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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., Competing Interests: None., (Copyright: © 2023 Indian Journal of Dermatology.)

Background: A sustained inflammatory state of psoriasis causes comorbidities such as psoriatic arthritis, metabolic syndrome (MetS), and cardiovascular disease., Aims: To note the duration and severity of psoriasis, assess prevalence of MetS, and correlate these with indicators of sub-clinical atherosclerosis., Methodology: Thirty-two patients of chronic plaque psoriasis were enrolled in the study. Their demographic particulars, clinical details, results of investigations to assess MetS, and indicators of sub-clinical atherosclerosis, namely, carotid intimal media thickness (CIMT) measured using B-mode USG and epicardial fat thickness (EFT) using 2-D ECHO, were recorded., Results: The study participants were predominantly male (2.5:1); their mean age was 40.45 ± 12.42 years, the median disease duration (DD) was 2 years, and the mean psoriatic area severity index (PASI) score was 8.62 ± 7.49. Mild disease (PASI <5) was present in 12 participants (37.5%), and shorter DD (<5 years) was present in 16 (50%) participants. MetS, detected in 11 (37.5%) study participants, was not significantly associated with CIMT, EFT, DD, and PASI. CIMT and EFT too did not correlate significantly with DD, PASI, or measures of MetS. Neither did there exist any significant correlation between CIMT and EFT., Conclusion: Sub-clinical atherosclerosis in our study participants was not significantly associated with either measures of MetS or duration/severity of psoriasis., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Dermatology.)

Although the impairment of quality of life (QoL) in individuals with keloids is profound, it has neither been well quantified nor correlated with severity in people with skin of colour. This cross-sectional, questionnaire-based study comprised 110 patients with keloid(s). A physician measured the severity of keloids using the Vancouver Scar scale and impairment of QoL using the patient-filled Hindi version of Dermatology Life Quality Index questionnaire. The relationship among QoL and severity score as well as with components of demographic data was analysed using SPSS. Our study found the severity of keloid(s) to be moderately but significantly correlated with the QoL of its sufferers. Individuals with multiple keloids were found to be significantly younger than those with solitary ones. Itching, pain, along with restricted mobility significantly impacted the QoL as well as severity of keloids. Individuals who had undergone prior treatment were found to have a worse QoL than the treatment naive. Recurrence was found to be associated with lower scar severity, multiple keloids, and younger age. Increasing age, though associated with greater scar severity, lacked any relationship with the QoL. Our study also found that individuals with bigger keloids sought treatment earlier and more often. Hyperpigmented keloid(s), more common in individuals with skin of colour, were associated with a significantly worse QoL and a higher scar severity., (© 2022 The Wound Healing Society.)

Objective The pathophysiology of polymorphic light eruption (PMLE) is uncertain; however, it is considered to commonly involve an autoimmunological mechanism. It is a common condition, usually affecting subjects staying at temperate latitudes, and presents with eruptions post-exposure to sunlight and artificial UVR (ultraviolet radiation), lasting from hours to, in rare cases, days of exposure. This present study aims to compare biochemical thyroid function tests in cases of PMLE.  Methodology The present case-control study was conducted with a total of 120 participants. Patients with polymorphic light eruption aged 18 years or above of either sex attending the dermatology outpatient department were included in the study. TSH (thyroid-stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine) were analyzed among the participants. The data was recorded on a Microsoft Excel spreadsheet and analyzed using SPSS Statistics v. 21 (IBM Corp., Armonk, NY). The qualitative data was assessed in the form of numbers and percentages and the quantitative data was assessed using measures of central tendency such as mean and standard deviation. A chi-square test was applied to find out the association and their strength between the variables to validate the findings of the study. A p-value <0.05 was considered to be statistically significant. Results The TSH was elevated in 56 (93.3%) cases and two (3.3%) among the controls; T3 and T4 were low in 24 (40%) cases, and in seven (11.7%) among the controls. Conclusion PMLE usually has an autoimmune basis for its occurrence; similarly, thyroid disorders being themselves autoimmune in origin might lead to hypersensitivity reactions and generation of autoantibodies. We suggest that screening for thyroid should be conducted for all PMLE patients as they are at higher risk of developing thyroid disorders. The relationship between the two should be studied with a much larger cohort of participants to evaluate whether this is autoimmune-related or accidentally related., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mishra et al.)

Introduction:  Neurofibromatosis type 1 (NF1) is an inherited neuroectodermal abnormality with multisystem effects, which can have heavy psychological and physical burdens, especially in countries like India, wherein skin disease is significantly stigmatized. This study was performed to understand the clinical and epidemiological trends of NF1 at a tertiary care center in India and evaluate the association between clinical severity and quality of life in these patients., Methods:  We conducted a cross-sectional study of 40 patients with NF1 over a period of two years at a tertiary hospital in western India. After obtaining consent, demographic and clinical information was collected from the patients and recorded in a pre-designed proforma. Quality of life was assessed by a validated Dermatology Life Quality Index (DLQI) questionnaire in languages understood by the patients and subsequently analyzed., Results:  This study included 40 patients at a mean age of 28.6 years, with a slight male predominance. The most frequently occurring lesions were café-au-lait macules, followed by neurofibromas and intertriginous freckling. The mean DLQI score was 12.35, implying a large effect on most patients' lives. Questions related to self-consciousness, embarrassment, and the influence of skin lesions on clothing choices had the highest scores, indicating a significant effect on social perception., Conclusion:  NF1 has a profound impact on a patient's quality of life, as evidenced by the high DLQI scores in our patient cohort. The early identification and management of such patients can help prevent further deterioration of their quality of life., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mahajan et al.)

