Penile ulcerative pyoderma gangrenosum: A rare entity.

Pyoderma gangrenosum (PG) is a rare, chronic, ulcerative, neutrophilic, and inflammatory skin disease. It most commonly affects the lower limb, may affect peristomal skin, and rarely involves mucosal and internal sites. Genital involvement has been rarely reported. Hereby, we report a case of penile PG in a 70-year-old male treated with oral steroids.

Plica Neuropathica: Bird's Nest under Dermatoscope.

Plica polonica is a rare condition presenting as a mass of scalp hair with irregular twists and irreversibly entangled plaits, which are firm to hard impenetrable mass of keratin cemented together with dirt and exudates. The exact etiopathogenesis of plica neuropathica is not known, but it can be due to longitudinal splitting or weathering of hair shaft due to vigorous friction and frequent use of harsh shampoos and cleansers or long hair with poor hair care Drug-induced hair matting due to chemotherapeutic drugs and due to neurotic illness like hysteria, anxiety, to psychotic illness have also been reported. Dermatoscopy showed interwining of hair shaft with matting and honey-colored concretions mimicking "wrangled mesh of wires" appearance. The treatment of plica neuropathica involves cutting the matted hair and evaluating underlying psychiatric illness to prevent recurrence.

Atypical Presentation of Halo Nevus over Eyelid with Poliosis: A Dermatoscopic Perspective.

Halo nevus (HN) is benign skin condition with a central melanocytic nevus, surrounded by an area or halo of depigmentation. It is the result of immunological response of the body toward the nevus, which destroys the melanocytes in surrounding skin, leading to the depigmented halo. An increased frequency of HN in patients with vitiligo is observed. It is more commonly seen in children or young adults of either sex, particularly on the trunk, less commonly on the face, neck, and limbs. We present a rare case of HN which was present on the lower eyelid associated with poliosis, diagnosed with dermatoscopy.

Topical steroids: Awareness and misuse among patients, pharmacists and general medical practitioner.

AIMS AND OBJECTIVES: (1) To determine the level of awareness among patients, pharmacists and general practitioners about commonly available topical steroids and its combinations.(2) To determine the source of recommendation/prescription of topical steroids and its combination creams.(3) To know and create awareness about the side effects of topical steroids in all the study groups. METHODS: This was a prospective questionnaire-based study where three study groups, namely patients, pharmacists and general practitioners, were included. This study was approved by the institutional ethics committee. after ethical clearance. The patients who used topical steroids for dermatoses where it is an absolute contraindication, as well as those who developed side effects, were included in the study. ThoroughComplete cutaneous examination was done specifically to detect the side effects of steroids. Seminars were conducted and questionnaires were given to both the pharmacists and general practitioners of nearby areas. The questionnaire consisted of questions regarding their prescription and dispensing practices of topical steroids and its combinations. RESULTS: Out of 95 patients seen, the most commonly used steroid molecule was clobetasol propionate 0.05% in 44 (46.3%) patients, the common source of recommendation was general practitioners in 36 (37.8%), the common indication was superficial dermatophytosis in 85 (89%) and the most common adverse effect was recurrence/increase in the extent of the infection in 72 (75.78%) patients. Out of total 44 general practitioners enrolled in the study, 22 (50%) were qualified allopathic medical practitioners and22 (50%) were homeopathic/ayurvedic doctors. Superficial dermatophytosis [19 (43.18%)] was the common dermatosis seen by them. While 29 (65.90%) preferred prescribing topical steroids or its combination, rest of them preferred plain steroid creams. Out of 179 pharmacists, 74 (41.34%) did not have appropriate knowledge of topical steroids, 35 (19.55%) were not aware that steroids are isschedule "H" drugs. Commonest molecule sold over the counterwas clobetasol propionate 0.05% by 74 (41.89%). The limitations of our study were small study group and short duration. CONCLUSION: As dermatologists, it is our responsibility, to correctly educate the society, particularly the non-dermatologist medical fraternity, about ethical and rational use of topical steroids.

Epidermodysplasia verruciformis with plane warts over lower abdomen and genitals.

Epidermodysplasia verruciformis (EDV) may clinically vary from pityriasis versicolor-like macules to wart-like flat papules, psoriasiform red papules, or pigmented keratotic lesions resembling seborrheic keratosis. Sun-exposed areas are commonly affected with genital areas rarely involved. It is associated with more than 30 human papillomaviruses (HPVs). In 90% cases of squamous cell carcinomas, HPV5 and HPV8 is isolated. A case of EDV with plane warts involving the genital area in a 35-year-old male is reported here.

Congenital Triangular Alopecia - A Case Report.

Congenital triangular alopecia also known as temporal triangular alopecia or Brauer nevus may be present at birth or acquired during the first decade of life. It can present as triangular, oval, or lancet-shaped patch of alopecia. It may be misdiagnosed as alopecia areata, traction alopecia, trichotillomania, tinea capitis, and aplasia cutis congenita. Histopathological features and dermoscopic features help in its diagnosis. There is no effective treatment for it and, in most cases, there is no need for therapeutic intervention. Therapeutic modalities include topical minoxidil, surgical excision, and hair transplantation.

Circle Hairs Involving the Extremities in a Young Girl.

Circle hairs (CHs) represent a body hair growth disorder which is characterized by asymptomatic presence of hairs in typical circular or spiraliform arrangement. It is not associated with follicular or inflammatory abnormalities. CHs are rarely reported, probably underestimated, as medical consultation for CH only is rare in practice. It needs to be differentiated from rolled hairs, which is a relatively common disorder of hair growth associated with follicular hyperkeratosis and keratin plugging. Trichoscopy is a noninvasive technique to confirm the diagnosis without biopsy. We present a 20-year-old female who presented with CHs over bilateral upper and lower limbs involving extensors.

Primary Idiopathic Pseudopelade of Brocq in a Young Child.

Pseudopelade of Brocq (PPB) is a rare, chronic, slowly progressive cicatricial alopecia that generally affects middle-aged women. Vertex and parietal scalp are commonly involved. It can be primary or secondary to end stage of other scarring alopecia such as lichen planopilaris and discoid lupus erythematosus. It is diagnosed by exclusion both clinically and trichoscopy. There is no standard treatment for PPB. We hereby report a case of rapidly progressing primary idiopathic pseudopelade of Brocq in a young female child confirmed by trichoscopy and histopathology.

Palmoplantar exfoliation due to chloroquine.

Chloroquine is the drug very frequently used for the treatment of malaria. It is also used in amebiasis, rheumatoid arthritis, and various dermatological conditions. Chloroquine can cause muscle problems, loss of appetite, and diarrhea as a side effect. Cutaneous toxicity includes pruritus, hair loss, photosensitivity, and color changes. Exfoliation of skin over palms and soles is caused by chemotherapeutic drugs such as axitinib, fluorouracil, idarubicin, doxorubicin, sunitinib, sorafenib, and paclitaxel. Here, a case of a 40-year-old female is presented who developed palmoplantar exfoliation with depigmentation after taking chloroquine. Although not life-threatening, this side effect of a commonly used drug may cause anxiety and functional impairment which in turn affects the quality of life of an individual.