Trichostasis spinulosa misdiagnosed as alopecia areata.

A Brief Synopsis on Scalp Melanoma

Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however, the early-stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries to comprehensively highlight the various diagnostic, therapeutic, and outcome aspects of scalp melanomas. The literature research includes peer-reviewed articles (clinical trials or scientific revie…

Learning from history: Coronavirus outbreaks in the past

Interleukin 23p19 inhibitors in chronic plaque psoriasis with focus on mirikizumab: A narrative review.

Psoriasis, a T-cell mediated chronic dermatosis, has a complex etiopathogenesis. There has been extensive research into the aberrant immune response, which leads to the formation of clinical lesions, and the need for developing better and safer drugs has been unrelenting. The past two decades of research has opened up new areas of the immune pathway that can be targeted in order to control the disease. Therefore, we have seen the emergence of biologics which either target T-cell receptors or inhibit Tumor Necrosis Factor-alpha (TNF-α) or inhibit interleukins (IL) like IL-12, IL-17, IL-17 receptor, and more recently IL-23. Drugs specifically targeting the p19 subunit of IL-23 have shown prom…

Therapeutic options in vitiligo with special emphasis on immunomodulators: A comprehensive update with review of literature

Vitiligo is a relatively common disorder characterized by areas of depigmented skin. It may be associated with social stigma and adversely affects the quality of life. Although many treatment options are available, none is curable. The search continues for an effective therapeutic option. New targeted options include biologics and other immunomodulatory agents, with varying degrees of evidence. We have discussed briefly the therapeutic options with special emphasis on the newer immunomodulatory agents. We undertook a comprehensive English literature search across multiple databases such as PubMed, SCOPUS, EMBASE, MEDLINE, and Cochrane using keywords (alone and in combination) and MeSH items…

Update in minimally invasive periorbital rejuvenation with a focus on platelet-rich plasma: A narrative review.

Background The periorbital region is among the first areas to be affected by the process of aging, which is influenced by genetic and constitutional factors. As the region plays an important role in overall facial appearance, rejuvenation of the area has immense cosmetic benefit and various treatment modalities have been used to achieve the same. Aims This article reviews commonly used non-surgical and minimally invasive modalities for periorbital rejuvenation. Methods The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles.…

Safety of the current drug treatments for vitiligo

Introduction: Vitiligo is an acquired depigmenting skin disorder adversely affecting the patient's quality of life. Despite the presence of several treatment modalities, ranging from medical to physical to surgical options, none is curative. Each modality has its own drawbacks and side effects. Thus, the treatment modality needs to be tailored for each individual patient taking into consideration the disease characteristics and also its efficacy and safety to obtain a favorable risk-benefit ratio.Areas covered: This review highlights the different treatment modalities utilized in vitiligo up until 4 November 2019 along with their adverse effects and contraindications, if any.Expert opinion:…

Allergic contact dermatitis in patients with frontal fibrosing alopecia: An international multi‐center study

Frontal fibrosing alopecia (FFA) mainly affects the anterior hairline and eyebrows and its etiology and associated factors remain obscure. The aim of this study was to evaluate the allergic contact dermatitis with patch test in patients with FFA. In this prospective study, 20 patients with FFA and 24 age and sex-matched healthy individuals were evaluated with patch testing. Diagnosis was made histologically, clinically and based on dermoscopic findings. Demographic data, age of onset, disease duration and FFA severity index are evaluated in all patients. Positive patch test reaction to one or more allergen was observed in 65% of patients while it was 37.5% in control group (P = .003). There…

Cutaneous and Allergic reactions due to COVID‐19 vaccinations: A review

ABSTRACT Introduction The pandemic caused by the novel coronavirus disease 2019 (COVID‐19) has had an unprecedented impact on the overall health and the global economy. Vaccination is currently the most dependable strategy to end the pandemic, despite the slower‐than‐hoped‐for rollout, particularly for low‐to‐middle‐income countries, and the uncertain duration of protection afforded by vaccination. The spike protein of the virus (immunodominant antigen of the virus) is the main target of the approved and candidate SARS‐CoV‐2 vaccines. This protein binds to the ACE2 receptor of the host cell, initiating the entry of the virus into the cell and the chain of subsequent events ending to Acute R…

Penile burn due to sulfuric acid: A case report

Low dose of isotretinoin: A comprehensive review

Isotretinoin is a first-generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti-inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date-unlimited PubMed search, from inception till December 2019, using the following search terms: "low-dose isotretinoin" and "dermatology," "isotretinoin and safety," "isotretinoin, off-label uses," "isotretinoin and male fertility," "isotretinoin, iPLEDGE system," aiming to deliver a therapeutic …

Postherpetic neuralgia and recalcitrant cystic lesions following herpes zoster: A case report and review of treatment options.

