Pediculosis pubis presenting as pediculosis capitis, pediculosis corporis, and pediculosis ciliaris in a case of Alport syndrome.

Pediculosis is an infestation of lice on the human body. Pediculosis pubis is primarily found in the pubic region and is usually transmitted by sexual contact. Diagnosis is done by visualization of mites which can be aided by the use of dermoscope. Hereby, we report a case of an Alport syndrome patient having extensive pubic lice infestation with no sexual history and probable transmission from cattle.

Efficacy of Low-Level Laser Therapy in Androgenetic Alopecia - A Randomized Controlled Trial.

Background: Androgenetic alopecia (AGA) is caused by the susceptibility of hair follicles to androgenic miniaturization, which leads to hair loss. The most common modalities for the treatment of AGA include the use of topical minoxidil and oral finasteride. Low-level laser therapy (LLLT) is a newer modality of treatment for AGA. We tried to evaluate the added benefit of LLLT in AGA compared with topical minoxidil 5% alone. Aim: The aim of this study was to compare the efficacy of LLLT combined with topical 5% minoxidil in AGA versus topical 5% minoxidil used alone. Materials and Methods: After ethics committee approval, 54 patients of AGA were randomly divided into two groups. Group A participants received LLLT therapy twice a week plus topical 5% minoxidil and Group B participants received only minoxidil 5% solution. Both the groups were followed up for 16 weeks and evaluated with gross photographs, TrichoScan analysis, and dermoscopy to look for any improvement in hair density. Results: After 16 weeks, improvement in hair density of 14.78% ± 10.93% in Group A was recorded compared to 11.43% ± 6.43% in Group B. However, while comparing both means, P value was 0.45 which was not significant. The physician global assessment and patient satisfaction score revealed no significant difference between both the groups. Conclusion: Although LLLT appears to be safe and effective in the treatment of male pattern hair loss, we did not observe any significant difference in terms of improvement in hair density between both the groups.

Nailfold Capillaroscopy of Healthy Individuals - An Observational Study.

Background: Nailfold capillaroscopy (NFC) is a noninvasive quick method to visualize capillaries in the nailfold. There is paucity of these studies in healthy individuals in skin of color. Aim: To evaluate the morphological characteristics and density of nailfold capillaries in healthy individuals. Settings and Design: This observational cross-sectional study was conducted in the Department of Dermatology at a tertiary care hospital. About 150 healthy individuals by consecutive sampling were included in the study. Materials and Methods: A total of 150 healthy individuals aged between 20 and 60 years were enrolled from January 2021 to September 2021 after consenting to the study protocol and qualifying the inclusion and exclusion criteria. NFC was performed for various morphological parameters and mean capillary density was also calculated. Comparison was done in male vs female, age group 20-40 vs 41-60, and body mass index (BMI) <24.9 vs >25. Statistical Analysis: Different morphological parameters and capillary density were recorded and analyzed. The Mann-Whitney and Pearson's chi square was used according to type of data. Results: The study observed tortuous capillaries (45.33%), meandering capillaries (44.66%), neoangiogenesis (38.66%), plexus visibility (36.66%), dilated capillaries (33.33%), receding capillaries (31.33%), angulated capillaries (14.66%), and ramified capillaries (6.6%). The study found significantly decreased plexus visibility in those with BMI > 25.Tortuous and receding capillaries were significantly increased in age group >40 years. Conclusion: Various capillary morphological findings can be present in normal individuals but their presence in more number of fingers should be considered to be pathological. This data on normal morphology and capillary density add to the physiological NFC findings and thus aid in identifying the abnormalities.

A cross-sectional study of variations in the biophysical parameters of skin among healthy volunteers.

