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Background: Fordyce granules, sometimes referred to as Fordyce dots, are aberrant sebaceous glands that present as diminutive, non-painful, elevated lesions exhibiting a yellowish or whitish hue, measuring 1 to 3 mm in diameter, and manifesting inside the oral cavity. Likewise, these particles may also be seen in the vaginal region and inside the oral cavity. Aim: The primary objective of the current study is to evaluate the potential association between Fordyce granules and the skin type of individuals who seek dental care at the Dental Clinics of Qassim University. Materials and Methods: The current cross-sectional research was undertaken at the Dental Clinics of Qassim University, with a sample of 87 patients diagnosed with Fordyce's granules. The research consisted of a heterogeneous sample of participants, including individuals of all genders, ranging in age from 18 to 85 years. The study included a comprehensive evaluation of several anatomical regions to identify the existence of Fordyce's granules. This examination was conducted by a single examiner who had undergone calibration. Additionally, the participants' skin types were established using the Baumann Skin Typing System questionnaire. The data that was gathered was afterward analyzed utilizing statistical methods via the use of SPSS software. A pre-set significance level was established at P < 0.05. Results: The distribution of skin types among the study participants with Fordyce's granules were found to be oily skin (51.3%), dry skin (47.9%), sensitive skin (49.3%), and resistant skin (56.3%). The results of the research showed that there was no statistically significant correlation between the two variables, i.e. skin type and the presence of Fordyce's granules. This conclusion is supported by the increased P values of 0.941 for those with oily skin and 0.785 for individuals with dry skin. Conclusion: No relation between skin type and Fordyce's granules in the current study. [ABSTRACT FROM AUTHOR]

Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission. [ABSTRACT FROM AUTHOR]

Schwannomas synonymously known as neurilemmomas or neurinomas are uncommon benign neoplasms of neural sheath origin. They account for 5% of all benign soft-tissue tumors. 6%-8% of tumors occur intracranially and 25%-45% occur extracranially in the head-and-neck region, of which cutaneous schwannomas located in the dermis or subcutaneous tissue in the head and neck are an unusual entity. Of the seven subtypes described by Erlandson, ancient schwannoma is a very rare distinctive histopathological variant resulting from long-term degenerative changes and accounts for 0.8% of all soft-tissue tumors. This seminal article is a systematic review of schwannomas in the ear in its entirety from 1977 to 2023 along with a case report of a profusely bleeding cutaneous ancient schwannoma occurring in the mastoid region in a swelling of a short duration of 6 months in a 75 year old female. To the best of our knowledge, this case has two firsts to its credit. It is the first reported case of an ancient schwannoma in the mastoid region and also the first reported case presenting with bleeding from the schwannoma. Due to its rarity, ancient schwannoma must be included in the differential diagnosis for any bleeding mass in the ear to avoid an erroneous diagnosis of malignancy. [ABSTRACT FROM AUTHOR]

Dermoscopy refers to evaluation of the skin surface using surface microscopy. It is mainly used for the diagnosis of skin disorders. We report two cases in which dermoscopy played a role in treatment. Our first case was a 40-year-old female with history of insect bite. We evaluated the patient using a dermoscope and removed the tick with mouth part embedded in dermis using forceps ensuring full removal after procedure. The second case was a 35-year-old female who presented with a non-healing ulcer over lower back, following excision of epidermoid cyst. Dermoscopy showed the presence of a thread which was removed and repeat dermoscopy following extraction ensured its full removal. [ABSTRACT FROM AUTHOR]

