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This series introduces the clinical management of difficult-to-treat non-melanoma skin cancers (NMSCs) through a multidisciplinary approach, emphasizing the integration of dermoscopy and Ultra high-frequency ultrasound (UHFUS) for accurate diagnosis and treatment planning, particularly in cases referred for radiotherapy (RT). Dermoscopy aids in diagnosing both pigmented and non-pigmented skin lesions, guiding treatment margins and reducing the benign-to-malignant biopsy ratio. UHFUS provides valuable insights into tumor size, depth, and vascularity, complementing clinical evaluations and assisting in RT planning. Three challenging cases are presented, highlighting the pivotal role of dermoscopy and UHFUS in decision-making and treatment optimization. Collaboration between dermatologists, radiation oncologists, and radiologists enhances diagnostic accuracy, tailoring treatment plans to individual patient needs and preferences, ultimately improving patient outcomes and experience. The integration of these imaging techniques holds promise for optimizing non-surgical treatments like RT and monitoring treatment progress, offering a personalized approach to NMSC management.

Pigmented Bowen's disease is one of the subtype of Bowen's disease which presents with a pigmented plaque arising in photo exposed areas of the body. We describe a case of Pigmented Bowen's disease in a 67-year-old male who presented with progressive growth of a pigmented and asymptomatic skin lesion of four years duration over right chest involving his right nipple. Dermascopy and histopathology was suggestive of Pigmented Bowen's disease. We report this case due to the pigmented variant which is a rare subtype and also the presence of lesion, over the sun-protected area, in an immunocompetent male in Indian type IV skin. [ABSTRACT FROM AUTHOR]

Background: Lichen planus pigmentosus (LPP) is considered an infrequent variant of Lichen planus (LP) clinically characterized by insidious onset of discrete, ill-defined, and dark brown or slate gray macules, primarily appearing over sun-exposed areas and flexures. Materials and method: This was a cross-sectional study conducted over a period of 1 year from July 2017 to July 2018 among the patients attending the OPD of the Department of Dermatology, Government Medical College, Kota, India. This study evaluated the LPP and its association with metabolic syndrome and cutaneous manifestations. Serum high-density lipoprotein (HDL)-cholesterol (HDL-C) and triglycerides (TG) were measured with enzymatic procedures. Plasma glucose was measured using hexokinase method. Results: There were 16 (32.0%) males and 34 (68.0%) females affected with LPP. Majority of the patients were in the age group of 40 to 49 years [15 (30.0%)] and above 50 years [16 (32.0%)]. Diabetes mellitus type 2 was reported among 17 (34.0%), hypertension among five (10.0%), and obesity among five (10.0%) patients. Increased low-density lipoprotein (LDL) and very LDL was found among 15 (30.0%) patients and decreased HDL was found among 19 (38.0%) patients. Conclusion: A 34.0% prevalence of metabolic syndrome was found in patients with LP. Central obesity, increased fasting blood sugar (FBS), and low HDL-C were the metabolic syndrome parameters found to be more common in patients with LP in our study.

Tinea capitis (TC) is the most common dermatophyte scalp infection in children and an unusual dermatophytosis in adults. The clinical appearance of tinea capitis is highly variable and depends on the causative organism, type of hair invasion, and degree of the host inflammatory response. The commonly observed features are patchy hair loss with varying degrees of scaling and erythema. The clinical signs may be subtle and diagnosis may be challenging. We report the case of an adult patient with tinea capitis mimicking alopecia areata. The patient was initially diagnosed with alopecia areata and completed one month of treatment without clinical benefits. In view of no clinical signs of tinea capitis, a biopsy was performed. A scalp punch biopsy revealed an endothrix dermatophytosis. The patient's medication was switched to 250 mg terbinafine daily for 8 weeks and 2% ketoconazole shampoo. The patient completed two months of therapy with maintenance of hair regrowth and resolution of symptoms and scales. [ABSTRACT FROM AUTHOR]

Although the characteristic clinical appearance and the differences in distribution, it is often difficult to differentiate keratosis follicularis squamosa (Dohi) from other keratotic disorders. Here, we describe the case of a 5-year-old boy with Dohi in the first time that by using dermoscopy. Dermoscpoy of the lesion showed typical lotus leaves on the water appearance and follicular plug in the center. We reported the usefulness of dermosocopy in Dohi. [ABSTRACT FROM AUTHOR]