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Psoriasis is a complex disease that requires carefully designed therapy in order to achieve sustained remission. The disease can be effectively controlled by various therapeutic options, used alone or in combination. Phototherapy may be combined with topical or systemic agents to achieve higher clearance rates, longer disease free intervals and a lower carcinogenic risk. The combination of NB-UVB with calcipotriol increases the therapeutic efficacy of phototherapy as well as UVB reduces the irritation caused by calcipotriolThe chief purpose of this study was to compare the efficacy and safety of Narrow Band-UVB alone and in combination with topical calcipotriol in patients with psoriasis vulgaris.Patients with chronic plaque type psoriasis of 100 numbers involving less than 20% of body surface area were randomly allocated to any one of the following 2 groups. Group A- Narrow Band UVB phototherapy. & Group B- Narrow Band UVB with topical calcipotriol ointmentIn group A (NB-UVB), the mean baseline PASI score was 12.1 and the mean PASI score at the end of 12 weeks was 2.54. There was 79% reduction in PASI score at the end of 12 weeks. 31 patients showed good response and 13 patients showed more than 70% clearance.When NB-UVB group was compared with NB-UVB and calcipotriol combination group, there was a significant difference (p<0.05) in PASI scores at 4 weeks, 8 weeks and 12 weeks.Further studies with additional numbers of patients are essential to compare the efficacy and safety of Narrow Band-UVB alone as well as in combination with topical calcipotriol in patients with psoriasis vulgaris

Background: Female Pattern Hair Loss [FPHL] is the most common cause of diffuse hair loss in women. It is a result of altered hair follicle cycling and miniaturization, which leads to the transformation of terminal to villous hair follicles and the production of shorter finer hair shafts. The pathophysiology of FPHL is not well understood and it is likely to be a multifactorial genetic trait. Unlike in men, an androgen-dependent nature has not been proven in FPHL. Serum levels of vitamin D and Ferritin are factors recently considered in approaching patients with hair loss complaints. Methods: A case control study with 30 FPHL cases and equal number of healthy controls was conducted among female patients between 17 and 50 years of age. Serum levels of 25 hydroxy vitamin D and Ferritin were measured and compared with the stage of the disease and other parameters. Results:The serum ferritin values of the FPHL cases [17.02 +/-16.07 ng/ml] were significantly lower than that of the controls [49.40 +/-27ng/ml; p=0.001]. The serum 25 hydroxy vitamin D level in FPHL cases [15.98 +/-7.33 ng/ml] were also significantly lower than that of controls [32.89 +/-20.63ng/ml; p=0.001]. While comparing the serum ferritin with Ludwig's grading, a statistically significant difference between the grades of the disease was found with the lowest value in stage 1 disease. No statistically significant difference was found when grade of disease was compared with vitamin D status, although vitamin D status decreased with severity of the disease. Conclusions: The levels of serum 25 hydroxy vitamin d and serum ferritin are decreased in patients with female pattern hair loss and the altered levels of these could be a risk factor for the development of the disease.

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Obesity is a chronic disease that is increasing worldwide, both amongst adults and children. As per family health survey conducted by Ministry of Health and Family Welfare in 2022, 38% women and 36.5% of men in Kerala are overweight or obese. It can affect almost all organs, including the skin. Obesity among children is increasing in India with an overall prevalence of 8-10% (15-20% in urban population). The cutaneous manifestations can be associated both with the age of onset and duration of obesity. However, studies showing association with class of obesity and cutaneous manifestations are lacking and hence we undertook this study, to know the association in children attending a tertiary care center. This was a prospective study carried out over a period of 6 months from May 2021 to November 2021 in our centre. A total of 133 children, aged 6–16 years with BMI >25 kg/ m2 were included in the study. After taking informed consent from the parents/attendants; demographic details, height and weight were recorded and systemic examination was done. A detailed cutaneous examination was performed, and all the findings were noted in a predesigned proforma. Relevant investigations were carried out, wherever deemed necessary. A total of 133 children (male/female 63.9%/ 36.1%) were included in the study with a mean age of 10.97 ± 2.72. The mean BMI of the patients was 28.43 ± 3 kg/ m. Majority of the patients (78.9%) were overweight; 17.3% had Class I obesity, 3% had Class II obesity and 0.8% had Class III obesity. The most common cutaneous changes observed in our patient group were acanthosis (62.4%), seborrheic dermatitis (47.4%), sebomelanosis (37.6%), frictional dermatitis (29.3%), striae distensae (24.8%), tinea cruris (24.8%), SD-seborrheic dermatitis(18.1%), plantar hyperkeratosis (10.5%) and achrochordon (3.8%). The incidence of acanthosis nigricans, striae, sebomelanosis, frictional dermatitis, seborrheic dermatitis, verruca, keratosis pilaris and acne were higher in children with Class II obesity while acanthosis, striae, acne, and hirsutism was more common in Class III obesity.As the prevalence of obesity is increasing among the children, the paediatricians and dermatologists should be aware of its various manifestations including the cutaneous ones to ensure their early diagnoses and treatment, which are as common as in adults, and can be a source of great physical or psychological morbidity.