Search

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]

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]

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]

A letter to the editor is presented about the case of benign migratory glossitis or geographic tongue in two siblings.

A 25-year-old, 7-month pregnant woman presented with rapidly progressive multiple ulcerated nodules present for 5 months on her left thigh. The lesions began as small red-colored papules, becoming nodular within few days. Initially, she was treated with systemic antibiotics and analgesics, and later a local physician performed incision and drainage. The lesions further increased, becoming indurated and ulcerated. Two months after her delivery, the lesions had extended to the middle of the medial side of her left thigh. On admission, she had a history of fever and weight loss, but there was no trauma. She delivered a full-term healthy baby boy. Past and family history was not significant. Examination revealed 15-20 ill-defined, erythematous, immobile, and irregular nodules of varying sizes, measuring 4 × 5 cm 2 , and extending from the inguinal region to the middle portion on medial aspect of the left thigh (Figure 1). Some of the nodules ulcerated with yellow color discharge with crusting, attributed to secondary bacterial infection. Multiple palpable and matted inguinal lymph nodes were present in the left inguinal region.

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., Competing Interests: FUNDING:No funding was provided for this study. DISCLOSURES:The authors have no conflicts of interest relevant to the content of this article., (Copyright © 2020. Matrix Medical Communications. All rights reserved.)