Hyperkeratotic lesions on the palms and soles are one of the most frequent clinical presentations encountered in dermatological practice, with a myriad of underlying etiologies that closely resemble one another and are clinically indistinguishable. Histopathological examination is the tool used by dermatologists to arrive at a final diagnosis, but it is invasive and not feasible under all circumstances. Dermoscopy is a new age, increasingly popular, noninvasive diagnostic technique of great value that is used to diagnose underlying etiology by acting as a bridge between clinical and histopathological pictures. This study aimed to evaluate the various etiologies underlying palmoplantar hyperkeratosis and the role of dermoscopy in the diagnosis of each disease along with its ability to delineate a close differential diagnosis and ensure appropriate treatment. Materials and methodsThis was a hospital-based observational cross-sectional study conducted from July 1 to December 31, 2022. Consenting patients with hyperkeratotic palmoplantar lesions on clinical examination attending the dermatology outpatient department at our tertiary care hospital were included after institutional ethical clearance was obtained. Patients with HIV, hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) infection, or a history of hyperkeratotic lesions since birth, i.e., inherited palmoplantar keratodermas, were excluded from the study. A total of 60 patients aged between 18 and 60 years who met the above criteria were included. A complete history was taken; a thorough examination was performed. Routine investigations and tissue histology were done. Potassium hydroxide (KOH) mount and patch testing were done as and when required. Dermoscopy with DermLite DL4 was performed in all cases on lesional areas, and the findings were noted.

Introduction: Practically all physicians encounter a diverse range of suspected cutaneous adverse drug reactions (CADRs) in their daily clinical practice. The skin and mucosa are the most often encountered areas for the early presentation of numerous adverse drug reactions. Cutaneous adverse drug reactions are classified as benign or severe. The clinical manifestations of drug eruptions can range from mild maculopapular exanthema to severe cutaneous adverse drug reactions (SCARs).Objective: To determine the varied clinical and morphological presentations of CADRs and to identify the culprit drug and common drugs causing CADRs.Materials and methods: Patients with clinical features suspected of CADRs presenting to the outpatient department (OPD) of dermatology, venereology, and leprosy (DVL) between December 2021 to November 2022 at Great Eastern Medical School and Hospital (GEMS), Srikakulam, Andhra Pradesh, India, were considered for the study. This was a cross-sectional, observational study. The patient's clinical history was taken in detail. This included chief complaints (symptoms, site of onset, duration, drug history, latency time between drug administration and the appearance of cutaneous lesions), family history, associated diseases, the morphology of lesions, and mucosal examination. Upon drug discontinuation, improvement in cutaneous lesions and systemic features were noted. A complete general examination, systemic examination, dermatological tests, and mucosal examination were performed.Results: A total of 102 patients were involved in the study, of whom 55 were males and 47 were females. The male-to-female ratio was 1.17:1, with a slight male majority. The most common age group was 31 to 40 years for both males and females. Itching was the predominant complaint in 56 patients (54.9%). The mean latency period was shortest in urticaria (2.13+/-0.99 hours) and longest in lichenoid drug eruption (4.33+/-3.93 months). Most patients developed symptoms after a week of taking the drug (53.92%). A history of similar complaints was present in 38.23% of patients. Analgesics and antipyretics (39.2%) were the most common culprit drugs followed by antimicrobials (29.4%). Among analgesics and antipyretics, aceclofenac (24.5%) was the commonest culprit drug. Benign CADRs were observed in 89 patients (87.25%), and severe cutaneous adverse reactions (SCARs) were observed in 13 patients (12.74%). The common CADRs presented were drug-induced exanthem (27.4%). Imatinib-induced psoriasis vulgaris and lithium-induced scalp psoriasis were observed in one patient each. Severe cutaneous adverse reactions were observed in 13 patients (12.74%). Anticonvulsants, nonsteroidal anti-inflammatory drugs (NSAIDs), and antimicrobials were the culprit drugs for SCARs. Eosinophilia was present in three patients, deranged liver enzymes was present in nine patients, a deranged renal profile was present in seven patients, and death occurred in one patient with toxic epidermal necrolysis (TEN) of SCARs.Conclusion: Before prescribing any drug t...

