Search

The article discusses the use of assisted teledermatology services through the e‐Sanjeevani platform in Haryana, India, to connect healthcare experts with rural populations. A total of 7062 patients sought teledermatology consultation, with 3931 successful consultations, predominantly for infectious skin conditions. The study highlights the potential of assisted teledermatology in addressing healthcare disparities and improving access to dermatological care, particularly in rural areas. The authors acknowledge the support of the National Health Mission, Haryana, India, in implementing the project. [Extracted from the article]

A case study of an 8-year-old female presented with itchy, scaly, and crusted skin lesions all over the body for 1 year. Topics include multiple erythematous to lichenoid papules coalescing to form plaque in the bilaterally symmetrical reticular pattern on the trunk and extremities; and Skin biopsy was advised and was consistent with the features of Keratosis lichenoides chronica (KLC).

Recently, topical Tranexamic acid (TXA) has been used in melasma management. On detail search of literature, this may be the first study‐assessing efficacy on combining of Topical TXA with GA peel in melasma. The aim of this study is to assess efficacy, safety, and improvement in quality of life index on combining 30% GA peel with 5% TXA solution topically in melasma of epidermal type. Sixty patients of epidermal melasma were included in the study and were categorized into two groups: Combination group was treated with 30% GA peel at 2 weekly intervals with 5% TXA solution applied twice daily and Control group was treated with only 30% GA peel every 2 weeks for 12 weeks. Melasma area severity index (MASI) was used for assessing clinical improvement. Hi‐MELASQOL and HRQOL scales were used to measure Melasma related quality of life and were compared between both groups. At each visit, adverse effects were noted. A significantly decreasing trend was seen regarding the MASI score when compared within the group, but the difference was statistically not significant between the two groups at 12 weeks. However, significant reduction in MASI score was attained earlier in the combination group than the control group. Similarly, there was significant improvement in Hi‐MELASQOL and HRQOL in both the groups, but the difference between them was statistically not significant. Side effects experienced by patients in both groups were trivial and did not require stoppage of therapy. This study concluded that topical TXA with GA peel has comparable result with GA peel alone, but the therapeutic response was achieved in patients of combination group earlier in comparison to control group patients. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of primary cutaneous histoplasmosis in a 43-year-old man. The patient presented with multiple red-colored skin lesions on his face that had been progressively increasing in size and number over a period of two years. The lesions were non-itchy and painless, and the patient did not have any other systemic symptoms. Dermoscopy revealed distinctive features such as yellowish-orange areas, linear vessels, arborizing telangiectasias, and perifollicular casts. Biopsy confirmed the diagnosis of histoplasmosis. The article highlights the importance of dermoscopy in diagnosing and managing this rare disease. [Extracted from the article]

Glycolic acid (GA), lactic acid (LA) and trichloroacetic acid (TCA) peels have been used in various combinations for treating melasma patients, but none of the studies have compared their therapeutic efficacy and improvement in quality of life (QOL) index with these three peeling agents in melasma. Our study aims to compare the clinical efficacy, safety, tolerability and improvement in QOL index between 30% GA, 92% LA, and 15% TCA peeling in epidermal melasma. Ninety patients were divided into three groups with 30 in each. First group was treated with 30% GA peel, second with 92% LA peel, and third with 15% TCA peel at every 2 weeks interval for 12 weeks. Melasma area severity index (MASI) and QOL index (Melasma quality of life and Health related quality of life index) were used for clinical evaluation. Patients were observed for side effects and tolerability. The mean MASI score after therapy was significantly lower in patients treated with GA and TCA peels as compared with the group receiving LA peel. However, there was no significant difference in the mean MASI scoring at 12 weeks between GA peel and TCA peel groups. The improvement in QOL index was higher among patients undergoing GA peel followed by TCA and LA peel. Adverse effects were noted mostly with TCA peels followed by GA and LA peel. Thus, GA and TCA peels were equally efficacious and more effective than LA peels. LA peel had minimum side effects and better tolerability than GA and TCA peels. [ABSTRACT FROM AUTHOR]

