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Anticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non-thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others. Further, the use of anticoagulants for any indication is associated with various adverse effects with dermatologic manifestations including specific reactions such as warfarin-induced skin necrosis, heparin-induced thrombocytopenia and anticoagulant-associated cholesterol embolization syndrome.

The neonates are unique in several ways in comparison with older children and adults which render them highly susceptible to severe, sometimes life threatening dermatological disorders. The neonatal dermatological emergencies are a diagnostic and therapeutic challenge. A wide range of dermatoses such as infections, genodermatoses, metabolic disorders and vascular tumors may require emergency care. The clinical presentation also varies from generalized involvement of skin to localized disease with or without systemic symptoms. Irrespective of the etiology and clinical presentation, these disorders are associated with significant morbidity and mortality. With the availability of effective drugs and monitoring facilities, and awareness of need for immediate care, there has been a significant decline in the fatality rate associated with neonatal dermatological emergencies. Knowledge of clinical presentations, rapid diagnostic methods, emergency care and monitoring of progress of the disease helps in comprehensive multidisciplinary care of neonates with these disorders.

Cutaneous pitting, dimpling, or depressions are frequently dealt with in clinical practice. Such lesions may be primary manifestations of a disorder or develop as secondary changes during the course of the disease. Cutaneous pitting may be a manifestation of certain genodermatoses and internal disorders when it serves as a marker of such conditions. This article describes various types of pitted lesions affecting the ectodermal structures (skin, nails, and teeth) and their clinical significance along with brief description of the associated conditions. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 10-year-old boy who developed congenital asymptomatic papule on the lower eyelid. He was examined using dermoscopy and showed a circumscribed lesion with perilesional erythema, surface scaling and a hyperpigmented core embedded in the center of the lesion revealed papillary structures invaginating into the dermid.

Many paradoxical phenomena related to clinical, immunological, and therapeutic dermatology have been described. While some of them can be explained logically, the cause for others can only be speculated. Whenever encountered in clinical practice, background knowledge of such paradoxes may be useful to the clinician. [ABSTRACT FROM AUTHOR]

Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation. With the change in lifestyle and also with increased opportunity to use many new brands of cosmetics and toiletries, there has been an increase in females complaining of unique sensation in their facial skin. Sensitive skin presents as smarting, burning, stinging, itching, and/or tight sensation in their facial skin. The condition is found in more than 50% of women and 40% of men, creating a sizable demand for products designed to minimize skin sensitivity. Good numbers of invasive and non-invasive tests are designed to evaluate and predict the sensitive skin. Management includes guidelines for selecting suitable cosmetics and toiletries in sensitive skin individuals. [ABSTRACT FROM AUTHOR]

An adult female patient on hemodialysis for chronic renal failure presented with large, brownish, and indurated plaques with bound-down skin on both lower limbs and abdomen along with difficulty in movement of the legs. Histopathological features revealed thick collagen bundles admixed with mucin and intercalating spindle-like cells characteristic of nephrogenic fibrosing dermopathy (NFD). Immunohistochemical study showed prominent CD68 positivity and weak CD34 positivity suggesting that the plaques were more than 20-weeks old. NFD in patients with chronic renal failure of unknown cause is a poor prognostic indicator. Early detection before the development of contracture and prompt treatment of NFD and underlying renal failure may reverse this disabling condition. [ABSTRACT FROM AUTHOR]

Cutaneous mastocytosis is a rare infiltrative disorder of the skin. Though often asymptomatic, systemic features may be associated with any clinical pattern of the disorder at any age group. We present our experience with six cases of cutaneous mastocytosis, including three with diffuse cutaneous mastocytosis, a rare entity. [ABSTRACT FROM AUTHOR]

Acute skin failure is a state of total dysfunction of the skin resulting from different dermatological conditions. It constitutes a dermatological emergency and requires a multi-disciplinary, intensive care approach. Its effective management is possible only when the underlying pathomechanism of each event is clear to the treating clinician. The concept of skin failure is new to non-dermatologist clinicians and sketchy among many dermatologists. Here the pathomechanism of skin failure has been analyzed and a guideline for monitoring has been provided. There is a need for intensive care units for patients with acute skin failure. [ABSTRACT FROM AUTHOR]

Menke's syndrome and Elejalde disease are the two neurodegenerative disorders of dermatological interest. These patients present with characteristic hair changes which may be of diagnostic value in resource-poor setup where facilities for specific genetic analysis are not available. Simple light microscopic examination of hair may be a helpful diagnostic tool to pick up such cases. [ABSTRACT FROM AUTHOR]

A quiz concerning the medical term for a bluish nodule that appears on the arm is presented.

Describes a case of acquired digital fibrokeratoma and spinal dysraphism with tail-like projection. Occurrence of a solitary elongated or dome-shaped lesion with a characteristic collarette of raised skin at the base in acquired digital fibrokeratoma; Suggestion that spinal dysraphism refers to incomplete fusion of malformations of structures in the dorsal midline of the back.

This article presents a case report of an 8 year old boy presented with skin lesions and hair and nail abnormalities. On examination it has been found that he had palmoplantar keratoderma with deep fissuring and slight flexion deformity of the fingers. Marked fissuring of the lips with hyper-keratotic plaques around the oral cavity were observed. There was a total loss of hair and eyebrows and very sparse eyelashes. Other findings included groups of hyperkeratotic papules over the flexures and trunk. These were arranged in linear streaks over the anticubital and popliteal fossae. All of his toenails and the right thumbnail were dystrophic. Examination of the oral mucous membranes revealed multiple asymptomatic leukokeratotic plaques on the hard palate, buccal mucosa, and lateral and undersurface of the tongue.

Presents the case of a 24-year-old lady with progressive hypertrophy and lateral curvature of the left leg of long duration. Remarkable vascular prominence showed by the overlying skin; Asymptomatic involvement of the limb except minor restriction of movements; Differential diagnosis of vanishing bone disease from the dermatologist's point of view.

A quiz about the skin disease melanoacanthoma is presented.

The article presents several case studies related to multiple skin nodules in infants. One of the case is of a 3-month-old baby girl with congenital lesion on her right leg and foot. The lesion had grown in proportion to her and was otherwise unchanged since birth. Another case is of a 3-month-old boy, who was born by natural delivery after an uneventful pregnancy and in good general condition was evaluated for a congenital asymptomatic nodule on the medial side of the right thigh.

Reports on a case of an 11-year-old girl with three nodular lesions on the medial aspect of the right knee that have been present since early childhood with hyperhidrosis. Size of the lesions; Occurrence of occasional pain; Consistency of the nodules; Histopathologic findings.

Presents a quiz that asks readers to diagnose the case of a 41-year-old agricultural worker with asymptomatic nodulo-ulcerative lesions on the nose and adjacent areas, hoarseness of voice and difficulty in swallowing. Symptoms; Case description; Implications on dermatology, venereology and leprology.

A 14-year-old girl with diffuse palmoplantar keratoderma with hyperhidrosis and progressive extension of keratoderma to the dorsum of the hands and feet is reported. The inheritance pattern was autosomal dominant. [ABSTRACT FROM AUTHOR]