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Byline: Aakanksha. Arora, Rajesh. Mehta, Bhikam. Ghiya, Prasoon. Soni, Alpana. Mohta, Rajesh. Khokhar, Vishnu. Jangir, Manoj. Yadav, Sumiti. Pareek Background: Erbium-YAG laser has been the working horse in dermatology for [...]

Byline: Alpana. Mohta, Asha. Nyati, Bhikam. Ghiya, Rajesh. Mehta, Suresh. Jain Background: Global phase III trials have established the effectiveness and the safety profile of 5 and 10 mg twice-daily [...]

Objectives: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are treatment options available. In this study, we aimed to compare the efficacy of microneedling with platelet-rich plasma (PRP) against subcision with PRP in treating atrophic post-acne scars in a split-face study design. Material and Methods: Fifty patients with atrophic post-acne facial scars were included in this prospective interventional study. Group A (left side of the face) was managed by microneedling with PRP and group B (right side of the face) was subjected to subcision with PRP. Results were assessed based on Goodman and Baron qualitative and quantitative grading. Results: In our study, at the end of the treatment, on the left side, 5 (10%) had 1 grade of improvement showing good response, 35 (70%) had 2 grades of improvement showing very good response, and 10 (20%) had 3 grades of improvement showing excellent response. On the right side, 1 (2%) patient had no improvement in acne grade showing poor response, 9 (18%) had 1 grade of improvement showing good response, 25 (50%) had 2 grades of improvement showing very good response, whereas 15 (30%) had 3 grades of improvement showing excellent response. Conclusion: Both modalities showed statistically significant results individually, there was no significant difference in qualitative improvement of acne scars between the two groups. [ABSTRACT FROM AUTHOR]

Byline: Alpana. Mohta, Bhikam. Ghiya, Rajesh. Mehta Sir, Zoon's balanitis (ZB) was described for the first time by Zoon in 1952 in eight men having chronic balanitis who were initially [...]

Aging is of two types, namely extrinsic and intrinsic aging. Extrinsic aging or photoaging is caused mainly due to damage caused by solar radiation. We report the case of a elderly male who presented with large growth on the scalp and ulcer on the face. However, on clinical examination, almost all the changes of photoaging, namely solar lentigo, cutis rhomboidalis nuchae squamous, and basal cell carcinoma were present. This case highlights the importance of thorough clinical examination needed in the geriatric population for the early diagnosis and timely management of their ailments. This will not only prolong but also improve their quality of life. [ABSTRACT FROM AUTHOR]

Xanthelasma palpebrarum (XP) is a benign cosmetic condition. Although the role of CO2 laser is well described, there are only a few studies on Erbium: YAG in XP. Similarly, trichloroacetic acid (TCA) is commonly used in XP. However, there are only a few studies comparing these modalities in the treatment of XP. Aim: To evaluate the effectiveness and safety of Erbium: YAG laser and 50% TCA in the treatment of XP with the role of dermoscope in the evaluation of lesions. Materials and Methods: A total of 20 subjects were randomly allocated into two groups: group A (TCA) and group B (laser). All patients were subcategorized into three grades viz. I (mild), II (moderate), and III (severe) using a self-devised scoring system. Results: About 25% and 70% of patients achieved complete clearance in groups A and B, respectively (P = 0.017). The rate of recurrence was 40% and 15% in groups A and B. Dyspigmentation and erythema were the most common side effects. Pretreatment dermoscopic evaluation of the lesion showed a network of brown streaks on a background of a yellowish structureless area and was used to assess the area and margins of the lesion where the adipose tissue was found during the procedure and serial assessment of the lesion. [ABSTRACT FROM AUTHOR]

