IADVL SIG Pediatric Dermatology (Academy) Recommendations on Hemangioma of Infancy (HOI).

Hemangioma of infancy (HOI) is a benign vascular proliferation. Though resolution is the norm, potential complications make an accurate diagnosis and early management of importance. The Indian association of dermatologists, venereologists and leprologists (IADVL) special interest group (SIG) paediatric dermatology in association with IADVL academy did an extensive analysis of the literature on the clinical features, diagnosis, and management of HOI published between 2010 and 2021. Online meetings were conducted from February 2021 to March 2022 to reach a consensus on these recommendations which are made from an Indian perspective.

IADVL SIG Pediatric Dermatology (Academy) Recommendations on Childhood Alopecia Areata.

Alopecia areata (AA) is a chronic inflammatory disease characterized by nonscarring alopecia. In contrast to adult onset AA, the epidemiology, clinical characteristics, and therapy of childhood AA are less explored. This study aims at providing recommendations for the management of childhood AA. The special interest group (SIG) in pediatric dermatology under the Indian Association of Dermatology, Venereology and Leprosy (IADVL) conducted online meetings from February 2021 to September 2021, intending to identify the critical aspects in the diagnosis and treatment of AA. The classification, diagnosis, and tools for assessment of disease activity of childhood AA have been described in this study, along with recommendations for topical and systemic therapy, including newer therapeutic options.

Genome wide association study and genomic prediction for stover quality traits in tropical maize (Zea mays L.).

Maize is rapidly replacing traditionally cultivated dual purpose crops of South Asia, primarily due to the better economic remuneration. This has created an impetus for improving maize for both grain productivity and stover traits. Molecular techniques can largely assist breeders in determining approaches for effectively integrating stover trait improvement in their existing breeding pipeline. In the current study we identified a suite of potential genomic regions associated to the two major stover quality traits-in-vitro organic matter digestibility (IVOMD) and metabolizable energy (ME) through genome wide association study. However, considering the fact that the loci identified for these complex traits all had smaller effects and accounted only a small portion of phenotypic variation, the effectiveness of following a genomic selection approach for these traits was evaluated. The testing set consists of breeding lines recently developed within the program and the training set consists of a panel of lines from the working germplasm comprising the founder lines of the newly developed breeding lines and also an unrelated diversity set. The prediction accuracy as determined by the Pearson's correlation coefficient between observed and predicted values of these breeding lines were high even at lower marker density (200 random SNPs), when the training and testing set were related. However, the accuracies were dismal, when there was no relationship between the training and the testing set.

Recommendations for Management of Childhood Psoriasis.

Childhood psoriasis is recognized as a potential multisystem disorder and hence it is imperative to optimize disease management to arrest progression, minimize psychological burden and evolution of metabolic syndrome. Clinical practice recommendations are necessary to assist practitioners in appropriate decision making based on available evidence. Owing to the lack of Indian recommendations on childhood psoriasis, the SIG Pediatric Dermatology under IADVL Academy undertook an evidence-based approach based on published literature on the topic, between January 2000 and July 2020 to frame the recommendations.

Genetic gains with rapid-cycle genomic selection for combined drought and waterlogging tolerance in tropical maize (Zea mays L.).

Rapid cycle genomic selection (RC-GS) helps to shorten the breeding cycle and reduce the costs of phenotyping, thereby increasing genetic gains in terms of both cost and time. We implemented RC-GS on two multi-parent yellow synthetic (MYS) populations constituted by intermating ten elite lines involved in each population, including four each of drought and waterlogging tolerant donors and two commercial lines, with proven commercial value. Cycle 1 (C1 ) was constituted based on phenotypic selection and intermating of the top 5% of 500 S2 families derived from each MYS population, test-crossed and evaluated across moisture regimes. C1 was advanced to the next two cycles (C2 and C3 ) by intermating the top 5% selected individuals with high genomic estimated breeding values (GEBVs) for grain yield under drought and waterlogging stress. To estimate genetic gains, population bulks from each cycle were test-crossed and evaluated across locations under different moisture regimes. Results indicated that the realised genetic gain under drought stress was 0.110 t ha-1 yr-1 and 0.135 t ha-1 yr-1 , respectively, for MYS-1 and MYS-2. The gain was less under waterlogging stress, where MYS-1 showed 0.038 t ha-1 yr-1 and MYS-2 reached 0.113 t ha-1 yr-1 . Genomic selection for drought and waterlogging tolerance resulted in no yield penalty under optimal moisture conditions. The genetic diversity of the two populations did not change significantly after two cycles of GS, suggesting that RC-GS can be an effective breeding strategy to achieve high genetic gains without losing genetic diversity.