Background: Nasal reshaping using hyaluronic acid (HA) filler has become a widespread technique and injections are usually performed in deep layers. As an alternative, we propose an innovative approach where HA is injected into the dermis, the so called MesoRhinoFiller. Aims and Objectives: The aim of this study was to describe our injection technique using a smooth, cohesive, and slightly viscous HA filler injected in the dermis. Materials and Methods: A retrospective review of the author’s clinical experience from March 2017 to March 2020 was presented. A total of 280 consecutive patients were treated with HA injections to improve their nasal appearance. The mean volume was 0.5 cc HA filler/treatment. Results: An average increase of 4.9±3.4° was obtained for the nasofrontal angle, and of 7.0±4.5° for the columella labial angle. Asymmetries in the nasal profile and alar rim were also corrected. All the patients were satisfied with the results and no complications occurred. Conclusion: Injecting HA fillers in the dermal plane is a versatile approach that provides very satisfactory results. This technique allows one to better correct aesthetical, post-traumatic, and post-surgical defects compared with the usual injection rhinoplasty procedures where the filler is injected deep onto the bone/cartilage in the midline of the nose. [ABSTRACT FROM AUTHOR]

Becker’s naevus (BN) presents as a unilateral, hyperpigmented patch with hypertrichosis over the upper trunk/proximal upper extremity. Usually, block-like/geographical pattern is seen; however, linear forms have also been reported. A 21-year-old man presented to us with a history of hyperpigmented, well to ill-defined discrete-to-coalescent plaques with brownish macules scattered at the periphery, over posteromedial aspect along Blaschko’s lines, extending from the buttock to the ankle of the right lower limb. No associated hypertrichosis/focal defects were seen. On dermoscopy (10×, DermLite DL4W, Dana Point, California) pigment network, scaling with perifollicular accentuation, perifollicular hypopigmentation, and uniform brown dots/globules/lines were seen. A skin biopsy revealed acanthosis and focal papillomatosis with increased pigment in the basal layer; pigment incontinence and melanophages were seen in the dermis. To the best of our knowledge, only one such case has been reported with Blaschko-linear BN over the lower limb. We present here an uncommon case of Blaschko-linear BN over the lower limb with dermoscopy and a concise literature review of BN over the lower limb. [ABSTRACT FROM AUTHOR]

A case study involves an 8-year-old boy with unique cutaneous morphological features, novel variant of epidermal naevus termed "naevus spinofiliformis," characterized by multiple spinous projections and filiform hyperkeratotic lesions, highlighting the need for further study and validation of this rare entity in epidermal naevi.

Hair is a feature that is only found in mammals. In all species, it is an epidermal protrusion composed of an outer cuticle, middle cortex, and inner medulla. Hair's primary purpose in mammals is to aid with thermoregulation. Every domestic animal species has a distinct hair pattern that can be used in forensic investigations. The aim of the present study is to observe the different animal hairs under stereomicroscope for forensic analysis. Hair is a unique characteristic seen only in mammals. It is an epidermal protrusion composed of an outer cuticle, middle cortex, and inner medulla in all species. The primary function of hair in animals is to aid with thermoregulation. Every domestic animal species has a specific hair pattern that forensic investigators can employ. The shaft profile was straight in all the animal hairs. In the proximal end, the root was absent because the hair was cut from the respective animals. Cuticles were absent in all the hair strands. The surface texture was smooth in dog hair, rough and spiculated in cat hair, and coarse in horse and rat hair. Microscopic examination of hairs reveals morphological distinctions that allow animal hairs from different species to be distinguished. In forensic investigations, microscopic examinations of various animal hairs are useful. [ABSTRACT FROM AUTHOR]

Acute graft-versus-host disease of the gastrointestinal tract (GI-aGVHD) is a rare condition, often requiring multiple laparotomies, ultimately leading to a burst abdomen. We report the successful use of a dermal regeneration template (DRT), combined with negative pressure wound therapy (NPWT) and skin grafts, to reconstruct the abdominal skin in an 11-year-old boy. The patient was a case of aplastic anemia, who underwent bone marrow transfers, the first of which failed and the second one was successful. He eventually developed gastrointestinal GVHD. Repeated laparotomies were done for recurrent intestinal obstruction. He also underwent resection anastomosis and end ileostomy, after which he developed an anterior abdominal wall defect due to a burst abdomen. After 12 months of management with multiple dressings, NPWT, and DRT, a stable coverage was achieved, without skin retraction. We report our experience in anterior abdominal wall reconstruction in a case of GI-aGVHD using DRT [ABSTRACT FROM AUTHOR]