Introduction: Seborrheic keratosis (SK) are benign lesions with cosmetic concerns. Role of TCA and erbium YAG laser has already been described individually in the literature. However, there is a scarcity of data on the comparative evaluation of these two modalities in SK. Aim: The aim of this study was to compare the efficacy and safety profile of Erbium YAG laser ablation with 70% TCA for the treatment of facial SK. Materials and Methods: A total of 50 cases of facial SK were included in the study. Group A included SK lesions on the right side of face treated with Erbium YAG laser ablation while Group B included SK lesions on the left side of face treated with topical 70% trichloroacetic acid. Repeated sessions of laser and TCA application were given at 2-week intervals till cure was achieved or up to a maximum of three sessions. Grading of response to treatment was assessed as complete response (100% clearance), partial response (>50 to 99% improvement), and inadequate or no response (<50% improvement). Results: Complete clearance was observed in 40 (80%) and 29 (58%) cases in Groups A and B, respectively. There was a statistically significant difference in clearance rates between the two groups (P = 0.019). Number of sessions was significantly lesser in laser group (mean ± SD = 1.24 ± 0.43) than in the 70% TCA group (mean ± SD = 1.88 ± 0.79) (P = 0.001). Statistically significant lesser downtime was observed in group A (P = 0.001). Patient satisfaction rate was much higher in group A. Hyperpigmentation was more common in group B (TCA). Conclusion: Although both the treatment modalities achieved good results, erbium YAG laser ablation showed superior results than 70% TCA with better patient satisfaction rates but more downtime. Also, no major adverse effects were observed in the two groups. [ABSTRACT FROM AUTHOR]

This article discusses a case of oil granuloma, specifically facial oil-granuloma, caused by a self-injected mixture of almond oil and vitamin E oil. The patient presented with swelling around the eyes and multiple yellowish-brown papulo-nodular lesions. A biopsy confirmed the diagnosis of suppurative and foreign body-oil injection granuloma. Treatment options for oil granulomas include oral and/or intralesional corticosteroids, antibiotics, retinoids, and surgical excision. The article emphasizes the importance of obtaining a detailed history and prompt diagnosis to prevent further complications. [Extracted from the article]

Background: Vascular endothelial growth factor (VEGF)-mediated angiogenesis's role in developing psoriasis and cardiovascular events has been established. However, the interplay between the two diseases regarding this cytokine remains an understudied area. Aim and Objectives: This case--control study aimed to investigate the relationship between VEGF-mediated angiogenesis and cardiovascular ischemia in patients with psoriasis. Materials and Methods: The study included 200 clinically diagnosed treatment-naïve cases of psoriasis and 200 controls. The VEGF level, cutaneous vascularity, and cardiovascular ischemia were measured between cases and controls. Cutaneous vascularity was assessed using non-invasive imaging technique such as laser doppler imaging (LDI) and measuring skin blood flow measurement (SBFM). Cardiovascular ischemia was evaluated using noninvasive techniques by measuring carotid intima--media thickness (CIMT) and pulse-wave velocity (PWV). The arterial vasa vasorum was evaluated using ultrasound imaging. Results: The study found a significant correlation between psoriasis severity and levels of VEGF (P < 0.001). Cases had significantly higher CIMT and PWV levels (P = 0.001 and <0.001, respectively). There was a significant positive correlation between the severity of psoriasis and the levels of cutaneous angiogenesis (r = 0.7, P < 0.001). Conclusion: According to this study, patients with psoriasis are at a higher risk of developing cardiovascular ischemia due to excessive angiogenesis associated with the condition. VEGF plays a key role in atheroma formation in psoriasis patients. [ABSTRACT FROM AUTHOR]

Background: Up to 30-50% of cases of psoriasis experience nail involvement, while 5-10% may have only isolated nail disease. Recently, the use of onychoscopy, a non-invasive technology, has emerged as a promising tool that may eliminate the necessity of a nail biopsy in most cases. Objective: The objective of this study was to assess the onychoscopic characteristics of the nail unit in individuals with nail psoriasis. Materials and Methods: The study recruited fifty patients with a clinical diagnosis of nail psoriasis. Each nail underwent onychoscopic assessment. The clinical degree of cutaneous and nail involvement was evaluated with the Psoriasis Area and Severity Index (PASI) and the Nail Psoriasis Severity Index (NAPSI), respectively. Results: The following findings were observed significantly more often on onychoscopy than with the naked eye: pitting (p = 0.03), leukonychia (p = 0.04), onycholysis (p = 0.04), and splinted hemorrhage (p = 0.05). The other novel findings included fuzzy lunula, which was only onychoscopically (8%), We also encountered 4% of cases of triangular onychomadesis and 6% of non-traumatic Median canaliform dystrophy of Heller. Conclusion: Our findings suggest that, even before clinical symptoms become obvious, onychoscopy may help with nail lesion diagnosis. [ABSTRACT FROM AUTHOR]

