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Dermoscopy of folliculitis is typified by white roundish globules around the hair follicles. Clinically, folliculitis mimics pseudo folliculitis which results from close shaving of beard hairs. Thus, management in both is entirely different. Dermoscopy of latter entity reveals buried hair at both ends. Here, authors described a case of folliculitis caused by Staphylococcus lentus.

Introduction and Aim: Psoriasis is one of the salient dermatological disorder and a chronic recurrent cutaneous disease. Research shows that immunological cells and cytokines play a principal causative role for skin lesions and comorbid systemic effects in these patients. Like other autoimmune diseases, psoriasis is also a multifactorial disorder which is triggered either by injury, trauma, infections, medications, and psychological stress. Among the cytokines, hs-CRP acts as both inflammatory and cardiovascular marker. It is markedly increased in psoriasis patients, there by leading to subsequent co-morbidities in these patients. The aim of present study was to estimate inflammatory markers viz-TNF-?, IL-2, IFN-? and hs-CRP in psoriasis patients and controls and correlate these inflammatory markers with PASI score in psoriasis patients. Further to correlate hs-CRP with TNF-?, IL-2, IFN-? in these patients. Materials and Methods: The study is conducted at a tertiary level hospital and is designed as a Case Control study design conducted from January 2019 to January 2021. 110 subjects having diagnosed as psoriasis were included as cases and 110 controls. Inflammatory markers were estimated by ELISA method. Statistical analysis was done. Results: The study showed that inflammatory markers in cases with psoriasis were significantly elevated when compared with controls. The inflammatory markers were proportionately altered from mild to severe in psoriasis patients but were not statistically significant. The hs-CRP showed negative significant correlation with IFN –?. Conclusion: The present study concludes that the inflammatory markers are significantly increased in psoriasis patients, and this is correlated with PASI score. These simple biomarkers are of utmost importance in the clinical scenario for better treatment and prognosis and thereby reducing comorbidities in these patients.

Background Dermoscopy has been shown to be a useful supportive tool to assist the diagnosis of several non-neoplastic dermatoses (i.e. inflammatory, infiltrative and infectious skin diseases), yet data on skin of colour is still limited. Objectives To characterize dermoscopic features of non-neoplastic dermatoses in dark-skinned patients in order to identify possible clues that may facilitate the differential diagnosis of clinically similar conditions. Materials & methods Members of the International Dermoscopy Society were invited to submit cases of any non-neoplastic dermatosis developing in patients with Fitzpatrick phototypes V-VI whose diagnosis had been confirmed by the corresponding gold standard diagnostic test. A standardized assessment of the dermoscopic images and a comparative analysis according to clinical presentation were performed. Seven clinical categories were identified: (I) papulosquamous dermatoses; (II) facial hyperpigmented dermatoses; (III) extra-facial hyperpigmented dermatoses; (IV) hypopigmented dermatoses; (V) granulomatous dermatoses; (VI) sclerotic dermatoses; and (VII) facial inflammatory dermatoses. Results A total of 653 patients (541 and 112 with Phototype V and VI, respectively) were recruited for the analysis. Thirty-six statistically significant dermoscopic features were identified for papulosquamous dermatoses, 24 for facial hyperpigmented disorders, 12 for extra-facial hyperpigmented disorders, 17 for hypopigmented disorders, eight for granulomatous dermatoses, four for sclerotic dermatoses and 17 for facial inflammatory diseases. Conclusions Our findings suggest that dermoscopy might be a useful tool in assisting the diagnosis of clinically similar non-neoplastic dermatoses in dark phototypes by revealing characteristic clues. Study limitations include the retrospective design, the lack of a direct dermoscopic-histological correlation analysis and the small sample size for less common diseases.

Background: The International Dermoscopy Society (IDS) recently released a set of five basic dermoscopic parameters (vessels, scales, follicular findings, "other structures," and specific clues) encompassing a total of 31 subitems to standardize the use of dermoscopy in non-neoplastic dermatoses, yet they have been developed taking into account Caucasian/Asian skin, with consequent possible limitations if used in dark skin. Objectives: To validate the abovementioned criteria for the use in dark-skinned patients (phototypes IV-VI) through an expert consensus. Methods: The two-round Delphi method was adopted, with an iterative process consisting of two rounds of email questionnaires. Potential panelists were recruited via e-mail from all over the world based on their expertise on dermoscopy of non-neoplastic dermatoses in skin of color. Results: Twenty-two panelists took part in the validation process. All of the five originally proposed parameters and subitems reached agreement during the first round, aside from "follicular red dots." Additionally, during round 1, five new subitems were proposed (perifollicular scales distribution, follicular openings obliteration, broken hairs, eccrine pigmentation, and eccrine ostia obliteration), along with the possibility to change the denomination of parameter 3 (from "follicular findings" to "follicular/eccrine findings") and split it into two subparameters ("follicular findings" and "eccrine findings"). All such proposals reached agreement during the second round and therefore were included in the final list, for a total of 37 items. Conclusions: Although nearly all the dermoscopic criteria originally proposed by the IDS are applicable even to darker phototypes, several additional variables need to be assessed.

