Urticaria is a common skin disorder. Chronic urticaria, i.e., the presence of symptoms for more than six weeks, is associated with a significant adverse impact on sleep, performance, quality of life, and financial status of the patients. Although several treatment options are available, the condition can be challenging to treat for many clinicians. Several updates have been published on the subject of urticaria and its management since the publication of an updated consensus statement in 2018 by Indian experts. The objective of this consensus statement is to summarize the updates and provide concise information, including classification, diagnosis, and management of urticaria. Understanding and elimination of the underlying eliciting trigger are essential in all possible cases. The goal of pharmacological treatment is to provide symptomatic relief. Second-generation nonsedating H1 antihistamine continue to be recommended as the first-line treatment, the dose of which can be increased up to four times in patients not responding satisfactorily, in the second step. The role of omalizumab, cyclosporine, H2 antihistamines, and other options is also discussed.

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Introduction: Leprosy is a chronic granulomatous disease of the peripheral nerve and muscle of upper respiratory tract. Consequence to the neighbouring primary site, oral lesions have been seen in 20-60% of patients with leprosy mainly lepromatous leprosy. The lepromatous nodules may be infective and may lead to the spread of disease and hence require proper diagnosis. Aim: To assess oral lesion in leprosy patients. To assess the disease and the occurrence of oral lesion according to age and gender. To detect any primary lesion in oral cavity and compare these lesions in duration to study. Material and Methods: One hundred patients with leprosy were examined and their oral manifestations were recorded. Results: It was found that 70 (70%) leprosy patients showed oral manifestations. Eighteen (25%) had chronic generalized periodontitis, 9 (12.8%) cases of oral melanosis, 7 (10%) atrophy of papillae and loss of taste sensation each, 6 (8.5%) complained of aphthous and candidiasis each, 5 (7.14%) depigmentation and 4 (5.71%) smokers palate, oral submucous fibrosis and fissured tongue. Conclusion: Our clinical findings are in conjugation with previous studies; however, as per the review of literature, this is the first study worldwide where we have examined 100 cases of leprosy which has not been documented till date. We suggest that the lesser incidence of oral lesions is observed recently compared to older reports because of more effective present treatment which is initiated earlier.

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Background: Pemphigus vulgaris (PV) is a rare immunobullous disease with a higher mortality rate than the general population. The aim of this study was to investigate P-wave duration and P-wave dispersion (PWD) in patients with PV as predictors of atrial fibrillation (AF). Materials and Methods: In this case-control study, the risk of AF development was determined by measuring maximum and minimum P-wave duration (P-max and P-min) and PWD in 45 PV patients and 45 healthy individuals. The incidence of metabolic syndrome was evaluated. Results: PWD and P-max values of the study group were significantly higher than those of the control group. No difference was observed between PWD with regards to disease duration and disease phenotype (p > 0.05). There was no significant difference regarding the prevalence of metabolic syndrome in PV patients compared with the control group. Conclusion: PWD and P-max, which are accepted as risk factors for AF development, were found to be higher in PV patients. Some components of metabolic syndrome were more prevalent in PV patients. It seems that there is an increased risk of CVD and AF in PV patients.

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Objectives: To study the biochemical, metabolic and hormonal profile among children presenting with acne and to determine the correlation of these parameters with acne grading. Methods: The observational cross-sectional study was conducted for a duration of 18 months on a total of 50 children between 1 and 12 years of age with clinical features of acne. The detailed information regarding the type of acne, biochemical profile (lipid profile, blood sugar levels), hormonal profile and associated illnesses were recorded. Spearman's rank correlation coefficient was used to find out the correlation of acne grading with hormonal and metabolic changes. Results: The mean age of the children was 11.4 years. Among the various lesions, comedones were seen in 98% cases, papules in 94.00% cases, a scar in 14.00% and pustule in 4.00% cases. As compared to children of age 1-7 years, those in age group 8-12 years had significantly more comedones (48 vs 1, P = 0.04), significantly fewer pustules (0.00% vs 100.00%, P = 0.001), and a comparable number of papules and scars. Most of the children (88.00%) had acne vulgaris grade 1. There was a significant negative correlation of Blood sugar-fasting (r = -0.312, P = 0.0275) and a significant positive correlation of HDL (r = 0.28, P = 0.0491) with acne grading. Conclusion: Comedones and papules are the commonest and the earliest forms of pediatric acne. Severe forms of acne are rarely seen below 12 years, age group. Preadolescent acne is commoner than mid-childhood acne, with no difference between male and females. Blood sugar levels and lipid profile derangements have a weak correlation with acne grading.