Angiosarcoma (AS) is a rare malignant tumor of vascular or lymphatic epithelium, typically presenting as a bruise-like patch over the face or scalp in the seventh–ninth decades. Here, we report a case of cutaneous AS (cAS) in a 51-year-old male patient who presented with a cauliflower-like growth in the groin with skin-colored shiny flat-topped satellite papules in the surrounding areas, some of which were umbilicated. Based on examination, the patient was considered retro positive and the following differentials were considered: Buschke–Lowenstein tumor with giant molluscum, Kaposi sarcoma, and squamous cell carcinoma. Histopathological examination suggested the diagnosis as AS, which was confirmed by immunohistochemistry that was positive for CD31 and CD34. The report highlights the unusual site and clinical presentation of cAS. [ABSTRACT FROM AUTHOR]

The article focuses on a case study of a rare lipidized fibrous histiocytoma (LFH) in a young Indian woman, detailing its clinical presentation as a hyperpigmented and hyperkeratotic nodule on the leg. It covers the diagnostic challenges, histopathological features, and a comparative analysis of LFH with other dermatofibromas, emphasizing the rarity of this variant and its distinct presentation in Fitzpatrick type IV skin.

Context: Chronic non-healing ulcer causes significant morbidity, high cost and reduced quality of life. Aims: To compare autologous platelet-rich fibrin matrix and transplantation of autologous non-cultured epidermal cell suspension in the treatment of chronic non-healing ulcers. Methods: The study was single-centre, prospective, randomised comparative study conducted in a tertiary care center in North India. Patients with chronic non-healing ulcer were included and randomly divided into two treatment groups- Group 1: Platelet-rich fibrin matrix (PRFM) procedure was done every 2 weeks with maximum three sittings and in Group 2: Transplantation of autologous noncultured epidermal cell suspension (NCES) procedure was done once. Follow-up was done every 2 weeks for 8 weeks then monthly for up to 5 months to evaluate the healing of the ulcer. The data were analysed by statistical package for social science (SPSS) trial version 22. To find out a significant difference in mean value between groups, the Chi-square test, student's t-test, and Mann–Whitney U test were used. Results: A total of 41 patients were included in the study. Complete healing of ulcers occurred in 89.5% of the patients in the PRFM group and 93.8% of the patients in the NCES group at the end of 5 months (P = 0.33). The mean duration of complete healing in PRFM was 1.7 months and in NCES was 2.13 months (P = 0.20). Conclusions: Both procedures were effective, and there was no significant difference between the two procedures. [ABSTRACT FROM AUTHOR]

Lack of quality control can affect the safety, efficacy, and acceptability of herbal products that may lead to health problems. Cannabis sativa L. (Cannabaceae) has been widely used as an ethnomedicinal practice for its medicinal values. This study aims to establish pharmacognostic specifications of C. sativa as per standard procedures. Macroscopic-microscopic characteristics, physicochemical parameters, thin-layer chromatography (TLC) fingerprinting, and phytochemical screening of C. sativa leaves collected from various locations throughout Thailand were investigated. Leaves are palmate consists of seven leaflets with green color, margin is serrate with acuminate apex. Anomocytic stomata were found in the upper epidermis while unicellular and glandular trichomes with cystolith were found in the lower epidermis and the epidermis layer covered with cuticle. The physicochemical analysis revealed that the loss on drying (4.068 ± 0.084 %w/w) was within acceptable limits, total ash (14.360 ± 0.084%w/w), acid insoluble ash (2.726 ± 0.080%w/w), ethanol-soluble extractive (11.101 ± 0.223%w/w), water-soluble extractive (23.038 ± 0.306%w/w), and water content (7.523 ± 0.524%w/w). TLC fingerprint showed nine spots with Rf value 0.14, 019, 0.23, 0.29, 0.32, 0.45, 0.58, 0.70, and 0.76. Phytochemical screening of Cannabis leaves indicated the presence of phenolic compounds, flavonoids, alkaloids, diterpenes, triterpenes, and steroids. This study provided referential data for the accurate plant identity, and establishment of cannabis leaves monograph in Thailand. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 65-year-old male with a rare pigmented variant of eccrine poroma on the palm. Topics discussed include the clinical presentation and histopathological features of pigmented eccrine poroma, its rare occurrence on atypical sites such as the palm, and the importance of surgical excision in its treatment.