Background: Periorbital hyperpigmentation (POH) is a very common, yet unexplored aesthetic condition. Topical therapy is mainstay of treatment which includes chemical peels and other depigmenting agents. Aims: To compare clinical efficacy, safety, and tolerability of 20% glycolic acid peels, 15% lactic acid peels, and 12% ferulic acid peels in the treatment of constitutional type of periorbital hyperpigmentation in Indian patients. Methods: Ninety patients of constitutional POH were enrolled for 12 weeks. They were divided into three groups of 30 each. In 1st group 20% glycolic acid peeling, in 2nd group 15% lactic acid peeling and in 3rd group 12% ferulic acid peeling sessions were performed at 3 weekly intervals. Clinical improvement was assessed objectively using POH grading, physician's and patient's global assessment, and patient's global tolerance. Results: Significant improvement in periorbital hyperpigmentation was noted in all the three groups. Physician and patient's global assessment was excellent with glycolic acid peel followed by ferulic acid peel and lactic acid peel. The incidence of side effects in the form of erythema and itching was maximum with glycolic acid followed by lactic acid and least with ferulic acid, which did not necessitate cessation of therapy. Conclusion: Glycolic acid produced the best results among the three peels; however, ferulic acid peel emerged as a safe and effective modality for the treatment of POH. [ABSTRACT FROM AUTHOR]

Nevus comedonicus and hidradenitis suppurativa (HS) are disorders of the pilosebaceous unit sharing a similar pathogenesis of follicular occlusion. To our knowledge, less than 10 cases of HS-like lesions complicating nevus comedonicus have been reported. We describe a six-year-old female child with congenital linear nevus comedonicus in the left axilla and groin, complicated by recurrent HS-like lesions in the two years prior to presenting to our clinic. After a meticulous review of the literature, we propose a novel term, nevus comedonicus suppurativa, for this clinical entity. [ABSTRACT FROM AUTHOR]

Background: Syphilis causes considerable morbidity not only in adults but also in children. Unfortunately, acquired syphilis in children has not received due attention and remains a relatively ignored field. Methods: This was a retrospective study, in which epidemiologic, clinical, and investigational data were analyzed from medical records of all sexually transmitted infection (STI) cases attending the STI clinic of Pt. B. D. Sharma, PGIMS, Rohtak from January 1992 to November 2018. Children of age ≤14 years with acquired syphilis were studied. Results: Of 9138 STD cases registered from January 1992 to November 2018, 39 were children with acquired syphilis, of whom 22 were males and 17 were females. The majority were in 12‐14 years age group (22 cases; 56.41%). A history of sexual abuse could be elicited in 10 patients. Three gave a history of voluntary sexual activity. Examination revealed secondary syphilis in 32, latent syphilis in 6 and only one case of primary chancre. Analysis of incidence of pediatric acquired syphilis cases over three‐year intervals during the last 27 years indicated an initial decreasing trend followed by recent slight rise in last 3 years. Conclusion: Social inhibitions and reluctance to report child sexual abuse may have led to an underestimate of actual prevalence. The prevalence in the 12‐ to 14‐year age group may indicate emerging trends of promiscuous sexual behavior. The recent rising trend in occurrence of childhood acquired syphilis may mirror the recent resurgence of adult syphilis. [ABSTRACT FROM AUTHOR]

Background: Chemical peels have become a popular modality in the treatment of acne vulgaris (AV). Mandelic acid (MA) is a new emerging peeling agent for AV owing to its antibacterial and anti‐inflammatory properties. Hence, it is worthwhile to evaluate the effectiveness and safety profile of this newer agent and to compare it with an older established peeling agent, salicylic acid (SA) in the treatment of AV. Objective: Comparison between therapeutic efficacy and safety of 45% MA peel with 30% SA peel in Indian patients suffering from mild‐to‐moderate facial AV. Methods: A total of 50 patients suffering from mild‐to‐moderate AV were randomly divided into two groups, with one receiving 30% SA peels and the other receiving 45% MA peels at an interval of 2 weeks for six sessions. Total duration of the study was 12 weeks. Michaelsson acne scores (MAS) and clinical photographs were used to evaluate the efficacy of therapy objectively. Adverse effects of both the agents were also noted at each visit. Results: Both agents showed almost equal efficacy in improving mild‐to‐moderate AV. Salicylic acid was found better in treating noninflammatory lesions, while MA had an upper hand in treating inflammatory lesions. Overall, there was no significant difference between the two peels in improving MAS and percentage decrease in MAS. However, adverse effects were lesser with MA peels. Conclusion: About 45% MA peel was found to be equally effective as 30% SA peel in mild‐to‐moderate facial AV. However, safety and tolerability of MA peel were better than SA peel. [ABSTRACT FROM AUTHOR]

Scalp hair heterochromia involves the presence of two different colors of the scalp hair in the same individual. It may be of three types: patchy, diffuse, and segmental. Isolated patchy heterochromia of the scalp hair is a rare entity, and a very few cases have been described in the literature. Hereby, we report one such case of isolated patchy scalp hair heterochromia in a 2-year-old healthy male child with black hairs presenting with a bunch of blond hairs without any underlying abnormalities along with the literature review. [ABSTRACT FROM AUTHOR]

