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Byline: Vibhu. Mendiratta, Amit. Meena, Bharati. Verma, Ashna. Jain Background: Psoriasis begins in childhood in around one-third of the cases. There has been conflicting evidence regarding the association of paediatric [...]

Byline: Vidya. Yadav, Damini. Verma, Vibhu. Mendiratta Sir, Adult-on set atopic dermatitis (AD) is categorized as a subgroup of AD in which the onset of AD is after the age [...]

Byline: Vidya. Yadav, Vibhu. Mendiratta, Aparna. Agrawal, Kavita. Bisherwal, Ritu. Singh, Amit. Meena Background: Psoriasis is a chronic, immune mediated inflammatory condition of the skin and imbalance in inflammatory mediators [...]

Byline: Himadri, Vibhu. Mendiratta, Rashi. Pangti, Shilpi. Aggarwal Case Presentation A 23-year-old gentleman presented with a history of asymptomatic growth over the upper lip for two years. The lesion started [...]

Byline: Vibhu. Mendiratta, Vidya. Yadav, Apoorva. Bhardwaj, Rashi. Pangti Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent follicular disorder affecting apocrine gland bearing areas such as axillae, inframammary area [...]

Byline: Akanksha. Agarwal, Vibhu. Mendiratta Background: Female pattern hair loss (FPHL) affects a significant proportion of population and poses a major therapeutic challenge. Aims and Objectives: To compare the efficacy [...]

Rationale: Though cutaneous tuberculosis accounts for a small proportion of all tuberculosis cases, it becomes an important health issue considering its high prevalence in tropical countries. Due to its myriad clinical manifestations, it becomes difficult to diagnose and may pose a great diagnostic dilemma. Patient concerns: A 17-year-old male complaint of ulcerproliferative lesion on the left lower leg for 5 years. There was no history suggestive of tuberculosis. On cutaneous examination, single well-defined erosiocrustive plaque of size 14 cm × 13 cm with yellowish adherent crust presented over the left lower leg. The underlying surface shows ulceration after removing the crust. Diagnosis: Ulcerative Lupus vulgaris. Interventions: Anti-tubercular drug therapy (isoniazid, rifampicin, pyrazinamide and ethambutol). Outcomes: Lesion showed dramatic improvement after one month of anti-tubercular therapy. Lessons: Dermatologists should be aware of variable clinical presentations of cutaneous tuberculosis so as to diagnose it timely and correctly.

Introduction: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, systemic therapies, or physical therapies including laser have been explored. However, there are not many randomized controlled studies for the majority of therapy alternatives besides lifestyle modifications and weight reduction. Objectives: The aim of this study was to compare the effectiveness of 15% trichloroacetic acid (TCA) and 35% glycolic acid (GA) peel for AN. Materials and Methods: Forty participants were included and randomized into two groups. In groups A and B, peeling with 15% TCA and 35% GA was done, respectively. The effectiveness of each peel was assessed using changes in the Acanthosis Nigricans Area and Severity Index Score (ANASI) and Physician Assessment Score. Statistical analysis included Wilcoxon-Mann-Whitney test, Friedman test, and generalized estimating equations. Results: The overall change in ANASI over time was compared in the two groups using the generalized estimating equations method. A significant difference was observed in the trend of ANASI over time between the two groups (P < 0.001). TCA peel group showed more change in ANASI as compared with GA peel group. Conclusion: In our research, 15% TCA has a better efficacy when compared with 35% GA peel after three sessions of chemical peeling. We therefore recommend the use of 15% TCA peel in AN as a safe and effective treatment option. However, more comprehensive randomized control studies are required for supporting data. [ABSTRACT FROM AUTHOR]