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Introduction: Vitamin D is involved in the activation of innate and adaptive immunity. In the epidermis, vitamin D is involved in the differentiation and maturation of keratinocytes. A fall in the vitamin D levels can activate auto-immunity. Aims and Objectives: This study was aimed at correlating the serum vitamin D level of psoriasis patients with disease severity. Materials and Methods: This case-control study included 50 newly diagnosed cases of psoriasis (group A) and 50 controls (group B). Serum vitamin D levels were assessed in both groups. The levels were correlated with the duration of disease, psoriasis area and severity index (PASI) score, and erythrocyte sedimentation rate (ESR) level. Results: Psoriasis patients had significantly lower vitamin D levels than controls. There was a significant negative correlation between serum vitamin D level and disease duration, PASI score, and ESR level (p-value <0.001). Rising age and female gender were also associated with significantly lower vitamin D. Conclusion: We found a high prevalence of vitamin D deficiency in psoriatic patients. The level is strongly associated with every aspect of disease severity. Its level can predict the course of disease and prognosis.

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Background: Acne is one of the most common skin diseases in adolescents and results in high healthcare costs and psychological burdens severely affecting individuals. Treatments other than contraceptives, antibiotics, and photodynamic therapies are needed to prevent and/or improve acne's onset and evolution. Aims: The purpose of this study was to investigate the efficacy of a fermentation lysate of Lactiplantibacillus plantarum VHProbi^® V22 in ameliorating acne. Methods: An anti-acne skincare cream containing fermentation culture lysate was applied to subjects with mild-to-moderate acne vulgaris for 4 weeks. The assessments were evaluated based on instrumental measurements using Visia^®-CR and CK-MPA^® systems. Results and Conclusions: The anti-acne skincare cream was found to be safe and not cause any irritation. Significant improvements in the acne lesion proportion (P < 0.01), transepidermal water loss (P < 0.001), and sebum secretion (P < 0.05) were observed in comparison to the baseline in the subjects. The analysis of the statistical data after 4 weeks of treatment showed a positive decrease in skin tone, stratum corneum hydration, and superficial pH without statistical significance, compared with the baseline. The results of this study suggest that the topical application of the anti-acne skincare cream was effective and safe in subjects with mild-to-moderate acne and could represent an optional complement for acne treatments.

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Background: Leprosy, a chronic infectious disease, is associated with a high risk of psychiatric disorders. Aims and Objectives: We aim to estimate the prevalence of anxiety and depressive symptoms among people living with leprosy at a special community residence in Nepal. We also aimed to find the correlation between anxiety and depression. Materials and Methods: This is a cross-sectional descriptive study conducted in a community of people with leprosy staying at a centre in Nepal using all enumerative sampling. The semi-structured schedule, hospital anxiety and depression scale and stigma assessment and reduction of impact (SARI) stigma scale were applied among 119 participants. Results: About 10.1% (n = 12) and 12.6% (n = 15) of participants scored above the threshold score indicative of definitive clinically significant anxiety and depression symptoms. In multivariable analysis, leprosy-related stigma and attribution of leprosy to bad deeds were significant correlates of anxiety; whereas leprosy-related stigma and duration of stay at the centre were significant correlates of depression. Conclusion: The prevalence of depression and anxiety symptoms among people living with leprosy is higher than that in the general population. Sigma is a significant correlation for both. It is important to screen for mental health issues while managing patients with leprosy and implement strategies aimed at leprosy-related stigma reduction.