Primary lymphangioma circumscriptum (LC) is a superficial lymphatic malformation, presenting as multiple fluid-filled grouped vesicular lesions which may be associated with slight hemorrhages. We report a rare case of primary LC with exclusive involvement of area around the external urethral meatus in a 10-year-old male child. We treated the patient with radiofrequency ablation under topical anesthesia with eutectic mixture of local anesthetics (EMLA). No recurrence has been observed in the past 1 year. LC must be included in differentials when presented with vesicular lesions near the external urethral meatus in male pediatric patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a common chronic inflammatory and proliferative condition of the skin and its presentation as targetoid lesions has not been described. A 29-year-old male came to the outpatient department with multiple red color elevated skin lesions over the forehead and trunk for the past 10 days. Multiple targetoid lesions of size 2 cm × 2 cm to 5 cm × 4 cm having central edematous crusted zone and the peripheral zone of erythema with irregular to well-defined margins present almost all over the body. Differential diagnosis included psoriasis, erythema multiforme, pemphigus erythematosus, and reiter's disease. The biopsy confirmed the diagnosis of psoriasis. The patient was started on injection methotrexate and responded well. [ABSTRACT FROM AUTHOR]

Introduction: Trichloroacetic Acid (TCA) is a versatile peeling agent for treatment of melasma. However, Post-Inflammatory Hyperpigmentation (PIH) is reported to be the most common side-effect associated with TCA peel. Topical Ascorbic Acid (AA) due to its effect as antioxidant and tyrosinase inhibitor helps to prevent PIH and maintains the response. Aim: To assess the clinical efficacy, safety and reduction in Melasma Quality of Life (MELASQOL) on combining 20% TCA peel with 5% ascorbic acid cream in epidermal melasma. Materials and Methods: This study was conducted in the Department of Dermatology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Rohtak. This was an open labelled prospective randomized study in which 60 patients of epidermal melasma were enrolled for 12 weeks. Patients were divided into two groups: Combination group received 20% TCA peel every two weeks with once daily 5% ascorbic acid cream and Control group received only 20% TCA peel. Melasma Area Severity Index (MASI) was used for evaluating clinical improvement of melasma. Improvement in Quality Of Life (QoL) was assessed by MELASQOL scale in both groups. Adverse effects were evaluated at each visit. All statistical analysis was carried out with SPSS 20th version. The differences in change in mean MASI scoring and MELASQOL scores between the two groups was analysed using Mann- Whitney test. The side effects between the two groups were compared using Chi-square test. Results: The combination group demonstrated a statistically significant improvement in MASI, percentage decrease in MASI and quality of life as compared to control group after treatment. At the baseline there was no statistically significant difference in MASI between the two groups (i.e., MASI in combination group and control group were 23.55+4.61 and 23.613+4.088 respectively). However, it was statistically significant at the end of therapy (i.e., MASI in combination group was 9.50+5.31 and in control group was 15.10+4.44). When the results were analysed in terms of percentage decrease in MASI from baseline, there was statistically significant difference in combination group (i.e., 10.87+4.11) as compared to control group (i.e., 6.3+1.97) after 2nd week of therapy. When the mean MELASQOL scores were compared between the two groups at the end of therapy (i.e., 12 weeks), it was found to be statistically significantly lower in combination group (16.60+8.03) as compared to control group (25.90+8.17). Minor adverse effects like post peel erythema, pruritus, burning and stinging sensation were observed in some of the patients, which didn't necessitate termination of the therapy. Conclusion: Combination of 20% TCA peel with topical 5% ascorbic acid is a highly effective, safe and promising therapeutic option in treatment of melasma which significantly improves the QoL. [ABSTRACT FROM AUTHOR]

A number of congenital and acquired dermatological diseases are known to follow lines of Blaschko. Lichen Planus (LP), commonly acquired inflammatory dermatosis, presents with various morphological forms but Blaschkoian variant is very less published in literature. We herein report a case series of six patients of various age groups with Blaschkoian LP, without any underlying predisposing factors. All these cases presented with asymptomatic to mildly pruritic, violaceous to hyperpigmented papules and plaques following the Blaschko lines. In all the patients, lesions responded well to topical steroids and oral antihistamines, leading to gradual resolution of lesions with post-inflammatory hyperpigmentation. Blaschkoian LP is not a rare condition and may remain under reported because of its insignificant clinical features especially the absence of pruritus. Thus, the physician should always keep this entity in mind while considering the lesions following lines of blaschko. [ABSTRACT FROM AUTHOR]

A case study of 45‑year‑old female who is diagnosed with Trichophyton Verrucosum is presented. Topics discussed include hematological and biochemical investigations were within normal limits; histopathology showed subepidermal bulla with fungal hyphae present in the stratum corneum; and mandatory that the dermatologist fraternity be made aware of the unusual presentations of dermatophytosis.

