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Retinoids are used topically as well as orally, and the most commonly used oral retinoids are isotretinoin and acitretin. Mucocutaneous adverse effects are frequently seen with the use of systemic retinoids, the most common being cheilitis, which is dose-dependent and seen in almost all patients using it. To study the comparative effect of topical tacrolimus 0.1% ointment versus topical white soft petrolatum jelly in the treatment of cheilitis due to retinoids. A total of 26 patients with cheilitis post-treatment with isotretinoin were enrolled in this cross-sectional study conducted over a period of 6 months. They were randomized into two groups of 13 patients each to receive topical tacrolimus 0.1% ointment and soft petrolatum jelly twice daily, respectively. Patients were followed up weekly with clinical photographs. Resolution of cheilitis was assessed on the basis of photograph and ICGS score. About 84.6% of patients of group A and 53.8% of patients of group B showed resolution of symptoms within 1 week of treatment. A significant difference was seen in duration for complete cheilitis resolution and relapse rate in the two groups. Our study concludes that oral retinoid-induced cheilitis shows faster and more significant resolution with twice-daily topical tacrolimus 0.1% ointment application compared to twice-daily topical petrolatum jelly.

Background: Becker nevus (BN), a common nevoid hamartoma, presents as a hypermelanotic often hypertrichotic plaque localized to the chest, shoulder, or back in the first two decades of life. Aims: The aim of the study was to evaluate clinicohistopathological and dermoscopic findings of BN in the Indian population. Methods: Thirty-five clinically diagnosed cases of BN were enrolled. Sample characteristics, clinicohistopathological findings, dermoscopic findings, and developmental abnormalities were noted and an observational analytical study was carried out. Results: The mean age of the patients was 18.9 years and 28 (80%) were Males. BN was present since birth in 12 (34.3%), developed in the first decade in 5 (14.3%), and in the second decade in 18 (51.4%). Common sites included the chest in 10 (28.6%), the face in 8 (22.9%), and the upper limb in 7 (20%). Hypertrichosis was observed in 24 (68.6%) and acneiform lesions in 2 (5.7%). Twenty-two (62.9%) patients had right-sided lesions. No developmental abnormalities were detected. Skin biopsy findings included hyperkeratosis in 25 (71.4%), acanthosis in 32 (91.4%), elongation of rete ridges in 32 (91.4%), basal layer pigmentation in 35 (100%), and smooth muscle hyperplasia in 4 (11.1%) patients. Dermoscopic findings included reticular brown lines (pigmentation network) in 32 (91.4%), perifollicular white color (perifollicular hypopigmentation) in 27 (77.1%), skin furrow hypopigmentation in 17 (48.6%), and focal hypopigmentation in 15 (48.6%) cases. Conclusions: Onset at birth and facial lesions are common in those of Indian ethnicity, while developmental abnormalities associated with BN are infrequent.

Background: Nail disorders account for about 10% of all dermatological conditions. Onychoscopy is useful not only for their diagnosis but also for assessing severity/progression and monitoring the response to therapy. Aims and Objectives: Describing dermoscopic features of nail disorders in patients reporting to the dermatology OPD of our tertiary care hospital and recording the sociodemographic profiles thereof. Materials and Methods: This cross-sectional observational study was carried out on 176 patients with effect from August 2019 to August 2021. Results: Males (99; 56.25%) outnumbered females (77; 43.75%); males: female: 1.28: 1; their mean age was 35.8 years. Fingernails were affected more oftener (84.09%) than toenails (38.64%). Onychomycosis, the commonest (58;32.95%) condition, revealed findings of aurora borealis pattern (75.86%), subungual hyperkeratosis (72.41%), and onycholysis with jagged edges and spikes (68.97%). The next frequent (32;18.18%) condition was nail psoriasis which revealed pits (81.25%); onycholysis (62.5%) and dilated globose nail fold vessels on capillaroscopy (25%). Limitations: The small sample size proved inadequate for the evaluation of statistical significance in the less common conditions and the correlation of disease severity of many. Ideally, confirmatory diagnostic tests should have been done in every patient, as indicated. The magnification of our dermoscopy was 10X; 20- and 40X permit better capillaroscopy. Conclusions: Onychocopy can minimize the need for biopsy by highlighting subtle changes and helps narrow down the differentials. It is potentially a diagnostic test of choice in younger children. Our study helped to grade the severity of connective tissue disorders and establish the benignity of melanonychia. Photographic documentation facilitates record-keeping.

Abstract A provisional diagnosis of urticaria pigmentosa was revised to lichen planus pigmentosus with dermatographism, after histopathologic examination of specimen from hyperpigmented patch. It is important to keep differential diagnosis of inducible wheals while making a diagnosis.

Enoxaparin is a low-molecular-weight heparin (LMWH), i.e., widely used for prophylaxis and therapy of venous thromboembolism. Skin necrosis after subcutaneous injection is an uncommon and possibly underreported complication of LMWH. We report a case of enoxaparin-induced localized skin necrosis. Prompt diagnosis, discontinuation of LMWH, and work-up to rule out heparin-induced thrombocytopenia, a potentially life-threatening condition goes a long way in improving the outcome.

Background: Coronavirus disease 19 (COVID-19) pandemic is a recent outbreak of a viral infection caused by severe acute respiratory syndrome coronavirus 2. Increase in the use of personal protective equipment (PPE) among doctors has resulted in increase in adverse effects such as contact dermatitis, urticaria, acne, and infections. Objectives: To identify the prevalence of common dermatosis developing in doctors using PPE. To compare if dermatosis is more common in doctors working in COVID-19 dedicated setup. To assess if the development of dermatosis use was related to the duration of PPE use. Materials and Methods: A cross-sectional type of observational study was conducted. A questionnaire was circulated on social media to the doctors. The response was collected in Microsoft Excel and analyzed. Results: Two hundred and sixty-nine (71.35%) doctors reported the development of dermatosis due to personal protective equipment (PPE) use. Eczema of the face (30%) and acne (26.25%) were the commonly reported dermatosis in our study. The development of dermatosis was significantly related to the duration of PPE use. Our study revealed a high prevalence of dermatosis among doctors using PPE, which was related to the duration of work. Conclusion: Hence, there is a need to make the doctors aware about such dermatosis, suggest prevention measures, provide them with effective dermatological treatment, and establish guidelines for prevention for occupational skin disorders at a national level.

Background: Dermoscopy is a non-invasive method of evaluating disorders of the skin. Dermoscopy of hair and scalp disorders termed trichoscopy is useful in assessing scalp disorders with alopecia. Aim and Objectives: The aim of the study was to evaluate trichoscopic features of common scalp disorders with alopecia. The primary objective was to identify distinctive features of these disorders while the secondary objective was to formulate a simplified algorithm to arrive at a diagnosis. Material and Methods: A descriptive, cross sectional study of common scalp disorders with alopecia was conducted over a period of 2 years at a tertiary care centre. Two hundred cases were enrolled after obtaining approval of ethics committee and informed consent of patients. A detailed history was taken and general physical and dermatological examination carried out. Trichoscopic evaluation was carried out using Heine Delta 20T dermatoscope. Results: Common scalp disorders with alopecia included male pattern androgenetic alopecia (20.5%), alopecia areata (19.5%), telogen effluvium (12.5%) and female pattern hair loss (10.5%) and their trichoscopic features were tabulated. On the basis of trichoscopic features, an algorithm for rapid diagnosis was formulated. Conclusion: Common scalp disorders with alopecia have characteristic trichoscopic signs. A simplified algorithm formulated from the study may help in rapid diagnosis. [ABSTRACT FROM AUTHOR]