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Background: Chronic spontaneous urticaria (CSU) refers to urticaria that has no specific cause or trigger, present on most days of the week for 6 weeks or more. The incidence of chronic urticaria in the pediatric age group is between 0.1% and 3%. Levocetirizine and bilastine are nonsedative second-generation antihistamines used to treat urticaria in both adults and children. Objective: The primary objective was to compare the effectiveness of levocetirizine and bilastine in cases of pediatric CSU using Urticaria Activity Score (UAS) and Urticaria Severity Score (USS). The secondary objective was to evaluate and compare the safety and quality of life (QoL) using the Dermatology Life Quality Index (DLQI) score. Materials and Methods: This was a randomized, observer-blinded study where 65 patients (6–16 years) with a history of urticaria >6 weeks were divided into two groups with computer-generated randomization. Thirty-two patients were included in Group A, who received levocetirizine, and 33 patients were included in Group B, who received bilastine. UAS7, USS, and DLQI were recorded at every visit. The primary outcome was measured using UAS and USS and the secondary outcome in the form of patient's QoL was assessed using the DLQI score. Laboratory parameters were assessed at the first visit and at the end of 3 months. Results: There was a significant difference (P = 0.002) in UAS7, USS, and DLQI between the baseline and last visit scores for each group. There was no significant difference (P = 0.28) in the scores between the two groups. Laboratory parameters like liver enzymes and complete blood count also did not show any significant differences between the two groups. Conclusion: Both levocetirizine and bilastine are equally effective and safe in the treatment of CSU at the end of 3 months. However, bilastine showed a better fall in the DLQI as compared to levocetirizine. [ABSTRACT FROM AUTHOR]

Background: Pediatric procedural dermatology is a broad and emerging aspect in the field of dermatology. Pediatric procedures require great expertise, skill, empathy, and confidence on the part of the treating physician. The challenging factors such as parental anxiety and doubts, the child’s cooperation, and the risks versus benefits are further contributory. Objective: The objective of the study was to summarize the risks of intra‑ and postoperative complications/side effects during diagnostic and therapeutic procedure in the pediatric population. Materials and Methods: We conducted a retrospective study in our hospital. Patients were taken between ages 0 and 18 years who had attended the dermatology outpatient department from January 2019 to March 2022. Results: In a total of 527 outpatient department patients, 267 (50.66%) were males and 260 (49.33%) were females (male: female ratio 1.02:1). Out of diagnostic procedures, the most commonly performed procedures were punch biopsy (14.61%), followed by autologous serum skin test (11.81%) and slit‑skin smear (1.90%). Out of 15 therapeutic procedures, intralesional steroids (21.34%) were the most frequently performed therapeutic procedure, followed by radiofrequency cauterization (16.51%), autologous skin therapy (6.98%), cryotherapy (8.76%), nail surgery (2.79%), chemical peeling (2.79%), comedone extraction (2.66%), chemical cauterization (2.54%), neodymium‑doped yttrium aluminum garnet laser (2.16%), platelet‑rich plasma therapy (1.39%), diode laser (1.27%), measles, mumps, and rubella vaccine injection (0.89%), fractional carbon dioxide laser (0.63%), suction blister epidermal grafting (0.63%), and platelet‑rich fibrin therapy (0.25%). Conclusions: This study provided comprehensive data on the various dermatological procedures done for pediatric cases in a tertiary care teaching hospital. Both diagnostic and therapeutic procedures caused mild and transient side effects such as pain, edema, erythema, burning sensations, and irritation that did not affect the patient’s lifestyle. [ABSTRACT FROM AUTHOR]

In respect to COVID-19 vaccination, both immediate (median 1-3 days) and delayed reactions (median 7 days) dubbed as "COVID Arm", have been described.3 Herpes zoster post-vaccination with both mRNA-based and inactivated COVID vaccines have been described. (C) Dermographism on the back of patient 2 days post-vaccination gl All seven patients who developed a cutaneous reaction after first dose were advised to go ahead with second dose vaccination. Herpes zoster reactivation (Pfizer vaccine), COVID-ARM (Moderna), and urticaria (AstraZeneca) were the commonest reactions noted.2 Cutaneous adverse reactions after COVID-19 vaccination could be due to multiple factors. [Extracted from the article]

Background: Palmoplantar psoriasis is a chronic debilitating condition which significantly impairs quality of life., Objectives: To assess the efficacy and safety of the combination of apremilast and methotrexate compared with methotrexate monotherapy in the treatment of palmoplantar psoriasis. Also, to study the impact on treatment on the Dermatology Life Quality Index and Palmoplantar Quality of Life Index., Methods: A total of 64 patients were randomised to two groups in a 1:1 ratio - Group A received both methotrexate and apremilast in combination, while Group B received only methotrexate, for 16 weeks. The primary endpoints were the mean score of Modified Palmoplantar Psoriasis Area and Severity Index at week 16, the proportion of patients achieving modified palmoplantar psoriasis area severity index-75 and/or Palmoplantar Psoriasis Physician Global Assessment score 0/1 at week 16., Results: A significantly higher proportion of patients in Group A achieved Modified Palmoplantar Psoriasis Area and Severity Index-75 at week 16 (43% in Group A vs 30% in Group B). The Modified Palmoplantar Psoriasis Area and Severity Index score was significantly lower in the combination group at week 16 (4.03 ± 2.05 in Group A and 5.89 ± 2.31 in Group B, P-value = 0.002). About 80% of patients in the combination group with baseline Palmoplantar Psoriasis Physician Global Assessment ≥3 achieved Palmoplantar Psoriasis Physician Global Assessment 0/1 compared to 60% in Group B. The combination group showed a significantly higher reduction in Dermatology Life Quality Index and Palmoplantar Quality of Life Index scores compared to the methotrexate alone group (P-value = 0.025). No notable adverse events were observed., Limitation: The limitations of the study were single blinding, small sample size and a lack of longer follow up to assess the rate of relapse. We did not account for attrition during sample size calculation. Also, due to the paucity of data regarding the use of apremilast in palmoplantar psoriasis, definitive comparisons could not be made with previous studies., Conclusion: The combination of apremilast and methotrexate has superior efficacy and a similar safety profile as compared to methotrexate monotherapy for the treatment of moderate to severe palmoplantar psoriasis.