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Context: Amyloidosis is group of rare diseases that are characterized by extracellular deposition of abnormal amyloid proteins either involving multiple organ systems (systemic amyloidosis) or restricted to a single-tissue site, such as skin (localized amyloidosis). In primary cutaneous amyloidosis, there is deposition of amyloid in apparently normal skin. The hyperpigmentation in all the lesions of primary cutaneous macular amyloidosis gives us an insight of a possibility of a connection between amyloid fibrils and melanogenesis. Aims: To compare the melanin content from the lesional skin of upper back and surrounding non-lesional skin of macular amyloidosis. Settings and Design: A hospital based, cross-sectional study conducted over a period of 6 months. Methods and Materials: Forty-two patients (30 females and 12 males) clinically and histopathologically diagnosed as macular amyloidosis were enrolled in the study. A Mexameter MX18 was used to measure the melanin index of the lesions of Macular amyloidosis over upper back and non-affected similar areas (control). Results: The melanin index of the lesional skin of female patients ranged from 552 to 823 (mean = 705.1). The melanin index of the lesional skin of male patients ranged from 621 to 792 (mean = 697.41). In the non-affected surrounding skin of females, the mean melanin index was 357.66, whereas in males, the melanin index of the surrounding normal skin was 296.75. The P value came out to be significant, that is

Objective: Comparative analysis of expression of lupus erythematosus (LE) in geriatrics versus adults. Materials and Methods: We analyzed and compare the patient's records attending our department between June 2017 and June 2019, diagnosed clinically and immunologically as LE between the two groups. Results: Sixty patients, 30 in each group, met ACRA criteria, were enrolled with mean age of presentation for early-onset was 28 ± 9.8 years and late-onset, 59 ± 4.8 years. Most of the patients were females with decrease in sex ratio with age. The most common presentations were malar rash, photosensitivity, and oral ulcers. Joint complaints, lung and cardiac involvement, and nonscarring alopecia were more common in the elderly. Direct Coombs test positive hemolytic anemia, renal involvement in forms of proteinuria and lupus nephritis, and neurological involvement were seen more commonly in adults. In immunological parameters, antinuclear antibody, anti-double standard DNA antibody (AntiDsDNA), and anti-smith antibody testing were done. AntiDsDNA positivity was more in adults correlate with disease severity. We calculate the systemic LE disease activity index 2000 score was higher in the adult population. Conclusion: Our study illustrated that disease activity and damage are more in adults in comparison to geriatrics. However, geriatrics had more organ damage that may be attributable to associated comorbidities. Although the connective tissue diseases in the elderly needs less aggressive management, it requires more attention for possible organ damage due to associated comorbidities.

Syringoma is a benign adnexal tumor of intraepidermal portion of the eccrine sweat ducts. Eruptive syringoma is a rare clinical variant characterized by small, flesh-colored papules with both follicular and nonfollicular distribution that occur in successive crops on the anterior body surface. We report a case of 35-year-old female with familial eruptive syringoma with predominant acral distribution. We report this case because of the rarity of disorder and acral predominance.

Background: Vitiligo prevails to be a skin disease with endless possibilities but no promises. Despite substantial research in pathogenesis and therapeutic modalities, the literature is deplete with technologies to predict the probabilities for repigmentation with or without therapy in the common generalized vitiligo. Aim: To correlate pretreatment melanin index in skin patches of nonsegmental vitiligo to probable extent of repigmentation following 6 months of monotherapy with a topical corticosteroid. Methods: A prospective study was conducted including thirty patients of vitiligo and their melanin index (melanin value; pigmentation index) in representative skin lesion was determined using Mexameter® MX 18. Patients were studied under three groups (A, B, and C) based on the obtained melanin indices. The extent of repigmentation following 6 months of topical therapy with mometasone furoate 0.1% cream was correlated with pretreatment melanin indices. Results: Repigmentation in Group C (mean melanin index >200) was significantly higher in terms of number of patients (P = 0.000) and area of patch coverage (P = 0.00) as against the other two groups with lower melanin indices. Conclusion: Melanin index in depigmented lesions is a useful indicator in the management of nonsegmental vitiligo to predict the repigmentation and to choose the appropriate treatment option. Mexameter is a simple, noninvasive, low cost staging, and monitoring device to estimate the melanin reservoir in vitiligo.

Gardner's syndrome is a hereditary autosomal dominant disorder with complete penetrance and variable expression. The disease is characterized by multiple intestinal polyps, osteomas and supernumerary teeth. Gardner's syndrome is linked to mutations on the long arm of chromosome 5 (5q21-q22) referred to as the adenomatous polyposis locus. It has 100% potential for malignant change. Increase in loss of heterozygosity percentages of chromosome 18q21 have suggested that 'Deleted in Colon Cancer' (DCC) gene may be involved in the progression of benign adenomas to malignant carcinomas. We report a case of Gardner's syndrome with similar findings along with presence of multiple epidermal inclusion cysts. The patient's father had died of intestinal cancer. An oral physician may be the first person diagnosing the condition based on orofacial manifestation. Early recognition of this disease can be lifesaving to the patient.

Lupus vulgaris is the most common presentation of cutaneous tuberculosis in India and can present as papular, nodular, plaque, ulcerative, vegetating, and tumid forms. Unusual variants include the frambesiform, gangrenous, ulcerovegetating, lichen simplex chronicus, myxomatous, and sporotrichoid types. We describe a rare sporotrichoid presentation of lupus vulgaris on the leg of a 28-year-old female of 12 years duration.

Background: Sexually transmitted infections (STIs) increase the risk of transmission of Human Immunodeficiency Virus (HIV) infection causing immense need to understand the patterns of STIs prevailing in the regions of a country for proper planning and implementation of STI control strategies. Due to the lack of adequate laboratory infrastructure in the country, information regarding the profile of STIs relies essentially on syndromic diagnosis. Aims and Objectives: To study the pattern of common STIs and the prevalence of HIV infection in patients attending the STI clinic of a tertiary care hospital in northern part of India using a syndromic approach. Materials and Methods: A retrospective analysis of data collected from the clinical records of 2700 patients over a period of 21 months (July 2012 to March 2014) was carried out at the Skin and VD Department of SMS Hospital, Jaipur. Detailed history, demographical data, and clinical features were recorded from all the patients. All patients were tested for HIV by ELISA and rapid plasma reagin. STIs were categorized in different syndromes as depicted by National AIDS Control Organization in the syndromic management of STIs. The data collected was analyzed statistically. The proportions were calculated for various syndromes and disease prevalence. Results: The overall most common STI was balanoposthitis, followed by genital herpes, vaginal/cervical discharge, molluscum contagiosum, genital warts, nonherpetic genital ulcer disease, lower abdominal pain, and urethral discharge in decreasing order. Among the study population, 2.55% were found to be HIV-positive. Conclusion: Viral STIs such as molluscum contagiosum, herpes genitalis, and condylomata acuminata are on the rise among STI/RTI clinic attendees.