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Background: Patch test is the gold standard for diagnosing allergic contact dermatitis. Conventionally, the patches are applied for 48 h, which in tropical weather conditions causes excessive sweating, leading to irritation, and sometimes the patches come off, making the test inconclusive. Objective: To compare the patch test positivity after 24 and 48 h of occlusion time in patients of allergic contact dermatitis, using standard allergen concentration. Materials and methods: Clinically suspected patients of allergic contact dermatitis were enrolled and patch tested using the Indian Standard Series, parthenium acetone extracts (1:50, 1:100 and 1:200 dilutions) and patient material. Patches were applied in duplicate on either side of the back, using a random number table. One set of patches was removed after 24‐h of occlusion, while the other set after 48‐h. Readings were performed at 48‐ and 96‐h by two independent dermatologists, blinded to the duration of occlusion. Results: The study had 97 adult patients (58 males and 39 females; mean age: 48.12 ± 13.07 years). A total of 133 and 142 positive reactions were observed after 48 h occlusion at 48 and 96 h reading, respectively. Of these 117 (87.9%) and 132 (92.9%) patches were positive and concordant and noted at 24 h occlusion time. The Cohen's kappa coefficient were 0.94 for 48 h and 0.97 for 96 h reading, hence showing an almost complete agreement (ⱪ > 0.81) between patches occluded for 24 and 48 h. Conclusion: Though there is no significant difference in patch test positivity among ISS allergens after either occlusion time, 48 h occlusion performs significantly better compared with 24 h, when reactions of all allergens (ISS, patient material and parthenium acetone extract) are analysed together. [ABSTRACT FROM AUTHOR]

This article discusses two cases of vulval extramammary Paget's disease and their treatment with topical imiquimod cream. The patients experienced symptoms such as itching, skin-colored plaques, and erosions, and their diagnosis was confirmed through skin biopsies. Imiquimod cream was used as a treatment, resulting in a good response in one case and a partial response in the other. Surgical excision was recommended for the patient with a partial response. The article also provides information on the prevalence, diagnosis, and treatment options for extramammary Paget's disease. The Indian Dermatology Online Journal has released its January-February 2024 issue, which can be accessed and downloaded online. [Extracted from the article]

Symmetrical peripheral gangrene is a rare condition characterized by the simultaneous development of gangrene in multiple extremities. It can be caused by various conditions, including peripheral vascular disease, sepsis, infections, and hypercoagulable states. This article reports a case of symmetrical peripheral gangrene in a 13-year-old girl due to antiphospholipid antibody syndrome. Early recognition and treatment are crucial to prevent serious consequences, and individuals at higher risk should be educated about the symptoms and advised to seek immediate medical attention. [Extracted from the article]