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Atopic dermatitis (AD) is a prevalent, chronic inflammatory skin condition characterized by pruritus, erythema, and impaired skin barrier function. AD management presents significant challenges due to its complex pathophysiology involving immune dysregulation and genetic predispositions. While traditional therapies, such as topical corticosteroids and emollients, remain foundational, their limitations have spurred the development of novel pharmacological approaches. This comprehensive review explores current pharmacological trends in the management of AD, focusing on emerging therapies that target specific immunological pathways. Biologic agents, including monoclonal antibodies against interleukin (IL)-4, IL-13, and IL-31 receptors, offer targeted mechanisms to modulate immune responses implicated in AD pathogenesis. Janus kinase (JAK) and phosphodiesterase-4 (PDE-4) inhibitors represent another class of promising therapies, providing alternatives for patients resistant to conventional treatments. The review synthesizes evidence from clinical trials and studies to evaluate these pharmacological agents' efficacy and safety profiles. Considerations for personalized medicine approaches, including biomarkers for treatment response prediction and genotype-based therapies, are discussed to highlight the potential for tailored treatment strategies in AD management. In conclusion, this review underscores the evolving landscape of pharmacological interventions for AD, emphasizing the need for continued research to address unmet clinical needs and optimize patient outcomes. By delineating current advancements and future directions, this review aims to inform clinical practice and guide future research endeavours in dermatology., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bhatt et al.)

Scrofuloderma, a manifestation of cutaneous tuberculosis, is a less common but clinically significant form of mycobacterial infection. It typically arises from the contiguous spread of Mycobacterium tuberculosis from an underlying infected lymph node or osseous structure to the adjacent skin. The condition manifests predominantly as chronic, granulomatous inflammation that leads to skin ulcers and abscesses. Despite its rarity, scrofuloderma presents substantial diagnostic challenges, primarily due to its nonspecific clinical presentation, which may mimic other dermatological conditions. This case report delineates the clinical journey of a patient with scrofuloderma who was attended to in a tertiary care setting. It emphasizes the diagnostic complexities encountered, underscored by a comprehensive discussion of the investigative modalities used to establish the diagnosis. This report elaborates on the therapeutic regimen taken, showcasing the effectiveness of a customized antituberculosis treatment plan., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Meghe et al.)

Mal De Meleda is a rare genetic disorder characterized by palmoplantar keratoderma, often presenting challenges in diagnosis and management. This case report discusses an 18-year-old male presenting with thickened, yellowish skin on both palms and soles, accompanied by itching and cracking. A diagnosis of the transgradiens variant of Mal De Meleda was established through clinical and histopathological examination. Treatment with oral acitretin and topical moisturizers resulted in significant improvement. This report highlights the importance of recognizing rare variants of palmoplantar keratoderma and the need for a multidisciplinary approach to diagnosis and management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khan et al.)

Background Acquired palmoplantar keratodermas (PPKs) pose diagnostic and therapeutic challenges due to their varied clinical presentations and overlapping features. This study aims to elucidate diagnostic criteria; assess correlations between clinical, dermoscopic, and histopathological features; and evaluate treatment outcomes for acquired PPKs, particularly palmoplantar psoriasis. Methods A prospective, cross-sectional study will be conducted at the Department of Dermatology, Venereology, and Leprosy, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra. Patients with acquired PPKs will undergo comprehensive clinical, dermoscopic, and histopathological evaluations. Treatment outcomes for palmoplantar psoriasis will be assessed following standard therapy. Statistical analysis will include descriptive statistics, diagnostic accuracy assessments, correlation analyses, and treatment outcome evaluations. Results The study is anticipated to establish reliable diagnostic criteria for acquired PPKs, identify correlations between features, and demonstrate the effectiveness of standard therapies for palmoplantar psoriasis. The findings are expected to inform evidence-based guidelines and protocols for diagnosing and managing acquired PPKs. Conclusion This study aims to advance the understanding and management of acquired PPKs by providing insights into diagnostic accuracy, correlations between features, and treatment outcomes. The study seeks to enhance patient care and outcomes for individuals affected by acquired PPKs by improving diagnostic precision and guiding therapeutic interventions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khan et al.)

Pemphigus, an autoimmune blistering disorder, poses significant therapeutic challenges due to dysregulated B cells and the involvement of CD20. This review assesses the efficacy of anti-CD20 therapies, including rituximab, ofatumumab, ocrelizumab, and obinutuzumab, in pemphigus treatment. Mechanisms of action, clinical studies, and safety profiles were analyzed, revealing diverse impacts on disease severity. B cell depletion emerged as a pivotal factor, disrupting the autoimmune process and reducing pathogenic antibodies. Varied efficacy and safety profiles among agents underscore the need for personalized treatment strategies guided by biomarkers. Challenges such as resistance and long-term safety concerns necessitate continued research and vigilance. In clinical practice, insights from this review inform nuanced, tailored approaches for improved pemphigus management. The dynamic landscape of emerging therapies and personalized medicine emphasizes the need for ongoing research and strategic clinical decision-making. This review is a foundation for future investigations, providing insights for clinicians and researchers in optimizing pemphigus treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khan et al.)