Necrolytic acral erythema (NAE) is now considered as a distinct clinical entity. It clinically presents as well demarcated hyperpigmented papules and plaques with thick adherent scales distributed symmetrically over dorsum of feet. It usually develops in patients with Hepatitis C virus (HCV) infection. Cases of NAE have been reported in patients without HCV infection. Hepatic dysfunction resulting in metabolic alterations like hypoalbuminemia, hypoaminoacidemia, hyperglucagonemia and transient zinc deficiency has been proposed as underlying pathogenic mechanism of NAE. Clinically, NAE resembles other necrolytic erythemas like necrolytic migratory erythema (NME), acrodermatitis enteropathica (AE) and pellagra. Better understanding of etiopathogenesis and histopathological features is important to distinguish NAE from other necrolytic erythemas. The disease runs a natural course of exacerbations and remissions. Non-invasive diagnostic tools like dermoscopy can be used in differential diagnosis of NAE. Oral zinc therapy is the most effective treatment of NAE reported in most of the cases irrespective of HCV status or serum zinc levels.

Introduction: Hypopigmented or depigmented lesions are considered as important dermatoses in daily practice. Their accurate diagnosis is very much crucial because of social stigma attached to these diseases in Indian subcontinent. Authors have proposed basic guidelines for dermoscopic assessment in terms of approach to a given hypopigmented/depigmented lesion. The following conditions are dermoscopically described here, they are vitiligo, idiopathic guttate hypomelanosis, lichen sclerosus, pityriasis alba, leprosy, pityriasis versicolor and nevus depigmentosus. Aim: To propose basic dermoscopic guidelines in terms of approach of a hypopigmented/ depigmented lesion in skin of color. Summary: Dermoscopic patterns highly depend on melanin skin layers and thus analysis of dermoscopic patterns in hypopigmented/depigmented lesions is difficult owing to the reduction or absent melanin in the epidermis. All hypopigmented/depigmentary conditions are described based on the 5 dermoscopic parameters which include; i) background colour, ii) vessels, iii) scales, iv) follicular findings and v) specific clues. Glowing white color in vitiligo and pale or dull white color in IGH and white with little brownish color in PA and PV are the different shades of color in the background in dermoscopy. In leprosy, PMH and ND, background color is brownish-white rather white. LSEA, color is white with bluish or pinkish hue is observed. Furthermore, dermoscopic diagnosis should be based on every parameter visible in a given lesion and not in isolation as each pattern or parameter is immensely contributory to the final diagnosis. Conclusion: Thus, dermoscopy aids in the distinction of hypopigmented/depigmentary lesions by demonstrating characteristic and definitive patterns.

Hyperpigmented skin lesions are common presentation of Indian patients. It causes cosmetic disfigurement, as well as has immense psycho social impact. Most of the lesions are diagnosed clinically but some of them are difficult to diagnose because of overlapping features. To form basic dermoscopic guidelines to approach a hyperpigmented lesion. LPP and EDP demonstrate brownish background with bluish gray hue and brown to gray globules, which is also seen in PCD with superimposition of brown globules. Linear cristae cutis and sulci cutis forms a special clue in AN. Frictional melanosis displays bluish gray globules with patulous follicles with plugs and perifollicular scaling. Patulous follicular opening with whitish yellow excrescences on pseudopigment network is seen in seborrheic melanosis. PDL displays peri-follicular brown globules with no vasculature changes or scales. Melasma shows prominent brown background with reticular or reticulo-globular pigment pattern. Exogenous ochronosis demonstrates grayish brown globules with obliteration of follicular openings. Brown polygonal globules with scales along skin lines and over the globules are noted in CRP. Hub and spoke pattern of pigmentation is a feature of macular amyloidosis. Hyperpigmented pityriasis versicolor demonstrates accentuated pigment network with scaling in diffuse or perifollicular or along skin lines seen. Dermoscopic diagnosis should be based on amalgam of all parameters identified in a given lesion and not in isolation. Dermoscopy is of great importance for assessment of hyperpigmentation disorders in dark-skinned patients as they may clinically look similar due to the natural brownish background.