Background: Because of the counter-regulation of Th1 and Th2 cells, Th1-type autoimmune diseases like thyroid autoimmunity and Th2-mediated allergic diseases like atopic dermatitis (AD) should occur in mutually exclusive populations. However, thyroid autoimmunity has been associated with chronic urticaria, and atopy is considered a cause of both AD and urticaria. Objectives: To assess the frequency of thyroid autoimmunity in children with AD and to study the correlation between the clinical severity of AD using the SCORing Atopic Dermatitis (SCORAD) score, and biochemical parameters of serum immunoglobulin E (IgE), absolute eosinophil count, and vitamin D levels. Materials and Methods: A hospital-based cross-sectional study was conducted, recruiting children (0-18 years) with AD. Patients on drugs affecting thyroid dysfunction and those with sick euthyroid syndrome or an immunodeficiency disorder were excluded. Clinical severity was assessed using SCORAD, and the thyroid profile, anti-thyroid peroxidase antibodies, antinuclear antibody (ANA), absolute eosinophil count, serum IgE, and vitamin D levels were measured. Results: Thyroid autoimmunity was diagnosed in 18.9% (10/53) of children. There was a significant correlation between SCORAD and serum IgE (r = 0.432, P = 0.002) and absolute eosinophil count (r = 0.575, P = <0.001). There was a negative correlation between SCORAD and vitamin D levels (r = -0.373, P = 0.006). Conclusions: Thyroid autoimmunity may be associated with AD, and a high index of suspicion is essential. Vitamin D also should be supplemented in children with AD as it is frequently found to be low, especially in severe cases. Multi-center case-control studies are required to determine the prevalence of thyroid autoimmunity in children with AD. [ABSTRACT FROM AUTHOR]

Lymphomatoid papulosis (LYP) is a chronic CD 30 + lymphoproliferative disorder (LPD) which is characterized by chronic, recurrent, and self-healing papulonecrotic or papulonodular skin eruptions, which are clinically benign and histopathologically malignant. It can resolve spontaneously; however, long-term follow-up is essential as it can progress to malignant lymphoma in 10-20% of the patients. We hereby report a case of a 42-year-old male presenting with recurrent papulonecrotic lesions over the face, trunk, and extremities from the last 3 years which heal with post-inflammatory hyperpigmentation and atrophic scars with a history of treated pulmonary tuberculosis one year back. There was no systemic involvement. LYP, involving cosmetically sensitive area like face, is an infrequent finding. [ABSTRACT FROM AUTHOR]

Byline: Vibhu. Mendiratta, Deepika. Yadav, Dharitree. Senapati, Shilpi. Agarwal Sir, Erythema induratum of Bazin (EIB) is a chronic recurrent disease characterized by erythematous plaques and subcutaneous nodules, which usually ulcerate, [...]

Introduction: Psoriasis is a common skin disorder and is relatively less studied in children. The objective of this study was to evaluate the clinical and epidemiological profile of pediatric psoriasis (PP). Materials and Methods: All patients of psoriasis (age <18 years) who visited PP clinic from January 2017 to September 2021 were included in this record-based study, which was conducted in a tertiary care center in North India. Results: Records of 100 patients were analyzed, with female-to-male ratio of 1:1. The mean age of diagnosis was 10.87 ± 3.96 years. The most common initial site of onset was elbows, followed by knees and soles. The most common subtype was plaque psoriasis followed by palmoplantar and guttate types. Average body surface area (BSA) involved was 5.43% with majority (49%) had involvement of 3%-10% BSA. Average psoriasis area and severity index (PASI) in our study was 2.47. PASI >10 was seen in only 5% of patients. Joint involvement was found in 7% of patients and nail changes in 54%. Infection (15%) was the most common aggravating factor, followed by trauma and stress. Koebner phenomenon was present in 15% of patients. Family history of psoriasis was reported in 22% of the patients. A history of other autoimmune disease was present in 5 patients, out of which vitiligo and hypothyroidism was present in 2 patients each and 1 had morphea. Conclusion: PP is a persistent, chronic condition that can have significant psychosocial and emotional implications. For better understanding of PP, more population-based studies are required from different parts of the world. [ABSTRACT FROM AUTHOR]

Background: Fever with rash is common among children and is seen by both dermatologists and pediatricians. The various causes of fever with rash in children include viral infections, bacterial infections, rickettsial species, collagen vascular diseases, and drug hypersensitivity rash. Viral exanthems are by far the most common cause of fever with rash in children. Common viral etiologies are measles, rubella, varicella, adenovirus, herpes simplex virus (HSV) 1 and 2, human herpes virus 6, human herpes virus 7, Epstein-Barr virus, coxsackie, dengue, chikungunya, influenza A and B, and hepatitis B. Aims: The study aimed to study the magnitude of various viral causes of fever with rash in children and to study the various morphological patterns of rash. Materials and Methods: This was a hospital-based observational study which included 90 children presenting to the dermatology and pediatrics outpatient department with fever and rash. Immunoglobulin M antibody testing for measles, rubella, varicella, HSV, chikungunya virus, dengue virus, and hepatitis B virus was done. Reverse transcription-polymerase chain reaction for COVID-19 virus was done when suspected. Results: The most common etiology of fever with rash was viral (51.1%). Out of all viruses isolated, measles was the most common (15.55%), followed by Chikungunya (14.44%). Maculopapular rash was the most common morphology of rash (40%) found in patients. Among the patients having maculopapular rash, measles was the most common virus isolated. Conclusion: Viral exanthems should be considered a strong differential in all children presenting with fever and rash. [ABSTRACT FROM AUTHOR]