Acute herpes zoster lesions in most cases are self-limited except in older and immunocompromised patients, wherein the pain can cause significant suffering. Postherpetic neuralgia is a painful situation for patients that can compromise the quality of life. Here, we report a 30-year-old healthy young man who developed treatment-resistant postherpetic neuralgia after herpes zoster (fourth/fifth thoracic segment) without any underlying immunocompromised state. He also developed some cystic lesions, which were removed by aspiration and surgery. The skin lesions improved 2 weeks after the surgery and postherpetic neuralgia was completely cured after 5 months, however cystic lesions recurred mult…

STAT3 ‐mutated hyperimmunoglobulin E syndrome with perianal skin tags and erosions: A case report

Pharmaceutical promotion and guided-prescription in low- and middle-income countries: A need for new regulations.

5‐Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety

Androgenetic alopecia (AGA) is a multifactorial disease that carries a significant psychological burden with it. Dihydrotestosterone, the main pathogenic androgen in AGA, is produced by conversion of testosterone, which is catalyzed by the 5-alpha reductase (5-AR) isoenzyme family. Finasteride and dutasteride are inhibitors of these enzymes. Finasteride, which is a single receptor 5-alpha reductase inhibitor (5-ARI), acts by blocking dihydrotestosterone (DHT). Dutasteride, a dual receptor DHT blocker, has a higher potency than its predecessor, finasteride. This review corroborates the evidence of superiority of dutasteride over finasteride, and its comparable safety profile concerning ferti…

Complications of botulinum toxin and fillers: A narrative review

Background Cosmetic surgery and esthetic procedures have become a billion dollar industry owing to the ever-growing demand of the population to stay young. The injectable treatments including fillers and botulinum toxin have become highly popular because of their quick, predictable and lasting results in the management of facial wrinkles and rejuvenation. Although these treatment modalities are relatively safe, they are associated with certain side effects. Aims In this review, we will focus on the complications of fillers and botulinum toxin. Patients/methods The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by se…

Review of biologics in allergic contact dermatitis

The resistant and recalcitrant nature of severe allergic contact dermatitis (ACD) makes its management challenging. With advances in the understanding of the cellular and molecular pathogenesis of ACD, newer therapeutic targets are becoming apparent. In particular, the use of biologics has gained momentum, given the specificity of their action. This article aims to review the presently available data on the use of biologics in ACD. English-language-based literature available on the use of biological therapy was thoroughly probed in the following databases as on October 14, 2019: PubMed, Google Scholar, The Cochrane library, Embase, Scopus, and EBSCO. The following keywords were used: "conta…

Solidarity and transparency against the COVID ‐19 pandemic

Uncommon presentation of pigmented paraungual basal cell carcinoma on the first toe treated with total excision

Basal cell carcinomas (BCCs) are the most common types of skin neoplasm. The finger, toe, and nail unit are uncommon and rare locations of BCC. Only a few patients with foot BCC have been reported, and ungual BCC is even less frequent. We present a patient with a BCC on the left first toe. Clinically, it appeared as a brown-colored plaque with an irregular border on the nail fold and dorsum of the left thumb. Histopathological findings were consistent with the pigmented type of BCC. Surgical approach with subsequent full thickness mesh graft led to a complete remission. Follow-up at 10 months revealed a functionally and cosmetically acceptable outcome. The clinical presentation of nail unit…

Selective RAR agonists for acne vulgaris: A narrative review.

Background Acne vulgaris is a chronic disfiguring inflammatory disease of adolescents and adults affecting up to 90% of the population around the world. The sequence of etiopathogenesis in acne is not completely understood but involves abnormalities in sebum production, follicular plugging, proliferation of propionibacterium acnes, and chronic inflammation. Aims This review aims to summarize the features of the topical selective RAR agonists in treating acne vulgaris with a special emphasis on the 4th generation topical retinoid trifarotene. Methods Studies were identified by searching electronic databases (MEDLINE and PubMed) till August 2019 and reference lists of respective articles. Onl…

Efficacy of 595- and 1319-nm pulsed dye laser in the treatment of acne vulgaris: a narrative review

Acne is one of the commonest problems of adolescence with almost half of the patients experiencing persistence into adulthood. Pulsed dye lasers (PDL) with wavelengths of 585 and 595 nm targeting hemoglobin have been used for the treatment of this condition and its sequelae. Recent introduction of PDL with a higher wavelength of 1319 nm has been reported to offer some benefit to acne patients. We reviewed the literature on the use of 595-nm and 1319-nm PDL in the management of acne. A PubMed literature search for search terms "pulsed dye laser," "acne laser therapy," "light therapy for acne," "595 nm and acne," "1319 nm and acne" was done. Studies, series and case reports were included. The…

COVID ‐19: A relationship to climate and environmental conditions?

Carboxytherapy in dermatology.