Introduction: Dermoscopy is a non-invasive tool which demonstrates characteristic patterns in many dermatoses. To understand dermoscopy, basic elements, vascular structures and pigment netwrok should be dealt with. One needs to understand the concept of basic physics of dermoscopy and cross polarization. Non-polarized and polarized lights show particular patterns in prominence. Hence both are complementary to each other. It is recommended to use both lights in clinical practice. Essentially, dermoscopic features should be analyzed and interpreted in terms of pattern of dermoscopic changes, predominant color and any specific clues present in the lesion. This is basic approach to a given lesion to arrive at accurate diagnosis dermoscopically. Aim: To understand the basic principles of dermoscopy and the types of dermoscopy. Summary: Dermoscopy is a rapid method that involves the use of a hand-held device with a built-in illumination and magnification systems. It is an in-vivo technique to observe the surface and subsurface structures in the skin layers. In the past, it was employed exclusively to diagnose and rule out melanoma in a given pigmented lesion. Its confirmed utility in inflammatory and infective dermatoses has enhanced its popularity as dermatologist's stethoscope.

Introduction: Dermoscopy is an in vivo and non-invasive tool that assists as an adjunctive method in the diagnosis of many dermatoses. Dermoscopic studies and research in the field of inflammatory and infective lesions are limited to case series or case reports without definitive criteria. Authors have attempted to describe a very basic approach to dermoscopic diagnosis of inflammatory conditions like psoriasis, eczema, lichen planus, pityriasis rosea, prurigo nodularis, and discoid lupus erythematosus. Aim: To propose basic dermoscopic guidelines in terms of approach to an inflammatory lesion.Summary: Dermoscopy of inflammatory conditions is referred to as 'inflammoscopy'. Basic approach in inflammoscopy is based on 5 dermoscopic parameters which include; i) background colour, ii) vessels, iii) scales, iv) follicular findings and v) specific clues. Dermoscopy helps in the differentiation of many inflammatory lesions by demonstrating characteristic patterns thus aiding in its diagnosis. Uniform and regular dotted vessels are seen in psoriasis. Wickham striae, adherent fabric fibre sign, yellow clod sign and white rosettes are respectively a special clue for the diagnosis of lichen planus, prurigo nodularis, eczema and early DLE lesion. Collarette scales over brownish yellow background are seen in P. rosea. Dermatologist dealing with skin lesions in patients with skin types IV, V, and VI should be aware that there are slight variations in the dermoscopic pattern owing to amount of melanin.

Background: Clinical differentiation of onycholysis due to various etiologies is difficult task that compels to do invasive investigations to arrive at accurate diagnosis. Wrong diagnosis often leads to treatment failure and physicians and patient's anxiety. Dermoscopic patterns in nail psoriasis, onychomycosis are well established. Here, authors attempted to describe dermoscopic patterns in onycholysis due to psoriasis, onychomycosis and trauma in skin of color. Methodology: Study was conducted in a tertiary hospital in Southern India. Ethical clearance and informed consent from patients was obtained. Sixty consecutive patients who attended dermatology outpatient department with onycholysis were included in the study. Nail potassium hydroxide (KOH) study was done in all the cases. Onychoscopy was done with DermLite 3 with ultrasound gel as interface medium. Results: Totally 60 patients (42 males; 18 females) with onycholysis were included. Mean age was 37 years (range; 6-68 years). KOH was positive in 22 (36.6%) cases. Onychoscopy showed proximal erythematous rim, red dots, splinter hemorrhages in 23(65.71), 26 (74.28) and 21(60) in nail psoriasis respectively. Spiked and jagged-edges, aurora borealis and ruins pattern (65%) suggestive of onychomycosis were seen in 18(90%), 17 (85%) and 13 (65%) patients respectively. Plain edges without erythema or spikes were noted in 5 (8.33%) in traumatic onycholysis group. Conclusion: Onychoscopy is a non- invasive modality to diagnose psoriasis, onychomycosis and traumatic involvement of nail apparatus by demonstrating characteristic patterns. Hence, it also plays an important role in effective management of such cases.

