Depression, Anxiety, and Coping During the COVID-19 Pandemic Among Indian Expats in the Middle East: A Survey Study.

OBJECTIVE: There are multiple studies indicating that the Indian expat population working in the Middle East is at a significantly high risk for developing anxiety, depression, and suicidal thoughts. The coronavirus disease 2019 (COVID-19) pandemic can precipitate or exacerbate psychological distress among the expat population. The objective of this study was to evaluate psychological distress and coping mechanisms among Indian expats working in the Middle East during the COVID-19 pandemic. METHODS: An online survey was conducted with a semistructured questionnaire using a nonprobability snowball sampling technique. In addition to demographic data, a list of COVID-19 pandemic-related questions, the Brief COPE, the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) were also utilized. RESULTS: A total of 94 responses were received. Of the respondents, 52% reported clinically significant anxiety levels, and 41% reported clinically significant depression levels. Both the PHQ-9 and GAD-7 scores were significantly associated with the level of concern with air traffic restriction (P < .05). CONCLUSIONS: Our findings show that governments of both Indian and Middle Eastern countries should pay more attention to the mental health of the expat population while combating COVID-19.

Comorbid psoriasis-bipolar disorder successfully treated with apremilast: much more than a mere coincidence?

Psoriasis is a chronic, immune mediated, systemic inflammatory skin disease with a reported prevalence of 0.6%-4.8% in the general population. Bipolar disorder (BP) is a severe episodic psychiatric disorder that ranks as the fourth leading cause of disability. Recent evidence suggests that genetic and immunological factors play a significant role in the development of both disorders. Studies have also shown a higher association of psychiatric disorders among patients with psoriasis. Moreover, several autoimmune comorbidities have been reported in association with BP. Here, we describe a young woman with BP who developed psoriasis after 1 year of developing BP and showed exacerbations in psoriasis lesions with each manic episode. We also highlight the safe and efficacious use of apremilast for psoriatic lesions in the woman.

Novel dermoscopic features of pityriasis versicolor-like macules in epidermodysplasia verruciformis.

Epidermodysplasia verruciformis (EV) manifests early in childhood as pityriasis versicolor (PV)-like macules on sun-exposed sites such as the face. These hypopigmented lesions closely resemble commoner pediatric dermatoses such as PV or pityriasis alba. In this report of two cases, we describe the distinguishing dermoscopic features of PV-like macules in EV. Unfocused dotted vessels in a hypopigmented or erythematous background with whitish scales and pigment diluted vellus hairs on dermoscopy should raise the suspicion of EV in children presenting with PV-like lesions.

Clinical Spectrum of Autoerythrocyte Sensitization Syndrome: A Series of Five Cases.

Autoerythrocyte sensitization syndrome (Gardner Diamond syndrome or GDS) is a rare syndrome characterized by painful and spontaneous purpura commonly affecting adult women, and is mostly associated with psychiatric illness. Diagnosis is mainly based on clinical presentation, exclusion of other simulating diseases, and psychiatric evaluation. Only few cases have been reported till date. We report five cases of spontaneous purpura with a normal investigation profile, except for iron deficiency anemia in 1 patient, of which three had associated underlying psychiatric illness. Autoerythrocyte sensitization test was positive in all our cases. Patients presenting with painful bruises without significant medical history such as underlying bleeding disorder or drug history or history of trauma should be considered for autoerythrocyte sensitization syndrome, and managed accordingly. The present study is a case series of patients with characteristic features of autoerythrocyte sensitization syndrome, considering the rarity of the reports on its clinical spectra.