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Background: Acne Vulgaris is a common chronic inflammatory skin disease, with a prevalence of about 80% among adolescents and adults. Aim: The study was designed to assess knowledge and treatment behavior of acne vulgaris among female students of the University of Nigeria, Enugu campus, Nigeria. Method: Descriptive survey design was adopted for this study. Three hundred and nineteen (319) female students of the University of Nigeria, Enugu Campus recruited through stratified random sampling were involved in the study. A questionnaire with a reliability coefficient of 0.80 Cronchbach alpha was used for data collection. Ethical clearance was obtained from the University of Nigeria, Teaching Hospital. Ethical principles of Informed consent, confidentiality and anonymity were maintained in the study. Data were presented in tables and analysed using descriptive statistics of frequency, percentages, means and standard deviation; and Chi-square (P < 0.05) inferential statistics. Findings: Majority (95.3% (304)) of the respondents have good knowledge of acne vulgaris. Consultation with a dermatologist was seen as very important for the management of acne vulgaris (M = 3.42 ± 0.62), removing acne by squeezing is not considered necessary (M = 2.04 ± 0.92) and the majority of the respondents (86.8%) use medically approved drugs and formulations like cleansers, exfoliants, sunscreen. No statistically significant relationship was found between the level of academic study and knowledge of acne vulgaris. Conclusion: Nurse educators must consolidate health campaigns on the evidence-based treatment options available for acne vulgaris. This is necessary to prevent complications arising from the use of untested dermatological products.

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Twenty nail dystrophy refers to the condition of trachyonychia affecting all the twenty nails. The term trachyonychia is used to describe thin brittle nails with excessive longitudinal ridging. Treatment of twenty nail dystrophy is difficult due to poor bioavailability of drugs in nails. Tofacitinib is novel JAK-STAT inhibitor that has been used successfully for the treatment of nail dystrophy with alopecia areata suggests the possibility of the drug being used for twenty nail dystrophy.

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Background: It is known that platelets play an important role in inflammatory diseases. Atopic dermatitis (AD) is a chronic, itchy, recurrent inflammatory skin disease that affects 2%-30% of the population, especially in childhood. Aims: We investigated the role of platelet count and mean platelet volume (MPV) as biomarkers in children with AD. Methods: This cross-sectional retrospective study examined the medical reports of patients who were referred to the Pediatric Allergy and Immunology Outpatient Clinic of the Medical Faculty Hospital, Istanbul Biruni University and the Pediatric Immunology and Allergy Diseases Outpatient Clinics of the Izmir S.B.U Tepecik Training and Research Hospital, for AD. A total of 167 children with AD and 170 healthy children were included in the study. Results: Among all participants, 36.5% (n = 61) and 31.8% (n = 54) were female in the patient and control groups, respectively. The mean age was 2.8 ± 2.8 and 3.3 ± 2.5 years in the patient and control groups, respectively. MPV was statistically significantly higher in the patient group than in the control group (P =0.003). Mean platelet to neutrophil ratio and mean absolute lymphocyte count values were significantly higher in the patient group (P <.0001 for both values). However, the mean absolute neutrophil count was lower in the patient group than in the control group and it was considered statistically significant (P <.0001). Conclusion: In conclusion, we found significantly higher platelet counts in patients with AD. The decrease in the neutrophil to lymphocyte ratio rate was remarkable. However, there was no significant difference in the MPV values between the patient and control groups.

