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Introduction: Periorbital melanosis (POM) has a significant impact on quality of life. There is a dearth of literature regarding POM, especially in Asian population. Accurate classification of POM is contributory to the choice of therapy. The aim of this study was to assess the role of dermoscopy in etiologic classification of POM. Methods: Two hundred and fifty adult patients (age > 18 years) of POM were enrolled over a period of 2 years. POM was classified clinically and re‐evaluated based on their dermoscopic findings (pattern of pigmentary and vascular involvement, surface changes). Results: Pigmented, vascular, structural, and mixed types of POM represented 6.4%, 4.8%, 0.4%, and 88.4%, respectively. Dermoscopy was found to be statistically more accurate in classifying pigmentary and vascular types of POM as compared to clinical examination with the naked eyes (p‐ value <0.05). Patchy or post‐inflammatory pigmentation was the most common pigmentary pattern on dermoscopy (53.8%) followed by pseudoreticular (37.1%) and mixed pattern (9.1%). 80.4% patients had vascular involvement of which the most common vascular pattern was telangiectasia (58.8%). Wrinkling or increased skin laxity as a cause of shadow effect was found in 52% patients. Diffuse erythema and scaling suggestive of subtle inflammation was detected in 47.6% patients on dermoscopy. Conclusion: Dermoscopy as a diagnostic modality is more accurate in detecting pigmentary and vascular causes of POM and subtle signs of active inflammation in the form of erythema and scaling which is difficult to detect clinically. The major limitations of this study were lack of correlation of dermoscopic findings with the histological findings and the absence of any control group for comparison. [ABSTRACT FROM AUTHOR]

Dear Editor, Alopecia areata is a commonly encountered clinical problem. The treatment of choice for localized disease is intralesional steroid injection, which, though usually effective, is an invasive, painful procedure and may require repeated sessions, affecting patient compliance. [Extracted from the article]

Hailey-Hailey disease (HHD) is an autosomal dominant genodermatosis related to mutations of the ATP2C1 gene (encoding a calcium pump of Golgi apparatus).[1] It typically manifests during the second or third decade of life and is clinically characterized by erosions/fissures and scaly/macerated plaques or chronic vegetations mainly involving flexural sites.[1] These clinical manifestations are similar to those of other common intertriginous dermatoses, making the differential diagnosis particularly challenging.[1] This is even more relevant in dark-skinned patients, in which important clinical features (e.g., shade of erythema and sharpness of lesions margins) may be less evident.[2] Over the last few years, dermoscopy has been shown to improve the recognition of several inflammatory dermatoses in both light and dark phototypes.[[3]] However, data on HHD are sparse and limited to single case reports.[[5], [7]] In this multicentric retrospective observational study conducted by the "Imaging in Skin of Color" Task Force of the I International Dermoscopy Society i (IDS), we sought to characterize dermoscopic findings of HHD, as compared to those of the main clinical mimickers. Dermoscopy in general dermatology (non-neoplastic dermatoses) of skin of colour: a comparative retrospective study by the International Dermoscopy Society. Moreover, a possible overlap with flexural lesions of Darier's disease due to histological similarities should be considered, thereby clinical/anamnestic data remain of utmost importance in distinguishing these dermatoses. [Extracted from the article]

Introduction: Lupus vulgaris is the most common form of cutaneous tuberculosis caused by contiguous spread from an underlying infective focus or lymphatic or hematogenous spread. It can also develop at the site of direct inoculation (e.g., tattooing and ear piercing) or Bacillus Calmette-Guerin vaccination. The solitary involvement of the pinna is rare and may face clinicians with a diagnostic dilemma. Herein, we reported the case of a 37-year-old female presenting with lupus vulgaris of the left pinna with a history of ear piercing. Case Report: Our case was a 37-year-old female presenting with asymptomatic erythematous plaques on the left pinna for 2 years. She had a history of ear piercing done 20 years ago. After 6 months of ear piercing, she suffered from recurrent infections at the site of piercing in the left ear, while the other ear was normal. Two years earlier, she developed a small erythematous papule, which slowly progressed in size to the present status. On examination, well-defined erythematous scaly plaques were noted on the left helix. The histopathology of the skin biopsy showed multiple confluent granulomas consisting of the epithelioid cells and lymphocyte with a focal area of necrosis in the dermis. Acid-fast bacilli were not seen in modified Ziehl-Neelsen (ZN) and routine ZN staining. A final diagnosis of lupus vulgaris was made, and the patient was started on antitubercular drugs. There was a significant resolution of the lesion after 2 months of treatment. Conclusion: Cutaneous tuberculosis should be considered in the differential diagnosis of chronic nonhealing granulomatous skin lesions developing at the site of ear piercing. [ABSTRACT FROM AUTHOR]

