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Pustules in a neonate can be due to various causes. Though the majority of conditions causing pustules in a neonate are benign, it is essential to clearly differentiate these from serious ones. A systematic approach based on detailed history and clinical examination of the neonate along with basic laboratory evaluation narrows down diagnostic possibilities and aids in the correct diagnosis. This review outlines a step-by-step approach so as to avoid clinical dilemmas and unnecessary intervention.

Objective: Early and higher detection rates of depression among dermatology patients can lead to better prognosis. Increased depression literacy among dermatologists might play a vital role in the early and successful detection and treatment of depression among their patients. The objective of this study was to investigate depression literacy among dermatologists working in India., Methods: An online survey with a questionnaire comprising sociodemographic variables and the Depression Literacy Questionnaire was conducted to collect data on depression literacy among dermatologists between July 6, 2019, and August 6, 2019. Sociodemographic variables included age, sex, educational qualification, practice location, practice duration, and practice type., Results: The response rate was 56.99%. The majority of respondents were aged 31-50 years, female, and working in urban areas. The mean ± SD total score of the respondents was 17.4 ± 2.36, with the lowest score being 10 and the highest score 22. More correct answers (98.1%) were recorded for the items "loss of confidence and poor self-esteem may be symptoms of depression" and "sleeping too much or too little may be sign of depression." The mean total score of female respondents was higher than that of men, and the difference was significant (P = .003)., Conclusions: The study revealed good depression literacy status among dermatologists working in India. Female respondents were found to have higher depression literacy., (© Copyright 2020 Physicians Postgraduate Press, Inc.)

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Dowling-Degos disease (DDD) is a late-onset genodermatosis characterized by hyperpigmented macules on the flexures along with scattered comedo-like lesions and pitted acneiform scars. Follicular Dowling-Degos is a rare type of DDD, with only two reports so far. It presents with follicular papules and comedo-like lesions predominantly on the face and trunk. Dermoscopy of follicular DDD shows irregular star-shaped/Chinese letter pattern pigmentation along with comedo-like lesions. Herein, we describe diagnostic clues including dermoscopy in three patients of follicular DDD which can help in differentiating it from other disorders presenting with comedo-like lesions., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Dermatology.)

Psoriasis is a chronic, immune mediated, systemic inflammatory skin disease with a reported prevalence of 0.6%-4.8% in the general population. Bipolar disorder (BP) is a severe episodic psychiatric disorder that ranks as the fourth leading cause of disability. Recent evidence suggests that genetic and immunological factors play a significant role in the development of both disorders. Studies have also shown a higher association of psychiatric disorders among patients with psoriasis. Moreover, several autoimmune comorbidities have been reported in association with BP. Here, we describe a young woman with BP who developed psoriasis after 1 year of developing BP and showed exacerbations in psoriasis lesions with each manic episode. We also highlight the safe and efficacious use of apremilast for psoriatic lesions in the woman., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Subcision is a simple such procedure with considerable efficacy especially in the management of the rolling type of atrophic post-acne scars. Since its introduction in 1995, the technique has undergone several modifications to enhance its results as well as to improve the ergonomics. However, 'gushing' of blood through the hub of the needle smears the surgeon's gloves and the treatment field, which is not desirable both aesthetically and hygienically., Aim: To describe a simple technique to avoid blood spillage to the treatment field while doing subcision., Method: While doing subcision, the open hub of the needle used was plugged with a button of sterile cotton and cyanoacrylate glue. The new technique was demonstrated on a patient with atrophic post-acne scars., Results: There was no blood spillage through the hub of the needle., Conclusion: This simple modification of subcision helps to attain a bloodless treatment area which also has an added advantage of better assessment of the targeted endpoints at the treatment site., (© 2019 Wiley Periodicals, Inc.)

Epidermodysplasia verruciformis (EV) manifests early in childhood as pityriasis versicolor (PV)-like macules on sun-exposed sites such as the face. These hypopigmented lesions closely resemble commoner pediatric dermatoses such as PV or pityriasis alba. In this report of two cases, we describe the distinguishing dermoscopic features of PV-like macules in EV. Unfocused dotted vessels in a hypopigmented or erythematous background with whitish scales and pigment diluted vellus hairs on dermoscopy should raise the suspicion of EV in children presenting with PV-like lesions., (© 2019 Wiley Periodicals, Inc.)