Acne scarring is a prevalent issue affecting millions worldwide, with significant psychological and social implications. Microneedling and CO 2 laser therapy have emerged as promising modalities for acne scar remodelling. Microneedling induces controlled micro-injuries to stimulate collagen production, while CO 2 laser therapy precisely ablates scar tissue. This comprehensive review evaluates the efficacy, safety, and comparative benefits of microneedling and CO 2 laser therapy. Literature synthesis reveals both modalities to improve acne scars, albeit with different mechanisms and risks. Factors influencing treatment selection and the role of combination therapy are discussed. Future directions include optimising protocols and exploring novel techniques. Overall, microneedling and CO 2 laser therapy offer valuable options for acne scar management, empowering individuals to address the physical and emotional burden of scarring., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Meghe et al.)

Introduction Reflection is the intentional evaluation of one's beliefs or understanding in consideration of the available evidence. Reflection has been noted to enhance profound learning and critical thinking and is an essential foundation of experiential learning. The Reflective Practice Questionnaire (RPQ) is a valid and reliable tool for assessing reflective capacity among medical students. It assesses not only reflective capacity but also other psychological constructs relevant to reflective practice, such as job satisfaction, confidence while interacting with patients, stress during patient interaction, desire for improvement, and feelings of uncertainty. The use of RPQ as a diagnostic tool for improving reflective capacity among medical students is scarcely available in the literature. Thus, the present study aimed to utilize the RPQ for identifying discrete action points for training and future improvement in reflective capacity. Materials and methods The present cross-sectional descriptive study was conducted among 300 medical students of a medical college. To identify the clusters or meaningful subgroups within the study population, cluster analysis was done. Inter-correlation between subscales of RPQ was performed by forming Pearson's correlation matrix to understand the dynamics between various subscales of RPQ. Results Five groups were identified in the cluster analysis: typical (25.6%), reflective (27%), non-reflective (16.7%), unconfident (14%), and overconfident (16.7%). This sets the template for specific action points for each group identified above. Reflective capacity was positively correlated with Desire for Improvement (DfI), General Confidence (CG), Communication Confidence (CC), and Job Satisfaction (JS). It was also positively correlated with negative outcomes such as Uncertainty (Unc) and Stress when Interacting with Patients (SiC). Conclusion RPQ can be used as a diagnostic tool in terms of reflective capacity for action research., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Dhurandhar et al.)

Pemphigus erythematosus is an uncommon autoimmune bullous skin disorder with clinical, histological, and serological characteristics that overlap with lupus erythematosus and pemphigus foliaceus. The autoantigens are desmoglein 3, desmoglein 1, and desmosomal adhesion proteins in keratinocytes. When these bonds are disrupted, it causes acantholysis of keratinocytes, leading to the fluid collection between layers. Hence, the patient will present clinically with small flaccid bullae with crusting and scaling, mainly on the seborrheic areas. We report the case of a 21-year-old female presenting to us with multiple hyperkeratotic plaques, mainly on the seborrheic areas, including the face, chest, and elbows. The patient was evaluated further, and based on clinical and laboratory investigations, the diagnosis of pemphigus erythematosus associated with anti-double-stranded deoxyribonucleic acid (anti-dSDNA) and anti-nuclear antibody (ANA) positivity was made. The patient was then managed using immunosuppressant therapy, and the entire course has been detailed in this case report., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2023, Jangid et al.)

Our skin and nervous system are tightly connected. Numerous dermatomes on our skin provide sensory information to the brain. Because skin changes can occasionally be the first sign of a neurological problem, understanding skin alterations is crucial as it can indicate early about the underlying condition, which can affect the prognosis of the disease. In these cases, the dermatologists' and neurologists' skills are complementary to each other. In this article, we have categorized diseases with neuro-cutaneous manifestations under different headings, such as infections, metabolic diseases, connective tissue disorders, genodermatoses, nutritional deficiency, and the diagnostic criteria of some commonly encountered diseases. Through tabulation, it has been observed that this categorization can serve as a useful reference for managing day-to-day patients who are either diagnosed with the diseases mentioned above or suspected to have the conditions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Lahoti et al.)

