Tofacitinib has revolutionized the treatment of numerous dermatological conditions in different age groups. However, evidence for its effectiveness, safety and tolerability in the paediatric population is limited. We performed a literature search, which showed that oral tofacitinib is a reliable option in refractory juvenile dermatomyositis, severe alopecia areata, atopic dermatitis and psoriasis. Topical tofacitinib is an effective option in vitiligo and halo naevus. The risk–benefit ratio should be assessed prior to consideration of this molecule. In this narrative review, we have attempted to present a summary of the evidence of using tofacitinib (oral and topical) in paediatric dermatoses. [ABSTRACT FROM AUTHOR]

Background: With the COVID-19 vaccination taking stride all across the globe, there are multiple reports of vaccine-induced adverse reactions (cutaneous and systemic). Objectives: To study the frequency and characteristics of mucocutaneous reactions to COVID-19 vaccines. Methods: An online questionnaire-based study was performed among the recipients of COVID-19 vaccines Results: Majority (73.6%) of the responders had received the Covishield vaccine (AstraZeneca-Oxford), while 26.4% had been vaccinated with Covaxin (Bharat Biotech-ICMR). One or more post-vaccination mucocutaneous effects were experienced in 87 (19.6%) participants. Vaccine-associated mucocutaneous changes were observed in 19.7% and 22.2% of individuals who received Covishield and Covaxin, respectively. Local injection site reaction was the predominant mucocutaneous finding, followed by urticarial rash, exacerbation of preexisting dermatoses, morbilliform rash, apthous ulcers, pityriasis rosea like eruption, telogen effluvium, herpes zoster, purpuric rash, erythema multiforme and others. Anaphylaxis was reported in three individuals. However, fatality was not reported in any of the vaccine recipients. Intergroup assessment of parameters with respect to type of vaccine was found to be insignificant. Conclusion: Majority reported mild and self-limiting reactions. This outcome should not discourage the common man in getting vaccinated. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is currently considered to be a global epidemic, causing a significant increase in the cost of health care, apart from deteriorating the quality of life. Skin serves as a mirror of underlying metabolic sinister. Various dermatological conditions like psoriasis, acanthosis nigricans, lichen planus, acne vulgaris, acrochordons, atopic dermatitis, etc. have been reported to be associated with metabolic syndrome. We hereby present an evidence-based review of the various dermatological conditions and their association with the development of metabolic syndrome. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old man with pustules on the extremities of 1-month duration and recurrent oral erosions for 6 months. Topics include consulted dentists, ear-nose-throat specialists, and physicians for oral lesions; and examination showing a well-built lady with palatal erosions and targetoid lesions.

Background: Frontline doctors engaged in COVID-19 duties have to adopt enhanced protective measures to minimize their risk of exposure. However, these measures may lead to several skin problems, thereby affecting their performance. Objectives: To analyze skin changes induced by enhanced protective measures and explore possible risk factors. Materials and Methods: A web-based descriptive study was conducted among 212 frontline COVID-19 doctors. Data were collected regarding their demography, duty, use of enhanced protective measures including prophylactic hydroxychloroquine, recent skin changes with affected sites, and possible risk factors. Results: Skin changes were reported by 41.5% of respondents (mean age 34.8 ± 5.6 years) across 210 sites. Hands were involved most commonly in 77.3% of doctors, followed by nasal bridge, cheeks, and retroauricular area. Dryness (84.1%) and skin peeling (79.5%) were the commonest clinical features. Regression model showed prolonged PPE wear (>6 h) adjusted odd's ratio (AOR) 2.9, P = 0.005], heavy sweating [AOR 12.8, P = 0.001] and frequent hand hygiene (>10 times/day) [AOR 3.1, P = 0.0006] to be significant risk factors. Hydroxychloroquine prophylaxis was deemed safe as treatment-emergent adverse events were uncommon (17.4%). Conclusion: Frontline doctors have an increased risk of developing skin damage due to enhanced protective measures. Appropriate steps should be taken to address the risk factors and minimize skin damage. Persistent cases mandate dermatology referral for optimum management. [ABSTRACT FROM AUTHOR]

Skin serves as the mirror of underlying systemic problems. The early diagnosis of subtle cutaneous clinical pointers often helps in identifying renal disorders, obviating the delay in diagnosis and treatment. Cutaneous changes can be observed from the beginning of renal impairment until the evolution to terminal stage, in uremia, hemodialysis, and after kidney transplantation. In the review, we have discussed the cutaneous changes, its implicated etiopathogenesis, and their treatment options, as encountered in chronic kidney disease, hemodialysis and post-renal transplantation. [ABSTRACT FROM AUTHOR]