Onychoscopy provides a better understanding of nail lesions in terms of diagnosis, monitoring of progression and response to treatment. Author have put forward a simplified way to approach to a nail lesion by onychoscopy. Onychoscopy of pigmentary, inflammatory, infections, neoplastic and connective tissue diseases affecting the individual of skin of color are described to construct a basic outline for onychoscopic approach to a nail lesion. Onychoscopy shows homogenous dark band in longitudinal melanocytic nevus (LMN), irregular black pigment with irregular longitudinal lines in melanoma, multi-colored pigmented patches in fungal melanonychia, purplish-black in subungual hematoma, transverse bands in the under surface of plate in true leukonychia, whitish- yellow patches in pseudoleukonychia. In psoriasis, irregular pits, salmon spots are seen whereas in lichen planus onychorrhexis, whitish linear splits and pterygium are observed. Eczema shows pits with lusterless surface. In Darier's disease, characteristic alternate white and red bands are present. Lichen striatus shows longitudinal erythematous bands and ridging. Red dots with white halos are characteristics in warts. Onychomycosis shows 'aurora borealis' pattern and white opaque and friable spots. Bowen's disease shows white scales with red dots. 'Woodworm appearance' and keratotic mass are seen in onychomatricoma and respectively. Squamous cell carcinoma reveals destruction of nail plate and glomus tumor demonstrates pinkish blush. In connective tissue diseases, characteristic changes are present nail fold capillaries. Onychoscopy assists in the analysis and differentiation of many dermatoses which affect nail unit with similar clinical manifestations.

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent severe reactions in the skin and the mucous membranes, most commonly caused by drugs. An adult female developed erythematous and dusky red lesions over the body 5 days after oral albendazole. Atypical target lesions sparing the scalp were seen on day 2 of admission with positive Nikolsky sign. A clinical diagnosis of SJS (with 12.1% predicted mortality) was made which correlated with biopsy. The patient responded well to intravenous dexamethasone and oral cyclosporine. The report highlights the drug, albendazole, as a sole factor causing SJS/TEN and warrants further evaluation and subsequently control measures.

Introduction: Lupus Vulgaris (LV) is the chronic, progressive, tissue destructive form of cutaneous tuberculosis. LV should be diagnosed and treated to prevent scaring and deformities. Histopathology is the gold standard for the diagnosis. Dermoscopy is helpful tool in diagnosing different dermatological condition. Here, dermoscopic and histopathogical correlation in LV was attempted. Materials and Methods: It was a cross sectional, observational study done from February 2019 to October 2019. Nineteen patients of LV were included. Dermlite 4 with attached smart phone (iphone) was employed. LV lesions were subjected to skin biopsy to confirm the diagnosis. Results: Study enrolled 19 patients, with 8males, 5 female and 6 children. Dermoscopy showed yellowish-white globules, white structureless areas and white scales were noted in 19 (100%) patients. Telangiectasias were seen in 16 (84.21%) patients as long linear, branching and short linear vessels. Pinkish-red background was noted in all patients (100% n=19). Newer observations included white shiny streaks, white rosettes and bluish hue. Age, sex, duration of lesions had no influence in the dermoscopic patterns. Discrepancy in dermoscopic-histopathologic correlation was noted. Facial lesions showed increased frequency of follicular plugs, patulous follicles and white rosettes. Conclusion: Dermoscopy is widely gaining importance in the realm of dermatology. In this study, dermoscopy demonstrated characteristic patterns in LV. Thus, dermoscopy a non-invasive procedure can be used as diagnostic tool in many infective dermatoses.

Background: Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. Objectives: To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. Methods: This was a retrospective, multicenter study being a part of an ongoing project “Mucoscopy – an upcoming tool for oral mucosal disorders” under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. Results: Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. Conclusion: Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis.

