A Cross-Sectional Study to Assess the Role of Dermoscopy in Differentiating Palmar Psoriasis, Chronic Hand Eczema, and Eczema in Psoriatico.

BACKGROUND: Overlapping clinical features often make the differentiation between palmar psoriasis, hand eczema, and eczema in psoriatico a difficult task. In such cases, history and biopsy often aid in the diagnosis. Dermoscopy acts as a link between clinical dermatology and dermatopathology. AIM: To study the dermoscopic features in biopsy-proven cases of palmar psoriasis, hand eczema, and eczema in psoriatico. METHODS: A 1-year cross-sectional study was conducted using a video dermatoscope, Dinolite premier AM4113ZT, on 60 patients having clinical diagnosis of either of palmar psoriasis, hand eczema, and eczema in psoriatico. Statistical analysis was performed using R i386 3.6.3 software. RESULTS: Among 60 patients, 38 were psoriatics followed by 14 of eczema and 8 of eczema in psoriatico. On dermoscopy, characteristic features of psoriasis lesions were diffuse scaling in 76.3% (29/38), white scales in 60.5% (23/38), and dotted vessels in 76.3% (29/38) along with regular distribution of vessels in 71% (27/38); in hand eczema lesions, diffuse scaling in 78.5% (11/14), white and yellow scales in 57.1% (8/14), and dotted vessels in 78.5% (11/14) along with a patchy distribution of vessels in 57.1% (8/14); in eczema in psoriatico, diffuse scaling in 75% (6/8), white and yellow scales in 62.5% (5/8), and dotted vessels in 87.5% (7/8) along with regular distribution of vessels in 50% (4/8). CONCLUSION: The various patterns and combinations reflecting specific features give an insight into the cases of palmar psoriasis, hand eczema, and eczema in psoriatico on dermoscopy. However, a study with larger sample size is required to validate the findings of our study. LIMITATIONS: Inability to perform a patch test for eczema due to unavailability.

1-Year Hospital-Based Observational Study of Trichoscopy Findings and Disease Activity in Alopecia Areata.

INTRODUCTION: Alopecia areata (AA) is a chronic, non-scarring type of alopecia that presents as patchy hair loss over the scalp and other parts of the body. The diagnosis of AA can sometimes be challenging. Trichoscopy can be used to observe certain follicular patterns, shaft changes, and interfollicular pattern which help in diagnosing and determining the disease activity in AA. MATERIALS AND METHODS: This study was a 1-year hospital-based observational cross-sectional study consisting of 60 patients clinically diagnosed with AA. Trichoscopic examination of the scalp and hair was performed using a videodermatoscope-Dinolite premier AM4113ZT model, trichoscopic images were recorded, and results were analyzed statistically. RESULTS: AA was more common in males 39/60 cases (65%) with male to female ratio of 1.85:1. Scalp was the most frequently involved site, seen in 52/60 cases (86.67%) and patchy alopecia was the most frequent clinical pattern of presentation (83.33%). The characteristic follicular features noted were black dots, yellow dots, and empty hair follicles. Black dots were the commonest finding (63.33%) and represented a marker for active disease. The characteristic hair patterns noted were broken hair, micro-exclamation mark hair, coudability hair, all of which were commonly seen in active cases. 72% of cases that had clinically inactive disease showed active disease on trichoscopy. CONCLUSION: Trichoscopic features of AA are characteristic and they not only provide an important clue to the diagnosis in doubtful cases but also help in assessing disease activity in AA.

Anti-thyroid peroxidase antibody in vitiligo: a prevalence study.

Aim. The aim of the study was to study the relation of vitiligo with demographic data like age, sex, and duration and determine the prevalence of thyroid autoimmunity in vitiligo patients. Materials and Methods. This study was a cross sectional study consisting of 100 patients clinically diagnosed (old and new) as having vitiligo irrespective of age or sex. Patients with known thyroid disease on supplementation therapy, or who had undergone thyroid surgery, those on antithyroid medication, patients with other causes of leukoderma, and cases who do not provide informed consent were excluded from the study. Serum TSH and anti-TPO antibodies were measured in all the patients. Results. The prevalence of anti-TPO antibody positivity was found to be 28%. Conclusion. According to our study, none of our vitiligo patients had symptoms or signs of thyroid disease at the time of presentation but, on biochemical evaluation, anti-TPO antibodies were found in a considerable number of patients. Hence, we recommend screening of these patients with thyroid antibodies.

Primary cutaneous actinomycosis.

Actinomycosis is a chronic, progressive, suppurative infection, prevalent over the neck, thorax or abdomen. As it rarely occurs with few clinical symptoms, its diagnosis requires a high index of clinical suspicion. We report a case of primary cutaneous actinomycosis affecting the back. The patient was treated with benzyl penicillin and sulfonamides and showed no recurrence at 1 year follow-up.

Ecthyma gangrenosum in a new born child.

Ecthyma gangrenosum is one of the most serious and specific cutaneous infection caused by Pseudomonas aeruginosa. We report a case of ecthyma gangrenosum in a new born child who responded poorly to the antipseudomonas treatment to highlight the poor prognosis in new born.