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Systemic sclerosis (SSc) is a chronic multisystem disease characterized by excess deposition of connective tissue in skin and internal organs, associated with microvasculature changes and immunologic abnormalities. We hereby report a case of scleroderma in a 52 year old female with classical clinical and histopathological findings. The latter part of this article discusses and reviews existing and novel emerging therapies for the treatment of SSc, with an emphasis on recent trials targeting the cutaneous and pulmonary manifestations of this disease.

Psoriasis is a chronic hyperproliferative condition of the epidermis which requires systemic therapy. Anxiety, depression, poor self-esteem, alcoholism, sexual dysfunction, suicidal ideation are the commonest psychological problems encountered in psoriasis. Quality of life may be severely affected by the chronic nature of the psoriasis as well as the need of life long treatment. In general, psychological factors include poor self-esteem, stigmatization, depression and anxiety which are the strong determinants which determine the disability in psoriasis more than the disease itself. This is a review article highlighting on the psychological aspects of psoriasis.

Dermatitis cruris pustulosa et atrophicans is a distinct type of folliculitis that presents as pruritic, diffuse tiny follicular pustules with perifollicular edema and alopecia commonly occurring over the legs most commonly caused by Staphylococcus aureus. This was rst described by Clarke in his book titled Skin diseases in the African as Nigerian shin disease in the year 1952. Dermatitis cruris pustulosa atrophicans is therapy resistant and recurrences are quite common in spite of proper treatment. Self-resolution occurs as scarring sets in. Despite being a well-recognized entity, it has been less commonly reported or studied in dermatological literature. In this article, we highlight four classical cases of dermatitis cruris pustulosa et atrophicans and its review of literature. Further studies on a larger scale need to be done to elucidate the exact etiopathogenesis and its proper management.

Traction alopecia is a type of hair loss caused due to mechanical trauma to the hair by traumatic hairstyling with continued long term traction. This can be secondary to social, cultural, religious or occupational practices. The hair loss depends on the extent, force and the duration of the traction. This non-scarring form of hair loss if not addressed early can lead to permanent scarring alopecia. In most of the patients, this is an accidental diagnosis especially in school going girls in India where they need to tie tight braids as a part of their curriculum. In this article, we report a case series of traction alopecia with emphasis on its early diagnosis, clinical features and management

Melasma is an acquired ,chronic pigmentary disorder that predominantly is seen over the sun exposed areas of the face[1]. It can be regarded as a dysfunction in human melanogenesis [2] and results from increased activity of melanocytes [3], increased melanocytes, melanin, melanosomes and increase in synthesis of tyrosinase[4]

Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist with an anti-androgenic effect. This drug has proven to be useful in several dermatological entities, however its use has not been well explored. Its use in diseases such as acne has opened the door to the possibility of new therapies depending on the clinical manifestations of the patients, as well as its possible to use it as a first line treatment. Other diseases associated with the use of spironolactone where its effects have been shown to be useful are hidradenitis suppurativa, hirsutism and female pattern androgenetic alopecia. In this review we discuss the use of spironolactone in different skin diseases that are common in our environment, dosage according to different studies, treatment recommendations and adverse effects; all of the above mentioned in order to use this drug in a daily clinical practice.

Background: Granuloma annulare (GA) is a benign, self-limiting inflammatory skin condition of unknown origin that may occur following multiple etiological triggers. GA incited secondary to vaccinations has been rarely reported in the medical literature. The COVID-19 pandemic has introduced extensive global immunization against the SARS-COV-2 virus, bringing a gamut of vaccine-related complications. We elucidate a case report of the spontaneous eventuality of GA following ChAdOx1 nCoV-19 Corona Virus Recombinant Vaccine. Case Report: A healthy 26-year male presented with a one-week history of asymptomatic single, flesh-pink patch with a raised margin over his left ventral forearm. On close examination, the margin of the lesion had multiple annularly arranged papules. Biopsy of lesion was done, and histopathology revealed numerous palisading granulomas in the dermis consistent with findings of localized GA. The patient was managed with once-daily external application high potent topical corticosteroids, which was used intermittently by the patient. However, the lesion showed spontaneous resolution in one month. Conclusion: Identifying ChAdOx1 nCoV- 19 Vaccine-related adverse events following its first dose is paramount, as evidence of the proportion of local or systemic severe cutaneous adverse skin reaction (SCAR) on subsequent dosing is a paucity. A more extensive systematic review corroborating SCARs and safety profile following immunization with ChAdOx1 nCoV-19 Vaccine prevails to be the need of the hour.

