Background: Vesiculobullous diseases have been the focus of intensive investigation in recent years. However, these disorders are still associated with substantial morbidity, considerable mortality and impaired quality of life. Accurate diagnosis of vesiculobullous lesions of skin entails evaluation of clinical, histopathologic and immunofluorescence findings.Methods: Hospital based prospective study for a period of 24 months from August 2014 to July 2016 in the Department of Pathology at Andhra Medical College, Visakhapatnam, India. Total of 50 patients aged 3-70 years with vesiculobullous lesions of both sexes attending the Department of Dermatology were selected and analysed clinically, histopathological examination and direct immunofluorescence (DIF).Results: In the present study, majority of patients presented between 51-60 yrs of age (32%) with male to female ratio of 1.08:1 and mean age of 46.02 years. Pemphigus vulgaris constituted the most common vesiculobullous disorder (32%) followed by bullous pemphigoid and pemphigus foliaceous, 18% each. Bullae were located intra epidermally in 68% and sub epidermally in 32% of the patients. DIF was positive in 80% of the cases. Overall clinicopathological correlation was established in 74%. Overall histopathological and direct immunofluorescence correlation was established in 78%. Out of 50 cases, 35 cases (70%) correlated clinically and histo-pathologically with direct immunofluorescence.Conclusions: In the present study, on histopathological examination alone pemphigus foliaceus and pemphigus vulgaris could be differentiated. Direct immunofluorescence was useful in differentiating epidermolysis bullosa acquisita from bullous pemphigoid which have similar histopathological picture. This study proves that direct immunofluorescence is confirmatory as well as diagnostic for vesiculobullous disorders.

Background: Androgenetic alopecia (AA) is one of the common cosmetic concerns. It affects more than 50% of adults. AA alopecia is a benign condition and it affects the psychology of patients. Microneedling (MN) – minimally invasive procedure. Minoxidil is an antihypertensive and causes vasodilation. Aims and Objectives: The present study was aimed to compare the efficacy of MN with minoxidil solution versus MN with hair multivitamin solution of male androgenetic alopecia. Materials and Methods: The study was conducted in the Department of Dermatology, Akash Institute of Medical Sciences and Research Centre, Devanahalli, Bengaluru, Karnataka, India. After following inclusion and exclusion criteria, 50 subjects were involved. Subjects were divided into two groups, 25 in each group. Group I, MN with dermaroller having needle length of 1.5 mm was done and minoxidil solution was applied over the scalp and the again MN was done. Group II, MN was done and hair multivitamin solution was used. MN was done for every 3 weeks and a total of nine sessions were done. From the last session, all the study subjects were followed for 6 months. Baseline investigations were done. Side effects such as pain, bruising, and folliculitis were recorded and monitored. Response of the patients to the treatment (hair growth) was assessed by physician global assessment scores. Visual analog scale score was done to assess the subjective improvement of the patients. Results: In this study, 50 male androgenetic alopecia patients were involved. In this, 21 (42%) were in the age group of 20–40 years and 29 (58%) were in the 41–60 years of age group. In Group I, excellent response was seen in 19 (76%), very good response in 4 (16%), good response in 2 (8%) patients, and none of the patients showed average response. In Group II, excellent response was seen in 10 (40%), very good response in 4 (16%), good response in 6 (24%) patients, and average response in 5 (20%). Following side effects were observed in the study subjects, pain in 6 (24%), bruising 4 (16%), and folliculitis 2 (8%). Conclusion: MN is safe and cost-effective procedure, which causes stimulation of hair follicles and improves hair growth.

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Hyper IgE Syndrome (HIES) is a rare multi system genetic immunodeficiency disorder, with immunological and non-immunological features. Immunolgical features are 1) Recurrent cutaneous abscesses, 2) Atopic dermatitis like lesions, 3) Sino pulmonary infections, 4) Elevated serum IgE levels and 5) Abnormal neutrophil chemotaxis. Non immunological features include cranio facial and skeletal abnormalities. We are reporting a girl with classical features of HIES with umbilical hernia with her younger brother suffering from right sided inguinal hernia, as both herniae are hitherto unreported in patients with HIES.