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Background: As face is the index of the mind, so is the nail the index to health, as the nail is capable of mounting only a limited number of reaction patterns to the large number of disorders affecting it. Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value. Aims: To study the clinical and dermoscopic features in nails of papulosquamous disorders and correlate it with disease severity. Methods and Material: This was a cross-sectional study with convenient sampling. After obtaining ethical clearance, according to inclusion and exclusion criteria, papulosquamous disorders were enrolled in the study. Finger nails and toe nails were numbered 1–10. Detailed clinical examination was done. Wet and dry dermoscopic examination was made in both polarised and non-polarised mode using ultrasound (USG) gel. Psoriasis area and severity index (PASI) and body surface area (BSA) were compared with nail changes. Statistical analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: Out of 203 patients, 117 were male. Psoriasis was the most common disease (55.6%). A total of 65.51% of patients had nail changes. Pitting was the most common finding in psoriasis, both dermoscopically and clinically. Splinter haemorrhage, oil drop, dilated capillaries, and pseudofibre sign were detected better on dermoscopy (P < 0.05). Positive correlation was found between PASI and nail psoriasis severity index (NAPSI). A strong correlation was also found between clinical (cNAPSI) and dermoscopic (dNAPSI). Thinning was the most common in lichen planus. No relation between BSA and nail changes was observed. Conclusions: Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value and reducing the requirement for invasive procedures like nail biopsies, early diagnosis, directing management.

Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae). Diagnosis of leprosy is confirmed based on cardinal signs and symptoms along with supportive laboratory investigations. Early diagnosis and treatment of new cases are essential to prevent disease burden and spread in community. Aim: To evaluate the efficacy of currently available laboratory tests like M.leprae-specific repetitive element Polymerase Chain Reaction (RLEP-PCR) and conventional methods like, Slit Skin Smears (SSS), Histopathology (HP) and Fite-Faraco (FF) staining for detection of M. leprae in clinically diagnosed cases of early- stage leprosy. Materials and Methods: A cross-sectional study of 82 newly diagnosed cases of leprosy was carried out in S.C.B Medical College, a tertiary care hospital of Odisha, India from September 2018 to August 2020. For every case, skin tissue was punched out to get biopsy for HP and FF staining and incised for SSS. At least two SSS slides were prepared per case. One SSS slide was stained by modified Ziehl-Neelsen (ZN) staining to demonstrate Acid Fast Bacilli (AFB). The other SSS slide was air dried and the dried material was scraped off to perform PCR. Data were analysed by Statistics software IBM Statistical Package for the Social Sciences (SPSS), version 24.0. Association between categorical variables was studied by using Chi-square test. Comparison of mean±SD and median (IQR) were done by using independent sample‘t’ test. Agreement on different types of laboratory methods was done by using Kappa test. Results: Among 82 cases, 68.3% were RLEP-PCR positive, 56% had relevant chronic granulomatous features histopathologically, 39% were FF stain positive, and only 29% were ZN stain positive. Improvement in case detection of 39%, 29.3%, and 12.2% by PCR over SSS, FF Stain and HP respectively proved superiority of PCR over other procedures. Conclusion: PCR was most sensitive to detect leprosy both in pauci and multibacillary groups, thus considered as investigation of choice for diagnosis of early-stage leprosy.

Multiple myeloma (MM) is a proliferative disorder of plasma cells which produce abnormal immunoglobulin proteins. Skin involvement is rarely found in this disorder. They are either specific or nonspecific lesions. We report four such interesting patients who presented to us initially with common dermatoses such as leukocytoclastic vasculitis, pyoderma gangrenosum, and vesiculobullous disorders and were subsequently diagnosed to have MM. There were no skeletal involvements or renal function abnormality at the time of presentation. Unusual presentation, nonresponsiveness to conventional therapy, and abnormal blood parameters prompted us to suspect some underlying systemic conditions which were later confirmed to be MM after serum immunoelectrophoresis for M-band and bone marrow biopsy.

We report two cases of epitheloid hemangioma presented with multiple nodular lesions over head and neck region. One of them gave history of bleeding on minor trauma. Pyogenic granuloma was considered as a differential diagnosis from the morphological appearance and history of bleeding. Nodular leprosy, sarcoidosis, and secondary syphilis were also considered. Histopathological examination of both was typical of epitheloid hemangioma, an entity commonly overlooked clinically due to its rarity.

Byline: Mohapatra. Liza, Dash. Gaurav, Mohanty. Prasenjeet, Jena. Swapna, Behera. Binodini The hyper-IgE syndrome (HIES) is a rare group of primary immunodeficiency characterised by recurrent infections, eczema, and elevated serum [...]