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Skin colour usually depends upon melanin, haemoglobin, and carotenoids. Pigmentary disorders indicate an increased amount of melanin, leading to a darker colour of the skin, called hypermelanosis. Addison's disease is a rare endocrinal disorder with severe oral and systemic manifestations. Any form of diffuse skin hyper-pigmentation which is more pronounced on sun-exposed areas mimics Addison's disease and is called Addisonian pigmentation. Pigmentation often precedes other manifestations by months to years and hence can lead to early diagnosis and can prevent life-threatening adrenal crisis. The most common cause of adrenal insufficiency in developing countries is tuberculosis. A similar pattern of pigmentation has been reported in Cushing's syndrome, ectopic ACTH-producing tumours, vitamin B12 deficiency, and thyrotoxicosis. Addisonian pigmentation can be a manifestation of multiple systemic diseases; hence, an inter-disciplinary approach is needed with extensive clinical and laboratory evaluation. It is not merely a cosmetic concern. Not much data are available in the literature regarding this entity. This brief review serves as an important source for clinicians to stay up-to-date regarding the history, clinical presentation, differential diagnosis, and management of this entity. Keywords: Addison's disease, Addisonian pigmentation, tuberculosis, Author(s): Damini Verma (corresponding author) [1]; Rashmi Sarkar [1]; Vibhu Mendiratta [1]; Amol Srivastava [2] Introduction Normal skin colour depends mainly on melanin, haemoglobin (oxidized and reduced), and carotenoids. Melanin [...]

Author(s): Rashmi Sarkar [1]; Amit K. Meena [1]; Vibhu Mendiratta [1]; Sneha Sonker [1]; Smita Singh [2] Sir, Cutaneous lymphomas are a wide group of skin non-Hodgkin lymphomas (NHLs) that [...]

Background: Tacrolimus, a topical calcineurin inhibitor (TCI) with immunomodulatory effects, is considered a viable treatment option for vitiligo. A consensus building exercise was undertaken to determine the role and clinical utility of topical tacrolimus in the management of vitiligo using input from experts in the field of dermatology. Methods: Seventeen experts collaborated to create consensus statements using a modified Delphi methodology. A questionnaire on effectiveness, safety and utility of topical tacrolimus in different types of vitiligo, duration, frequency, monotherapy and combination and other aspects was shared, and a concordance rate of 75% was preset to have consensus. A physical meeting was conducted to discuss statements, which did not achieve consensus. Results: Amongst 34 statements derived from round one, consensus was not achieved for 9 statements. In the second round, consensus was achieved for 2/9 statements, hence in the physical meeting, discussion was done to reframe the remaining seven statements. Apart from these 34 statements, questions pertaining to "Vitiligo: types and presentation in clinical practice", where consensus was not intended, are presented as descriptive statements. Conclusion: Topical tacrolimus ointment has a favorable risk benefit profile to be used as one of the first-line agents for vitiligo. Combination of topical tacrolimus and narrow band Ultraviolet-B (NBUVB) was recommended as an effective treatment for non-segmental vitiligo. Recommended frequency of application was once or twice daily for optimal results. Apart from a transient burning sensation, topical tacrolimus has a favorable safety profile. [ABSTRACT FROM AUTHOR]

The article "Deciphering the landscape of hereditary angioedema in India: Perspective for Indian dermatologists" published in the Indian Journal of Dermatology, Venereology & Leprology provides insights into hereditary angioedema (HAE) in India. It highlights the genetic causes, clinical manifestations, and management strategies for HAE, emphasizing the need for awareness and timely diagnosis. The article also discusses the availability of first-line treatment options in India and the importance of specialized care for patients with HAE. Additionally, it mentions patient advocacy groups like HAE India that aim to raise awareness and improve access to medications for individuals with HAE. [Extracted from the article]

Rash and fever are some of the most common chief complaints present in paediatric dermatology emergencies. The spectrum of differential diagnosis is broad, including many different infectious and some non-infectious agents. A systematic approach involving detailed history taking, careful clinical examination along with particular attention to epidemiological features are the most important factors to make a diagnosis. This article reviews the morphological patterns of various causes of fever with rash in children, including infectious as well as non-infectious causes, with special emphasis on the Indian scenario. We intend to highlight the clinical characteristics of each cause, which will not only help make a clinical diagnosis but also distinguish benign versus life-threatening causes of skin rash in febrile paediatric patients and provide early medical intervention. Keywords: Child, fever, India, rash, Author(s): Rashmi Sarkar (corresponding author) [1]; Anukriti Yadav [1]; Apoorva Maheshwari [1] Introduction Fever with rash is perhaps one of the commonest presenting complaints in routine and emergency paediatric dermatology [...]

Byline: Kiran. Godse, Rashmi. Sarkar, Venkataram. Mysore, Manunath. Shenoy, Manas. Chatterjee, Rajetha. Damisetty, Swapnil. Shah, Maya. Vedamurthy, Sanjeev. Aurangabadkar, Chakravarthi. Srinivas, Anil. Ganjoo, Sudip. Das, Anant. Patil Melasma, a chronic [...]