Cutaneous pili migrans (CPM) is an uncommon condition in which a hair fragment penetrates the skin and produces a creeping lesion similarly of cutaneous larva migrans associated with local pain. There are few reports of CPM in the literature, and none visually describes the migration of the hair shaft in the epidermis associated with pain. Herein, we showed the first report describing a case of an in situ sequential migration of CPM in an adult patient. [ABSTRACT FROM AUTHOR]

A 15-year-old healthy boy presented with multiple eruptive brown-colored to hyperpigmented papules all over the body for 1 year. His serum lipids were normal, and HIV serology was negative. Biopsy revealed hyperplastic epidermis along with an ill-defined lesion in the dermis that was composed of spindle-shaped fibroblastic cells and multiple cholesterol clefts within foamy macrophages. A diagnosis of cholesterotic dermatofibroma was made. The case is unusual for the young age of presentation and the presence of multiple eruptive papules. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 19-year-old Chinese female with facial erythema and papules. Examinations revealed a slight thickening of the facial epidermis and epithelioid granulomas in the dermis, and a positive purified protein derivative (PPD) skin and the T-cell spot test. The patient was finally diagnosed with cutaneous tuberculosis (CTB), was given quadruple antitubercular therapy, after which a 2-year post-treatment follow-up showed no recurrences.

Nevus lipomatosus superficialis is a rare hamartomatous lesion of skin, also named as pedunculated lipofibroma. This entity is unknown to many primary care physicians, Hence, many times, it is not diagnosed and misinterpreted as any of its differential diagnoses like lipofibromas, skin tags, hemangioma, lymphangioma, and focal dermal hypoplasia. Histopathologically, it is characterized by the presence of clusters of mature fat cells in the dermis. Here we report a case of an 11-year-old male who presented with a lower back swelling since birth (4.8 x 3.6 cm) which gradually increased over time and became lobulated, pedunculated, and non-tender. It is an uncommon entity with distinct clinical and histopathological features. Awareness about this lesion, its clinical presentation, morphological features, and favourable outcome is necessary so that it can be differentiated from other skin neoplasms. [ABSTRACT FROM AUTHOR]

Introduction: Atrophic dermatofibroma is a rare variant of dermatofibroma which is many times underdiagnosed. Case Report: We report a case report of a 29-year-old female who came to the dermatology department with black-colored lesions on the lower leg for the past 7 years. Histopathological examination revealed a non-encapsulated dermal tumor involving upper to deep reticular dermis and extending to superficial subcutis. There was epidermal hyperplasia, and at the center of the lesion a slight epidermal atrophy was present. Discussion: It is a commonly underdiagnosed variant of dermatofibroma. Histopathologically, this disorder presents as a decrease in at least 50% of the thickness of the dermis relative to the adjacent dermis. The case is rare and hence reported. [ABSTRACT FROM AUTHOR]

Introduction: Morphea profunda or subcutaneous morphea is a variant of morphea in which inflammation and sclerosis found in deep dermis, subcutaneous tissue, fascia or muscle. Case report: We are report an atypical case of subcutaneous morphea in five year-old girl, presenting with atrophy of subcutaneous fat over the left lower limb in a liner pattern, closely mimicking linear lipoatrophy. Discussion: Early intervention in such cases can halt progression of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Morphea is a rare fibrosing disorder of the skin and underlying tissues. Deep morphea involves the deep dermis, subcutis, fascia, muscle, and bone. The above structures may be involved independently or in combination. Case report: We describe a case of deep morphea presenting as muscle weakness, independent of skin lesions, in a child with generalized morphea. Discussion: Muscle weakness, even in the absence of overlying or progressive skin sclerosis, can be deep morphea, especially when segmental and associated with atrophy. [ABSTRACT FROM AUTHOR]

