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Background: Topical corticosteroids is a boon and also a bane in treating chronic skin conditions. The risk of cutaneous infections due to topical steroids increases with their potency, dose, and duration of treatment. Herein, we present a case series of severe debilitating infections secondary to topical steroid abuse. Materials and Methods: We came across five cases of severe skin infection following the prolonged application of topical steroids. These cases gave a history of the use of steroid creams for persistent skin conditions and the inability to visit the hospital due to the prevailing COVID-19 pandemic. Observations: We came across two cases of crusted scabies, two cases of Fournier's gangrene, and a case of erosio interdigitalis blastomycetica. These cases had been using topical steroids for a prolonged period for other dermatological conditions. Conclusion: We propose that, as crusted scabies and erosio interdigitalis blastomycetica mimic various other papulosquamous disorders, a KOH examination is a diagnostic tool. Topical steroid abuse is one of the predisposing factors for Fournier's gangrene. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic inflammatory disorder and is associated with obesity, diabetes mellitus, and hypertension. There is an increased expression of inflammatory cytokines (interleukin [IL]-17, tumor necrosis factor [TNF]-a, IL-22, vascular endothelial growth factor [VEGF]) in the serum of psoriasis patients. Serum levels of IL-10, another anti-inflammatory cytokine, have been found at varying values in psoriasis in different regions of the world. Aims and Objectives: The aim of this article is to assess the serum IL-10 and serum VEGF in psoriasis patients with no co-morbidities and healthy controls. Materials and Methods: This study was conducted on 46 serum samples (23 psoriasis subjects and 23 healthy controls). After informed consent, 3 mL of serum was obtained and stored at -70°C. The samples were quantitatively assessed for VEGF-A and IL-10 by the enzyme-linked immunosorbent assay. Results: This study revealed that the mean (±SD) value of serum VEGF in cases was significantly higher than that in controls (cases = 235.21 ± 138.71; controls = 104.73 ± 36.01 pg/mL). However, levels of serum IL-10, although increased in cases (2.37 ± 1.61 pg/mL) when compared with controls (1.64 ± 0.89 pg/mL), showed no statistical significance. Conclusion: In this study, serum VEGF and IL-10 levels were increased in psoriasis when compared with controls but were not significantly related to the Psoriasis Area and Severity Index. The significant correlation between serum VEGF and IL-10 levels in cases when compared with controls suggests their role in the pathogenesis of psoriasis. Persistently increased values in psoriasis patients may lead to the development of comorbidities. [ABSTRACT FROM AUTHOR]

Localised morphea is an autoimmune sclerosing disorder of unknown aetiology. Various triggering factors are known to be associated with the disease including infections, vaccination, autoimmune disorders, and trauma. Amongst the infections, the common causative organisms associated with morphea are Borrelia burgdorferi, varicella, and Epstein-Barr virus (EBV). Localised morphea presents as an initial inflammatory stage and a late inactive stage. It is characterised by sclerosis of skin with hyper or depigmentation. The antibiotics effective against borrelia infection are benzyl penicillin, doxycycline, and ceftriaxone. These antibiotics are tried in the treatment of localised morphea. Ceftriaxone is one of the best antibiotics preferred to treat borrelia infection at all stages. Apart from its antibiotic properties, it also has an anti-inflammatory and collagen remodelling properties. All five cases of localised morphea reported here were biopsy proven, Antinuclear Antibody (ANA) and Rheumatoid Arthritis (RA) factor negative. All the cases were treated with weekly single intramuscular dose of ceftriaxone 250 mg. After eight weeks there was remarkable improvement in the induration and pigmentation of the lesions. [ABSTRACT FROM AUTHOR]

Unilateral type I segmental Darier's Disease (DD) is a rare variant of DD. It is characterised by eruptions which are erythematous and keratotic papules. The authors, hereby reporting a case of an 18-year-old male patient, who presented with waxy hyperpigmented keratotic papules on the right-side of the trunk and lower limb and was confirmed by histopathology and treated with oral acitretin, 25 mg once a day, which showed a marked clinical improvement within four months. [ABSTRACT FROM AUTHOR]

Kimura’s disease is characterized by a triad of painless subcutaneous masses, eosinophilia in the peripheral blood and in tissues with marked increase in Serum Ig E. Angiolymphoid hyperplasia with eosinophilia (ALHE) manifests with the presence of dermal papules and nodules. Unique clinical, histopathological, and biochemical findings are noted in these individual entities. A 32‑year‑female presented with multiple nodules in the axillae for 2 years. Peripheral smear showed eosinophilia with AEC of 6080. Histopathological examination showed features of overlap. Antinuclear antibody immunoflorescence was was negative. CD31, CD34, and FVIII were positive in vascular component. A CT chest revealed left axillary lymphadenopathy. The patient was treated with Cryotherapy and there was complete regression of skin lesions, with no recurrence after 1 year of follow‑up. ALHE and KD are common in the head and neck region, but no reports of an overlap, presenting with lesions in the axillae are available to date, to the best of our knowledge. Response of skin lesions to cryotherapy is highlighted. [ABSTRACT FROM AUTHOR]