Genomic Regions Associated with Root Traits under Drought Stress in Tropical Maize (Zea mays L.).

An association mapping panel, named as CIMMYT Asia association mapping (CAAM) panel, involving 396 diverse tropical maize lines were phenotyped for various structural and functional traits of roots under drought and well-watered conditions. The experiment was conducted during Kharif (summer-rainy) season of 2012 and 2013 in root phenotyping facility at CIMMYT-Hyderabad, India. The CAAM panel was genotyped to generate 955, 690 SNPs through GBS v2.7 using Illumina Hi-seq 2000/2500 at Institute for Genomic Diversity, Cornell University, Ithaca, NY, USA. GWAS analysis was carried out using 331,390 SNPs filtered from the entire set of SNPs revealed a total of 50 and 67 SNPs significantly associated for root functional (transpiration efficiency, flowering period water use) and structural traits (rooting depth, root dry weight, root length, root volume, root surface area and root length density), respectively. In addition to this, 37 SNPs were identified for grain yield and shoot biomass under well-watered and drought stress. Though many SNPs were found to have significant association with the traits under study, SNPs that were common for more than one trait were discussed in detail. A total 18 SNPs were found to have common association with more than one trait, out of which 12 SNPs were found within or near the various gene functional regions. In this study we attempted to identify the trait specific maize lines based on the presence of favorable alleles for the SNPs associated with multiple traits. Two SNPs S3_128533512 and S7_151238865 were associated with transpiration efficiency, shoot biomass and grain yield under well-watered condition. Based on favorable allele for these SNPs seven inbred lines were identified. Similarly, four lines were identified for transpiration efficiency and shoot biomass under drought stress based on the presence of favorable allele for the common SNPs S1_211520521, S2_20017716, S3_57210184 and S7_130878458 and three lines were identified for flowering period water-use, transpiration efficiency, root dry weight and root volume based on the presence of favorable allele for the common SNPs S3_162065732 and S3_225760139.

Cutaneous manifestations of chikungunya fever.

Chikungunya fever, a re-emerging RNA viral infection produces different cutaneous manifestations in children compared to adults. 52 children with chikungunya fever, confirmed by positive IgM antibody test were seen during 2009-2010. Pigmentary lesions were common (27/52) followed by vesiculobullous lesions (16/52) and maculopapular lesions (14/52). Vesiculobullous lesions were most common in infants, although rarely reported in adults. Psoriasis was exacerbated in 4 children resulting in more severe forms. In 2 children, guttate psoriasis was observed for the first time.

Evaluation of Five Different Regimes For the Treatment of Vitiligo.

Response of vitiligo patients to five different regimes was evaluated taking only those patients who had either static or progressively increasing lesions. Selection of the regimen depended upon the clinical characteristics of the disease. Each regime was tried for at least 4 months and if a patient didnot improve with one regime, he was shifted to another regime. A patient was considered to have improved, if the lesions started regimenting or the previously progressive lesions stopped increasing further. Regime I consisted of 150 mg levamisol orally on two consecutive days per week, given to 13 cases, it resulted in improvement in 7 (53.80/o). Regime II consisted of levamisole in the same dose combined with once a day topical massage with 0.1% fluocinolone acetonide acetate cream; it led to improvement in 27 (81.8%) of the 33 cases. Regime III consisted of 3 mg betamethasone orally on alternate days combined with levamisole and topical fluocinolone; given to 32 cases, it was successful in 28 (87.50/o). A combination of 2 mg betamethasone orally alternating with 20 mg 8-methoxypsoralen and sun exposure (regime IV) caused improvement in 17 (85%) of the 20 cases. An oral mini pulse consisting of 5 mg betamethasone orally twice a week combined with 50 mg cyclophosphimide daily orally (regime V) was successful in 20 (90.9%) of the 22 cases, the remaining two cases showed unprovement when the dose ofbetamethasonc .was increased from 5 mg to 7.5 mg twice a week. Thus ultimately each one of the 91 patients responded to one or the other regime. The side effects were minimal and insignificant.The degree of improvement at the time of analysis was 100% in 23.3% cases, 50-100% in 44.2'Yo cases and less than 50% in 32.5%, after 4-14 months of treatment. It is felt that the results may be better after a longer follow-up although all patients are not expected to get complete repigmentation.