Background Melasma is a persistent skin condition affecting individuals of Asian, African, and Hispanic backgrounds. It causes dark patches on sun-exposed areas of the face. The exact causes are unclear, but UV light and hormonal factors play a role. Melasma significantly impacts physical appearance and quality of life, causing emotional and social distress. Objective The objective was to compare the efficacy of a combination of oral tranexamic acid and modified Kligman's formula vs. oral tranexamic acid and 15% azelaic acid. Material and methods This two-year interventional study occurred at the Outpatient Department of Dermatology, Venereology, and Leprosy in Sawangi, Maharashtra. It included male and female patients aged 18-50 with melasma seeking treatment. Ethical approval was obtained, and data collection involved medical histories, skin examinations, and calculating the Melasma Area and Severity Index (MASI). Results The study found no significant association between age groups and subject distribution in Groups A and B. Significant differences were observed in MASI scores within each group over time. There was a significant difference in mean MASI scores between Group A and Group B at the eight-week mark. A burning sensation was significantly associated with the groups, while no significant association was found for erythema. Conclusion This study concludes that combining oral tranexamic acid with a modified Kligman's formula is more effective in treating melasma than combining oral tranexamic acid with azelaic acid 15%., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Singh et al.)

Background Chronic spontaneous urticaria (CSU) is a medical condition characterized by the persistence of urticaria for more than six weeks, primarily caused by mast cell activation. Autoimmune thyroid diseases (AITDs) are the most common cause of dysfunction of the thyroid gland, and they are influenced by both genetic and environmental factors. Mast cell mediators have a significant role in the pathogenesis of CSU through two main pathways: the derangement of intracellular signaling pathways in mast cells and basophils and the production of autoantibodies against these cells. This study aimed to explore the association between AITDs and CSU by examining clinical features and measuring thyroid hormones and anti-thyroid peroxidase (anti-TPO) antibodies in patients. Aim and objectives The primary aims of this study are to investigate the prevalence and clinical characteristics of autoimmune thyroid disorders in patients with chronic spontaneous urticaria. The specific objectives are to evaluate the triiodothyronine (T3), tetraiodothyronine (T4), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) antibody levels in patients and controls and to explore the correlations between these parameters and the development and severity of chronic spontaneous urticaria. Material and method The present study was an observational investigation that enrolled 40 patients, consisting of 20 cases and 20 controls. The inclusion criteria involved patients of both sexes, aged above 18 years, who had chronic spontaneous urticaria and agreed to participate in the study with informed consent. Patients with other skin conditions lacking abnormal thyroid etiopathogenesis were also included. Exclusion criteria included patients with major systemic disease, uncontrolled medical or surgical illness, renal or hepatic disorders, and pregnant or lactating females. Patients with chronic spontaneous urticaria underwent a comprehensive clinical evaluation, and their urticaria severity was scored using an established scoring system. Blood samples were collected from both cases and controls for measuring T3, T4, TSH, and anti-TPO antibody levels. The anti-TPO antibody was processed using the enzyme-linked immunosorbent assay (ELISA) method. The autoimmune thyroid disease was screened by monitoring T3, T4, TSH, and anti-TPO antibody levels. Results There were significant variations observed in thyroid-stimulating hormone and anti-thyroperoxidase antibody levels. Among the cases analyzed, 40% demonstrated an urticaria severity score of one, while 25% reported a duration exceeding eight weeks. Additionally, 25% of patients experienced severe pruritus and intense wheals. Conclusions This research has discovered a robust association between serum anti-TPO antibodies and the occurrence of chronic spontaneous urticaria. To mitigate the potential for chronic spontaneous urticaria to lead to long-term morbidity, it is imperative to consider testing for serum anti-TPO antibodies in conjunction with primary thyroid markers, including T3, T4, and TSH., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pendam et al.)

Introduction Acne vulgaris is an androgen-dependent disorder with excessive sebum production and proliferation of Propionibacterium acnes.  Metabolic syndrome (MetS) is a multisystem disorder that increases the risk of diabetes mellitus, stroke, and cardiovascular diseases. ​This study aims to analyze the association of MetS with acne vulgaris. Methods A cross-sectional study was conducted with 65 cases of acne vulgaris and 65 age and sex-matched controls. We used the system provided by the Indian authors for grading acne according to the clinical severity. In addition, the criteria updated according to the joint consensus of 2009 were employed for the diagnosis of MetS. Results On clinical examination, grade 2 was the most prevalent grade of acne. We observed an increased incidence of abnormal waist circumference, triglyceride, HDL, and fasting blood glucose among the cases (p<0.05). Consequently, an increased occurrence of MetS was observed in the case group (p=0.011). While comparing the mean values of the parameters, we noted a significant difference in terms of waist circumference and HDL values. An increased mean value of waist circumference was noted in the case group while an increased mean value of HDL was reported from the control group (p<0.05).  Conclusion Patients with acne vulgaris have a greater chance of developing MetS. Hence, an in-depth examination of clinical, anthropometric, and biochemical parameters that may lead to the development of MetS is necessary., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Chandak et al.)