Hansen’s disease or Leprosy, is a chronic infectious disease that is contagious and has a slow evolution. It affects mainly skin and schwann cells in the peripheral nerves and causes peripheral neuropathy which contributes to the permanent functional impairments [1]. It is caused by a rod shaped,acid fast staining bacteria known as Mycobacterium Leprae which has parallel sides, round ends and a characteristic bundle of cigar appearance due to the presence of a glial substance which is a surface lipid that makes the bacilli to be arranged side by side in parallel arrays [2]. It has a distinctive empathy towards the peripheral nerves where it establishes originally therefore it is the site where the pathological processes start mainly with the principal target being Schwann cell [3,4]. Amidst the communicable diseases, Leprosy is the most common cause of physical disabilities which is permanent. When the bacterium enters a person with good cell-mediated immunity against it, it gets destroyed. If there is a slight impairment in the cell-mediated immunity against it, some bacilli will multiply and a lesion develops. Depending upon the immune status of a host, it expresses itself in different clinico-histopathological forms [5]. Ridley and Jopling suggested a five-group classification of leprosy known as immunological classification based upon the immunological status of the patient as (a) tuberculoid (TT), (b) borderline tuberculoid (BT), (c) mid-borderline (BB), (d) borderline lepromatous (BL) and (e) lepromatous (LL) [6]. Bacteriological, immunological, clinical and histopathological features exhibit continuous but slow changes from one pole to another pole. The main disadvantage of this classification is that there is no specific position for pure neuritic as well as indeterminate leprosy in the spectrum [7].

This article lays out the common hypopigmented \depigmented lesions in geriatric population encountered in dermatology OPD in a tertiary care centre in India. Hypopigmented/depigmented lesions is commonly encountered in a dermatology OPD on a day to day basis. This study is an observational study carried out on 100 patients in dermatology OPD in a tertiary care centre who satisfied the inclusion criteria of age more than 60 years with hypopigmented or depigmented lesions. Hypopigmented/depigmented lesions have a great impact on patients aesthetic appearance leading to psychosocial impairment. A further research with larger sample size and longer study duration can help us understand hypomelanosis in geriatric population better.

Aim and Objectives: Dermatophytosis is a fungal infection of the outermost layer of skin and its appendages such as hair, nails and scalp. The present study was undertaken with a view to find out the clinical pattern of dermatophytic infections in our hospital. Materials and Methods: A total of 100 patients were included in the study. History was taken, general and physical examination was done. Multiple sites were involved in some cases, but were categorised prioritising the most predominant site involved. Patient was diagnosed and classified based on clinical types, age and sex. Results and Conclusion: A total of 100 patients were enrolled in the study in which 56 males and 44 females were affected. The most commonly affected age group was 19 to 59 years (63%). The most common clinical type of infection was T. cruris affecting 41% of the study population.

