Cleansing trends promise freshness, sensory and health benefits but may also be accompanied by an increase in soap-induced skin irritation. The aim of this study was to evaluate the irritant effect of 31 cleansers (28 bar soaps and 3 liquid cleansers) available in the Indian market. Eight percent w/v solutions of the soaps/cleansers were made and 30 microL of each of the solutions were applied to Finn chambers and occluded for 24 h along with distilled water (negative control) and 20% sodium dodecyl sulphate (SDS) as positive control. The sites were graded for erythema and scaling 30 min after removing the patches. The pH of each of the soap solutions was determined. Mean with SD and ANOVA (F-value) was computed separately for each soap/cleanser with respect to the two parameters, erythema and scaling. The total of the means for both the parameters, erythema and scaling was also computed. The cleansers were listed based on this total from the least irritant to the most irritant. The differences between soaps (F-value) was significant for erythema and scaling [erythema = 4.106 (P = 0.000); scaling = 6.006 (P = 0.000)]. Cetaphil cleansing lotion had the lowest erythema score of 0.25. Lowest scaling score of zero was recorded for Cetaphil cleansing lotion and Elovera moisturizing body wash. Aquasoft and Lifebuoy soaps had the highest erythema score of 2.13. Acnex had the highest scaling score of 1.75; Aquasoft, Hamam scrub bath soap and Naturepower sandal soaps were the next with a scaling score of 1.63. Cetaphil cleansing lotion, Aquaderm liquid soap, Dove bar soap and Elovera moisturizing body wash proved to be the least irritant cleansers with a total score of less than 1. The four most irritant soaps/cleansers had an average score of 3.65. The irritant potential of the majority of the cleansers fell between these extremes. The pH of all the soap/cleanser solutions was neutral to alkaline (pH 7-9) except that of Dove bar, Cetaphil cleansing lotion, Aquaderm liquid soap and Elovera moisturizing body wash which tested acidic (pH 5-6). The pH of the positive control--20% SDS, was acidic (pH 6). The difference in the irritancy potential between soaps/cleansers as determined by the 24-h patch test was significant. There were individual variations in the irritant potential of the soaps/cleansers in the volunteers, thus when the patient queries on what soap to use, it may be advisable to test each patient separately and educate him/her regarding the soaps/cleansers less likely to cause irritation. The limitations of the study was that it was single blind and non-randomized as all the 14 soap solutions were applied on 15 volunteers in the first panel and subsequently all the 17 soap solutions were applied on eight volunteers in the second panel. However, we could compare the irritant potential of 31 cleansers. The results of 24-h patch testing of 31 soaps/cleansers in the Indian market in two panels of 14 and 17 soaps/cleansers on 15 and eight volunteers, respectively, are presented.

BACKGROUNDDermoscope is non-invasive diagnostic tool, which allows rapid and magnified in-vivo observation of the skin and helps in visualization of morphologic features invisible to naked eye. Dermoscopy is useful in evaluating pigmented lesions, but it can also be used in evaluating the inflammatory skin disorders but little is currently known about their dermoscopic features. Dermoscopy of Psoriasis shows red globules, red lines, red dots, glomeruli-like vessels and light red background. Dermoscopy of Lichen planus shows Wickham's striae, central yellow brown area, grey blue dots, comedo-like opening, corn pearls. AIMSTo determine and compare dermoscopic patterns of Psoriasis and Lichen Planus and correlate the dermatoscopic images with histopathology of Psoriasis and Lichen planus in clinically difficult cases and compare the findings seen in our study with previous studies. MATERIALS AND METHODSA cross-sectional comparative study, during course of 2 years, total of 80 cases in which 40 patients each of Psoriasis and Lichen planus were included. Digital dermoscopic images of lesions were obtained with Hanse microscope, after lesions were covered with olive oil. All dermoscopic findings of both psoriasis and lichen planus were observed, captured and data was analysed statistically. In clinically difficult and atypical cases, histopathology was done and correlated with dermoscopy. STATISTICAL ANALYSISFor all the statistical analysis SPSS statistical software, version 17.0 for windows (SPSS Inc. Chicago, IL, USA) was used. ChiSquare (χ 2 ) test was done for statistical significance. In all instances, a "p" value of 0.05 was considered significant. Charts were prepared with Microsoft Excel 2010 version. RESULTSOn dermoscopy there is statistical significance at 5% confidence interval of red globules (p=0.001, χ 2 =37.143), Wickham's striae (p=0.001, χ 2 =34.286), grey blue dots (p=0.000, χ 2 =13.067) and glomeruli like vessels (p=0.003, χ 2 =8.538) in comparison between psoriasis and lichen planus. Dermoscopic findings of psoriasis were predominantly vascular while those of lichen planus were predominantly non-vascular. CONCLUSIONClinical use of dermoscopy in inflammatory dermatosis improves diagnostic ability and improves fundamental aspects of daily practice such as improvement of morphologic knowledge for visual tele-dermatology and in addition plays a psychological placebo effect on patients suffering from common inflammatory dermatosis.

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