Lipedematous scalp (LS) is a rare cutaneous disorder of unknown etiology, characterized by significant thickening of subcutaneous tissue which results in a thick, boggy, scalp swelling. To the best of our knowledge, less than 50 cases are reported till date. Hereby, we present a total of four cases of LS, that is, two cases of LS and two cases of unusual associations of LS with alopecia areata and intradermal nevus. LS with intradermal nevus and alopecia areata are the first of its kind, not yet reported till date.So far, only two cases of LS had been reported from Indian population. Hence, our effort is to bring into notice this growing yet an uncommon condition in the Indian population. [ABSTRACT FROM AUTHOR]

The article informs about an 18-year-old woman with a rare presentation of Blaschkoid Angioma Serpiginosum, characterized by asymptomatic red-colored eruptions on the right upper limb, swelling of the right hand and forearm since the age of 3. Topic include Clinical and histopathological findings led to the diagnosis, highlighting the unusual soft tissue hypertrophy associated with the condition.

Introduction Periorbital Melanosis (POM) is a very common esthetic condition, yet there is no definite treatment modality. Topical therapy is the mainstay of treatment which includes chemical peels, vitamin C, and other depigmenting agents. Objective To compare clinical efficacy, safety, and tolerability of 20% glycolic acid peels, 15% lactic acid peels, and topical 20% vitamin C in treatment of constitutional type of POM in Indian patients. Method Ninety patients of constitutional POM were enrolled for 12 weeks. The patients were distributed into three groups. One-third of patients underwent 3-weekly GA peel, another one-third underwent 3-weekly lactic peel, and rest applied vitamin C daily. Clinical improvement was assessed objectively using POM grading. Patient's and physicians global assessment along with patient's global tolerance was also evaluated. Results More than 50% improvement in POM was observed in 73.34% of patients on GA peel, 56.67% on lactic peel, and 26.67% on vitamin C. On comparing improvement with respect to duration of therapy, GA peel was significantly more effective than lactic peel from 12 weeks onward, while it was more effective than vitamin C from 6 weeks onward. Lactic peel was more effective than vitamin C from 6 weeks onward. Physician and patient global assessment was excellent with glycolic peel followed by lactic peel and vitamin C. The incidence of adverse effect was maximum with GA peel followed by lactic peel and vitamin C. Conclusion Glycolic peel was best among the three modalities, although it was associated with increased rate of side effects. [ABSTRACT FROM AUTHOR]

Background/Objectives A combination of narrowband ultraviolet B ( NBUVB) phototherapy plus topical tacrolimus has been used in adult vitiligo but has not yet been explored in children. We therefore sought to highlight the efficacy of this synergistic combination in childhood vitiligo. The objective was to study the clinical efficacy and safety of a combination of NBUVB with topical tacrolimus ointment 0.03% in childhood vitiligo. Method In this open-label study, 20 children, 4 to 14 years of age, with symmetrical vitiligo lesions were enrolled for 24 weeks. All were instructed to apply tacrolimus ointment 0.03% on a target patch on the left side of the body twice daily and no topical on a target patch on the right side. The whole body was irradiated with NBUVB three times per week. All patients were examined and the same dermatologist photographed lesions to assess for repigmentation at 4-week intervals. Response was noted as the percentage of repigmentation (none, 0%; poor, 1-25%; moderate, 26-50%; good, 51-75%; excellent, >75%). Result Our study found a statistically significant difference in the mean percentage of repigmentation at 4 and 6 months between combination therapy and NBUVB monotherapy. The mean cumulative dose and average number of exposures for the first clinically visible response were significantly lower with combination therapy. No serious adverse events were noted during the study period. Conclusion Our preliminary data suggest that a combination of NBUVB phototherapy with topical tacrolimus is a highly effective and promising therapeutic option for vitiligo in children, whose treatment options are very limited, but long-term studies are needed to evaluate the future risk of malignancy. [ABSTRACT FROM AUTHOR]