Background: Barraquer-Simons syndrome (BSS) or acquired partial lipodystrophy is a disorder of loss of subcutaneous fat from the upper part of the body. The resulting cosmetic disfigurement causes significant psychological distress in the affected individuals. Fillers, autologous fat transplant or cosmetic surgeries can be used to correct the volume deficit., Methods: The authors report a case of a young woman, who presented with gradual loss of subcutaneous fat from the face, upper limbs, and trunk. On evaluation, she had low complement C3 levels, but there were no features to suggest any metabolic complication. She was diagnosed with BSS. Her volume deficit in the midface area was managed with hyaluronic acid (HA) filler., Results: The treatment has resulted in the correction of her facial volume loss immediately following the procedure with a maintained effect at follow-up visits. She experienced no major adverse events., Conclusion: Hyaluronic acid filler is safe and effective for the management of volume loss in BSS. It gives a long lasting result and an added self-confidence to the patient., (© 2019 Wiley Periodicals, Inc.)

Depigmented patches in vitiligo, a common dermatosis, cause a great psychological distress to the patients. Hence, apart from halting the disease process, the strategies to impart normal skin colour to these white patches carry an important role in the management of vitiligo. Surgical procedures are often required for stable vitiligo lesions not responding to medical therapies. It involves "shuffling" of melanocytes from the pigmented skin to the depigmented areas. During the last fifty years, the vitiligo surgery has evolved from tissue transplantation via cellular transplantation to reach a stage where the use of stem cells or immunomodulatory cells is contemplating. We would like to depict this wonderful journey of vitiligo surgery through this viewpoint., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Importance: Evidence is robust for the effectiveness of microneedle therapy in the management of postacne atrophic scarring. A home-based topical treatment with an efficacy comparable to microneedling would be a useful addition in the armamentarium of acne scar management., Objective: To compare the efficacy of topical tazarotene gel, 0.1%, with microneedling therapy in the management of moderate to severe atrophic acne scars., Design, Setting, and Participants: Prospective, observer-blinded, active-controlled, randomized clinical trial with 6 months of follow-up conducted between June 2, 2017, and February 28, 2018, at a tertiary care hospital in India. Thirty-six patients with grade 2 to 4 facial atrophic postacne scars and without a history of procedural treatment of acne scars within the previous year were recruited. Analyses were conducted using data from the evaluable population., Interventions: Both halves of each participant's face were randomized to receive either microneedling or topical tazarotene therapy. Microneedling was conducted on 1 side of the face with a dermaroller having a needle length of 1.5 mm for a total of 4 sessions during the course of 3 months. Participants were instructed to apply topical tazarotene gel, 0.1%, to the other side of the face once every night during this same period., Main Outcomes and Measures: Patients were followed up at 3 and 6 months by a blinded observer, and improvements in acne scar severity based on Goodman and Baron quantitative and qualitative scores and a subjective independent dermatologist score (range, 0-10, with higher scores indicating better improvement) were assessed. Patient satisfaction was assessed using a patient global assessment score (ranging from 0 for no response to 10 for maximum improvement) at these follow-up visits., Results: There were 36 participants (13 men and 23 women; mean [range] age, 23.4 [18-30] years), and the median (interquartile range [IQR]) duration of acne was 6 (4-8) years. For the 34 participants included in the complete data analyses, the median (IQR) quantitative score for acne scar severity at the 6-month follow-up visit following treatment with either tazarotene (from a baseline of 8.0 [6.0-9.8] to 5.0 [3.0-6.0]) or microneedling (from a baseline of 7.0 [6.0-10.8] to 4.5 [3.0-6.0]) indicated significant improvement (P < .001) that was comparable for both treatments (median [IQR] change in severity score from baseline, 2.5 [2.0-4.0] vs 3.0 [2.0-4.0]; P = .42). By contrast, median qualitative acne scar scores were the same for both treatment groups at baseline and did not significantly change following either treatment., Conclusions and Relevance: The present clinical trial showed comparable outcomes of both treatments for the overall improvement of quantitative facial acne scar severity., Level of Evidence: 1., Trial Registration: ClinicalTrials.gov identifier: NCT03170596.

Apremilast, an orally administered small molecule inhibitor of phosphodiesterase 4 (PDE4), has been licensed by the US Food and Drug Administration for the management of active psoriatic arthritis (March 21, 2014) and moderate to severe plaque psoriasis (September 23, 2014). It has got approval from Drug Controller General of India for marketing in India in 2017. The drug has drawn much attention from the practising dermatologists for its commendable safety profile and prescription convenience. Introduced initially as an orally administered small molecule in psoriasis patients, the drug has now been used in various other indications as evident by the recent surge in literature for its off-label uses. Being a relatively new drug in the treatment armamentarium of psoriasis and other inflammatory dermatoses; in this review, we will discuss various practical aspects of prescribing oral apremilast, based on the current and emerging literature., Competing Interests: There are no conflicts of interest.

Competing Interests: Competing interests: None declared.