Background: Polycystic ovary syndrome (PCOS) is a multisystem metabolic disorder, which has a significant impact on the quality of life as well as fertility. 1,2 Acne, hirsutism, androgenetic alopecia, acanthosis nigricans, seborrhea are commonly associated with cutaneous manifestations of PCOS. To identify cutaneous manifestations, their incidence and frequency in patients with PCOS in different age groups. Methods: An institutional based prospective study. Seventy PCOS patients attending out-patient departments of DVL and Obstetrics and Gynaecology, NRI Medical College and General Hospital, Guntur, fulfilling the inclusion criteria were included in the study and examined for the presence of cutaneous manifestations in the two year study period between January 2017 and December 2018. Results: In the present study, 70 patients with PCOS were taken up and the commonest age group affected was 21-25 years (42.8%). Positive family history of PCOS was observed in 12.8%. The commonest cutaneous manifestation was acne vulgaris (57.14 %). Obesity was present in 47.14% of the patients and all of them were found to have striae. Hirsutism was observed in 47.14% of the total patients studied and the majority of them had terminal hair in the chin region and upper lip. Acanthosis nigricans was present in 34.28%, seborrhoea in 21.42% and acrochordons in 17.14% of the patients. Of the 70 patients, 15.7% were overweight and 47.14% were obesity. Conclusions: The cutaneous manifestations of PCOS reserves major role in its management by Dermatologist. Recognizing PCOS in women presenting with hyperandrogenism offers a significant opportunity to begin a life-long conversation about prevention and treatment of a condition that has a multi-system impact on affected women.

<p align="left">We describe two cases of low dose methotrexate (MTX) toxicity in patients with psoriasis. Patient was a 49-year-old male, known case of chronic plaque psoriasis from 10 years on and off. He was advised to take MTX 2.5 mg 2 days a week but patient took 2.5 mg twice daily (BD) for 6 continuous days following which he developed ulceration over psoriatic plaques and bone marrow suppression. MTX is safe and effective if adhered to standard treatment guidelines but inadverent use may lead to it’s toxicity.</p>

<p class="abstract">Plummer-Vinson syndrome is a rare clinical entity characterized by the triad of iron deficiency anemia, esophageal webs and dysphagia. The condition may manifest with the features like chelitis, glossitis, atropy of papilla over tongue, koilonychia indicating the underlying iron deficiency anemia and vitamin deficiency. We report a case of Plummer-Vinson syndrome presenting with koilonychia and chelitis. Clinical, laboratory and endoscopic evaluation of the patient revealed diagnosis of Plummer-Vinson syndrome. Patient was advised iron supplementation which significantly improved patient’s hemoglobin levels and with that the associated symptoms.</p>

Aplasia cutis congenita (ACC) is a rare condition in which there is congenital focal absence of skin with or without absence of underlying structures such as bone. Consanguinity may play a role. The cause of this condition is unclear and appears to be multifactorial; contributory factors may include teratogens, genes, trauma and compromised blood flow to the skin. Various expressions of Adams Oliver syndrome (AOS) have also been reported which is a rare autosomal dominant congenital disorder characterized by absence of skin and or underlying structure over scalp along with transverse limb defect. It was first described by Adam and Oliver in 1945.