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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 75-year-old male presented with asymptomatic rashes recurring for 15 years in which Cutaneous examination showed multiple arcuate erythematous plaques over the trunk, with central clearing and raised edematous borders, along with fine scaling on the inner side. It also discusses that Neutrophilic figurate erythema is a rarely reported disease, presenting with annular rash over the trunk or limbs, and histology shows neutrophil predominant infiltrate.

Erythroderma in infants can be attributed to plenty of causes, the more common ones being nonbullous congenital ichthyosiform erythroderma, lamellar ichthyosis, bullous congenital ichthyosiform erythroderma, severe atopic dermatitis, etc., However, there can be circumstances where infantile psoriasis can present to us with erythroderma; this may be a diagnostic challenge to the clinician. Hereby, we present a case of a young boy with recurrent erythroderma. [ABSTRACT FROM AUTHOR]

Topical corticosteroids (TCs) are the pillars of dermatotherapeutics. These drugs are the "magic molecules," provided they are used judiciously and appropriately, following a rational prescription. On exhaustive literature search in multiple databases, we found a significant evidence favoring the use of TCs in atopic eczema, localized vitiligo, psoriasis, chronic hand eczema, and localized bullous pemphigoid. However, contrary to conventional wisdom, we did not find any high-level scientific evidence in support of prescribing TCs in cutaneous lichen planus, sarcoidosis, and seborrhoeic dermatitis. Besides, evidence clearly advocates judicious use of mild-to-moderate corticosteroids (if required) in pregnancy and lactation and there is no risk of any fetal abnormality. [ABSTRACT FROM AUTHOR]

We hereby report a case of a male child who presented with multiple brown to red papules and plaques in a seborrheic distribution. Histology and immunohistochemistry findings were consistent with a diagnosis of Langerhans cell histiocytosis with multifocal and multisystem involvement (Letterer-Siwe type). The case is being reported for its rarity. [ABSTRACT FROM AUTHOR]

Cooling devices and methods are now integrated into most laser systems, with a view to protecting the epidermis, reducing pain and erythema and improving the efficacy of laser . On the basis of method employed, it can be divided into contact cooling and non-contact cooling. With respect to timing of irradiation of laser, the nomenclatures include pre-cooling, parallel cooling and post-cooling. The choice of the cooling device is dictated by the laser device, the physician's personal choice with respect to user-friendliness, comfort of the patient, the price and maintenance costs of the device. We hereby briefly review the various techniques of cooling, employed in laser practice. [ABSTRACT FROM AUTHOR]

Kindler's syndrome (KS) is a rare inherited skin disease characterized by acral blistering, photosensitivity, progressive poikiloderma, and cutaneous atrophy along with different types of mucosal involvement. We hereby report KS in two siblings. The case is being reported for its rarity and for emphasizing the importance of considering this condition in the differential diagnosis of disorders that may cause blistering, cutaneous atrophy, and/or poikilodermatous skin changes. Besides, the presentation of the disease in two of the members of the same family makes the case even more interesting. [ABSTRACT FROM AUTHOR]

The article presents a case series of four patients presenting with erythema multiforme (EM)-like pityriasis rosea (PR) and discusses case history, examination and treatment of the patients with betamethasone.

The case of an 8-year-old boy is hereby reported, who presented with nail dystrophy, subungual hyperkeratosis, oral leukokeratosis, and numerous follicular papules all over the body. The features were consistent with a diagnosis of pachyonychia congenita type 1. The case is being reported for its rarity. We also discuss in a nutshell, the literature till date. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on the necrolytic acral erythema (NAE), skin disease, patient, without Hepatitis C virus infection.