Background: Leprosy by definition is a chronic granulomatous infection of the skin and superficial nerves in the skin caused by Mycobacterium leprae and Mycobacterium lepromatosis. [1] It most commonly involves the nose, eyes, throat, and sometimes the testicles. The bacilli are most frequently transmitted via droplets, from the nose during close contact with untreated cases of leprosy. Leprosy was first mentioned in 700BC. Leprosy is common in tropical and subtropical Asia, some Pacific countries, Africa, and South America [2]. It is not known how leprosy is transmitted. Although skin lesions and nerve thickening manifest together, they also appear as separate entities. This study aims to find out the frequently thickened nerves in different spectrums of Hansen’s disease. Objectives: To determine the frequently thickened nerves in different spectrums of Hansen’s disease. Methods: This descriptive study was conducted in Chettinad Hospital and the Research Institute from June 2021 to August 2021. The patients were biopsy-proven Hansen's disease in a different spectrum of the disease, nerve thickening was obtained using palpation method. The Sample size was small due to the prevailing covid situation at the period during which the study was conducted. Results: The data collected from the examination of the different spectrum of disease, the pattern of frequently thickened nerves were evaluated. A total number of 30 patients were examined by palpation method among which 10 patients showed ulnar nerve thickening,7 patients showed greater auricular nerve thickening, 4 patients showed radial cutaneous nerve thickening, 9 patients showed sural nerve thickening. Conclusion: In our study, the most common thickened nerve was the ulnar nerve, secondary to that was the sural nerve. This study concludes the only examination done by palpation method, further diagnostic studies might increase the accuracy and specificity of the above-collected data.

Aim: To compare the efficacy and safety of topical 3% tranexamic acid gel vs 35% glycolic acid peel in the treatment of melasma over face. Materials and Methods: This is an open labelled, Randomised Controlled Trial(RCT) conducted on 60 patients. Patients were randomly divided equally into 2 groups – Group A and Group B. Patients of Group A used topical 3% tranexamic acid gel twice a day and Group B patients were treated with 35% glycolic acid peel with a contact period of 5 minutes once in every 2 weeks. Patients were assessed every month for a period of 3 months and recurrence was assessed for the next consecutive 3 months following the treatment. Patients were asked to use a broad spectrum sunscreen before sun exposure during the entire study. Assessment of reduction in pigmentation was made by MASI score, subjective and objective valuation (blind observer) and photographic comparison. Safety profile was assessed by the side effects. Results: The mean value of Melasma Area and Severity Index(MASI) score for glycolic acid group at baseline was 14.41 which reduced to 7.05 at end of 3rd month. In tranexamic acid group, the mean value of MASI score at baseline was 14.58 which reduced to 5.96 at the end of 3rd month. The mean percentage of improvement in MASI score in glycolic acid group 52% whereas in tranexamic acid group it is 61%. The side effects were minimal in this study. Side effects were more in glycolic acid group than tranexamic acid group. A total of 8 patients had recurrence during follow up. In glycolic acid group, 5 patients had recurrence whereas in tranexamic acid group, only 3 patients had recurrence. The percentage of recurrence in glycolic acid group is 16.7 % whereas in glycolic acid group it is 10.7%. Conclusion: Tranexamic acid is a novel emerging therapy for melasma. In this study it has been found that topical 3% tranexamic acid is equally efficacious as 35% glycolic acid peel with minimal side effects in the treatment of melasma.

Atrophoderma vermiculata is a rare and benign follicular disorder of the skin occurs due to abnormal keratinisation in follicular pilosebaceous unit. It presents as multiple, symmetric, depressed pitted scars with reticular/ honeycomb atrophy of skin. It usually presents in face but in our case lesions are seen over chest, back, shoulder and gluteal region. The onset is mostly sporadic or sometimes inherited Autosomal Dominant. It is a clinical variant of Keratosis Pilaris Atrophicans. This condition is difcult to treat cosmetically. Hereby we report a rare case of Atrophoderma Vermiculatum with isolated presentation and different site involvement, treated with oral Isotretinoin showing good response

Nevus sebaceous (aka. Nevus Sebaceous of Jadassohn or Organoid nevus ) is a hamartomatous disorder of the skin and is an epidermal appendageal nevus disorder with predominant sebaceous gland involvement .The Diagnosis of which is mainly based on the clinical presentation ,histopathology and dermoscopy can be useful when the diagnosis is in doubt .Careful clinical follow up followed by a therapeutic excision might sufce but a prophylactic full thickness complete excision is recommended as there are rare chances of malignant transformation with chances of recurrence , metastasis and fatal outcome .In this article we report a case of nevus sebaceous along with a review of literature

