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Background: Patch test is the gold standard for diagnosing allergic contact dermatitis. Conventionally, the patches are applied for 48 h, which in tropical weather conditions causes excessive sweating, leading to irritation, and sometimes the patches come off, making the test inconclusive. Objective: To compare the patch test positivity after 24 and 48 h of occlusion time in patients of allergic contact dermatitis, using standard allergen concentration. Materials and methods: Clinically suspected patients of allergic contact dermatitis were enrolled and patch tested using the Indian Standard Series, parthenium acetone extracts (1:50, 1:100 and 1:200 dilutions) and patient material. Patches were applied in duplicate on either side of the back, using a random number table. One set of patches was removed after 24‐h of occlusion, while the other set after 48‐h. Readings were performed at 48‐ and 96‐h by two independent dermatologists, blinded to the duration of occlusion. Results: The study had 97 adult patients (58 males and 39 females; mean age: 48.12 ± 13.07 years). A total of 133 and 142 positive reactions were observed after 48 h occlusion at 48 and 96 h reading, respectively. Of these 117 (87.9%) and 132 (92.9%) patches were positive and concordant and noted at 24 h occlusion time. The Cohen's kappa coefficient were 0.94 for 48 h and 0.97 for 96 h reading, hence showing an almost complete agreement (ⱪ > 0.81) between patches occluded for 24 and 48 h. Conclusion: Though there is no significant difference in patch test positivity among ISS allergens after either occlusion time, 48 h occlusion performs significantly better compared with 24 h, when reactions of all allergens (ISS, patient material and parthenium acetone extract) are analysed together. [ABSTRACT FROM AUTHOR]

This article discusses two cases of vulval extramammary Paget's disease and their treatment with topical imiquimod cream. The patients experienced symptoms such as itching, skin-colored plaques, and erosions, and their diagnosis was confirmed through skin biopsies. Imiquimod cream was used as a treatment, resulting in a good response in one case and a partial response in the other. Surgical excision was recommended for the patient with a partial response. The article also provides information on the prevalence, diagnosis, and treatment options for extramammary Paget's disease. The Indian Dermatology Online Journal has released its January-February 2024 issue, which can be accessed and downloaded online. [Extracted from the article]

Cardiomyopathy (particularly dilated cardiomyopathy (DCM)) significantly contributes to development and progression of heart failure (HF), and inflammatory factors further deteriorate the symptoms. Morphological and functional defects of the heart in doxorubicin (DOX)-induced cardiomyopathy (cardiotoxicity) are similar to those of DCM. We used anagonist of PGC-1α (PPAR (peroxisome proliferator-activated receptor-gamma)-γ coactivator-1α) that is considered as the 'master regulator' of mitochondrial biogenesis with an aim to rescue the DOX-induced deleterious effects on the heart. Forty male C57BL/6J mice (8 weeks old) were divided in four groups, Control, DOX, ZLN005, and ZLN005 + DOX (n = 10 each group). The DOX-induced (10 mg/kg, single dose) cardiomyopathy mimics a DCM-like phenotype with marked morphologic alteration in cardiac tissue and functional derangements. Significant increased staining was observed for Masson Trichrome/Picrosirius red and α-Smooth Muscle Actinin (α-SMA) that indicated enhanced fibrosis in the DOX group compared to the control that was attenuated by (peroxisome proliferator-activated receptor-gamma (PPAR-γ) coactivator) (PGC)-1α (alpha) agonist (four doses of 2.5 mg/kg/dose; cumulative dose = 10 mg/kg). Similarly, elevated expression of necroptosis markers along with enhanced oxidative stress in the DOX group were alleviated by PGC-1α agonist. These data collectively suggested the potent therapeutic efficacy of PGC-1α agonist in mitigating the deleterious effects of DOX-induced cardiomyopathy, and it may be targeted in developing the future therapeutics for the management of DCM/HF. [ABSTRACT FROM AUTHOR]

Background: Impact of COVID-19 pandemic has been immense. An innocent casualty of this disaster is medical education and training. Dermatology, which primarily deals with out-patient services, medical and surgical interventions, and in-patient services, was one of the worst hit. The National Medical Commission of India has implemented competency-based medical education (CBME) in Dermatology, Venereology, and Leprosy since 2019. The new curriculum relies on acquiring practical and procedural skills, training skills in research methodology, professionalism, attitude, and communication. Objectives: The study was undertaken to understand the implications of the COVID-19 pandemic on postgraduate dermatology CBME training in India. Materials and Methods: A questionnaire-based survey was carried out on postgraduate dermatology teachers and residents in India after obtaining ethics committee approval. An online semi-structured English questionnaire was administered by Google Forms. The calculated sample size was 366 dermatology faculty and 341 postgraduate students. Validity (Content validity ratio (CVR) ≥0.56) and reliability (Cronbach's alpha coefficient 0.7249) of the questionnaire were determined. Results: Among the 764 responses received, 51.4% reported that their institutes were converted to exclusive COVID hospitals. Domains of dermatology education affected were procedural training (n = 655), bedside clinical teaching (n = 613), outpatient department-based clinical teaching (n = 487), bedside laboratory procedures (n = 463), research activities (n = 453), histopathology (n = 412), and theory classes (n = 302). To keep up with the teaching-learning process, online platforms were mostly utilized: Zoom Meeting (n = 379), Google Meet (n = 287), and WhatsApp Interaction (n = 224). Teaching during ward rounds was significantly more affected in exclusively COVID institutes than non-exclusive COVID institutes (P < 0.001). Psychomotor skill development suffered a major jolt with 26.7% of respondents reporting a standstill (P < 0.001). Communication skills among students suffered due to social distancing, mask, and poor attendance of patients. According to 23.84% of respondents, formative assessment was discontinued. Conclusion: Online seminars, journal clubs, and assessments have been incorporated during the pandemic. Online modalities should be used as a supplementary method as psychomotor skills, communication skills, research work, and bedside clinics may not be replaced by the e-learning. [ABSTRACT FROM AUTHOR]