Background: Levosimendan a calcium ion sensitizer improves both systolic and diastolic functions. This novel lusitropic drug has predictable antiischemic properties which are mediated via the opening of mitochondrial adenosine triphosphate-sensitive potassium channels. This action of levosimendan is beneficial in cardiac surgical patients as it improves myocardial contractility, decreases systemic vascular resistance (SVR), and increases cardiac index (CI) and is thought to be cardioprotective. We decided to study whether levosimendan has any impact on the outcomes such as the duration of ventilation, the length of Intensive Care Unit (ICU) stay, and the hospital stay when compared with the nitroglycerine (NTG), which is the current standard of care at our center.Materials and Methods: Forty-seven patients undergoing elective coronary artery bypass surgery were randomly assigned to two groups receiving either levosimendan or NTG. The medications were started before starting surgery and continued until 24 h in the postoperative period. Baseline hemodynamic parameters were evaluated before beginning of the operation and then postoperatively at 3 different time intervals. N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) levels were also measured in both groups.Results: In comparison to the NTG group, the duration of ventilation and length of ICU stay were significantly less in levosimendan group (P < 0.05, P = 0.02). NT-proBNP level analysis showed a slow rising pattern in both groups and a statistically significant rise in the levels was observed in NTG group (P = 0.03, P = 0.02) in postoperative period when compared to levosimendan group of patients.Conclusion: Levosimendan treatment in patients undergoing surgical revascularization resulted in improved CI, decreased SVR and lower heart rate. And, thereby the duration of ventilation and length of ICU stay were significantly less in this group of patients when compared with NTG group. [ABSTRACT FROM AUTHOR]

Cutaneous squamous cell carcinoma, characterized by malignant transformation of normal epidermal keratinocyte is the second most common nonmelanoma skin cancer that has many predisposing factors. Tuberous xanthomas have not yet been reported as a predisposing factor. We report here the case of long-standing tuberous xanthoma in a middle-aged gentleman complicated by cutaneous squamous cell carcinoma, probably the first such report in the Indian literature. [ABSTRACT FROM AUTHOR]

An 18‑year‑old girl presented with multiple itchy hyperpigmented papules and plaques, along with tense blisters over the lower limbs and buttocks for last 3 months. These papules, plaques, and bullae were mostly localized to preexisting scars. The histopathological findings from papule and bulla were consistent with lichen planus (LP) and bullous pemphigoid, respectively. Direct immunofluorescence (DIF) of perilesional skin around bulla showed linear deposition of IgG and C3. Considering clinical, histopathological and DIF findings, diagnosis of LP pemphigoides (LPP) was made. The preferential localization of LPP lesions over preexisting scars was a very interesting finding in our case an extremely rare instance of the isotopic phenomenon. [ABSTRACT FROM AUTHOR]

Based on the history, clinical features, and histology, a diagnosis of the inflammatory verrucous epidermal nevus with lobster claw hand was done. Sir, Inflammatory linear verrucous epidermal nevus (ILVEN) is a type of epidermal nevus characterized by linear, pruritic, erythematous, and hyperkeratotic papules that often coalesce into plaques, with a raised scaly surface, which may be unilateral or bilateral and usually follows the lines of Blaschko. [Extracted from the article]

Garlic burn was first described by Parish I et al i . in 1987.[[5]] Garlic burns may develop in other circumstances as well, including occupational dermatitis and factitious dermatitis. Sir, Skin acts as a barrier against external injurious stimuli including heat, friction, chemicals, etc., However, in many circumstances, patients land up to our clinic with self-inflicted injuries on the skin. [Extracted from the article]

Background: Pityriasis rosea (PR) is an acute inflammatory dermatosis. The association of human herpes virus 6 and 7 suggests the utility of use of antiviral agents in this disease. Aims and Objectives: To evaluate the effectiveness and safety of acyclovir in the treatment of PR. Methods: An observer-blind, randomized (1:1), parallel group, add-on trial was conducted on 24 adult patients with PR. Subjects of both Group A and B received the standard of care in the form of cetirizine 10 mg OD and calamine. Group A in addition received acyclovir 400 mg tablets thrice daily for 7 days. Both groups were followed up for four consecutive weeks for assessment of effectiveness and adverse events. Results: Group A complained of significantly fewer new lesions than Group B (P = 0.046). A complete response was obtained in all patients of Group A and 83% patients of Group B at the end of the follow up period. There was significant reduction in both lesional score and pruritus at second week follow-up in Group A and third week follow-up in Group B (P < 0.05). Minor adverse effects were observed in both treatment arms. Conclusion: Acyclovir offered rapid resolution of clinical severity of PR from second week onwards without significantly increased adverse events as compared to supportive therapy alone. [ABSTRACT FROM AUTHOR]

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]

An editorial is presented on the COVID‑19 and Dermatology. The article discusses that the pathogenesis of the disease has been attributed to a multitude of propositions. Recent updates have hypothesized that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) likely targets and perturbs cellular PDZ proteins (postsynaptic density protein, Drosophila disk large tumor suppressor, and zonula occludens-1 protein).

