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Pustular psoriasis is a specialized variant of psoriasis which can be life threatening if not treated at the earliest. The pathogenesis has been recently linked to the role of interleukin 36. Apart from the corticosteroids, systemic antipsoriatics like acitretin, cyclosporine and methotrexate have been used with some success though unpredictable. With recent identification of role of IL-36 in the pathogenesis of pustular psoriasis, biologics targeting the IL-36 receptors have been used to manage the situation with high degree of success. This narrative review deals with the recent concepts of pathogenesis of pustular psoriasis as well as the current management scenario. Keywords: IL 36R inhibitors, pustular psoriasis, systemic treatment, treatment, Author(s): Shrichand G. Parasramani [1]; Bikash R. Kar (corresponding author) [2]; Sushil Tahiliani [3]; Anchala Parthasarathi [4]; Shekhar Neema [5]; Satyaki Ganguly [6]; Dharshini Sathishkumar [7]; K Venkatachalam [8]; Haritha [...]

Psoriasis is a chronic and complex immune-mediated papulosquamous disease affecting almost 2 of the world population. The interaction between a genetically predisposed individual and environmental triggers leads to a vicious cycle involving autoreactive T cells, dendritic cells, keratinocytes and dermal cells. Up to 40 of the psoriasis cases develop disabling psoriatic arthritis and an equal number of patients also tend to develop metabolic syndrome as well as cardiovascular comorbidities; hence, this is no more considered to be a disease limited to skin only. Being a systemic disease, there is an urgent need to develop potential biomarkers for the assessment of disease severity, prediction of outcome of the therapeutic intervention and association with various systemic comorbidities. Diverse genetic markers not only function as predictors of diseases pathogenesis, but also help to predict development of psoriasis and psoriatic arthritis. Personalised medicine is customising the therapeutic needs of a psoriasis patient and improving the outcome as per the hints we receive from the various biomarkers. This review deals with the list of potential biomarkers proposed to be useful in psoriasis, though there is limited data validating their routine use in clinical practice and the progress so far made in the field of precision medicine for psoriasis. Keywords: Biomarkers, comorbidities, genetic markers, predictive factors, psoriasis, Author(s): Bikash R. Kar (corresponding author) [1]; Dharshini Sathishkumar [2]; Sushil Tahiliani [3]; Anchala Parthasarathi [4]; Shekhar Neema [5]; Satyaki Ganguly [6]; K. Venkatachalam [7]; Shrichand G. Parasramani [8]; Haritha [...]

Psoriasis is a common chronic, immune-mediated inflammatory skin disease associated with various comorbidities. Managing psoriasis is often challenging as the therapy is decided based on the area of the disease, associated comorbidities and impairment in quality of life, besides the patient's preference. Making progress in the development of new molecules that can be used topically or orally, effectively controlling the disease with minimal side effects and providing long-lasting remissions are the needs of the hour. Recent developments in understanding the complexities of the pathogenesis of psoriasis have resulted in the reinforcement of treatment modalities, leading to the evolution of various biologics and small-molecule inhibitors. In comparison with biologics, both patients and treating physicians prefer small molecules for various reasons such as avoiding injections and side effects that are associated with biologics biologics. Moreover small molecules are economical than biologics. Newer small molecules, both topical and oral, are promising additions to the therapeutic arsenal in the management of psoriasis in the future. Keywords: JAK inhibitors, PDE-4 inhibitors, psoriasis, small-molecule inhibitors, Author(s): Venkata Chalam Konakanchi [1]; Bikash R. Kar (corresponding author) [2]; Dharshini Sathishkumar [3]; Sushil Tahiliani [4]; Anchala Parthasarathi [5]; Shekhar Neema [6]; Satyaki Ganguly [7]; Shrichand G. Parasramani [8]; [...]

Author(s): Meghana Reddy [1]; Namrata Chhabra [1]; Anil Kumar Goel [2]; Satyaki Ganguly [1] Dear Editor, Atopic dermatitis (AD) is an itchy, chronic, or chronically relapsing inflammatory skin condition that [...]