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Background: Oral lichen planus (OLP) is one of the most common diseases of the oral mucosa, which exact pathogenesis remains unknown. Free radicals and reactive oxygen species could play an important role in the pathogenesis of oral lichen planus. Aims and Objectives: This study aimed to compare the salivary levels of uric acid, superoxide dismutase, glutathione peroxidase, and albumin in the patients with oral lichen planus and healthy subjects. Materials and Methods: Thirty patients with oral lichen planus and 30 healthy subjects, who were matched for age and sex, were enrolled in this case-control study. The salivary concentration of uric acid, superoxide dismutase, glutathione peroxidase, and albumin were examined in these individuals using the spectrophotometry and coulometric technique. The data were analyzed through Mann-Whitney test and T test by SPSS software (ver. 19). Results: Salivary uric acid and albumin levels in patients with oral lichen planus and healthy controls were not statistically different (p > 0.05); however, the concentrations of salivary superoxide dismutase in OLP patients (660.4 ± 266.4 U/g protein) and healthy controls (935.73 ± 561.9 U/g protein) were significantly different (p < 0/05). Also, salivary glutathione peroxidase levels in healthy controls (1049.98 ± 964.56 mU/mL) were remarkably higher than OLP patients (244.12 ± 170.78 mU/mL) (p < 0/001). Conclusion: The salivary superoxide dismutase concentration, as an indicator of antioxidant system, in OLP patients was significantly higher than healthy subjects. The glutathione peroxidase levels in these patients were remarkably lower than healthy controls. It is suggestive that these markers could be effective in pathogenesis of OLP.

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We report a case of porokeratosis ptychotropica with a rare manifestation. Dermoscopy showed dotted vessels, cerebriform pattern, white scales, and brown and greyish white tracks in the periphery over a red-brown background. A skin biopsy confirmed the diagnosis from the presence of cornoid lamellae.

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To our knowledge, there have been no previous reports of granulomatous periorificial dermatitis (GPD) in adult patients in contrast to childhood GPD (CGPD). We report cases of 9 adult patients with GPD with regards to the clinical and histopathological characteristics and their management. GPD in adults may be an entity that is actually underdiagnosed, especially in middle-aged females. It is a benign disorder, albeit requiring a relatively long-term treatment. Unlike CGPD, GPD in adults is frequently accompanied by pruritus with predilection for the eyelid and should be treated initially with oral medication.

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Recurrent aphthous stomatitis (RAS) is a common oral disease characterized by intermittent eruptions of painful oral ulcerations. Hippocrates first described aphthous stomatitis with the Greek word aphthi meaning “to inflame.” RAS affects 10–20% of the population with the incidence being the highest among young adults. The peak age of onset is between 10 and 19 years of age. It has three main forms of presentation. The most common being minor RAS, along with the major and herpetiform types. Many local and systemic factors are associated with RAS pathogenesis. The main concern with oral aphthae in many cases is local pain, which can be severe enough to interfere with eating, speaking, and swallowing. It is important to differentiate RAS from systemic diseases with aphthae—such as Behçet's syndrome and the newly-delineated, autoinflammatory PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome—as well as from other aphthous-like ulcerations like herpes simplex virus (HSV) or Coxsackie oral lesions. The management depends upon the clinical presentation and symptomatology—focusing on analgesic, antimicrobial, and immunomodulatory drugs.

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Karl Gustav Theodor Simon is considered as the founder of dermatopathology, because for the first time in modern times he beds the bases of the microscopical examination of the cutaneous diseases. He worked in Berlin as a private physician, general practitioner, especially for the poor patients, continuing his research in pathology and focusing on the cutaneous diseases, in which the use of the microscope had a central role. During his medical career, he achieved to be acknowledged as one of the most important figures in the treatment of cutaneous diseases and to be included among the best dermatologists and venerologists at the time worldwide.

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Background: The clinical effects of Pfizer-BioNTech coronavirus disease 2019 (COVID-19; BNT162b2) vaccine on the clinical course of chronic spontaneous urticaria (CSU) is unclear. Aims and Objectives: To evaluate the clinical effects of BNT162b2 vaccine on the clinical course of CSU. Methods: In this study, 90 CSU patients vaccinated with one or two repeated doses of BNT162b2 vaccine were included. Urticaria Activity Score over 28 days (UAS28), Urticaria Control Test (UCT), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and Medication Scores (MSs) were obtained before the vaccination, 28 days after the first and, if available, after the second dose of BNT162b2 vaccine. The demographic, clinical, and laboratory features were compared between the subjects with exacerbated (group A) and non-exacerbated (group B) disease activity. Results: Among the 90 study participants, 14 (15.5%) experienced exacerbations in their urticarial activity after the first or repeated doses of BNT162b2 vaccinations. The demographic, clinical, and laboratory features were similar between the exacerbated and non-exacerbated CSU patients. However, the rate of adverse reactions within 48 hours, such as hives, injection site reactions and wheals lasting <1 hour, were significantly higher in group A than in group B (P = 0.004, P < 0.001, P = 0.001, P = 0.018). Conclusions: BNT162b2 vaccination caused an exacerbation in 15.5% of CSU patients during the short-term follow-up. The long-term evaluation can be informative about the lasting effects of BNT162b2 vaccine on the clinical course of CSU patients.