Background Phototherapy especially narrow-band UV-B (NBUVB) has been considered as mainstay of therapy in nonsegmental vitiligo (generalized type). Topical tacalcitol has also been claimed to be effective, either as monotherapy or as combination therapy. Purpose Comparison of clinical efficacy and safety of NBUVB in combination with topical tacalcitol vs. NBUVB alone in vitiligo. Material & methods Thirty patients with symmetrical vitiliginous lesions were enrolled for 24 weeks. Patients were instructed to apply tacalcitol ointment on right side of body once daily. In addition, the whole body was irradiated with NBUVB thrice weekly. All the patients were examined, and lesional photography was done. Patients were also followed up for 6 months post-treatment. Results Our study resulted in two key findings: (1) There was a statistically significant difference in mean percentage of repigmentation at 8, 16 and 24 weeks between combination therapy and NBUVB. (2) The mean cumulative dose and number of treatment sessions for initial repigmentation were significantly lower with combination therapy. No serious adverse effects were observed during the study period. Conclusion Topical tacalcitol potentiates efficacy of NBUVB as it enhances extent of pigmentation, decrease time to repigmentation and lowers the cumulative doses of NBUVB, thereby leading to greater patient satisfaction and improved compliance. [ABSTRACT FROM AUTHOR]

Cutaneous larva migrans (CLM) is the most common tropically acquired dermatosis caused by infection with hookworm larvae. It is commonly seen in tropical areas, and in people who have a history of foreign travel and of walking barefoot on sandy soil or beaches. An increased incidence has been seen in non-endemic areas due to change in environmental and behavioral factors. The presence of this entity is questionable in Northern region as the environmental conditions and the type of soil is not favorable, both of which are required for the survival of nematode. We describe a case series of six patients presented during winter season in the outpatient department of Dermatology within a short period of 2 months. We also review the clinical features of various other creeping eruptions and factors that are responsible for boosting infection in North India. [ABSTRACT FROM AUTHOR]

Epidermal inclusion cysts (EICs) are the most common cutaneous cysts, occurring anywhere in the body but infrequently on the breast. It is usually seen in the third and fourth decades of life and very rarely seen in children. They can be either congenital or posttraumatic. Most of the EICs described in children were secondary to trauma. Congenital EIC on the breast is quite a rare entity. Thus, we herein describe two cases of congenital EIC on the breast in two infants of 3 months and 9 months of age, which to the best of our knowledge has not been reported previously [ABSTRACT FROM AUTHOR]

Nevus comedonicus (NC) is a rare developmental anomaly of follicular infundibulum plugged with keratinous material that resembles comedo-like lesions. Frequently affected sites are face, neck, trunk, and upper arm. Few cases have been described on palms, soles, scalp, and genitalia. We hereby report a rare case of NC on scalp in a 14-year-old boy. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a multisystem granulomatous disease which frequently affects young adults. Because of its rarity, the exact incidence and prevalence of childhood sarcoidosis is not known. It mostly affects children of older age group i.e., 13-15 years. Early onset sarcoidosis (<5 years) is characterized by a triad of arthritis, uveitis and rash. Late onset sarcoidosis present with a multisystem disease similar to adults, with frequent pulmonary infiltrations and lymphadenopathy. Herein, we report a case of early-onset childhood sarcoidosis in a four-year-old female along with uncommon clinical features like cutaneous ulceration, onycholysis and geographical tongue and its rarity in the literature. [ABSTRACT FROM AUTHOR]

Objective: There are various adverse drug reaction (ADR) associated with pharmacological therapy that differ in clinical presentation, prognosis and therapy. Among these, cutaneous eruptions are the most common type of all ADRs.Theclinical presentation of cutaneous drug eruptions ranges from common transient and benign erythema to the most severe forms such as Steven-Johnson syndrome (SJS), Toxic epidermal necrolysis (TEN). Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous drug reaction accounting for 1-5 cases/1,000,000 per year. Antibiotics like β-lactams and macrolides are the usual offending agents. Among anticonvulsants-carbamazepine, phenobarbital and phenytoin are commonly associated with AGEP. Sodium valproate is relatively free from cutaneous drug reaction. Thus, we hereby, report a rare case of AGEP in a 24 years old male, reaction following valproate intake used to control post traumatic seizure. [ABSTRACT FROM AUTHOR]

Acrodermatitis enteropathica (AE) is a rare disorder of zinc deficiency, which manifests as acral and periorificial dermatitis, alopecia, intractable diarrhea, and failure to thrive. It is classified as primary zinc deficiency, genetically based deficiency, and acquired secondary deficiency. We hereby report a case series of genetically based AE in two nonidentical twins of age two months and two siblings of age 3 and 6 months. After reviewing the literature, we have also emphasized the possible role of genetics in the manifestation of AE. [ABSTRACT FROM AUTHOR]