Background: A combination of topical retinoid and antibacterial therapy is often advocated for acne to enhance therapeutic efficacy. Aims: A preliminary study to evaluate the efficacy and tolerability of a topical fixed combination of nadifloxacin (1%) and adapalene (0.1%) in the treatment of mild to moderate acne in Indian patients. Materials and Methods: This was an open-labeled, phase 3 non-randomized, non-comparative study conducted at five centers (Ahmedabad, Nagpur, Thane, Bangalore, and Mumbai) across India. Of 119 enrolled patients with mild to moderate acne, 117 patients were evaluated at the end of the study for efficacy parameters. A fixed combination of nadifloxacin (1%) and adapalene (0.1%) topical gel was applied at the affected area once at night for a period of 8 weeks. Reduction in the total, inflammatory and non-inflammatory lesion counts from the baseline, investigator global assessment (IGA) and reduction in the severity of acne as per combined acne severity classification were the primary efficacy variables measured at 2 weeks, 4 weeks, and 8 weeks. Results: Overall, 98.3% patients showed a statistically significant progressive reduction in non-inflammatory lesion counts, inflammatory lesion counts, and total lesion counts over the study duration. By the end of 8 weeks, 75% of the patients had their global assessment scores approaching to normal healthy skin score. The adverse events were mild to moderate in severity. Conclusion: This preliminary study shows that a fixed combination of 1% nadifloxacin and 0.1% adapalene topical gel could be an effective and well-tolerated option for the treatment of mild to moderate acne vulgaris. However, further well-controlled, randomized and comparative evaluation of this combination is necessary. [ABSTRACT FROM AUTHOR]

Background. Acne vulgaris is a disorder of sebaceous glandsmainly affecting the adolescent population. There are some misconceptions about acne not only in the general population but also among themedical students. Methods. Second year medical undergraduate students attending dermatology postings for the first time were included in the study. A questionnaire (in yes or no answer format) with 20 questions on acne, each carrying one mark, was to be answered by the students. The students were categorized into 4 grades based on the marks obtained: Grade I 90% marks and above, Grade II 75%-90%, Grade III 50%-74%, and Grade IV <50%marks obtained. Results. Of the 144 students of the batch, 95 (69.5%) completed both pretest and posttest questionnaires.The average pretest score was 14.1 and that of the posttest was 16.9. The percentage of improvement inmean score frompretest to posttest was 16.5. Fischer's exact test was applied to analyze the improvement in scores between pretest and posttests which is significant at P = 0.015 (P < 0.05). In the paired t-test the improvement inmean scores between pretest and posttest was significant at P < 0.001. [ABSTRACT FROM AUTHOR]

Background: A combination of topical retinoid and antibacterial therapy is often advocated for acne to enhance therapeutic efficacy., Aims: A preliminary study to evaluate the efficacy and tolerability of a topical fixed combination of nadifloxacin (1%) and adapalene (0.1%) in the treatment of mild to moderate acne in Indian patients., Materials and Methods: This was an open-labeled, phase 3 non-randomized, non-comparative study conducted at five centers (Ahmedabad, Nagpur, Thane, Bangalore, and Mumbai) across India. Of 119 enrolled patients with mild to moderate acne, 117 patients were evaluated at the end of the study for efficacy parameters. A fixed combination of nadifloxacin (1%) and adapalene (0.1%) topical gel was applied at the affected area once at night for a period of 8 weeks. Reduction in the total, inflammatory and non-inflammatory lesion counts from the baseline, investigator global assessment (IGA) and reduction in the severity of acne as per combined acne severity classification were the primary efficacy variables measured at 2 weeks, 4 weeks, and 8 weeks., Results: Overall, 98.3% patients showed a statistically significant progressive reduction in non-inflammatory lesion counts, inflammatory lesion counts, and total lesion counts over the study duration. By the end of 8 weeks, 75% of the patients had their global assessment scores approaching to normal healthy skin score. The adverse events were mild to moderate in severity., Conclusion: This preliminary study shows that a fixed combination of 1% nadifloxacin and 0.1% adapalene topical gel could be an effective and well-tolerated option for the treatment of mild to moderate acne vulgaris. However, further well-controlled, randomized and comparative evaluation of this combination is necessary.

Background. Acne vulgaris is a disorder of sebaceous glands mainly affecting the adolescent population. There are some misconceptions about acne not only in the general population but also among the medical students. Methods. Second year medical undergraduate students attending dermatology postings for the first time were included in the study. A questionnaire (in yes or no answer format) with 20 questions on acne, each carrying one mark, was to be answered by the students. The students were categorized into 4 grades based on the marks obtained: Grade I 90% marks and above, Grade II 75%-90%, Grade III 50%-74%, and Grade IV <50% marks obtained. Results. Of the 144 students of the batch, 95 (69.5%) completed both pretest and posttest questionnaires. The average pretest score was 14.1 and that of the posttest was 16.9. The percentage of improvement in mean score from pretest to posttest was 16.5. Fischer's exact test was applied to analyze the improvement in scores between pretest and posttests which is significant at P = 0.015 (P < 0.05). In the paired t-test the improvement in mean scores between pretest and posttest was significant at P < 0.001.