Porokeratosis.

This case report describes multiple, hyperpigmented plaques involving the face, trunk, and bilateral upper and lower extremities.

Real-time Intraoperative Dermoscopic Monitoring of Common Acquired Melanocytic Nevi Following Shave Excision.

Background: The treatment of common acquired melanocytic nevus (CAMN) is mostly desired for cosmetic purposes due to which a number of "faster and less traumatizing" techniques have been developed. The major cause of recurrence is incomplete removal; there is a need for early detection of any residual pigment. Aims and Objectives: This study aimed to assess the recurrence of common acquired melanocytic nevi and whether dermoscopy can be used as a noninvasive tool for the assessment of residual pigment following shave excision. Materials and Methods: A total of 100 patients of age more than 18 years with clinical features suggestive of common acquired melanocytic nevi were enrolled in the study. The nevi were assessed clinically and dermoscopically and, if found benign, were excised using shave excision. The specimen obtained was sent for histopathological examination. Dermoscopy was used immediately after shave excision for observing any residual pigment and, if present, was removed using radiofrequency current. The patients were followed up at 6 and 12 weeks for recurrence. Results: On histopathology, 87% nevi were intradermal, 8% were compound, and 5% had insufficient tissue for diagnosis, which were clinically diagnosed as junctional nevi. Dermoscopy immediately after shave excision helped in detecting residual pigment in 91% nevi, which was immediately ablated with radiofrequency, thus decreasing the risk of recurrences. Recurrences were seen in 33% nevi and all were intradermal with the presence of hair in the majority (66.67%) of them. Conclusion: Shave excision is a minimally invasive and easily performed procedure. Dermsocopy can be used for assessing residual pigment after shave excision and thus reducing the risk of recurrences. On combining shave excision with radiofrequency ablation and assessing by dermoscopy, majority of patients were satisfied with the cosmetic results. Using dermoscope for follow-up helps in early recognition of recurrence and thus appropriate treatment can be provided at the earliest.

A Clinical, Dermoscopic, and Histopathological Analysis of Common Acquired Melanocytic Nevi in Skin of Color.

Background: Acquired melanocytic nevi are very common and usually multiple. Corroborating clinical and dermoscopic diagnosis with histopathology will help in differentiating benign nevi from malignant and thus, obviate the need of biopsy in benign nevi. Additionally, it helps in predicting the chances of recurrence after removal leading to better treatment outcome and patient counselling. Objective: This study aimed to examine the clinical, dermoscopic, and histopathological features of common acquired melanocytic nevi. It also assessed the association between the two. Methods: One hundred Indian patients aged 18 years or older with clinical features suggestive of common acquired melanocytic nevi were enrolled in the study. The nevi were assessed clinically and dermoscopically using ABCD rule and if found benign, were excised using shave excision. The specimen obtained was sent for histopathological examination. Results: The age of the patients varied from 18 to 50 years with 83 females and 17 males. There was a 100 percent concordance rate between the clinical and histopathology diagnosis of intradermal nevi whereas higher discordance rate for that of compound nevi. Hair was present in a total 25 nevi and all were intradermal nevi on histopathology. Dermoscopy features suggestive of compound nevi were biaxial symmetry, presence of pigment network, and structureless homogenous areas. Features suggestive of intradermal nevi on dermoscopy were presence of blue-grey color, globules, structureless areas, and branched streaks. Conclusion: This is a pioneering study correlating the clinical and dermoscopic features with histopathology in skin of color. There is 100 percent concordance rate between clinical and histopathological diagnosis of intradermal nevi. Dermoscopy is a useful non-invasive tool for assessing the presence of certain dermoscopic features and predicting the type of nevi and their recurrences.

Case Report: A Case of Tuberculosis with Psoriasiform Lichen Scrofulosorum Exhibiting Koebner's Phenomenon followed by Scrofuloderma.

Lichen scrofulosorum is the most common tuberculid in the Indian population and the second most common form of cutaneous tuberculosis. We discuss an uncommon presentation of lichen scrofulosorum, with psoriasiform morphology and koebnerization at tuberculin test site, associated with cervical lymphadenitis in a 17-year-old girl. Although the cutaneous lesions resolved completely after 3 months of antitubercular treatment (ATT), she developed scrofuloderma in the left cervical region at 4 months. In the absence of rifampicin resistance, ATT was continued for another 6 months, with no further evidence of disease activity. This case represents an infrequent occurrence of lichen scrofulosorum followed by scrofuloderma, which necessitated a prolonged course of first-line ATT.