<p class="abstract"><strong>Background:</strong> Keloid is a common presentation in clinical practice. Symptoms due to keloid are mild, but disfigurement and functional impairment can be severe. It is difficult to treat. Intralesional, injection triamcinolone acetonide, has limited efficacy, causes adverse effects such as local dermal atrophy, telengiectasia and hypopigmentation. Injection verapamil is reported to have similar efficacy, but lesser side effects, and is cheaper. Aim was to study efficacy and adverse effects of intralesional verapamil in treatment of keloid.</p><p class="abstract"><strong>Methods:</strong> An open label study on 25 patients of keloid, either gender, age 11 to 55 years at a medical college hospital. Injection verapamil 2.5 mg/ml was administered intralesionally, at an interval of 3 weeks, for a total of 6 sittings, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement. The statistical analysis was done using SPSS version 21.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Median duration of keloids was 8 months. The mean VSS score before treatment was 7.68 which reduced to 4.28 after treatment. Mean percentage change in VSS score was 46.21%, very highly significant (p&lt;0.001). Physician’s assessment was ‘very good’ in 32.0% and 'excellent' in 8.0%. The complaint of post-procedure pain was present in almost all.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional injection verapamil, gives very good to excellent improvement in 40% of patients of keloid. Post injection pain persists for more than 24 hours. Drug does not cause local dermal atrophy or hypopigmentation.</p>

<p class="abstract"><strong>Background:</strong> Uncontrolled use and abuse of topical steroids has led to increase in number of cases of superficial dermatophytosis of skin, hair and nail in pediatric age group as well. Our study aimed to analyse epidemiological and microbiological profile of steroid modified tinea (SMT) in pediatric age group.</p><p class="abstract"><strong>Methods:</strong> Clinically diagnosed tinea childhood patients with history of usage of topical steroids in children were included in our study. Detailed history was taken and clinical examination along with KOH mount and culture was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> 112 patients were clinically diagnosed as tinea out of which 61cases gave the history of topical steroids and were included in our study. Most common age group was 12-18 years with female:male of ratio approximately 3:1 and disseminated and atypical form was the most common variety. KOH mount was positive in 73.2% cases and culture was positive in 69.6% cases. Most common species found out to be <em>Tinea mentagrophytes</em> followed by <em>Tinea rubrum</em>. Among non-dermatophyte group, <em>Candida</em> was the commonest.</p><p class="abstract"><strong>Conclusions:</strong> There is rise in incidence of dermatophytosis, especially steroid modified, atypical and disseminated.</p>

Nicolau syndrome (NS) is a rare complication characterized by tissue necrosis that occurs after parenteral injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery, acute vasospasm and cytotoxic effects of the drug. Severe pain in the immediate post injection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Herein, we present a rare case of NS due to Diclofenac Sodium (Voltaren®) injection in an 80-year-old female suffering from Lower Respiratory Tract Infection (LRTI) who was managed conservatively. Keywords: Nicolau Syndrome, Embolia cutis medicamentosa, Voltaren, Diclofenac sodium

<p class="abstract"><strong>Background:</strong> Cutaneous manifestations are common in elderly. The elderly population is composed of persons over 60 years of age and very few studies are available on the dermatologic diseases in this group. This study was done to study the clinical pattern and frequency of cutaneous manifestations in the elderly.</p><p class="abstract"><strong>Methods:</strong> A cross sectional observational study was conducted on 540 patients, aged 60 years and above, who attended the out-patient department and admitted as inpatients having cutaneous manifestations were included, in the department of dermatology Era’s Lucknow Medical College And Hospital, Lucknow.  A detailed history was taken regarding the onset and duration of cutaneous manifestations. Thorough dermatological examination was carried out on all study patients. Relevant investigations which included haemogram, biochemical tests and a skin biopsy were performed, wherever needed. Skin changes in all the patients were recorded and were classified into physiological and pathological changes. Data were entered in an Excel sheet and were analyzed using descriptive statistics.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 540 patients studied, 55.7% were males and 44.3% were females. Pruritus was the single most common complaint elicited (90.6%). Among the physiological changes, wrinkling was the commonest (80.9%). Among the pathological changes skin tumours, eczemas, infections were the common findings.</p><p class="abstract"><strong>Conclusions:</strong> The geriatric dermatoses are different in different populations, as there is significant number of geriatric population, the increased emphasis on geriatric medicine is   inevitable.  This    present study helps in providing greater understanding of pattern of geriatric dermatoses that aids in early diagnosis and management.</p>

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