Abstract Carboxytherapy is a medical technique during which a sterile gas—carbon dioxide—is injected into the subdermal tissue. The utility of carbon dioxide injections has enhanced the practical relevance of carboxytherapy as a method for the management of multiple disorders. We have evaluated its use in the treatment of dermatologic conditions by searching electronic databases (ie, MEDLINE and PubMed) for contributions in the English language through January 2021. Carboxytherapy provides an attractive aesthetic option in skin rejuvenation, atrophic scars, striae distensae (stretch marks), cellulite-fibrolipodystrophy adhesions after liposuction, and certain types of alopecia. We discuss t…

A cross‐sectional, multi‐center study on treatment of facial acne scars with low‐energy double‐pass 1450‐nm diode laser

Acne scars are the ultimate outcome of acne vulgaris, a prevalent skin disorder affecting the pilo-sebaceous unit. Laser resurfacing has been demonstrated to be an efficient therapy option for acne scars. Hence, we adopted this concept and conducted a study to evaluate the safety and efficacy of low-energy double-pass 1450-nm diode laser on acne scars. This study was conducted on 48 patients with acne scars, treated at 4-week interval with low-energy double-pass 1450-nm diode laser. Patients were evaluated clinically and with photographs, at day 0, first month and third month post the final treatment and during follow-up visit. Five treatment sessions were completed by all patients. Approxi…

Priorities for global health community in COVID ‐19 pandemic

COVID-19 and economy.

Predatory journals: The silent intruder.

Emerging drugs for the treatment of vitiligo.

Introduction: Vitiligo is a relatively common autoimmune depigmenting disorder of the skin. There has been a great advance in understanding the pathological basis, which has led to the development and utilization of various new molecules in treating vitiligo. This review aims at a comprehensively describing the treatments available and the emerging treatment aspects and the scope for future developments.Areas covered: This study comprehensively summarizes the current concepts in the pathogenesis of vitiligo with special focus on the cytokine and signaling pathways, which are the targets for newer drugs. JAK kinase signaling pathways and the cytokines involved are the focus of vitiligo treat…

Psoriatic arthritis and COVID ‐19 pandemic: Consequences in medical treatment?

The COVID‐19 pandemic has a strong negative impact on human society world‐wide. Patients with immune‐mediated disease may be prone to an increased risk of infection and/ or more severe course. We review the available data for patients with psoriatic arthritis (PSA) and systemic treatments. Current treatment options are summarized. Based upon the experience with COVID‐19 the following problems are addressed: (a) Can systemic treatment reduce comorbidities of PsA that are also comorbidities for COVID‐19? Does systemic medical treatment pose an increased risk of infection with SARS‐CoV‐2? Does systemic drug therapy have an impact on the risk of pulmonary fibrosis ‐ a factor with strong negativ…

The COVID-19 outbreak and rheumatologic skin diseases.

Simvastatin in vitiligo: an update with recent review of the literature.

Patients with vitiligo often seek medical attention, as it diminishes their quality of life resulting in significant morbidity. Several topical and systemic therapies are in vogue targeting the immunological aspect of this disease, but results are often unsatisfactory, and complete cure remains elusive. Recently, simvastatin, a 3-hydroxy-3-methylyglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, is being evaluated for vitiligo management because of its multimodal action, easy availability, and low cost. The proposed multimodal actions range from anti-inflammatory, antioxidant, to immunomodulatory properties which may be of therapeutic benefit in vitiligo patients. The authors intend to eva…

Italian Euromelanoma Day Screening Campaign (2005-2007) and the planning of melanoma screening strategies.

Although no study has definitively shown that unfocused screening of skin cancer is effective, many campaigns have been organized with the aim of increasing awareness on melanoma risk factors. The objective of this study was to analyse the results of the Skin Cancer Screening Day in Italy during the period 2005-2007, to determine the priorities for melanoma control plans in a Mediterranean country. A total of 5002 patients were screened by dermatologists in 31 cities. Individuals who considered themselves to have many naevi and those with a family history of melanoma showed a higher number of common and atypical naevi. Ten melanomas, 20 basal cell carcinomas and two squamous cell carcinomas…

Alopecia areata and isotretinoin; coincidence or causal relation

Isotretinoin is a safe and useful medication for acne management. Adverse effects are mostly related to cutaneous and mucous membranes. We present a case of a 24-year-old female patient who was on treatment with isotretinoin for acne vulgaris Grade 4. After 6 months of treatment, the patient presented with localized patch of hair loss. Beginning of alopecia areata in patients with acne vulgaris could be regarded as a side effect of retinoids due to anti-acne therapy. The exact mechanism by which retinoids cause hair loss is not known.

COVID ‐19 in the pediatric population

Acanthosis nigricans: A review.

Background Acanthosis nigricans (AN) is a cutaneous disorder characterized by symmetric velvety hyperpigmented plaques on intertriginous areas like axilla, neck, inframammary, and groin. Aims To summarize the pathophysiology and classification of AN, provide an update of diagnostic testing strategies, and describe the current therapeutic options described so far in the literature for this disease. Methods A comprehensive english language literature search across multiple databases (PubMed, EMBASE, MEDLINE, and Cochrane) for keywords (alone and in combination) was performed. MeSH as well as non-MeSH terms such as "acanthosis nigricans," "classification," "pathophysiology," "diagnosis," "trea…