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly. [ABSTRACT FROM AUTHOR]

Melasma is a notorious dermatosis, often resistant to treatment. Chemical peeling constitutes an acceptable option of management of melasma (of any type and duration). In this article, as a group of experts from Pigmentary Disorders Society (PDS) in collaboration with South Asian Pigmentary Forum (SPF), we have tried to elaborate the various chemical peeling agents for the treatment of melasma. Besides, we have reviewed the indications, mechanism of action, rationality and the detailed procedure of peeling. The evidence in favor of various peeling agents have been summarized as well. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 23-year-old healthy gentleman, who was diagnosed with Dowling-Degos disease with hypopigmented lesions. The patient had developed multiple hypopigmented lesions on the trunk, face and neck. The patient has been underwent skin biopsy for both hyperpigmented and hypopigmented lesions. The patient has showed an increase in melanophages in the papillary dermis.

The article presents a case study of a 30‑year‑old woman presented with a plaque surmounted by erosion, crusting and haemorrhage, 5 cm in longest diameter at the left angle of the mouth, present for the preceding 10 days. It discusses that case is unique because of the unusual location, and the probability of Koebner's phenomenon behind the development of the association.

The article presents various cases of childhood diseases. Topics discussed include a case of onychomadesis in a two-year-old girl, a diagnosis of Acute hemorrhagic oedema of infancy (AHEI) that was made in a 14-month-old girl, and an X-linked ichthyosis that developed in a nine-year-old boy. Also discussed is a case of non-bullous congenital ichthyosiform erythroderma in a four-day-old infant.

Acanthosis nigricans (AN) is a fairly common dermatosis characterized by hyperpigmented velvety plaques, having a predilection for the intertriginous areas. We herein present a case of unilateral nevoid acanthosis nigricans over the left lateral chest, in an adult male. The rarity of documentation of this entity in the world literature prompted us to report the case. [ABSTRACT FROM AUTHOR]

Apremilast has recently garnered attention in the management of multiple dermatological conditions including psoriasis. The comparable effectiveness with immunosuppressive drugs and a favorable side effect profile makes the drug, a prudent alternative for managing a gamut of dermatoses. In this article, we have reviewed the literature on apremilast use in children. [ABSTRACT FROM AUTHOR]

Recurrent dermatophytosis is described as the reoccurrence of dermatophyte infection within few weeks after the completion of treatment.4 Superficial dermatophytoses have become a persistent disease lately, the predominant reasons being chronicity and recurrence. 36.57% of patients with dermatophytosis were found to have depression and 40.28% had altered social behavior.7 Tinea capitis is more common in children, and it is known to affect the QoL. Understanding the impact of dermatophytosis on QoL and psychological morbidity will help in a more patient-centered approach in the management of these disorders. [Extracted from the article]

The article describes the case of a 67-year-old man who presented with multiple asymptomatic skin-colored lesions on his face, upper trunk and upper extremities. A number of umbilicated papules on the face, ears and back were revealed by cutaneous examination. A lesion histopathology demonstrated a diffuse collection of macrophages and histiocytes filled with globi of acid-fast bacili that led to a diagnosis of bordeline lepromatous leprosy moving toward bipolar lepromatous leprosy.

A quiz on the diagnosis of a firm skin-colored nodules on the scalp of a 24-year-old male is presented.

The article presents a case of porokeratotic eccrine ostial and dermal duct nevus (PEODDN), a rare disorder of keratinization, with unique clinical and histopathological findings. Topics discussed include the characteristics of PEODDN, diseases reportedly associated with PEODDN, and the limited treatment options for PEODDN.

The article presents a quiz about the case of a 16-year-old boy with papulo-nodules and plaques of varied sizes on the axilla, neck and ear.

The article presents a case study of a 35-year-old man with paronychia and onychomadesis caused by pemphigus vulgaris.

The article presents a case of reticulate acropigmentation of Kitamura in a 14-year-old girl.

The article presents a case study of a 5-year-old girl who suffered with an asymptomatic white lesion due to steroid abuse.

The article describes a case of unilateral linear porokeratosis which manifested on the right forearm and right side of upper chest in a 12-year-old girl.