Background: Owing to the myriad clinical presentations of COVID-19 vaccine-induced adverse events, clinicopathological correlation is the key to understanding the underlying pathophysiology of these reactions. However, there is still a dearth of such systematic studies across a wide spectrum of vaccine reactions. Aim and Objectives: This study provides a clinical and histopathological correlation of COVID-19 vaccine-induced mucocutaneous reactions. Materials and Methods: The study population included all the individuals developing any form of self-reported mucocutaneous adverse events within 4 weeks of receiving the COVID-19 vaccine. The clinical and histopathological features were recorded. Results: A total of 126 cases were identified. Seven histopathological patterns were recognized. The most common histopathological feature was spongiotic dermatitis, seen in all the patients with "vaccine-related eruption of papules and plaques" (VREPP). Other patterns included lichenoid or interface dermatitis, dermal hypersensitivity reaction, leukocytoclastic vasculitis, subepidermal blistering, psoriasiform hyperplasia, and dermal granulomatous reaction. Conclusion: Owing to such myriad clinical presentations, utilizing a histopathological classification could ease categorizing the vaccine-induced mucocutaneous eruptions. [ABSTRACT FROM AUTHOR]

Background: Molluscum contagiosum (MC) is a common self-limiting viral infection of the skin. Many therapeutic agents have been used for it with varying success rates. Objective: To evaluate and compare the efficacy and safety profile of topical 20% glycolic acid and 30% salicylic acid in the treatment of MC in pediatric patients. Materials and Methods: All patients of MC between 1 and 15 years of age attending the outpatient department of dermatology were randomized into two treatment groups A and B. Group A was treated with 20% glycolic acid solution, and group B was treated with 30% salicylic acid solution daily for 4 weeks. Parents of patients were instructed to apply the medication once daily at night for 1 h on the lesions only. The assessment of response and side effects were analyzed in all the patients weekly for 4 weeks during the daily treatment protocol. Follow-up was done monthly for 3 months after the completion of therapy. Results: At the end of 4 weeks, group A patients (60 patients) were treated with 20% glycolic acid out of which 34 (56.66%) patients had a complete clearance of lesions. Group B patients were treated with 30% salicylic acid out of which 38 (63.33%) had a complete clearance of lesions. Secondary bacterial infection was the most common side effect followed by postinflammatory hyperpigmentation in both groups. Conclusion: 30% salicylic acid was found to be more effective and has less sideeffect profile in the treatment of MC than 20% glycolic acid. [ABSTRACT FROM AUTHOR]

Mucormycosis is a rare, aggressive angioinvasive deep fungal infection caused by mucorales. The epidemiology of mucormycosis has changed in recent times with the increase in incidence, identification of new causative agents, and predisposing factors. The clinical spectrum of mucormycosis includes rhinocerebral, sinopulmonary, cutaneous, and disseminated forms. Cutaneous mucormycosis is an emerging infectious disease especially in post COVID‑19 era. Cutaneous mucormycosis can be of two varieties: primary cutaneous and secondary cutaneous. Primary cutaneous mucormycosis is caused by direct inoculation of spores at the site of local trauma resulting in necrotic ulcers, especially, in immunosuppressed patient. Secondary cutaneous mucormycosis results from either dissemination or local invasion to the skin from a rhinocerebral form. The existing data on mucocutaneous mucormycosis is sparse especially in India. Herein, we present a case series describing the demographic factors, predisposing factors, clinical presentation, management of unique cases of mucocutaneous mucormycosis and its association with COVID‑19 infection. [ABSTRACT FROM AUTHOR]