Introduction: A structured set of eight basic dermoscopic parameters (lines, clods, dots, circles, pseudopods, structureless, else, and vessels) including a total of 77 variables with corresponding descriptive and metaphoric vocabulary has been released for evaluation of skin tumors by the International Dermoscopy Society (IDS). Objectives: To validate the aforementioned criteria for the use in darker phototypes (phototypes IV-VI) via an expert consensus. Methods: The two-round “Delphi method” was adopted, with an iterative process including two rounds of email questionnaires. Potential panelists were asked to take part to the procedure via email on the basis of their expertise on dermoscopy of skin tumors in dark phototypes. Results: A total of 17 participants were involved. All the original variables of the eight basic parameters reached agreement during the first round, except for “pink small clods” (“milky red globules”) and “structureless pink zone” (“milky red areas”). Moreover, during the first round, panelists proposed a change of three existing items and the introduction of four new items, i.e., “black, small clods” (“black globules”), “follicular plugs”, “erosions/ulcerations”, and “white color around vessels” (“perivascular white halo”). All such proposals achieved agreement, thus being included in the final list, for a total of 79 items. There was consistency between descriptive and metaphoric approach in terms of scoring. Conclusions: Albeit most of the original items were considered applicable even for skin of color, there are some points of differences that physicians need to know. No significant preference was found between descriptive and metaphoric terminology among panelists.

Livedoid vasculopathy (LV) is recurrent and episodic thrombotic dermatosis characterized by pain and ulcerations. It requires early diagnosis, and treatment with combination of drugs. Dermoscopy is a non-invasive technique which enables clinician to visualize subsurface structures of the skin. Here, dermoscopy of LV in skin of color which was treated with colchicine is reported.

Background: Painful lesions affecting the plantar aspect of the foot are routinely encountered in daily practice, and plantar wart, corn, and callus are the most common conditions. Although the clinical examination is sufficient to clinch an accurate diagnosis, atypical presentations indicate the need for invasive investigations like skin biopsy. Here we evaluated dermoscopic patterns of painful lesions affecting the plantar surface. Objectives: The current study aimed to, firstly, investigate the dermoscopic patterns and differentiate between painful papules and plaques on the foot, and, secondly, to analyze the histopathological correlation of these dermoscopic patterns. Methods: Following a cross-sectional design, the current study was carried out on patients with the clinical diagnosis of painful lesions of foot suggestive of plantar wart, corn, and callus referring to a tertiary care center from June 2019 to Jan 2020. Dermoscopy analysis and biopsy were performed for all participants. Results: Among 92 patients with painful plantar lesions, 56, 22, and 15 had a plantar wart, corn, and callus, respectively. Dermoscopy of warts revealed red dots (89.28%) and yellow halo (82.14%). A translucent central core (100%) and whitish ring (81.81%) on dermoscopy of patients with corn. Dermoscopy of callus demonstrated opaque yellow area in all (100%) the patients. Dermatoglyphics were absent in plantar wart in contrast to corn and callus, wherein they were preserved. Conclusions: Dermoscopy can be considered as a rapid, non-invasive, diagnostic tool in the daily practice of a dermatologist. Here, it assisted in distinguishing clinically akin painful plantar papules and plaques. These dermoscopic patterns also were well correlated histopathologically.

Acne vulgaris is an inflammatory disorder of the pilosebaceous unit typical of adolescent age, even though adulthood onset is not rare in females. Lesions typical of acne include comedones, inflammatory papules, pustules, nodules and cysts. Acneiform eruptions are the main differential diagnosis of acne vulgaris. The evidence of comedones may come in handy to differentiate acne vulgaris from acneiform eruptions as the latter typically do not display such a feature. Rosacea is a benign, inflammatory dermatosis, mainly affecting the central face, characterized by abnormal vasomotor responses, persistent vasodilatation and increased vascular permeability. The dermoscopic hallmark of erythematotelangiectatic rosacea is represented by blurred linear vessels arranged in a reticular pattern. Seborrheic dermatitis (SD) is a frequent inflammatory skin disorder involving areas characterized by high sebum production. Infantile SD typically presents as yellowish, greasy scale on the scalp that is often referred to as “cradle cap”.

Background: Vitiligo is a common skin disorder causing depigmented macules that can impair a patient's quality of life. There are number of treatment modalities are available but at the present, there are no studies compairing betamethasone pulse therapy versus azathioprine daily therapy in treatment of vitiligo. Objectives: To compare the safety and efficacy of Azathioprine daily and Betamethasone pulse therapy in the treatment of in vitiligo. Materials and Methods: We included two vitiligo patient groups. namely group A and group B Patients of group A were given oral Azathioprine to be given 50mg twice daily and those of second group B, Betamethasone were given as a single oral dose of 5 mg on two consecutive days per week. Therapy in both groups was given for a total of 6months with follow up at 1, 3 and 6th month. Clinical photographs were taken at each visit. Side-effects if any were noted. Results were calculated with help of VASI score (vitiligo area severity index). Results: At the baseline: The patients to group A (SD 3.81± 2.3) and of group B (SD 3.76± 2.28) were having depigmented patches (P = 0.90). At the first follow up: Although there was significant improvement with perifollicular repigmentation started in both groups but the patients are of group B (SD 3.38±2.06) were showing slower response as compared to oral group A (SD 3.70± 2.28). At the second follow up: Remarkable improvement is seen in both groups compared (P = 0.17). At the third follow up: Significant improvement is seen in both groups compared (P = 0.09). Conclusions: Azathioprine and betamethasone pulse therapy are equally effective in treatment of vitiligo.