We describe an objective method to measure the volume of a dermis-fat graft (DFG) implant for socket reconstruction. We reviewed the charts of 10 patients undergoing dermis fat grafting as a primary or secondary implant for anophthalmic socket reconstruction between January 2018 and December 2019. The amount of the DFG required to replace the volume of an appropriate spherical implant for the operated eye was predetermined. The volume of the DFG implant was measured by the water displacement method as per the Archimedes principle. Patient demographics, complications, and the outcome were analyzed regarding cosmesis and volume replacement. All patients were satisfied with the final cosmesis. Follow-up ranged from 6 to 18 months (mean 10.7 months). Thus, we concluded that the water displacement method is a simple and easy procedure to objectively determine the amount of the autologous DFG needed to replace the volume in an anophthalmic socket. [ABSTRACT FROM AUTHOR]

A case study of conjunctival melanoma invading the nasolacrimal duct, stressing the rarity of such cases and the potential challenges in managing them. Despite en bloc orbital exenteration and an 8-year post-surgery period without recurrence, the lacrimal drainage apparatus remains a high-risk site for metastasis, underscoring the importance of cautious treatment approaches.

A case study of a 12-year-old boy presented with an asymptomatic skin nodule on his cheek, diagnosed as an unruptured epidermal inclusion cyst. Dermoscopy revealed peripheral linear branched vessels, a white structureless background and a punctum, aiding in the accurate diagnosis and differentiation between ruptured and unruptured cysts, influencing treatment decisions.

A case study of a 21‑year‑old female presented with a complaint of an asymptomatic, blackish, and elevated lesion over her back for 3 years. Topics include skin‑colored papule that undergoes rapid growth to a dome‑shaped nodule with a central keratin plug giving a crateriform appearance; and tumors and perineural invasion require tissue sparing and should consider Mohs micrographic surgery.

The article presents a case study of a 15-year-old male with generalized erythema, crusting, scaling over the body. Topics include developed new flaccid fluid‑filled vesicles/bulla over upper and lower limbs with a positive direct and marginal Nikolsky sign; and prednisolone being hiked to 35 mg and azathioprine 50 mg twice daily added owing to lack of improvement and appearance of new lesions.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartomatous lesion, histopathologically characterized by the presence of ectopic dermal adipocytes. Herein, reported is the clinicopathological aspect of six cases of NLCS, consisting of three males and three females, with age at presentation ranging from 18 to 47 years and duration of lesion ranging from 2 to 18 years. Out of the six cases, five were of solitary NLCS, who presented with nodules or polypoidal masses of variable sizes and duration. The lone case of classical NLCS presented with multiple skin-coloured cerebriform nodules over the right lower back in zosteriform distribution. The commonest location was lower back and thigh. Histopathological examination revealed lobules of mature adipocytes in the papillary and/or reticular dermis in all cases, thereby establishing the diagnosis of NLCS. Additional microscopic features encountered were surface ulceration, focal myxoid degeneration, mild perivascular lymphocytic infiltrate and attenuation of adnexal structures. [ABSTRACT FROM AUTHOR]

A 30-year-old woman presented with an acute-onset high-grade fever (103°F), multiple episodes of throbbing abdominal pain in the right quadrant, and pustular red lesions on the left leg. The radiological findings were suggestive of autoimmune cholangitis and pancreatitis. The skin lesions recurred on different portions of the body, and histopathological findings showed lobular and septal lymphohistiocytic infiltrate without vasculitis. The epidermis had focal ulcerations, and the dermis showed the presence of subcutaneous fat and an infiltrate of lymphocytes, histiocytes, and neutrophils (described as lobular and septal panniculitis without vasculitis). Based on the clinical and histopathological features, a diagnosis of migratory panniculitis was made. The patient was managed with analgesics, antibiotics, and a long course of steroids; the patient responded well to these medications. To the best of our knowledge, this is one of the first case reports of migratory panniculitis associated with IgG4-related disease. Patients with migratory panniculitis should be investigated for the presence of IgG4-related autoimmune disease. However, steroids remain the drug of choice when these conditions occur together. [ABSTRACT FROM AUTHOR]