Introduction: The rapidly adapting neonatal skin, being anatomically and physiologically distinct from an adult, may exhibit a variety of entities, ranging from mild self-limiting to the severe life-threatening ones. The transition of neonatal skin from an aqueous to an air-dominant environment results in various changes, both physiological and pathological. Physiological and pathological dermatoses should be differentiated to avoid unnecessary treatment and psychological distress to parents. The present study was carried out to determine prevalence and patterns of physiological cutaneous manifestations among early neonates in western Rajasthan. Materials and Methods: This hospital-based, descriptive, observational study was carried at a tertiary care hospital over a period of 1 year. After due informed consent, total of 5000 early neonates delivered during this time were included in the study. A detailed history was taken and dermatological examination of each neonate was carried out. Laboratory procedures were performed to confirm diagnosis if required. Data were collected in a predesigned pro forma. Results: Out of 5000 newborns, 64.96% were male and 35.04% female. Ninety-two percentage had physiological changes and 21% had pathological changes. The physiological skin changes observed in order of frequency were sebaceous hyperplasia (65.32%), milia (51.12%), physiological desquamation (41.02%), vernix (35%), and physiological jaundice (9.32%). Cutis marmorata, harlequin skin changes, and lanugo hair were seen more in low-birth weight and preterm neonates. Conclusion: Most of the early neonatal dermatoses are physiological and transient in nature. Hence, it is important to identify and differentiate them from other serious conditions, thereby avoiding unnecessary diagnostic and therapeutic procedures and provide reassurance to overenthusiastic dermatologists, pediatricians, and parents. [ABSTRACT FROM AUTHOR]

A case study highlights various histopathological patterns in 52 cases of mucocutaneous reactions following COVID-19 vaccination, predominantly spongiotic and lichenoid dermatitis. It suggests a delayed type 4 hypersensitivity reaction, introducing the term VREPP for vaccine-related eruptions of papules and plaques, emphasizing the need for histopathological classification in post-vaccine mucocutaneous reactions.

Introduction: Ever since the outbreak of COVID-19, the respiratory system has been the chief focus of researches, however, understanding the impact of this disease on the integumentary system is just as essential. Objectives: We aimed at collecting data on any cutaneous manifestation arising in patients with active and recovering COVID-19 infection, or a direct consequence of the infection's treatment, and correlating these findings with systemic disease severity and duration. Materials and Methods: A prospective observational study was conducted in three tertiary care centers from Rajasthan, India, to acquire data of laboratory-confirmed cases of COVID-19 presenting with any mucocutaneous manifestation. Results: Eight predominant patterns of dermatological involvement were seen, namely, maculopapular (14.59%), urticarial (13.17%), perniotic (12.1%), pityriasis rosea (11.74%), acral erythema/edema (10.3%), petechial (4.63%), vesicular (2.49%), and livedo (1.78%). Rare findings included eruptive pseudoangioma, eruptive hypomelanosis, alopecia parvimaculata, geographic tongue, chikungunya-like hyperpigmentation, and nail changes. On correlating these findings with the gradient of the disease, livedo, vasculitis, exfoliation, and erythroderma were associated with severe disease, whereas perniosis and eruptive pseudoangioma were seen in mild illness. Conclusion: We reported a few previously unpublished skin manifestations of COVID-19, namely, geographic tongue, chikungunya-like pigmentation, eruptive hypomelanosis, and alopecia parvimaculata. This study provides a visual description of the muco-cutaneous manifestations of COVID-19 disease which could aid a dermatologist or physician in early diagnosis of this novel infection, especially in a resource-poor setting. [ABSTRACT FROM AUTHOR]

Introduction: The Centers for Disease Control and Prevention has included asthma as a risk factor for developing severe coronavirus disease 2019 (COVID-19) illness. Respiratory viruses are known to run a more severe course in patients with underlying respiratory illnesses. However, the reports on the association of atopic dermatitis and COVID-19 infection are contrasting. Aims and Objectives: We aimed at assessing the difference between the severity of COVID-19 illness in patients having concurrent atopic dermatitis compared to those without concurrent atopic dermatitis. Materials and Methods: Study subjects included real-time polymerase chain reaction (RT-PCR) positive COVID-19 patients under the age of 18 years. The patients were divided into two groups, namely, cases and controls. Cases included children with atopic dermatitis diagnosed according to revised Hanifin and Rajka criteria with positive COVID-19 RT-PCR report. Controls were age-and sex-matched children from the same center with COVID-19, without atopic dermatitis. Disease severity was compared between the two groups. In addition, the COVID-19 severity was correlated with the SCORAD in the "cases" group. Results: While assessing the severity of COVID-19 illness on the basis of computed tomography score and clinical severity, there was a higher proportion of "severe" illness in "cases" compared to "controls," however, the difference was statistically insignificant. There was no significant correlation between high SCORAD scores and severe COVID-19 illness. Conclusion: Our study contributes to the ever-growing data suggesting that atopic diathesis is not a risk factor for acquiring COVID-19. [ABSTRACT FROM AUTHOR]