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Pyogenic granuloma (PG) is a common acquired vascular tumor and may appear mostly as a solitary papulonodular lesion on the face, trunk, and extremities. Although the etiology of PG is unclear, trauma, infections, and hormones may play a role. Multiple disseminated PGs are a very rare form and mostly are seen after traumas such as burn. We presented a patient with multiple PGs secondary to oil burning. There has been no report of PG caused by scald burn due to oil before. We also reviewed the literature in English and found 24 other cases of disseminated PG that most of them developed post-boiling milk.

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Hidradenitis suppurativa (HS) is a chronic inflammatory condition characterized by the formation of nodules, abscesses, and sinus tracts with tunnels that primarily involves the skin folds. HS affects approximately 1% of the population, but its pathogenesis is unclear. Dysbiosis of skin microbiome is a major cause of HS and alterations of microbiome composition and diversity can be seen in the skin of patients with HS. These disruptions may contribute to the immune dysfunction seen in HS. Understanding these alterations and their contributions to the pathogenesis of HS could help guide future treatment. In addition to dysbiosis promoting immune dysregulation, HS may promote dysbiosis via differences in expression of antimicrobial peptides (AMPs). In this review, we have discussed the role of skin and gut microbiome in manifestation of HS and the consequences of dysbiosis on the immune system.

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Alopecia areata (AA) is type of autoimmune, T-cell-mediated disease with abnormal expression of MHC Class I, a common reason for non-scarring hair loss. Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by periodic fever and serositis. Various diseases and conditions that may be related to FMF have been reported. It has been known that patients with FMF are vulnerable to MHC Class I-related diseases. The co-existence of the two MHC Class I group-associated entities, FMF and AA, has not been reported in the literature. Here, we present three cases with AA and FMF and discuss the possible common pathway in their pathogenesis.

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Background: Acne vulgaris is a common chronic inflammatory skin disease in adolescents and oxidative stress plays an important role in acne pathology. However, the pathology of acne has not yet been fully elucidated. miRNAs are small noncoding RNAs, and there is increasing evidence for their role in the pathogenesis of skin diseases such as psoriasis, atopic dermatitis, and other inflammatory diseases. Aims and Objectives: The aim of the study was to investigate serum malondialdehyde (MDA) and glutathione (GSH) levels with plasma miRNA expression profile related with oxidative stress in patients with severe acne vulgaris. Materials and Methods: Fifty seven female patients with severe acne and 40 healthy women were included in the study. Plasma miRNA-31, miRNA-200a, and miRNA-21 levels were evaluated by using real-time quantitative polymerase chain rection analysis. MDA and GSH levels were measured as per the manufacturer's procedures using commercial ELISA kits. Results: Plasma miRNA-21 levels were statistically significantly higher in patients with severe acne compared to the control group (P =0.003). Plasma miRNA-200a (P =0.303) and miRNA-31 (P =.652) levels were slightly higher in patients with severe acne compared to the control group, but this difference was not statistically significant. Serum MDA levels (P =.047) were higher in patients with severe acne compared to control group, while serum GSH levels (P =.001) were lower. Conclusion: These results show that oxidative damage is involved in acne etiopathogenesis and especially miRNA-21 may have an important role in the pathogenesis of acne vulgaris.

