Study of Causative Factors and Clinical Patterns of Periorbital Pigmentation.

INTRODUCTION: Periorbital hyperpigmentation (POH) is one of the common conditions seen in outpatient department. Despite of its huge prevalence, clinical data regarding its etiology and associations are still insufficient. MATERIALS AND METHODS: We conducted a clinico-investigational study in 50 patients of periorbital pigmentation. A detailed clinical history was recorded, clinical examination and laboratory investigation including complete blood count, vitamin B12 level, and thyroid profile are done. RESULTS: The mean age of the patients presenting with periorbital hyperpigmentation was 29.5 years, out of 50 patients 42 (84%) were females and 8 (16%) were males. About 14% patients give positive family history of POH, history of atopy was positive in 30% of patients. History of various other habits like lack of adequate sleep, prolonged exposure to computers, rubbing eyes, and application of various cosmetics were also found to be positive in these patients. The other associated clinical findings were freckles (12%), telengectesia (2%), erythema (2%), and melasma (2%). In maximum (90%) number of patients, both upper and lower eyelids were involved and pigmentation involving >1 cm of eyelid margin was seen in 62% of patients. Laboratory investigations showed anemia in 10% of patients and low serum vitamin B12 in 12%; however, none of the patients has deranged thyroid profile. CONCLUSION: POH has a multifactorial etiology and role of correcting various faulty habits is important factor in its management. Presence of anemia and low serum vitamin B12 levels also points toward need of detailed laboratory evaluation in these patients.

Efficacy of microneedling with 70% glycolic acid peel vs microneedling alone in treatment of atrophic acne scars-A randomized controlled trial.

BACKGROUND: Microneedling with dermaroller and glycolic acid peels is commonly used for treatment of acne scars. OBJECTIVE: To compare efficacy of microneedling alone versus combination of microneedling with serial 70% glycolic acid peel in management of atrophic acne scars. METHODS & MATERIALS: Sixty patients with atrophic acne scars were randomized into group 1 receiving microneedling at 0, 6, and 12 weeks and group 2 receiving microneedling at 0, 6, and 12 weeks along with 70% glycolic acid peel at 3, 9, and 15 weeks. Acne scar scoring was performed by a blinded observer using ECCA (Echelle d'evaluation clinique des cicatrices d'acne) scoring at baseline and after 22 weeks. Additionally, patients were asked to grade the improvement in acne scars and skin texture on visual analogue scale (VAS). RESULTS: Of 60 patients, 52 completed the 22-week study period. The decrement from baseline in mean ECCA score was more in group 2 as compared to group 1 (39.65±2.50 vs 29.58±0.18; P<.001). Group 2 also showed more improvement in skin texture as compared to group 1 on VAS. CONCLUSION: Addition of sequential 70% glycolic acid peel to microneedling gives better scar improvement as compared to microneedling alone. In addition to this, it also improves skin texture.

Patch Testing in Patients with Suspected Footwear Dermatitis: A Retrospective Study.

BACKGROUND: Footwear dermatitis represents a common but often undiagnosed or misdiagnosed condition. Patch testing aids in its confirmation and identification of the offending allergen. AIMS: This study aimed to find the frequency of positive patch test reactions in cases with suspected allergic contact dermatitis (ACD) to footwear, as well as the common responsible allergens. MATERIALS AND METHODS: This is a retrospective record based study of 37 patients, with suspected ACD to footwear, who underwent patch testing with Indian standard series and Indian footwear series from July 2012 to July 2015. RESULTS: The majority of patients (45.94%) belonged to the age group of 20-40 years. Dorsal aspects of feet (81.08%) and soles (18.92%) were the common sites involved. Patch test was positive in 18.92% patients. The most common causative allergens were hydroquinone monobenzylether (8.11%) and 4-aminoazobenzene (5.41%). CONCLUSION: Common chemicals implicated in ACD were rubber, rubber additives, and dyes. The principal culprit allergens were hydroquinone monobenzylether and 4-aminoazobenzene.

Isolated cutaneous involvement in a child with nodal anaplastic large cell lymphoma.

Non-Hodgkin lymphoma is a common childhood T-cell and B-cell neoplasm that originates primarily from lymphoid tissue. Cutaneous involvement can be in the form of a primary extranodal lymphoma, or secondary to metastasis from a non-cutaneous location. The latter is uncommon, and isolated cutaneous involvement is rarely reported. We report a case of isolated secondary cutaneous involvement from nodal anaplastic large cell lymphoma (CD30 + and ALK +) in a 7-year-old boy who was on chemotherapy. This case is reported for its unusual clinical presentation as an acute febrile, generalized papulonodular eruption that mimicked deep fungal infection, with the absence of other foci of systemic metastasis.

Violaceous Maculopapular Rash in a Newborn: Congenital Rubella Syndrome.

Congenital rubella syndrome involves a configuration of systemic and cutaneous manifestations in a neonate due to in utero infection caused by the rubella virus. The case of a preterm neonate with blueberry muffin lesions and classical as well as rare systemic features of congenital rubella syndrome is reported.

Nevus Comedonicus Syndrome.

A case of nevus comedonicus syndrome with atypical cutaneous presentation (widespread involvement without any particular pattern, midline lesions involving lower abdomen and involvement of bilateral pinna), and some unusual skeletal (adduction deformity involving bilateral metatarsal along with medial deviation at the level of tarsometatarsal joint), central nervous system (agenesis of corpus callosum with a interhemispheric cyst), visceral (pancreatic cyst) and neurological manifestations have been illustrated.