BACKGROUND: Biophysical parameters of skin such as trans-epidermal water loss (TEWL), hydration, elasticity, pH, and sebum reflects it functional integrity. Advances in technology have made it possible to measure these parameters by non-invasive methods. These parameters are useful for the prediction of disease and its prognosis. It also helps in developing new skin care products according to various skin types, and to evaluate, modify, or compare the effects of existing products. AIM: The aim of the study was to measure, evaluate, and analyze variations in biophysical parameters at pre-selected skin sites in healthy Indian volunteers, across different age groups and gender. METHODS: The study was conducted among 500 healthy Indian volunteers, between 5 and 70 years of age, in the outpatient department of dermatology at Sir T. Hospital, Bhavnagar. Biophysical parameters such as TEWL, hydration, elasticity, and sebum content was measured on four pre-selected body sites by a Dermalab instrument (Cortex Technology, Denmark). The skin pH was measured with a sensitive pH probe (BEPL 2100). RESULTS: All parameters were higher in males compared to females, except for sebum content, which was equal in both genders. Transepidermal water loss and hydration was lower in middle and older age groups. The skin pH showed no statistically significant difference with age. Sebum content was higher in middle and older age groups. The nose had the highest sebum content across all age groups. The forehead showed higher median values of TEWL and hydration compared to other sites. Though elasticity has highest value on forearm, only leg region showed statistically significant value. LIMITATIONS: The present study was confined to a single geographical area, so the effect of environment changes could not be judged accurately. Seasonal variations were not studied as it was a cross-sectional study. CONCLUSION: Skin properties vary with age, gender, and location on the body. This knowledge will help to create a database of these parameters in the Indian population. It would assist in the diagnosis of various clinical conditions and monitor therapeutic response.

An atypical clinical presentation of lichen planus pigmentosus with typical dermoscopic pattern.

We report a rare and interesting case of a combined linear, Blaschkoid and zosteriform pattern of lichen planus pigmentosus. Dermoscopy showed discrete bluish-grey dots, globules, blotches and rods against a brownish background. A skin biopsy confirmed the diagnosis from the presence of civatte bodies, melanin incontinence and band-like inflammation.

A Rare Case Report of Toxic Epidermal Necrolysis Due to Ofloxacin.

BACKGROUND: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), also known as Lyell's syndrome, are rare and life-threatening conditions, for which etiopathogenesis, as well as pharmacotherapy, is yet unclear. CASE REPORT: A 45-year-old male patient by chance on re-exposure to Ofloxacin developed Severe Cutaneous Adverse Drug Reaction (SCADR), diagnosed with toxic epidermal necrolysis. His comorbid conditions and systemic complications of TEN lead him to death. In developing countries, where antibiotics especially fluoroquinolones are widely prescribed, a physician should be now vigilant for such kind of SCADRs because of increasing numbers of such kind of reports.

A nonrandomized study of trichoscopy patterns using nonpolarized (contact) and polarized (noncontact) dermatoscopy in hair and shaft disorders.

AIMS: The aim was to study the trichoscopy features of selected hair and scalp conditions by two dermoscopic devices with different modes that is, polarized (noncontact) and nonpolarized (contact) mode. MATERIALS AND METHODS: The present study included 11 clinical varieties of cases with total 112 patients, attending Sir Takhtasinh Hospital, Bhavnagar in the last 2 years. The clinical history was recorded for each case, and images were taken in both the Heine and DermLite II pro dermatoscope. We used polarized mode of the noncontact device (DermLite II) and the nonpolarized mode of the contact device (Heine) for our study. STATISTICAL ANALYSIS USED: Fisher's exact test to study dermoscopic observations for each mode. RESULTS: We observed different nonscarring alopecia cases such as alopecia areata, androgenetic alopecia, trichotillomania, and tinea capitis. Scarring alopecia included discoid lupus erythematosus, lichen planopilaris, pseudopelade of Brocq, systemic lupus erythematosus. Scaling disorders included the psoriasis and seborrheic dermatitis. Furthermore, infestations like pediculosis capitis were included in the study. Various features were divided into follicular, interfollicular, pigmentary, vascular and hair shaft patterns. Each of the features was correlated in both the Heine (nonpolarized) and DermLite II (polarized) dermoscope, and observational finding was put forward accordingly. CONCLUSIONS: Various variations were observed in the documentation of dermoscopic patterns of the two dermatoscopes with certain features such as vascular patterns, scaling, and reticular pigmentation being better appreciated in polarized mode, while certain features were better documented in nonpolarized mode that is, black dots and tapered hair.

Anogenital Crohn's disease with vitiligo.

Cutaneous Crohn's or anogenital granulomatosis is a rare disorder, which presents commonly as swelling and erosions on anogenital area and associated with features of intestinal Crohn's disease. We report a case of 23-year-old female who presented with vitiligo patches on back and legs for 1-year, painful edema and ulcers on anogenital area and oral cavity for 9 months and diarrhea with bleeding per annum for 1 month. Features on ultrasonography, multislice computed tomography scan, colonoscopy, and biopsy from nodule on anal wall were suggestive of granulomatous Crohn's disease. Thus, we present the case due to its rarity.