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Background: Tattoos are very popular in today's world. Objectives: The aim of this study was to determine the demographics, the characteristics of tattoos, motivations for getting tattoos, tattooing practices and tattoo regret. Materials and Method: This multi-centre, cross-sectional study was conducted among. 302 patients attending to the dermatology outpatient clinics and having at least one tattoo. A questionnaire form including all needed data about patients, tattoo characteristics and possible reasons for obtaining tattoos was designed and applied to all participants. Results: Of 302 patients, 140 (46,4%) were females and 162 (53,6%) were men. The mean age was28,3 ± 8,1 years (min-max, 16–62) for all study group, 53% of participants (n = 160) had at least one tattoo involving letters or number, 80 participants (26%) stated regret for at least one of their tattoos, and 34 of them (42,5%) had their unwanted tattoo removed or camouflaged with a new tattoo. The most common reason for regret was 'not liking the tattoo anymore'. The most common motivations for having tattoos were 'to feel independent', 'to feel better about himself/herself' and 'to look good'. Women had higher scores than men regarding tattoo motivations of 'to be an individual' and 'to have a beauty mark'. Conclusion: Given the rates, tattoo regret is a significant issue and as motivations differ between genders, age groups and other demographic characteristics; tattoos are not just an ink or drawing on the body, but a tool for individuals to express themselves and to construct self-identity. Tattoos have deep symbolic meanings for emotions, and they may be a clue for behavioural patterns of individuals.

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Background: Demodex parasites are the most common ectoparasites in humans. One of the factors in the pathogenesis of an increase in parasite density is immunosuppression. In this prospective study, we aimed to evaluate the effect of phototherapy-induced immunosuppression on Demodex density. Material and Methods: Thirty-five patients receiving phototherapy were included in the study. The number of parasites in the samples taken from the right cheek, left cheek, forehead, nose and chin of the patients, by standardized skin surface biopsy method, were recorded before phototherapy and in the third month of treatment. Results: Of the 35 patients, the female-to-male ratio was found to be 2.1:1. There was no statistically significant difference between the ages of the male and female patients. The increase in the number of parasites in the right cheek, left cheek, nose and chin in the third month was statistically significant; whereas the increase in the forehead was not. Conclusion: The results of our study showed that phototherapy can cause an increase in Demodex density, and these findings are compatible with those of other studies in the literature. Since our study aims to evaluate density at the beginning and the end of the third month of phototherapy, it differs from other studies by indicating the effect of phototherapy more accurately.

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Vitiligo is a disease characterized by acquired depigmentation, white macules, and patches on the skin due to the dysfunction of epidermal melanocytes. In this study, we attempt to profile the microRNA (miRNA) expression patterns and predict the potential targets, assessing the biological functions of differentially expressed miRNAs in the blood of generalized vitiligo patients. Peripheral blood samples were taken from all participants, and the expression levels of 89 identified miRNAs were analyzed with real-time quantitative polymerase chain reaction (PCR). The results indicated significant upregulation of six miRNAs and downregulation of 19 miRNAs in the plasma of vitiligo patients. The top three upregulated miRNAs were hsa-miR-451a, hsa-miR-25-3p, and hsa-miR-19a-3p, and the top three downregulated miRNAs were hsa-miR-146a-5p, hsa-miR-940, and hsa-miR-142-3p. Moreover, the miRNA expression profiles of patients with Type 3 and Type 4 phototypes were substantially different in such a way that the patients with Type 3 phototype would be more prone to the emergence of melanoma and cancer. While significant variations in the expression patterns of miRNAs in male and female vitiligo patients were demonstrated, miR-let-7i-5p, miR-19a-3p, miR-25-3p, and miR-451a were commonly upregulated, and miR-142-3p and miR-146a-5p were commonly repressed in both sexes. This study may shed light on the roles of differentially expressed miRNAs in vitiligo patients by examining the miRNA expression patterns and the combined effects of miRNA and their predicted targets.

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Hypertrichosis is a condition characterized by the presence of an abnormal increase in the number of hairs and either occurs in a localized pattern or a generalized pattern. Localized hypertrichosis around a healing wound is an infrequent postsurgical complication. A 60-year-old Asian man came for a consultation because of an increase in the amount of hair around his 2-month postsurgical wound of right knee arthroplasty. Neither history of topical medications nor systemic medications, which can cause hypertrichosis, were presented. A diagnosis of postsurgical hypertrichosis was made clinically without any laboratory investigations. The patient was reassured that the medication was not necessary and he was appointed for follow-ups. Within the next 4 months, the hypertrichosis resolved spontaneously without any treatment. The case demonstrates the correlation between wound healing and hair morphogenesis, especially as both processes involve some similar growth factors and signaling molecules. Further studies might lead to discovery and better management of hair disorders.