Primary cutaneous blastomycosis is very rare in non-endemic regions like India. Only few cases have been reported from India. Herein, we are reporting a rare case of chronic cutaneous blastomycosis in a young immunocompetent male presenting as mycetoma with multiple discharging sinuses in the anterior abdominal wall with no significant travel history. Keywords: Blastomycosis, fungal disease, immunocompetent, India, non-endemic, Author(s): Rakesh K. Gupta (corresponding author) [1]; Mousmi Agrawal [1]; Archana Keche [2]; Satyaki Ganguly [3] Introduction Blastomycosis is a fungal disease caused by organism Blastomyces dermatitidis.[sup.[1]] Blastomycosis commonly presents [...]

Author(s): Tejasvi Dwivedi [1]; Sri Sai Kaumudi Chirumamilla [1]; Jivtesh Singh [1]; Satyaki Ganguly [1] Dear Editor, A 37-year-old male, an office worker by profession, not trained in the handling [...]

Dermatomyositis (DM) is an autoimmune inflammatory disease, characterized by symmetrical proximal myopathy and cutaneous manifestations. DM is associated with upto a 6-fold increased risk of cancer. Complications secondary to underlying cancer are a leading cause of mortality in DM. Here, we discuss the two year clinical course of an elderly male with recalcitrant DM. This case was complicated by tubercular lymphadenitis followed by gumma. Subsequently, he was diagnosed with lymphoma and succumbed to death. This case emphasizes the need to do extensive malignancy screening at regular intervals in DM. Keywords: Dermatomyositis, paraneoplastic, tuberculosis, Author(s): Namrata Chhabra (corresponding author) [1]; Jemshi S. Rahim [1]; Satyaki Ganguly [1] Introduction Dermatomyositis (DM) is an inflammatory myopathy, which usually manifests as a subacute proximal myopathy, systemic inflammatory [...]

Resistance to antileprosy drugs is one of the main contributors for the persistence of leprosy in the present era. In the absence of universal antimicrobial resistance (AMR) surveillance through the national program, the indications for resistance testing remain a important dilemma to clinicians. WHO recommendations mainly focus on clinical relapse, which could be picked up late with continued transmission and repeated leprosy reactions in the patient. We report here a series of eighteen leprosy cases who were tested for AMR in view of the positive morphological index after completion of multidrug therapy, chronic Erythema nodosum leprosum, and clinical relapse. Keywords: Drug resistance, leprosy, morphological index, relapse, Author(s): Namrata Chhabra (corresponding author) [1]; Tamil S. Kumar [1]; Itu Singh [2]; Satyaki Ganguly [1] Introduction Leprosy, one of the oldest infectious diseases known to mankind, had been anticipated [...]

ABSTRACT: Background and Aim: Haemolysis due to dapsone as a part of MDT in leprosy patients has been long recognized. However, the frequency and severity of this side effect and factors associated with it have not been well documented. We planned to determine the frequency of dapsone-induced haemolysis in leprosy patients on MDT and various risk factors associated with it. Materials and Methods: This was a hospital-based retrospective analysis, conducted on 36 treatment completed or partially treated or on treatment leprosy patients in a tertiary care centre in Chhattisgarh. Results: Out of 36 patients, 83.3% showed a fall in haemoglobin from the baseline value (pre-treatment values). Dapsone was stopped in 33.3% of patients with a significant fall in haemoglobin. We found that the mean haemoglobin concentration for all patients fell from 13.05(+/−1.8) g/dl to 11.8(+/−1.9) g/dl (P < 0.05) which was statistically significant. A total of 25% of patients were labelled as confirmed cases of dapsone-induced haemolysis as per our definition. Conclusion: Our results underline the need to incorporate haematological investigations in leprosy management protocol, especially in primary care settings where the majority of leprosy patients are managed. [ABSTRACT FROM AUTHOR]

Basidiobolomycosis is an unusual chronic subcutaneous zygomycosis reported from tropical regions which is usually misdiagnosed because of its rarity. In this retrospective review, we describe 6 children with basidiobolomycosis who were managed in the Department of Paediatric Surgery at a tertiary institute in central India over a period of four and half years (January 2018 to June 2022). All patients were less than 5 years of age and had no co-morbidities (immune-competent). All were males. All were misdiagnosed at outside hospital. All responded well to anti-fungal therapy. High index of suspicion and biopsy of the lesions lead to appropriate diagnosis and management. Management appears good with triazole antifungals with fewer side effects and safety in children. [ABSTRACT FROM AUTHOR]

The article discusses a case of a 27-year-old male with lepromatous leprosy and chronic type 2 lepra reaction who developed cryptococcosis involving the skin and bone. The patient had received multiple courses of systemic steroids and other medications for the lepra reaction. Treatment with antifungal medications led to the healing of the skin lesions. The case highlights the importance of considering cryptococcosis in leprosy patients on immunosuppressive therapy to prevent serious complications. [Extracted from the article]

Byline: Satyaki. Ganguly, Kranti. Jaykar, Namrata. Chhabra, Neel. Prabha Background: Dermatology knowledge among fresh medical graduates is poor in India as undergraduate medical curriculum and Internship training lack adequate focus [...]