Transient neonatal occipital alopecia is a form of acute Telogen efuvium caused due to synchronous hair shedding in the occipital region seen in infants of 3 months of age resulting in hair shedding from the occipital region. Though it's a self-limiting condition, patients are often panic stricken due to sudden onset of hair loss in the infant. In this article we report a case of transient neonatal occipital alopecia along with review of literature

Background: Neonatal skin care practices that are often guided by personal experience and preferences result in substantial variation in the practices being followed across hospital settings. The objective of this consensus recommendations was to provide guidance to health care practitioners on evidence-based neonatal skin care practices for adoption in hospitals: from delivery to discharge.Methods: A Scientific Advisory Board meeting on “Evidence-based Neonatal Skin Care Practices and Protocols” was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynaecologists and a pediatric dermatologist were invited. A comprehensive literature search was performed using the PubMed and Google Scholar databases to source relevant evidence.Results: Recommendations were developed on critical aspects of skin care in healthy full-term neonates, including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, use of cleansers and emollients, and the criteria to choose appropriate skin care products. The newborn’s first bath should occur only once cardiorespiratory and thermal stability have been achieved, anywhere between 6 to 24 hours after birth. Bathing with water alone or water with a mild liquid cleanser demonstrated appropriate for newborn does not impact the developing skin barrier. The use of emollients to maintain and enhance skin barrier function was encouraged for neonates with risk factors that can affect skin barrier integrity. Skin assessment should become an integral part of routine neonatal care. Skin Care Advice with “Do’s and Don’ts” should be a part of the neonatal discharge checklist. The importance of rigorous quality control, high-quality clinical trials to evaluate the safety and efficacy of baby products, usage of products that contain only ingredients and which are formulated appropriately for newborn babies, and full label transparency for baby products were highlighted. The panel further identified gaps in the existing literature and discussed the scope for future research. Conclusions: The consensus recommendations may help standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings. This may also improve the quality of care that the neonates receive in the hospital and facilitate improvement in overall neonatal health outcomes.

Introduction: Alopecia areata is a common chronic autoimmune inflammatory disease that involves hair follicles, characterized by hair loss on the scalp and/or body without scarring. Clinically, the disease presents as smooth, patchy hair loss with various patterns - diffuse or reticulate alopecia, ophiasis, ophiasis inversus, alopecia totalis (loss of hair all the scalp), or alopecia universalis (loss of hair all over the body). Clinical diagnosis of AA is made based on typical pattern of hair loss and the presence of characteristic exclamation mark hair in microscopy. Invasive (punch biopsy) techniques are often required in some cases where the clinical diagnosis is not straight forward Biopsy shows peribulbar lymphocytic infiltrates in a “swarm of bee pattern” which is characteristic of the acute stage of the disease. Dermoscopy is an imaging instrument that immensely magnifies surface features of skin lesions. It works on the principle of illumination and transillumination of skin with different light sources and studying it with a high magnification lens. Dry dermoscopy was done with heine delta 20 dermoscope which was followed by wet dermoscopy. Liquid paraffin was used as the immersion media. It is a noninvasive, repeatable, recordable bedside investigation. Objective: To study dermoscopic findings in alopecia areata. Materials and Methods: Study Design: Cross sectional study; Study Area: Skin Outpatient Department, Sree Balaji Medical College and Hospital; Study Population: All patients with hair loss, attending skin OPD, who are clinically diagnosed as Alopecia Areata; Study Method: Observational study; Sample Size: 30. Results: Clinically, the disease presents as smooth, patchy hair loss with various patterns. Dermoscopy is useful for diagnosis of AA clinically by the presence of cadaverized hairs (black dots), circle hair, coudablity hair, exclamation mark hairs (tapering hairs), broken hairs, yellow dots and clustered short vellus hairs in the hair loss areas. The results wear tabulated.

