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Alopecia areata totalis and universalis are disabling conditions and therapeutically challenging as they are refractory to conventional options. Tofacitinib is a Janus-kinase (JAK) inhibitor utilized to treat alopecia areata (AA) as an off-label drug. In India, FDA-approved JAK inhibitors such as baricitinib and ritlecitinib are not available. There are only a few case reports on tofacitinib in AA in the Indian population. We present the data of 9 pediatric cases of clinically and histologically proven alopecia areata totalis (AT) and alopecia universalis (AU), for whom oral tofacitinib was given after baseline investigations. The following parameters were analysed: Photographic image and severity of alopecia tool (SALT) score at baseline, 3 months and 6 months, and Children Dermatology Life Quality Index (cDLQI) at baseline and 6 months. The mean ± standard deviation (M ± SD) of the SALT score and cDLQI(M ± SD) at baseline were 95 ± 5 and 17 ± 2. At weeks 4 and weeks 12, the SALT (M ± SD) score was 92.7 ± 6.1 and 34.35 ± 11.16, respectively. At weeks 24, the SALT (M ± SD) score and cDLQI (M ± SD) were 3.33 ± 5 and 6 ± 2. The final reduction in SALT score from the baseline was 100% in 6/9 cases (66.67%), 75% to 99% in 3/9 (22.23%), and 50 to 75% in 1/9 (11.12%). We also observed minimal adverse effects (one child developed herpes zoster) with tofacitinib. Our study demonstrates that oral tofacitinib represents a viable modality in managing difficult-to-treat pediatric AA, such as AT and AU, with a good safety profile. [ABSTRACT FROM AUTHOR]

This article discusses a case of an adolescent male who presented with a solitary firm nodule on his upper back. The nodule was asymptomatic and had been present for four years. Despite receiving multiple treatments, the nodule did not improve. Dermoscopy and histopathology revealed features consistent with aneurysmal dermatofibroma (ADF), a rare variant of dermatofibroma. ADF can be mistaken for other malignancies and requires a high degree of suspicion for diagnosis. The nodule was surgically excised without recurrence. [Extracted from the article]

This article discusses a case of cervicofacial actinomycosis, a bacterial infection that typically presents as an indurated and suppurative nodule. However, in this particular case, the patient had multiple painless red elevated lesions on his face that resembled a "bunch of grapes." The diagnosis was confirmed through histopathology, and the patient was treated with oral antibiotics, resulting in complete resolution of the lesions. The article emphasizes the importance of considering atypical presentations of cervicofacial actinomycosis and highlights the need for a high degree of suspicion in diagnosing the condition. [Extracted from the article]

Xeroderma pigmentosum (XP), a heterogeneous genodermatoses, has a variable clinical spectrum ranging from mild freckling and photosensitivity to severe skeletal and neurological abnormalities and cutaneous malignancies. Herein, we present the case of a 4‐year‐old boy with XP group G who presented with a pellagroid rash. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 48-year-old woman who developed an erysipelas-like eruption following her COVID-19 booster vaccination with Covaxin®. It states that the rash, characterized by sharply defined erythematous and edematous plaques on her limbs and trunk, appeared four days after vaccination and was associated with fever and loose stools.

This article presents a case study of a 7-year-old boy with a foot ulcer, resorption of digits, and anhidrosis. The boy had protruding ears, leg length discrepancy, calluses on the hands, and self-inflicted biting injuries in the mouth. The diagnosis was determined to be hereditary sensory autonomic neuropathy type IV, which is a rare condition characterized by impaired sweating, touch, and thermal perception. The article highlights the difficulty in differentiating this condition from childhood leprosy and emphasizes the importance of accurate diagnosis and appropriate management. [Extracted from the article]

This clinical correspondence discusses a case of primary urogenital tuberculosis with papulonecrotic tuberculid in a 32-year-old male. The patient presented with recurrent episodes of ulcerations and atrophic scars on the shins, as well as nail deformity. The diagnosis was initially considered to be epidermolysis bullosa acquisita, but further examination revealed ulceration on the penis and a positive Mantoux test. Biopsy results confirmed the presence of caseous granulomas and leukocytoclastic vasculitis. The patient was started on antitubercular therapy and showed improvement after 5 months of follow-up. This case highlights the importance of considering cutaneous tuberculosis in atypical presentations, particularly in countries where tuberculosis is endemic. [Extracted from the article]

Competing Interests: There are no conflicts of interest.