Byline: Prasoon. Soni, Neha. Prasad, Kanika. Khandelwal, Bhikam. Ghiya, Rajesh. Mehta, Ram. Bumb, Poonam. Salotra Cutaneous leishmaniasis (CL) is a vector borne disease caused by various species of Leishmania parasite. [...]

Hybrid or mixed teledermatology has been regarded to be the most efficient mode of teledermatology.[[5]] Apparently benign lesions, which can have a serious prognosis like tuberous xanthomas, can be missed in rural areas that lack dermatology services. In faraway rural areas where there is a pediatrician or general physician but no access to a dermatologist or pediatric dermatologist, the pediatrician can initiate video conferencing consultation with the dermatologist. When a patient communicates with a dermatologist again after the first consultation for a follow-up visit, it is known as patient-assisted teledermatology. [Extracted from the article]

Background/Aim: Intralesional bleomycin gained increasing popularity in the recent past for treatment of warts particularly in palmo-plantar and periungual regions as other modalities are not very effective. Hence we evaluated the role of intralesional bleomycin in periungual and palmo-plantar warts to know its efficacy in Indian patients. Settings and Design: This was a placebo-controlled study. Materials and Methods: Fifty patients of multiple palmo-plantar and periungual warts were included in this study and categorized in groups A and B of 25 each. Alternate patients were included in groups A and B and treated respectively with intralesional bleomycin (1 mg/mL solution) and normal saline as placebo, fortnightly for maximum up to two injections. Patients were followed up weekly for 1 month, fortnightly up to 12 weeks, and then quarterly for 1 year. If warts persisted after 12 weeks of starting treatment, it was considered a failure. Statistical analysis was done by the chi-square test using M-stat software. Results: Group A and B patients were having 85 warts and 72 warts, respectively. The cure rate in group A and B patients was 96.47% (82/85 warts) and 11.11% (8/72 warts), respectively, after one or two injections within 12 weeks. The difference in the cure rate between two groups was statistically highly significant (<0.0001). In group A patients, a haemorrhagic eschar was formed which gradually healed in 8-12 weeks without atrophy or pigmentation; this phenomenon was not seen in group B. Only moderate pain was observed by most of the patients during injection in both groups. Conclusion: The intralesional injection of bleomycin is highly effective, safe, and non-toxic in periungual and palmo-plantar warts. [ABSTRACT FROM AUTHOR]

A case study of 24‑year‑old man is presented with complaint of generalized body rash, facial edema, abdominal pain and high‑grade fever for 3 days. Topics include considered on mucocutaneous examination, there was presence of multiple well‑to‑ill‑defined erythematous non‑follicular papules and pustules all over the body involving several percentage of the body surface area, with the presence of purpuric targetoid lesions over bilateral legs.

Post-acne atrophic scars (PAS) are a common complication of acne, and their treatment can be limited in people of color due to dyspigmentation and scarring risks. This split-face study compared the efficacy of microneedling with topical insulin (TI) on one side of the face with microneedling with platelet-rich plasma (PRP) on the other side for the treatment of PAS. The study included 50 participants with Fitzpatrick skin types III to VI who had never been treated for PAS. Both sides of the face showed significant improvement, with the left side being treated with TI showing a 52% improvement and the right side being treated with PRP showing a 28% improvement. The treatment was well-tolerated, with no significant adverse effects, and no changes in blood glucose levels were observed. The researchers suggest that combining TI or PRP with microneedling can improve PAS treatment, with TI being a superior option due to its ease of use, low cost, and noninvasive nature., Competing Interests: There are no conflicts of interest., (© 2024 Published by Scientific Scholar on behalf of Journal of Cutaneous and Aesthetic Surgery.)