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Background: Trachyonychia is a benign nail condition, most commonly seen in children. Trachyonychia manifests as excessive longitudinal ridging, nail roughness, and nail brittleness. Treatment is sought mainly for esthetic reasons as well as functional reasons. A number of therapeutic approaches exist, mainly based on case reports or small non-comparative case series. Aims: To report treatment outcome among patients with trachyonychia. Methods: A retrospective case-series study was conducted among patients who were treated trachyonychia between years 2017 and 2020. Patients were prescribed fluocinonide 0.05% with bifonazole 1% cream, applied with or without occlusion, and methylprednisolone 1–2 mg/nail, injected into the involved nail matrix, or oral cyclosporine 3 mg/kg. Complete response (over 90% improvement) and partial response (over 50% improvement) were assessed. Results: A total of 43 patients with trachyonychia were included [mean age 10.0 years (±5.7), 69.8% males, mean disease duration 4.7 years (±3.0)]. In 90.7% of the cases, topical fluocinonide\bifonazole cream was prescribed. Under-occlusion topical application was found to be highly effective, achieving complete response in 35.3% and partial response in an additional 52.9% of the patients. Occluded application was also found to be significantly more effective than non-occluded application. Treatment efficacy was not affected by the severity of nail roughness, trachyonychia morphology, or whether trachyonychia was idiopathic or coexisted with other dermatological conditions. Conclusion: Occluded application of fluocinonide plus bifonazole cream is efficient for the treatment of trachyonychia and should be considered a first line of treatment.

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Background: Hidradenitis suppurutiva (HS) is a chronic auto-inflammatory disease with recurrent painful deep-seated nodules. Aims: The aim of this study was to qualitatively assess patients' perception for HS. Methods: A descriptive two-step questionnaire survey was conducted from January 2017 to December 2018. The survey was performed through self-assessed, online, standardized questionnaires. Clinico-epidemiological characteristics, medical history, comorbidities, personal perceptions and the impact of the disease on participants' professional and everyday life were recorded. Results: A total number of 1301 Greek people completed the questionnaire. Of them, 676 (52%) reported symptoms resembling HS, whereas 206 (16%) reported that have been officially diagnosed with HS. The mean age of the study group was 39.2 ± 11.3 years. More than half of the diagnosed patients (n = 110, 53.3%) reported that they developed their first symptoms between 12 and 25 years of age. Of the diagnosed patients (n = 206), the majority (n = 140, 68.0%) were females and active smokers (n = 124, 60.1%). Seventy-nine (n = 79, 38.3%) patients reported a positive family history for HS. Ninety-nine (n = 99, 48.1%) patients reported that HS has a negative effect on their social life, 95 (46.1%) on personal life, 115 (55.8%) on sexual life, 163 (79.1%) on their mental health and 128 (62.1%) on their overall quality of life. Conclusion: Our study showed that HS seems to be an underteated, time-consuming and cost-intensive disease.

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Previous studies have shown that erythema nodosum-like lesions in patients with Behçet's disease show cutaneous vasculitis of either phlebitis or dermal venulitis. To analyse the clinicopathological characteristics of superficial thrombophlebitis as well as cutaneous venulitis in Behçet's disease. We re-evaluated the histopathological features of superficial thrombophlebitis in patients with Behçet's disease. Five patients, one man and four women, developed superficial thrombophlebitis on the lower extremities. Two of the patients had vascular Behçet's disease, both also developed deep vein thrombosis. One patient had intestinal Behçet's disease. In all cases, venulitis in the overlying lower dermis or adjacent subcutis spreading from the main affected subcutaneous thrombophlebitis lesions was observed. Both neutrophilic venulitis (n = 2) and lymphocytic venulitis (n = 3) were observed at the same depth level or upper/lower location of the thrombophlebitis in the same specimens. In addition, concurrent venulitis with fibrin thrombus and fibrinoid necrosis was observed in one case, suggesting that fibrin thrombus affected both venules and muscular veins. By contrast, arteritis or arteriolitis at the same depth level was not observed. Our results showed histopathological features of coexistent thrombophlebitis and venulitis without involvement of either arteries or arterioles in the biopsied specimens of superficial thrombophlebitis. Further studies are necessary to support that those unique histopathological findings are the characteristic features and significant diagnostic indicators of Behçet's disease.

