Erosive pustular dermatosis of the scalp secondary to Erlotinib: A rare occurrence with trichoscopic perspective.

Epidermal growth factor receptor inhibitors are anti-tumour agents that are frequently used for the treatment of neoplastic disorders. In addition to their cutaneous adverse effects, these drugs can rarely lead to erosive pustular dermatosis of the scalp. We report a case of a 67-year-old female who developed erosive pustular dermatosis of the scalp after being started on erlotinib from a trichoscopic perspective, which has been described in literature only once till now.

Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis.

Background: Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country. Aim and Objectives: To analyze the changing trends in clinical presentation of syphilis and the current status of HIV/AIDS-syphilis co-infection in our area. Materials and Methods: This is a hospital-based retrospective analysis of records of sexually transmitted disease (STD) patients enrolled in "Suraksha clinic" in the department of Skin and VD at a Tertiary Care Hospital in North India. Patient records were analyzed from January 2018 to December 2021. The demographic, clinical, and serological profiles of patients were assessed to study the percentage of syphilis patients attending the STD clinic and their clinical presentations. Results: A total of 7153 patients were enrolled in the"Suraksha clinic" from January 2018 to December 2021, these included the venereal disease patients (3137) and nonvenereal disease patients (4016) who were registered for HIV and venereal disease research laboratory (VDRL) screening from the dermatology outpatient department. Out of 3137 sexually transmitted infection (STI) patients, 139 patients tested positive for VDRL. Treponema pallidum hemagglutination was found positive in 137 patients and negative in two patients. Hence, 137 patients were confirmed syphilis cases, constituting 4.36% of total STD cases in our STI clinic in 4 years. Out of 137 patients, 2 (1.45%) presented with primary chancre, 6 (4.37%) with lesions of secondary syphilis and 129 (94.16%) were found serologically reactive without any symptoms or clinical signs, i.e., in latent syphilis. Our records also showed 14 (10.21%) cases of HIV and syphilis co-infection. Conclusion: In our study, a remarkable rise in the number of patients in the latent syphilis stage is observed over primary and secondary syphilis stage. This signifies the persistence of syphilis in subclinical phase in the community and unfortunately, it goes unnoticed. These could be "warning signs" for changing disease pattern of syphilis in India and points toward hidden resurgence of syphilis as being reported in various parts of the world. To actively look for these "hidden cases," there is a need to strengthen "Suraksha clinics." VDRL testing should be mandatory along with routine testing in all patients visiting the hospital irrespective of their disease. We also propose for the central registration of syphilis patients on lines of HIV-infected patients' registry.

Serum Adiponectin Levels as an Independent Marker of Severity of Psoriasis: A Cross-Sectional Analysis.

Background: Adiponectin is an adipokine, having anti-inflammatory properties, the levels of which are reduced in metabolic syndrome. In psoriasis, it plays a preventive role by inhibiting the differentiation and proliferation of keratinocytes and decreasing the levels of the signature cytokine, IL-17. Aims and objectives: To find a correlation between serum adiponectin levels and the severity of psoriasis and to compare these levels amongst patients with parameters of metabolic syndrome vs those without it. Materials and methods: This was a cross-sectional observational study consisting of 60 cases of chronic plaque type psoriasis and 20 controls. Mild, moderate and severe disease was defined based on Psoriasis Area Severity Index (PASI). Serum samples were analyzed for fasting serum adiponectin levels. Results: The mean serum adiponectin level among cases (16.07 ± 8.55 µg/ml) was significantly lower than controls (21.65 ± 8.07 µg/ml, P = .012). It was not only lower among cases with MetS (14.28 ± 7.95 µg/ml), but also in patients without MetS (17.35 ± 8.83 µg/ml). Serum adiponectin levels were negatively correlated to age, Body Mass Index (BMI), PASI, disease duration and Erythrocyte Sedimentation Rate(ESR). However, only the negative correlation with PASI (P = .000), duration (P = .005) and ESR (P = .010), was statistically significant. Conclusion: Serum adiponectin is decreased in psoriasis, independent of metabolic syndrome and is negatively correlated with disease severity and duration. Limitations: Analysis on a larger sample size and response to treatment could not be assessed.