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Background: Inflammation and immune dysregulation have been associated with adverse outcomes in cardiovascular disease. There is limited understanding of the association of different profiles of white blood cell (WBC) subsets and red cell distribution width (RDW) in patients with chronic limb-threatening ischemia (CLTI). Methods: Patients with CLTI undergoing endovascular revascularization in our single-center, tertiary care hospital from 2017 to 2019, who had a preceding complete blood count (CBC) with WBC differentials (n =213), were included in the analysis. Patient characteristics, laboratory values, and clinical outcomes were collected. Cox proportional hazards regression models were used to assess for associations between all-cause mortality and leukocyte subset; multivariate analysis was used to account for confounders. Kaplan–Meier curves were generated to depict survival censored at 1 year postrevascularization using baseline CBC indices. Results: Adjusting for confounders, elevated RDW was associated with increased mortality (continuous per % increase, adjusted hazard ratio [HR] 1.33, p < 0.001). Baseline lymphopenia was associated with mortality in univariate analysis. Other leukocyte subtypes were not associated with mortality outcomes in our population. Exploratory analysis showed negative deflections in ∆WBC from pre- to postprocedure day 1 were affiliated with increased mortality when adjusted for age, sex, race, chronic kidney disease, and baseline hemoglobin (∆WBC HR 1.16, p = 0.004). Further exploratory analysis showed an association between RDW and all-comers readmission. Conclusions: The utilization of a periprocedural WBC subset differential can be a useful adjunct to risk-stratify patients with CLTI undergoing endovascular revascularization. Further studies are needed to understand potential ways to modulate immune dysregulation so as to improve mortality outcomes. [ABSTRACT FROM AUTHOR]

Byline: Maitreyee. Panda, Siddhartha. Dash, Biswanath. Behera, Abheek. Sil The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) causing the 2019 coronavirus disease (COVID-19) has infected millions in recent years [...]

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]

Introduction: Tattoo-associated complications are on the rise due to the popularity of decorative tattoos in recent years. The exact pathogeneses of various tattoo reaction patterns are still unclear, and their dermoscopic details are sparsely reported. Aim: We aimed to retrospectively study the clinical, dermoscopic and immunopathological details of patients with non-infectious, non-eczematous inflammatory tattoo reaction patterns in a tertiary care centre of East India. Method: The clinical, dermoscopic and pathological details of all the patients who had non-infectious, non-eczematous inflammatory tattoo reactions were collected. In all the cases, immunohistochemistry was done for CD1a, CD3, CD4, CD8, FoxP3, CD20 and CD56. Results: A total of five patients of skin phototypes IV and V and six tattoo reactions were analysed. Five lesions had reactions at the site of a black tattoo, and one at the site of red tattoo. Clinically, the patients presented with erythematous or blue-grey flat-topped to verrucous papules and plaques. Dermoscopic features were dominated by a central white to pink-white structureless area, a peripheral grey-white to bluish-white structureless area, white scales, comedo-like opening with keratotic plugging, milia-like cysts and shiny white structures. Pathologically, except for one lesion that only showed a lichenoid reaction pattern in the red tattoo, all had a combination of reaction patterns. Immunohistochemistry showed increased epidermal and dermal Langerhans cells, predominantly CD8 positive T cells in the epidermis and dermis, sparse dermal B cells and CD4 positive T cells, reduced T regulatory cells and a complete absence of CD56 positive NK cells. Limitations: Small sample size was the limitation of the study. Conclusion: The clinical morphology and dermoscopy may not differentiate between various types of non-infectious non-eczematous inflammatory tattoo reactions. The immunological profile supports a delayed hypersensitivity reaction due to contact sensitisation to tattoo pigment, and CD8 positive T cells play a central role in executing various pathological reaction patterns, both in the epidermis and dermis. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the frequency of non-venereal genital dermatoses in male patients. Methods: This was a descriptive, observational study was included adult male patients having non-venereal genital dermatoses attending the skin and venereal disease outpatient department of a tertiary care referral hospital between January 2014 and August 2015. All patients with any venereal dermatoses were excluded from the study. Results: The study included 200 male subjects with non-venereal genital dermatoses. The mean age of the study population was 39.8±14.1 years. Of the cases, 68 (34.0%) were dermatological, 52 (26.0%) were infectious causes, 32 (16.0%) were physiological variants, 29 (14.5%) were genital dermatoses revealed drug-induced, 11 (5.5%) were malignant, and 8 (4.0%) were idiopathic. Among the non-venereal genital dermatoses, the most common disorders were balanoposthitis with 42 (21.0%), erosive balanitis with 29 (14.5%), fixed drug eruptions with 29 (14.5%), pearly penile papules with 22 (11.0%), vitiligo with 15 (7.5%), and lichen planus with 15 (7.5%). Itching was the most common symptom in 73 (36.5%) of the cases. Glans and prepuce were the most frequent site of the involved area in 60 (30.0%) cases. Extragenital involvement was observed in 68 (34.0%) of the cases. The most common morphological presentation was papules in 50 (25.0%) cases, followed by plaques in 38 (19.0%) and erosions and fissuring in 35 (17.5%). Conclusion: Family physicians frequently encounter dermatological diseases. Therefore, the management of dermatological diseases by family physicians is important. [ABSTRACT FROM AUTHOR]

This article, published in the Indian Journal of Paediatric Dermatology, discusses a case of asymptomatic black macules on the feet of a 14-year-old boy. The lesions were found to be talon noir, a trauma-induced darkening of the skin commonly seen in athletes and people who walk barefoot. Dermoscopy was used to differentiate talon noir from other diseases such as melanoma. The article emphasizes the importance of using dermoscopy as a diagnostic tool in managing acral pigmented lesions. [Extracted from the article]