Background Urticaria, a vascular reaction of the skin, is marked by the transient appearance of erythematous papules or plaques (wheals) of varying sizes that are blanchable and associated with severe pruritus which lasts from a few hours to days. The etiological factors for urticaria include food, drugs, bacterial foci, pollen, fungi, dust, worms, physical stimuli, stress, anxiety, insect stings, etc. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose immunoglobulin E-mediated type 1 allergic reactions such as urticaria. A history suggestive of clinical sensitivity supported by a positive test strongly implicates the allergen in the disease process. In this study, we aimed to detect the common allergens and correlate the findings of SPTs with various epidemiological characteristics of urticaria patients. Methodology A total of 100 patients with urticaria were included in this study. After receiving written and informed consent from patients, SPTs using a battery of 45 allergens were performed. Results In our study, SPT positivity was seen in 88 (88%) patients. The highest sensitization was noted toward Dermatophagoides pteronyssinus (house dust mite) (30%), followed by D. farinae , Cynodon dactylon , and peanuts (each comprising 24%), and Ailanthus excelsa (20%). Conclusions Finding the causative allergen in urticaria is often a difficult and long-drawn process, both for the physician and the patient. Our study identified an allergen in 88% of patients with urticaria, thereby showing that the SPT is a cost-effective, easy, and reliable tool for diagnosing and guiding treatments in urticaria patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Lote et al.)

Background: The overall prevalence of vulvar diseases in the literature is low because of underreporting and is often neglected; thus, its impact on a female's life is often underestimated., Objectives: This study is aimed to determine the prevalence of vulvar diseases and their associated risk factors in patients attending a tertiary care hospital., Materials and Methods: This is a descriptive, cross-sectional, and case-controlled study wherein all female patients attending the dermatology outpatient department (OPD) were screened for the signs and symptoms of vulvar dermatoses and were enrolled after obtaining informed consent and institutional ethics committee approval for 21 months. Out of them, 200 patients who consented and had signs and symptoms of vulvar diseases were selected as cases, and the same number of age-matched females were enrolled as controls with no signs and symptoms of vulvar dermatoses., Results: During the study period, 9431 females attended the dermatology OPD, of which the prevalence was 2.12% (200 patients). The most common infection was genital infection without sexually transmitted infection (57%) (tinea cruris [33.5%]), followed by inflammatory dermatoses (21%) (lichen sclerosus et atrophicus [6%]). The most common risk factor found statistically significant ( P ≤ 0.005) were homemakers (49%) and the use of undergarments of mixed fabric (70.68%), followed by nonmenopausal females (63.15%)., Conclusion: Our study findings indicated that the prevalence was low, which reflects the tip of an iceberg. Further clinical and population-based studies, a multidisciplinary approach including gynecological consult for diagnostic and therapeutic approach is needed for the optimal management of vulvar diseases., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Sexually Transmitted Diseases and AIDS.)

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Singh, G.K., Mahendra Singh Deora, Rajan Grewal, A. Kushwaha, and Sukhmeet Minhas. Is high altitude a risk factor in development of herpes zoster? High Alt Med Biol. 19:244-248, 2018., Background: Old age immune-compromised states are known to increase the risk of herpes zoster (HZ). The aim of this study was to find out whether arrival into high altitude poses a risk for the development of HZ in lowlanders., Methods: A retrospective study of 173 cases of HZ was carried out between January 1, 2005 and December 31, 2010 in people working at high altitude areas of Leh. Data of lowlander people working at high altitude were compared with that of high altitude native and similar group of people working at plains during the same period., Results: HZ constitutes 2.36% (95% confidence interval [CI], 2.04-2.73) of total skin outpatient department cases at a hospital at high altitude, whereas it was 0.23% (95% CI, 0.18-0.29) at a tertiary hospital at plains. In lowlanders working at high altitude, frequency of herpers zoster varied between 2.63% and 3.59% with mean of 3.07%. Frequency of HZ in persons presenting to a tertiary dermatological center at plains varied from 0.19% to 0.26% (mean of 0.23%). Presence of high altitude posed a risk of almost seven times in developing HZ in comparison with its absence with odds ratio of 7.21 and 95% CI varying from 5.42 to 9.60. This result was statistically very significant with p value <0.0001., Conclusions: Lowlanders working at high altitude are at high risk to develop HZ in comparison with persons working at plains. However, a large population-based study is required to investigate and establish the same.