Background: Dermoscopy can reliably predict the diagnosis of plaque psoriasis. Ultrasonography has been increasingly used in dermatology in inflammatory diseases like psoriasis as a tool for evaluation. Hence, this study was done to evaluate the role of dermoscopy and ultrasonography as prognostic aid in plaque psoriasis. Aims and Objectives: To study the sonographic and dermoscopic findings of clinically diagnosed psoriatic lesions and the changes in the psoriatic lesions if any, with the treatment. How these findings can be utilized to assess the prognosis in these patients. Materials and Methods: The present study comprised 50 patients with clinically diagnosed plaque psoriasis. Lesions were assessed with Dino-Lite digital microscope AM7515MZT, followed by ultrasonography using a 15 MHz probe, and findings were recorded. All the patients included in this study were given appropriate treatment (topical/systemic) for 6 weeks and were followed up twice i.e., at 3 weeks and 6 weeks after initiating treatment. Results: Whitish scales were the most common scale color seen in our study seen in 35/50 patients (70%). All the vascular structures were reddish, red dots and globules being the predominant type and with the improvement of the lesions, brown structures increased. A total of 28 (56%) patients had a regular pattern of vessel arrangement. Mean capillary size was 0.097 ± 0.012 mm that reduced to 0.075 ± 0.019 mm at the end of the third week and 0.027 ± 0.032 mm at the end of 6 weeks. In ultrasonographic assessment, mean epidermal thickness reduced from 0.1008 to 0.0764 cm at third week and 0.068 cm at the sixth week, and mean dermal thickness reduced from 0.2692cm to 0.1906cm at the third week and then to 0.1906cm 0.1806cm at the sixth week. In our study, clinical improvement preceded dermoscopic improvement. Newer structures identified in the study are a perifollicular arrangement of capillaries and the presence of lacunar structures in the healing lesions. Conclusion: The scale distribution, capillary number, and capillary size in dermoscopic assessment, and epidermal and dermal thickness in ultrasonography showed statistically significant changes with treatment and thus may be taken as the prognostic indicators. Thus, both these noninvasive modalities may be useful in the therapeutic monitoring of plaque psoriasis. [ABSTRACT FROM AUTHOR]

Background: Acute photodamage is an acute inflammatory reaction of the skin after ultraviolet (UV) irradiation. Many drugs have been successfully used for the treatment and prevention of photodamage. Aims: To evaluate the molecular mechanism of N-terminal 5-mer peptide analog P165 of amyloid precursor protein in repairing photodamaged rat skin. Materials and Methods: We establish a rat model of acute UVB photodamage. The ratskin was treated with or without 250, 500, and, 1000 μM P165. Histological analysis was performed by hematoxylin and eosin staining. Apoptotic cells were analyzed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The kits were used to measure the levels of protein carbonyl (PC), malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione (GSH). Western blotting was used to measure Nrf2. Results: P165 repaired UVB-induced cutaneous erythema and edema, and reduced apoptosis of skin cells. The levels of PC, MDA, and 8-OHdG in 250 and 500 μM P165 groups were all lower than those in the solvent group. Activities of SOD, CAT, and GPx, and the level of GSH in P165 groups were higher than those in the solvent group. Nrf2 expression in the solvent group was higher than that in the negative group, whereas in the 500 μM P165 group was higher than in the solvent group. Conclusions: Our findings suggest that P165 repairs the rat skin with acute photodamage by reducing oxidative stress. These activities may be mediated by promoting the Nrf2 signaling pathway. Thus, P165 may be a promising agent for the treatment of acute photodamage, which may be used in cosmetics and postsun repair. [ABSTRACT FROM AUTHOR]