Introduction: Psoriasis is known to be proliferative, relapsing inflammatory disorder affecting mainly skin and other parts of body. There are several co-morbidities associated with psoriasis, of which ocular findings go unnoticed. Aim: To study the spectrum of ocular manifestations in psoriasis patients in Srikakulam, north coastal region of Andhra Pradesh, India and also to identify relationship between frequency of ocular involvement in psoriasis patients with age, gender, type and severity of psoriasis. Materials and Methods: The present cross-sectional study was conducted from March 2019 to March 2021 at Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh, India. The study included 80 psoriasis patients attending dermatology Outpatient Department (OPD) to know various ophthalmological manifestations. Detailed dermatological examination was done followed by ophthalmological examination. Clinical types of psoriasis, site of involvement, and the severity of the disease using Psoriasis Area and Severity Index (PASI) were noted. Statistical analysis was done using Z-test, Pearson’s correlation coefficient and linear regression coefficient. Results: Out of 80 patients with psoriasis, 51 (63.75%) were males and 29 (36.25%) were females. Out of total 80 patients, 56 (70%) patients had ophthalmic manifestations. The mean age of presentation was noted to be 49.22±8.53 years with range from 18-76 years. Most of the patients i.e. 30 (54%) had bilateral manifestations in both the eyes. Nearly 10 (18%) of psoriasis patients had multiple ocular manifestations. The p-value was calculated based on PASI score and with ocular manifestations which was found to be 0.0485 and was statistically significant. Cconclusions: Regular screening of psoriasis patients is useful in identification of ocular problems which may not be noticed by the patients until symptomatic.

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages, presents with various cutaneous manifestations regardless of its aetiology. Patients of CKD disease on hemodialysis treatment which prolong the life expectancy and can also produce skin lesions. Skin changes described in patients with chronic renal disease are also found in patients with renal failure undergoing treatment with either peritoneal dialysis or hemodialysis. High percentage of patients receiving dialysis complains of pruritus that may be severe, in some instances the pruritus worsens with dialysis. The aims of the present study were to study the pattern of cutaneous lesions in patients with chronic kidney disease and to determine the incidence of skin manifestations specific to and associated with CKD.</p><p class="abstract"><strong>Methods:</strong> Hundred patients of CKD on MHD with cutaneous manifestations attending skin outpatient department, nephrology out-patient department, dialysis center and patients admitted in medical wards were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The common cutaneous manifestations were xerosis 91%, pallor 78% and pruritus 69%. Nail manifestations include onycholysis 37% and half and half nails 33%. Hair manifestations in 24% patients.</p><p class="abstract"><strong>Conclusions:</strong> Most common cutaneous manifestation was xerosis, followed by pallor. Most common nail manifestation was onyholysis.</p>

Background: Diabetes is the most common metabolic disorder with increased prevalence in developing countries like India. It affects almost all organs among which skin is affected by the acute metabolic derangments as well as by chronic degenerative complications. The aims were to study the pattern of cutaneous lesions in patients with diabetes mellitus and to determine the incidence of skin manifestations specific to and associated with diabetics. Methods: Hundred cases of diabetes mellitus with cutaneous manifestations attending skin outpatient department and other patients admitted in medical wards were included in the study. Results: The common skin disorders were cutaneous manifestations (67%), dermatosis more commonly associated with diabetes (36%), neuropathic and ischemic diabetic skin disease (11%). Conclusions: Most common cutaneous manifestation was cutaneous infections followed by dermatosis more commonly associated with diabetes. Among cutaneous infections fungal infections were more common followed by bacterial infections. Cutaneous infections were more common in patients with poor glycaemic control and the association was found to be statistically significant.