Aim: The aim was to study the analytical pattern in dermatoglyphics. Materials and Methods: The study was conducted in Skin Opd, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India. A total of 100 participants with different hand dermatitis pattern were included in the study. All patients were subjected to: 1. Complete history, 2. Dermatological examination, 3. Finger print pattern of all the patients, 4. Informed consent. Results: This hospital-based study involved 100 patients with Psoriasis (47) Eczema (23) Dermatophytosis (12), Syphilis (3), Drug reaction (5) Palmar keratoderma. (10), the most common being psoriasis and eczema. In psoriasis patients, whorl pattern was the commonest (48.29%), followed by 31.43% loop, 21.43% arch and 2.86% composite pattern. In eczema patients, loop and whorl pattern was found in (44.74%) followed by 34.23% loop, 22.43% arch and 1.86% composite pattern. Conclusion: The palmar pattern intensities were increased in both sexes, while the digital pattern intensities were increased in males and decreased in females. TFRC was increased in males and decreased in female patients. In both cases and controls, TFRC was more in males than females. A-b count showed a significant reduction in both sexes.

Granulosis Rubra Nasi is an uncommon eccrine gland disorder with an autosomal dominant inheritance. It usually occurs over the face particularly on the tip of the nose and typically is thought to be initiated due to hyperhidrosis which then eventually manifests as diffuse erythema over the nose, chin, cheeks, and upper lip. Although frequently seen in childhood, it occasionally occurs in adults as well. Here we present a case report on a 22year old female patient who presented with complaints of uncontrolled sweating over the nose. On detailed examination of the nose, erythema and telangiectasias were noted. Biopsy ndings supported the diagnosis of granulosis rubra nasi as well. This case has been reported due to its rare occurrence.

Dowling-Degos disease is an uncommon genetic disorder commonly seen in women inherited as an autosomal dominant trait characterized by reticulate pigmentation over the intertriginous areas distributed symmetrically. The pigmentation is not congenital and age of presentation can be variable. We report the case of 35-year-old woman who came with complaints of asymptomatic pigmentation over the exural areas.

Atopic dermatitis is a chronic relapsing inammatory skin disorder with a complex pathogenesis involving genetic susceptibility, immunologic and epidermal barrier dysfunction, and environmental factors. Pruritus is a primary symptom; skin lesions range from mild erythema to severe lichenication to erythroderma. Diagnosis is by history and examination. Treatments include counseling on appropriate skin care, avoidance of triggers, and topical corticosteroids and immunosuppressants. Control of pruritus and superinfections is also important. Severe cases may require systemic immunosuppressive treatment. Childhood atopic dermatitis frequently resolves or lessens signicantly by adulthood.

Aggressive Angiomyxoma is a very rare, distinctive, locally invasive soft tissue tumour, that occurs most commonly in the perineum, pelvis, vulva and vagina. It is seen mostly in women of reproductive age group. It has a tendency for recurrence locally, treatment being surgical excision. We hereby describe a case of 38-year-old patient with a pedunculated growth on the right labium majora.

Coronavirus disease 2019 (COVID-19) pandemic has affected every sphere of life including management of psoriasis. The availability of COVID-19 vaccines has given rise to hope and at the same time some apprehensions as well. With the general population becoming eligible for vaccination, there is some confusion, on the eligibility of patients with different medical conditions and patients on immunosuppressive or immunomodulating medications for COVID-19 vaccination. Dermatologists treating psoriasis patients frequently face questions from them, whether they can undergo coronavirus disease 2019 vaccination. A PUBMED search was performed using the following strategy: ‘COVID-19’ AND ‘Vaccine’ AND ‘Psoriasis’. We also performed a PUBMED search using the following strategy: ‘SARS-CoV-2’ AND ‘Vaccine’ AND ‘Psoriasis’. All articles irrespective of language and publication date were included to arrive at this position statement. This position statement deals with the safety, eligibility and modifications of treatment, if needed among psoriasis patients with regards to the coronavirus disease 2019 vaccines currently available in India.