Hyperpigmentary disorders, including melasma, are challenging to treat. Glutathione has anti‐melanogenic and antioxidant properties, which led to its use as a skin‐lightening agent. Our objective was to review the published evidence and literature on the efficacy and safety of glutathione as a skin‐lightening agent and in the treatment of melasma. A literature search was done in the PubMed, Embase, and Cochrane library databases using the search terms “glutathione as a skin‐lightening agent” and “glutathione in melasma” for the past 10 years. The level of evidence, strength of recommendation, and risk of bias assessment were evaluated. Among various forms of topical glutathione, glutathione 0.5% was significantly more effective compared to glutathione 0.1% and placebo. For glutathione alone versus glutathione plus microneedling, more improvement was seen. Five randomized controlled trials and a single open‐arm clinical study on oral glutathione at doses of 250 mg once a day, 250 mg twice a day, and 500 mg once a day showed a significant reduction in the melanin index compared to placebo. The combination of topical 2% glutathione plus oral glutathione was superior to monotherapy alone. There was only one placebo‐controlled study on intravenous (IV) glutathione [6/16 (37.5%) vs. 3 (18.7%), (p0.054)]. The risk of bias assessment showed that almost an equal number of studies have low and high risk of bias. Topical versus oral glutathione both provide moderately efficacious skin‐lightening outcomes that are localized versus generalized and have minimal versus substantial adverse effects, but they are unsustainable, with variable costs. IV glutathione is contraindicated due to lack of efficacy and side effects. It may work more as an antioxidant in melasma. [ABSTRACT FROM AUTHOR]

Byline: Bhavya. Swarnkar, Rashmi. Sarkar Cutaneous mastocytosis is a neoplasm characterized by the proliferation and accumulation of mast cells in the skin. There can be involvement of other organ systems [...]

Lipoid proteinosis was first reported by Urbach and Wiethe in 1929. It is also known as hyalinosis cutis et mucosae or Urbach-Wiethe disease. It is a rare autosomal recessive disorder and characterized by the infiltration of hyaline material in the skin, oral cavity, larynx, and internal organs. Lipid proteinosis presents early in life. Hoarseness develops in infancy. The classic sign is beaded eyelid papules along the lid margin, also known as ‘Monilform Blepherosis’. In India about 30 cases have been reported to date. We report the following case because of its rarity in the Indian literature.

This article presents the findings of a study conducted among Indian dermatology residents to assess the prevalence and patterns of dermoscope use and the ability to identify common pigmentary dermatoses of the face. The study found that the prevalence of self-purchased dermoscopes increased with higher monthly stipends, but limited access and inadequate training were identified as potential reasons for variations in dermoscope use. The study also revealed that dermatology residents had higher accuracy in identifying dermatoses through clinical images compared to dermoscopic images. The study suggests the need for formal dermoscopy training in residency overseen by a program director. However, the study acknowledges limitations, including selection bias and the exclusion of certain graduates. [Extracted from the article]

Dermatological disorders constitute a significant proportion of primary health care (PHC) setups. The pattern of dermatological disorders varies among different countries and different parts of the same country owing to climatic and geographical variations, level of education, access to health care, etc. To study the clinical spectrum of patients presenting with dermatological disorders at an urban health center (UHC) in East Delhi. To identify the various risk factors associated with dermatological disorders in study subjects. A total of 1,148 patients who reported skin diseases for the first time at the Dermatology Outpatient Clinic at UHC in East Delhi were recruited. Detailed demographic data, history, and examination and potential risk factors of skin diseases (socioeconomic status, level of education, occupation, comorbidities, and addictions) were recorded on a predesigned proforma. A total of 616 (53.7%) patients had infectious dermatoses and 532 (46.3%) had non-infectious dermatoses. Among the infectious dermatoses, fungal diseases (44.8%) were the most common followed by parasitic infections (31.17%) and bacterial infections (9.74%). Among the non-infectious group, eczematous disorders (28.01%) were the most common, followed by pigmentary disorders (21.62%) and acne (19.55%). A significant association between level of education, occupation, and comorbidities with the distribution of infectious and non-infectious dermatoses was found. As a significant proportion of patients with a vivid spectrum of dermatological disorders present at the PHC setups, therefore dermatologists supervise that specialty clinics should be held regularly at these centers along with the availability of all the basic investigations to aid diagnosis and management. [ABSTRACT FROM AUTHOR]

The Indian Association of Dermatologists, Venereologists, and Leprologists (IADVL) has established the I-CuReD registry in India to collect data on rare skin disorders. The registry has recorded 323 patients with genodermatoses, with epidermolysis bullosa and congenital ichthyosis being the most common diseases. The article provides detailed information on the demographics, symptoms, and diagnostic methods used for these patients. The study found a lower number of cases compared to other countries and highlights the need for further research in this area. The authors acknowledge the limitations of their study and hope for more comprehensive studies in the future. [Extracted from the article]

Introduction: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, systemic therapies, or physical therapies including laser have been explored. However, there are not many randomized controlled studies for the majority of therapy alternatives besides lifestyle modifications and weight reduction. Objectives: The aim of this study was to compare the effectiveness of 15% trichloroacetic acid (TCA) and 35% glycolic acid (GA) peel for AN. Materials and Methods: Forty participants were included and randomized into two groups. In groups A and B, peeling with 15% TCA and 35% GA was done, respectively. The effectiveness of each peel was assessed using changes in the Acanthosis Nigricans Area and Severity Index Score (ANASI) and Physician Assessment Score. Statistical analysis included Wilcoxon-Mann-Whitney test, Friedman test, and generalized estimating equations. Results: The overall change in ANASI over time was compared in the two groups using the generalized estimating equations method. A significant difference was observed in the trend of ANASI over time between the two groups (P < 0.001). TCA peel group showed more change in ANASI as compared with GA peel group. Conclusion: In our research, 15% TCA has a better efficacy when compared with 35% GA peel after three sessions of chemical peeling. We therefore recommend the use of 15% TCA peel in AN as a safe and effective treatment option. However, more comprehensive randomized control studies are required for supporting data. [ABSTRACT FROM AUTHOR]

Byline: Ziaul. Ahmed, Komal. Agarwal, Rashmi. Sarkar Hand dermatitis (HD) is a chronic, relapsing, and remitting inflammatory condition that adversely affects the quality of life of the individual and gravely [...]