Excision and close follow-up are advisable in immunocompromised patients.[[6]],[[7]] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. The patient was prescribed betamethasone dipropionate 0.05% cream and levocetirizine 5 mg.{Figure 1}{Figure 2}{Figure 3} Porokeratoma needs to be differentiated from porokeratosis of Mibelli. Sir, Porokeratoma (porokeratotic acanthoma), a rare entity, is a tumor-like acanthoma with features of porokeratosis (cornoid lamellation), commonly found over extremities, head and neck, chest, buttocks.[[1]] We hereby present a case of a 13-year-old boy who presented with a solitary plaque on the right arm. [Extracted from the article]

There is a dearth of data regarding the safety and timing of the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) vaccination of patients on immunosuppressive or immunomodulatory therapies. However, data from other vaccine trials may be extrapolated to get an idea regarding the recommendation of SARS-COV-2 vaccines. All the novel SARS-COV-2 vaccines are non-live, thus ensuring the safety of the vaccines. However, the vaccines may not be able to generate an equipotent immunogenic response in patients receiving immunotherapeutics, in comparison to those who are not. We have attempted to put forward certain statements, with respect to SARS-COV-2 vaccination of patients who are on treatment for different dermatological conditions. However, the risk-benefit ratio must be discussed between the patient and the physician, and the final call should be individualized. [ABSTRACT FROM AUTHOR]

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 a case study of a 35‑year‑old female suffering from herpes zoster and consulted for rash. Topics discussed include distribution of erythematous scaly papules coalescing to form plaques over the left T8–T10 dermatomes, initiation of the immunological cascade of the pathogenesis of the second disease from neuropeptides, and elevation of TNF‑alpha in psoriatic skin lesions as the factor for the development of psoriasis over the healed sites.

A case study of a 32‑year‑old man suffering from occasional breathlessness is presented, who is admitted for the evaluation of treatment resistant popular, and cystic lesions. It mentions diagnostic test of the patient revealed pulmonary sarcoidosis. It mentions patients was later diagnosed with multiple eccrine hydrocystoma. It discusses the use of atropine, and botulinum toxin Type A, as a treatment procedure.

The article presents a letter report on the topic of poroid hidradenoma, a type of asymptomatic solitary swelling. It also presents a case study of a 36-year-old healthy male who was presented with a solitary mass on his left forearm present from the past three years. The patient is examined and was revealed with a solitary firm nodule. He was performed with excision biopsy that represented dermal neoplasm in the form of a tumor.

A case study is presented of a 59‑year‑old man presented with an asymptomatic solitary scaly elevated lesion near the nose. It informs that the patient was diagnosed with cutaneous B‑cell lymphoma (CBCL), a rare group of lymphoproliferative disorders of the skin. It mentions that he was offered intralesional rituximab as a therapeutic option.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is apparently benign, locally proliferating lesion composed of vascular channels with surrounding infiltrate of lymphocytes and eosinophils. We report two cases with long‑standing papulonodular lesions on the left ear who presented to us on account of trauma‑induced bleeding and cosmetic issues. Peripheral blood eosinophilia was present, and histological findings were consistent with a diagnosis of ALHE. The rarity of this disease in the pediatric age group prompted the present report. [ABSTRACT FROM AUTHOR]

Graham-Little-Piccardi syndrome (GLPS) is a rare form of follicular lichen planus and comprises cicatricial alopecia of the scalp, noncicatricial alopecia of the axillae, and/or pubis and spinous follicular papules involving the trunk and extremities. We herein report a classic case of GLPS in a 49-year-old female. Uniqueness of our case is due to its additional features of frontal fibrosing alopecia (FFA). Although overlap between GLPS and FFA has been mentioned in literature, such numbers are scanty. Therapeutic response with oral steroid and retinoid is also far better in contrast to what is described in the existing literature. [ABSTRACT FROM AUTHOR]

A 32-year-old lady presented with an asymptomatic, linear pigmented lesion on the forehead and left side of nose, of 2 months duration. Sir, Linear cutaneous lupus erythematosus is an uncommon variant of lupus erythematosus (LE) presenting along the lines of Blaschko. Linear lichen planus and lichen planus pigmentosus were considered as differentials and a punch biopsy from the active part of the lesion over the nose was done. [Extracted from the article]

Azithromycin-induced FDE is a rare condition.[[7]] Herein we report an interesting case of FDE due to azithromycin, with a peculiar linear non-dermatomal non-blaschkoid clinical pattern located over the lower back, in the midline. As the consumption of these drugs increases, the risk of drug reactions also increases and hitherto unseen reactions to drugs may be observed.[[1]] We hereby report a case of azithromycin-induced linear fixed drug rash. REFERENCES 1 Sehgal VN, Srivastava G. Fixed drug eruption (FDE): Changing scenario of incriminating drugs. [Extracted from the article]

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]

A quiz concerning the sudden appearance of numerous small nonpruritic eruptions or generalized papules all over the body of a pubertal female is presented.