Background: Literature on the dermoscopic patterns of basal cell carcinoma (BCC) in India is limited. Aim: To describe the dermoscopic pattern and dermoscopic–histopathological correlation in a large cohort of patients with BCC from India, with a particular focus on skin of colour (SOC). Methods: This retrospective study was conducted under the aegis of the Dermatoscopy Society of India. Clinical details were collected, and two lead authors independently analysed dermoscopic images of BCC for a predefined set of characteristics. Histopathological slides/blocks were reviewed, and dermoscopic–histological correlation attempted. Results: In total, 143 patients with BCC and skin phototypes IV–VI were included. The mean largest BCC diameter was 3.10 ± 3.68 cm and there was a significant but weak association between duration and largest dimension of the lesion (Spearman ρ = 0.33, P < 0.01). Nearly half of the cases were diagnosed with pigmented BCC and the most common histological subtype was nodular BCC (37.9%). Dermoscopically, blue–grey dots and arborizing vessels were the most common features (60.0%). Pigmentary changes were found in the majority of cases, and included blue–white veil, blue–grey ovoid nests and maple leaf‐like areas. A third of our patients had short linear telangiectasia, polymorphic vessels and regular dotted vessels, and another third exhibited a dermoscopic rainbow effect. Arborizing vessels were significantly more common with micronodular (78.9%) and nodular variants (74.1%, P = 0.05), whereas regular dotted vessels (68.4%, P = 0.04), blue–white veil (84.2%, P = 0.02) were significantly associated with micronodular variant. Conclusion: The dermoscopic patterns of blue–white veil and regular dotted vessels are indicators towards micronodular BCC in SOC and can help in prioritizing treatment. [ABSTRACT FROM AUTHOR]

Background and Aim: Deformities and disabilities in leprosy lead to significant morbidity to the individual and financial burden to the family. As the prevalence of leprosy is higher in central India, this study was conducted to know the burden of deformity and disability among leprosy patients in central India and the factors associated with it. Materials and methods: This was a hospital-based, cross-sectional study, conducted on 50 new or on treatment or released from treatment leprosy patients, attending the Dermatology OPD of a tertiary care institute in Central India. Disability was graded as per the WHO criteria for disability grading of hands and feet. Results: Grade 2 disability was found among 32% of the patients with leprosy, whereas a total of 60% of our patients had either grade 1 or grade 2 disabilities. Trophic ulcer was found among 20% and claw hand among 14% of leprosy patients. We found significant associations of lepromatous leprosy with trophic ulcer (p = 0.004) and grade 2 disability (p = 0.012). All patients with claw hands and 80% of the patients with trophic ulcers presented to the healthcare facility at least 6 months after the onset of symptoms. Conclusions: We found very high rates of disability and deformity among leprosy patients indicating possible huge burden of morbidity among leprosy patients in central India. The significant association of lepromatous leprosy with trophic ulcer and grade 2 disability indicated delayed presentation and diagnosis of lepromatous leprosy patients. Our results underlined the need for large scale community-based studies on disability and deformity among leprosy patients in Central India. These results also call for better training of primary level healthcare workers for early detection and management of deformities and disabilities as well as better patient education for leprosy patients regarding hand and foot care. [ABSTRACT FROM AUTHOR]