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Cicatrizing ectropion of the eyelid is an uncommon condition, possibly resulting in significant ocular morbidity. A potential cause can be a systemic disease, including autoimmune blistering disease (ABD). We herein report a case with a sixteen-year follow-up of a patient with a chronic cicatrizing unilateral ectropion caused by linear IgA bullous dermatosis (LABD). LABD is an ABD, characterized by the accumulation of IgA anti-basement membrane autoantibodies. It has a varied presentation; however, localized or ophthalmic manifestations have been infrequently described. The case demonstrates the benefits of immunohistochemistry in obtaining the correct diagnosis, and difficulties in the medical and surgical management of a recurrent cicatricial ectropion caused by chronic systemic disease.

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Background: Cutaneous malignancies are rare with respect to other malignancies. The distribution of various histologies of these malignancies is not uniform. We aimed to study the distribution of these malignancies and their epidemiological pattern in Eastern Rajasthan with the data collected from various pathology labs in Jaipur. Methods: In this retrospective chart review we analysed the data of 453 patients presenting with histopathologically proven cutaneous malignancies to four major pathology departments and labs in Jaipur, Rajasthan. We recorded the distribution of these histologies according to incidence, age of presentation, gender and site predilection. The data was subsequently analysed using statistical methods. Results: Squamous cell carcinoma (36%)was the most common histology which was closely followed by basal cell carcinoma(31%). Malignant melanoma (13%) was the third most common histology to present. Other less common histologies to present were dermatofibrosarcoma, Kaposi sarcoma, non hidgkin lymphoma etc. The age range varied from 14 to 90 years. The mean age of presentation was 54.3 years. Male had a slight preponderance (1.36 times more than females)overall. Except Bcc, which had a female preponderance. Head and neck(38.41%) was the most common site to be affected overall followed by lower limbs(31.56%). Interpretation: The idea of distribution of these rare malignancies in our part of the country will not only help us in proper surgical management but also in educating the public about the possible causes and the need for early intervention leading to better prognosis.

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Background: Chronic ulcers are defined as the breakdown of the epidermal and dermal tissue lasting for more than 6 weeks. There will be a lack of necessary growth factors in chronic non-healing ulcers. This study is aimed at accessing the efficacy of autologous platelet-rich fibrin in chronic non-healing ulcers. Aims and Objectives: To determine the efficacy of autologous platelet-rich fibrin in chronic non-healing ulcers and to compare the rate of healing in different ulcers based on aetiology. Methods: A hospital-based prospective study was conducted at the Department of Dermatology, Venereology, and Leprosy, at a tertiary care centre in Central Karnataka with 50 cases of chronic non-healing ulcers over 2 years. In each case baseline data including age and gender was collected and thorough general physical, local, and systemic examinations were done with the help of a predesigned proforma. PRF dressing was done weekly for 4 weeks with ulcer volume measured each time and improvement accessed. Results: In this study, the mean age of the study population was 43.56 ± 14.06 years, with 84% males. Good improvement in the volume of the ulcer was seen in 6 patients out of 50, moderate improvement was seen in 20 out of 50 patients and mild in the rest of the 24 patients. Improvement was more in the educated sector, more so in females and patients with trauma as the cause of ulcers without any comorbidities. Leprosy followed by diabetes was the main cause of chronic non-healing ulcers. Conclusions: This study shows that autologous platelet-rich fibrin therapy provides faster wound healing in chronic non-healing ulcers with no adverse events.

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