Further Studies on Pemphigus Patients Treated with Dexamethasone.

Our regime for the treatment of pemphigus consists of 100mg dexamethasone dissolved in 5% glucose given by a slow intravenous drip over 1-2 hours and repeated on 3 consecutive days. On the first day, 500 mg cyclophosphamide is also given in the same drip. Such dexamethasone cyclophosphamide pulses (DCP) are repeated once a month. In between the (DCP), the patient is given only 50 mg cyclophosphamide daily orally. During the first few methods of starting this treatment, most patients continue to get relapses of pemphigus lesions in between the DCP (phase I). After a variable period however, almost all patients stop having such relapses, but we continue to give once monthly DCP for atleast 6 months (phase II), After which the DCP is stopped and the patient continues to take 50 mg cyclophosphamide daily orally for a further period of one year (phase III). At the end of thos phase all treatment is stopped and the patients followed-up for any relapse (phase IV). Follow up of the first 100 patients, pemphigus vulgaris (92), pemphigus follaccus (6) and pemphigus erythematosus (2), has.

Passively Transferred Pemphigus in a Newborn.

A 24 yew old patient having pemphigus for the last 1 year delivered a female baby after 36 weeks of gestation. The baby had pemphigus like lesions on the skin and a single ulcer on the hard palate. The serum antibody titres of intercellular antibodies in the mother and the baby at the time of delivery were 1:80 and 1: 40 respectively. 1 The lesions in the baby healed completely by the 9th day after birth, without any specific treatment. Three months later the antibody titre in the mother was 1: 40, while in test became negative The baby the baby, the has since shown no recurrence of the lesions.

Nuts As a Cause of Contact Dermatitis of the Hands.

To evaluate contact hypersensitivity to some of the commonly used Indian nuts, patch tests were undertaken with cashew nuts, ground nuts, almonds and pistachio in 3 groups of individuals: (1) patients exposed to the corresponding nut and having dermatitis on their fingertips, (2) controls having no dermatitis, but exposed to the nut, and (3) unexposed group. A paste prepared by Cushing the nut and used as such gave positive patch test 'reactions in, all the 6 patients tested with cashew - nut, ground - nut and almonds, and these looked to be irritant reactions. Further patch tests with these three nuts were therefore done with 1:1 dilution of the paste with distilled water. The number of patients showing positive patch tests out of the total number.

Eosinophilic Spongiosis in Vesiculo-bullous Diseases.

A retrospective review of the skin biopsies of 93 patients having various vesiculo-bullous diseases seen between 1983 and 1985 revealed eosinophilic spongiosis (ES) in 31 cases. of these, 19 (36.5%) out of 52 patients having pemphigus vulgaris 2(20%) of 10 patiens having pemphigus foliaceous, one patient having pemphigus vegetans, 3 (15%) of 20 patients with bullous pemphigoid, and 3 (50%) of 6 patients with dermatitis herpetiformis had ES. The severity of eosinophilic spongiosis graded on an arbitrary scale, was 3 + in 2 cases of pemphigus vulgaris, 2 + in 7 cases of pemphigus vulgaris, 1 case of pemphigus vegetans and 2 cases of dermatitis herpetiformis, while in the remaining it was only 1 +. Only 3 patients of pemphigus vulgaris showed distinctive atypical clinical features in the form of erythema multiforme like lesions in 2 cases and erythema annulare centrifugum like lesions in 1 case. In the remaining cases the clinical presentation was not different from those who did not have ES.