Byline: Namrata. Chhabra, Saurabh. Raut, Satyaki. Ganguly, Nighat. Hussain Radiotherapy-induced or -aggravated pemphigus is not a common occurrence with only a few cases reported so far. The radiation disrupts the [...]

Background: Mycobacterium welchii (Mycobacterium w) vaccine was one of the many strategies used to both treat and prevent coronavirus disease 2019 (COVID-19) infection. We report the results of a retrospective analysis of 15 cases with vaccine-site granulomas after administration of prophylactic Mycobacterium w vaccine as part of a trial for COVID-19 and our experience in managing those cases. Methods: This was a retrospective analysis of 15 patients with vaccine-site granulomas who were given the vaccine as a prophylactic measure as part of a trial with informed consent. Results: The mean average age of cases was 37 and the male-to-female ratio was 1:0.87. All of the patients developed erythematous tender nodules over the injection sites within a month of receiving the inoculations. Mycobacterial cultures and cartridge-based nucleic acid amplification tests yielded negative results. Skin biopsy revealed granulomatous dermatitis with acid-fast bacilli positivity. A diagnosis of noninfective granulomatous dermatitis was made. Treatment started with analgesics and anti-inflammatory agents. Systemic antibiotics were required in 9/15 patients. Patients are being followed up with no reported recurrence till date. Conclusion: The possibility of injection-site granuloma should be taken into the risk–benefit analysis for the administration of Mycobacterium w vaccine and the patients should be counseled as such. Patients with persistent ulceration respond to combinations of doxycycline, ofloxacin, and clarithromycin. [ABSTRACT FROM AUTHOR]

Byline: Ghazal. Ahmed, Neel. Prabha, Satyaki. Ganguly Sir, Steatocystoma multiplex suppurativa (SMS) is an inflammatory variant of steatocystoma multiplex (SM). It is a nevoid condition of the sebaceous glands and [...]

Byline: Neel. Prabha, Ripu. Arora, Satyaki. Ganguly, Namrata. Chhabra Gentian violet, also known as crystal violet or methyl violet, is a triphenylmethane dye. It is commonly used as a stain [...]

Actinomycetoma is chronic, suppurative, granulomatous infection caused by bacteria and requires prolonged antibiotic therapy preferrably in combinations. Nephrotoxicity is a common side effect of aminoglycosides used in the management of actinomycetoma. We report here two cases of actinomycetoma due to Nocardia species who received linezolid as a substitute to aminoglycosides after developing nephrotoxicity. [ABSTRACT FROM AUTHOR]

Introduction: Psychogenic purpura, also known as autoerythrocyte sensitization syndrome, is a rare condition which is characterized by spontaneous development of painful purpura, or ecchymoses. Skin lesions are usually preceded by stress and emotional trauma. It is usually a diagnosis of exclusion after ruling out history of trauma, drug intake and other bleeding disorders. Autoerythrocyte sensitization test (AEST) and a psychiatric evaluation helps in the diagnosis and treatment. Objective: To demonstrate the importance of AEST in diagnosing the patient of Gardner Diamond syndrome. Materials and Methods: Five suspected cases of autoerythrocyte sensitization syndrome underwent AEST after ruling out other causes of bleeding. Results: Four out of five patients were positive for AEST while one patient was negative. Psychiatric complaints were present in three patients. One patient was lost to follow up. Rest all patients responded well to vitamin C supplementation. Conclusion: Autoerythrocyte sensitization syndrome is a rare disorder and is a diagnosis of exclusion, so a thorough workup of the patient to rule out common causes of bruising is essential. A high index of suspicion on the clinician's part and a simple OPD-based AEST may help in the diagnosis. Psychiatric consultation is important to find out the stress factor and timely management. [ABSTRACT FROM AUTHOR]