The article presents a case study about a 60-year-old man presented with a solitary, nonhealing fragile mass over the abdomen and have been diagnosed with a basal cell carcinoma, the most common malignancy of skin worldwide.

The article presents a case study about a 10-month-old female infant with an amniotic band syndrome or a congenital depressed scar over her face and scalp leading to facial asymmetry.

A letter to the editor is presented regarding the case study of a 21-year-old female who was diagnosed with Angioma serpiginosum after the complaints of a patchy and blaschkoid pattern in the left breast and left upper extremity.

Porokeratosis is a heterogeneous disorder of keratinization usually inherited in an autosomal dominant pattern. It usually affects the trunk and extremities. Lesions exclusively present over face are rare and not well-documented. We present a case of linear porokeratosis along the blaschkoid lines over the face in a 9-year-old girl. [ABSTRACT FROM AUTHOR]

A 10-year-old girl presented with a swelling on her left thigh that was associated with dripping of serous fluid from the lesion. Based on histological features of the excised tumor, a diagnosis of nodular hidradenoma was made. Atypical features including large size of the tumor, location on the lower limb, a weeping presentation, and histological finding of a nodular hidradenoma with an unusually large cystic cavity discharging fluid prompted us to report the case. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the report by researcher Piyush Kumar and others in the previous issue of the periodical. A response from the authors of the report in the previous issue of the periodical is presented.

Fixed drug eruption (FDE) is a common type of drug eruption seen in skin clinics. It is characterized by solitary or multiple, round to oval erythematous patches with dusky red centers, some of which may progress to bulla formation. Bullous FDE may be caused by a number of drugs. We hereby describe a case of azithromycin-induced bullous FDE; to the best of our knowledge, this is the first such case being reported. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the case of fixed drug eruption (FDE) in a 30-year-old man with a history of eryhtematous patches, buccal mucosa, and necrotic keratinocytes.

A letter to the editor is presented related to case study of a 30-year old woman suffering with aneurysmal benign fibrous histiocytoma (BFH).

A young girl presented to us with a solitary asymptomatic pedunculated mass over her right arm. Histology of the excised mass revealed features suggestive of pedunculated lipofibroma. The paucity of documentation of pedunculated lipofibroma in this age group incited the present report. [ABSTRACT FROM AUTHOR]

Angiokeratoma circumscriptum neviforme (ACN) is an extremely rare cutaneous disorder, occurring due to congenital malformation of the papillary dermal blood vessels. Clinically, it presents as well circumscribed, hyperkeratotic papules, nodules or plaques, often resembling malignant tumors like malignant melanoma or pigmented basal cell carcinoma. Thus, this uncommon but significant lesion should be diagnosed at the earliest, to avoid unnecessary confusion. We report here a case of congenital, linear, unilateral, verrucous plaques on the leg of a young girl, diagnosed as ACN. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 47-year-old man with multiple slowly progressive nodules over the dorsum of both feet. Topics include hyperpigmented swelling with minimal scaling seen over the dorsum of both feet extending up to the toes; and thinking of mycetoma, cutaneous tuberculosis, atypical mycobacterial infection, chromoblastomycosis, and osteomyelitis.

Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. Laser epilation was offered, but the parents refused.{Figure 1} Anterior cervical hypertrichosis is an uncommon variant of primary localized hypertrichosis.[[1]],[[2]]Commonest accompanying anomaly is peripheral neuropathy.[[3]] Active non-intervention with periodic follow-up is the best therapy. Cutaneous examination revealed localized tuft of hair over the laryngeal prominence [Figure 1].There was no hypertrichosis or any other anomaly in other parts of the body. [Extracted from the article]

The article presents the discussion on Chronic pruritus being a debilitating symptom in terms of the burden showing the effect on the quality of life. Topics include effective topical or systemic drugs being the need of the hour enhancing the dermatologist's armamentarium; and having a lipophilic aromatic group and hydrophilic amine group linked by an intermediate chain usually an ester or amide.