Introduction: Dermoscopy has gained tremendous importance in the recent past. It helps in the visualization of subsurface structures, whereby details of skin lesion are studied in depth. Nailfold capillaries are involved early in the course of disease process in connective tissue diseases. Videocapillaroscopy is used to examine the patterns in the nailfold capillaries. However, training, cost, and skilled technique limits the use of it. Dermoscopy, being handheld and easy to perform, is best alternative to videocapillaroscopy. Authors evaluated the utility of dermoscopy in the study of nailfold capillaries in connective tissue diseases in patient with the skin of color. To the best knowledge of authors, this is the first study from the Indian subcontinent. Materials and Methods: The study was conducted in a tertiary care hospital from January 2017 to June 2017. It was a cross-sectional pilot study. Sixteen consecutive patients with connective tissue diseases were included in the study. Connective tissue diseases comprised of systemic sclerosis, lupus erythematosus, mixed connective tissue disease, dermatomyositis, and rheumatoid arthritis. DermLite 3 dermoscope with Sony camera was employed. Polarized mode and ultrasound gel were used. Results: Of 16 patients, three, two, and three had systemic sclerosis, systemic lupus erythematosus, and discoid lupus erythematosus, respectively. Mixed connective tissue disease, dermatomyositis, and rheumatoid arthritis were seen in one, one, and five patients, respectively. One patient had Rowell syndrome. Scleroderma and nonspecific scleroderma patterns were observed in 75% and 12.5% of patients, respectively. In two patients, the nailfold capillaries appeared normal. Conclusion: Dermoscopy is an in vivo cost-effective method for studying nailfold capillaries in connective tissue diseases. Results obtained using handheld dermoscope were comparable to that of a videocapillaroscope. Authors recommend further studies involving large sample size of the population with skin of color to affirm the nailfold capillaries pattern observed in this study.

Background: Progressive pigmented purpuric dermatosis (PPPD) is a chronic cutaneous presents with petechiae, purpura on hyperpigmented yellowish-brown macules or patches. Diagnosis is straight forward, sometimes may be challenging for the diagnosis. Dermoscopy is a non-invasive tool. It gives characteristic patterns in PPPD. However, dermoscopic descriptions in skin of color are limited to case reports. Here, dermoscopic evaluation in skin of color is studied in detail. Methods: It was a cross sectional observation study. Ethical clearance and written consent was obtained. Patients of skin type 4 and 5, attending dermatology clinic with suspected lesions of PPPD were selected serially. Handheld dermoscope was used for examination. Site for dermoscopic examination was considered as target area. Skin biopsy was taken. Dermoscopic patterns were analysed and features were correlated with histopathological changes.Results: Totally 30 patients with 27 males and 3 females were enrolled. Schamberg’s disease was commonest type noted in 21patients. Eczematoid, lichen aureus, and lichenoid types were seen in 2 (6.7%) each. Hence, overall occurrence of Schamberg’s disease was statistically significant (p=0.028). Commonest dermoscopic findings were brown pigment network and yellowish-brown dots/globules. Least common features included linear vessels and bluish globules. Distorted pigment network noted in 29 (96.7%).Conclusions: Dermoscopy of PPPD shows characteristic patterns of which pigment network, red globules and yellowish-brown globules are the basic features. These features correlate well with histopathological changes. Yellowish-brown globules and background are prominently observed in skin of color. Larger studies are recommended to validate these differences.

Periungual and genital warts pose a therapeutic challenge to the treating clinician as there is lack of single curative treatment modality. All existing therapeutic options are associated with high rate of recurrence when employed alone. Here authors reported complete cure of periungual and genital warts that were treated by multiple approach consisting of mumps-measles-rubella vaccine, radiofrequency ablation and oral acitretin. Therapeutic response was assessed by dermoscopy which revealed specific patterns before and after treatment. There was no recurrence of lesions even after 1 year of follow-up period.