Byline: Vibhu. Mendiratta, Anuja. Yadav, Jyoti. Yadav, Smita. Singh, Neha. Suman Sir, Hyaline fibromatosis syndrome is a rare autosomal recessive disorder associated with deposition of amorphous, hyaline material in skin, [...]

Byline: Rashmi. Sarkar, Shashank. Bhargava, Vibhu. Mendiratta Severe Acute Respiratory Virus Corona Virus 2 (SARS-CoV-2) has got its name Corona from Latin meaning 'crown.' It has crown-like spikes present on [...]

Byline: V. Viraraghavan, Sarita. Sanke, Vibhu. Mendiratta, Aditi. Dewan, Ajay. Kumar, Rashi. Pangti Restrictive dermopathy is a rare, autosomal recessive, lethal congenital skin disorder. This congenital genodermatosis could be mistaken [...]

Introduction: Sexually transmitted diseases (STDs) continue to be a major public health problem with significant burden on the society. Some of this can be attributed to our lack of knowledge about the change of disease spectrum from time to time. Aims: The aim of the study was to understand the changing pattern of STDs over the past 17 years (2003–2019). Materials and Methods: It was a retrospective study where data of patients who attended our Suraksha Clinic from 2003 to 2019 were collected. All the cases were subjected to detailed history, examination, and investigations done to rule out STDs. Results: A total of 2436 patients were included in the study. The majority of the patients were in the age group of 18–30 years. The most frequent diagnosis was vulvovaginal candidiasis, followed by herpes genitalis. 3.3% of patients had human immunodeficiency virus. 4.8% of patients were men sex men (MSM). Overall, viral STDs were most common, followed by fungal and bacterial. To understand the changing trends, data were divided into different phases according to the time period. During Phase 1 (2003–2007), viral STDs were most common, followed by bacterial and fungal. However, this trend changed in Phase 4 (2016–2019) and fungal STDs became most common. Conclusions: Despite numerous health initiatives, the number of STD cases is rising day by day. The increasing number of MSM over the study period necessitates dedicated efforts to address the health needs of this population. The National AIDS Control Organization should take necessary measures and steps to address the overall increase in STDs considering recent trends showing a drop in bacterial STDs and an increase in fungal and viral STDs. [ABSTRACT FROM AUTHOR]

Byline: Vibhu. Mendiratta, Anuja. Yadav Sir, Anonychia (absence of nails) is a very rare congenital or acquired anomaly. Sometimes it may occur as a single feature or as a part [...]

This article discusses a case of a 13-year-old girl who presented with white discoloration of the skin on the right side of her trunk, diagnosed as segmental vitiligo. She received treatment for vitiligo, but later developed thinning of the left thigh, which progressed to involve the entire lower limb. The patient also developed hyperpigmented plaques and lipoatrophy. The article describes the clinical examination, investigations, and treatment provided for the patient. The authors highlight the association between vitiligo and morphea, and emphasize the need for further research to understand the relationship between these disorders. [Extracted from the article]

Granulomatous vulvitis (GV) is an idiopathic entity typically presenting with chronic, painless swelling of the genitals with histologic evidence of granulomatous inflammation. Granulomatous vulvitis can typically start as an acute inflammatory condition, which gradually transforms into a chronic disease with a relapsing and remitting course leading to swollen, indurated, and distorted external genitalia. Association of GV with Crohn's disease is being increasingly recognized. However, the association of GV with ulcerative colitis is unreported. Here, we report a rare case of GV in a middle-aged Indian female with characteristic gastrointestinal involvement suggestive of ulcerative colitis. We hope to contribute to an earlier recognition and a better management of the vulvar and gastrointestinal lesions of ulcerative colitis. [ABSTRACT FROM AUTHOR]