Postinflammatory Hyperpigmentation following Electrodesiccation with a Eutectic Mixture of Local Anesthetics.

We assessed the effects of prior application of a eutectic mixture of local anesthetics (EMLA) on the appearance of dyschromia at the site of superficial electrodesiccation in an observer-blind, case-control study in 60 patients. Thirty subjects each were assigned to Groups A and B; both groups underwent radiofrequency (RFC) ablation for facial dermatosis papulosa nigrans (DPN). Group A received RFC ablation with prior application of EMLA, whereas Group B did not. No significant difference was observed in the dyschromia between both groups. EMLA cream was well tolerated by the study participants. (SKINmed. 2020;18:222-225).

Utility of trichoscopy to diagnose early female pattern hair loss in resource-poor setting: A cross-sectional study.

BACKGROUND: Trichoscopy is a reliable instrument for diagnosis and for tracking therapy-related changes in female pattern hair loss (FPHL). Videodermoscopic diagnosis of FPHL has been established, which requires fine measurements of hair-related parameters; the method requires an expensive equipment/digital program. AIM: To determine whether a low-cost, simple USB dermoscope can ascertain the hair-related changes in early FPHL. METHODS: An age-matched, cross-sectional study was performed over 3 years on subjects with less than 6-month history of hair loss and without an obvious broadening of midline hair parting. Trichoscopic analysis of the frontal and occipital scalp of the study subjects were performed, using a USB-connected dermoscope. The subjects were analyzed for the presence of microscopic hair changes in the form of anisotrichosis, vellus-like hair, single hair follicle unit, peri-pilar sign and yellow dots. RESULTS: A total of 230 cases and 230 controls were analyzed. The dermoscopic hair changes were found to be significantly associated with the frontal scalp zone of cases. LIMITATIONS: Histopathological evaluation of the cases was not done. CONCLUSION: Microscopic changes recorded with the help of a simple USB dermoscope are helpful in establishing a diagnosis of FPHL even in early disease.

Oral histoplasmosis masquerading as acute necrotizing ulcerative gingivitis: A rare case report.

Histoplasmosis also called as "Darling's Disease" is a community-acquired primary pulmonary disease caused by inhalation of dust containing spores of soil-dwelling dimorphic fungi, Histoplasma capsulatum. Presentation of fungi in the oral cavity is usually rare and is generally associated with an immunocompromised state. Here, we present a rare case of histoplasmosis in an immunocompetent patient, with discrete oral presentation, that initially mimicked acute necrotizing ulcerative gingivitis. Gingival biopsy confirmed the diagnosis of histoplasmosis, which responded favorably to the initial treatment with intravenous amphotericin and later to oral itraconazole. Thus, a vigilant approach is paramount in reducing the fatality due to disease.

Autophagy: A brief overview in perspective of dermatology.

Autophagy, literally meaning "self-eating," is an intracellular catabolic process of delivering cytosol and/or its specific content to the lysosomes for degradation.The resulting macromolecular constituents are recycled and utilized again by the cells. Basal level autophagy plays an important role in cellular homeostasis through the elimination of the old or damaged organelles, as well as aggregated intracellular proteins. Autophagy refers to sequestration of intact organelles along with a portion of cytosol, into a double-or multi-membrane structure known as phagophore, which elongates, and after closure, forms a vesicular structure known as the autophagosome. Subsequently, the mature autophagosome fuses with a lysosome, thereby forming a single membrane structure, an autolysosome. Autophagy plays a critical role in inflammation, autoimmunity and cellular differentiation. Skin serves as the first line of defense against a variety of environmental insults and autophagy is thought to be a form of an endogenous defense mechanism against such environmental derangements. Autophagy has been linked with keratinocyte differentiation and melanocyte survival, as well as with the pathogenesis of diverse skin disorders including systemic lupus erythematosus, systemic sclerosis, psoriasis, vitiligo, infectious skin diseases and cancer. Autophagy has been one of the most studied phenomena in cell biology and pathophysiology, and given its broad clinical implications, has become a major target for drug discovery. The last decade has seen a substantial upsurge in autophagy-related research and publications; still, the dermatology literature appears to be less initiated. Autophagy will probably change our understanding of dermatological disorders/medicines. Hence, a basic knowledge of autophagy is a prerequisite to understand the developments in the field of autophagy-related research.

A Simple User-made Iontophoresis Device for Palmoplantar Hyperhidrosis.

Iontophoresis is defined as passing of an ionized substance through intact skin by application of direct electric current. Tap water iontophoresis is reliable and effective method for treatment of palmar and plantar hyperhydrosis when practiced with appropriate technique and timing. One of the major setback for using iontophoresis is that the apparatus is expensive and is not readily available. A simple user-made Iontophoresis device have been described here, which could be easily constructed and used at home.

Subungual hyperkeratosis nail biopsy: a better diagnostic tool for onychomycosis.

BACKGROUND: Onychomycosis is one of the most common nail disorders. Mycological examination by potassium hydroxide (KOH) mount and fungal culture is the most commonly used diagnostic method. However, it is associated with a low sensitivity. AIMS: To evaluate the technique of subungual hyperkeratosis nail biopsy in diagnosing onychomycosis in HIV-infected and immunocompetent adults and compare it with mycological examination. METHODS: 34 HIV-positive patients who presented clinically with onychomycosis were recruited in the study from the beginning. There was no screening done for patients with onychomycosis. This has been clarified in manuscript under the heading of methods. RESULTS: All the fungal cultures yielded dermatophytes correlating with the biopsy findings. Only hyphal form of fungus was detected in KOH examination, indicating it was not a contaminant. Clinical types of onychomycosis are stated in discussion. CONCLUSIONS: PAS stain of subungual hyperkeratosis nail biopsy was the most sensitive in the diagnosis of onychomycosis in both HIV-infected and non-infected groups.