Background: Narrow‑band ultraviolet B (NB‑UVB) is the standard therapy for vitiligo. Objective: The objective of this study is to compare the safety and clinical efficacy of a handheld NB‑UVB comb device with the standard whole‑body NB‑UVB therapy in localized stable vitiligo. Materials and Methods: Thirty‑one vitiligo patients were allocated to either daily therapy with a home‑based handheld comb device (group A, n = 17) or thrice‑weekly hospital‑based whole‑body NB‑UVB therapy (group B, n = 14) for 4 months, based on their preference. The primary and secondary outcomes were assessed at each follow‑up, and appropriate statistical tools were used for analysis. Results: Of the 31 patients enrolled, 26 patients (study groups A/B: 15/11) completed the study. Primary outcome: Median percentage repigmentation of the representative patch in groups A and B were 51.35% and 63.85%, respectively (P = 0.64). The median size reduction of the representative patch in both groups was statistically significant (P < 0.05). The mean difference between “per protocol analysis” and “intention to treat” showed noninferiority. Secondary outcomes: Both groups were comparable on Lund and Browder score, patient global assessment and investigator global assessment scores, adverse events, color match, and change in the quality of life. The comparison group had a significantly greater number of missed sessions (P = 0.02). The majority of patients had a “good” response in both groups. Conclusion: Handheld NB‑UVB comb device daily with a fixed dose of fluence was found to be noninferior with better compliance to standard whole‑body NB‑UVB therapy [ABSTRACT FROM AUTHOR]

Background: Moisturizers are first‐line therapy for treatment of atopic dermatitis (AD). Although there are multiple types of moisturizers available, head‐to‐head trials between different moisturizers are limited. Objective: To evaluate if a paraffin‐based moisturizer is as effective as ceramide‐based moisturizer in children with AD. Materials and Methods: In this double‐blind, randomized comparative trial of pediatric patients with mild to moderate AD, subjects applied either a paraffin‐based or ceramide‐based moisturizer twice daily. Clinical disease activity using SCOring Atopic Dermatitis (SCORAD), quality of life using Children/Infants Dermatology Life Quality Index (CDLQI/IDLQI), and transepidermal water loss (TEWL) were measured at baseline and at follow‐up at 1, 3, and 6 months. Results: Fifty‐three patients were recruited (27 ceramide group and 26 paraffin group) with a mean age of 8.2 years and mean disease duration of 60 months. The mean change in SCORAD at 3 months in the ceramide‐based and paraffin‐based moisturizer groups was 22.1 and 21.4, respectively (p =.37). The change in CDLQI/IDLQI, TEWL over forearm and back, amount and days of topical corticosteroid required, median time to remission and disease‐free days at 3 months were similar in both groups. As the 95% confidence interval (CI) of mean change in SCORAD at 3 months in both groups (0.78, 95% CI: −7.21 to 7.52) was not within the predefined margin of equivalence (−4 to +4), the conclusion of equivalence could not be proven. Conclusion: Both the paraffin‐based and ceramide‐based moisturizers were comparable in improving the disease activity in children with mild to moderate AD. [ABSTRACT FROM AUTHOR]

Byline: Prashant. Bharti, M. Ramam, Neetu. Bhari A 4-year-old boy presented with a vertically oriented, linear, erythematous atrophic plaque of size 4.5 × 0.5 cm in the midline of the [...]

Byline: Sanjay. Singh, Neha. Taneja, Subuhi. Kaul, Sudheer. Arava, Neetu. Bhari Sir, A 24-year-old woman presented with progressively increasing itchy, erythematous lesions on the face, trunk and arms since the [...]

Byline: Suman. Patra, Neetu. Bhari, Pratik. Mohta, Sanjay. Singh, M. Ramam, Shipra. Agarwal Sir, A 17-year-old girl presented to the dermatology department with fever, moderately itchy rash on the trunk, [...]

Byline: Vinod. Sharma, Neetu. Bhari, Suman. Patra, Anita. Parihar Indian J Dermatol 2019:64(5):417-9 Sir, Platelet-rich plasma (PRP) means 'abundant platelets that are concentrated into a small volume of plasma.' The [...]

Byline: Prashant. Gupta, Kaushal. Verma, Sujay. Khandpur, Neetu. Bhari Background: Corticosteroids are the most common agents used in the treatment of alopecia areata (AA), however, their long-term use is associated [...]

Byline: Sanjay. Singh, Sheikh. Naveed, Nikhil. Mehta, Sudheer. Arava, Neetu. Bhari A 26-year-old man presented with a single, asymptomatic, slowly progressive, firm swelling on the epigastrium, of 18 months' duration. [...]

Byline: Sanjay. Singh, Neetu. Bhari, Snehal. Agrawal, Kaushal. Verma Sir, A 4-month-old male child presented with rapidly progressing, tender, erythematous edematous swelling on the left side of the face and [...]

Byline: A. Narayanan, M. Ramam, Neetu. Bhari A 17-year-old boy presented with multiple, well-defined, erythematous plaques of variable sizes with fine scales on the forehead, supraorbital area, nose, cheeks, chin [...]