<p class="abstract"><strong>Background:</strong> Non healing ulcers have a worldwide prevalence of 1.9%-13.1% with lower extremity being the commonest site. They are difficult to manage for the physician and frustrating for the patient due longer duration of treatment, cost, unsatisfactory outcomes and impairment caused due to them. Standard conventional management may fail at times and hence growth factors derived from platelets have been tried in the management of these ulcers. The purpose of our study was to evaluate the efficacy of platelet rich fibrin matrix (PRFM) in treatment of these ulcers.</p><p class="abstract"><strong>Methods:</strong> Twelve patients with fifteen non-healing ulcers more than 3 months duration were included in the study. 10cc of venous blood was withdrawn in plain tube without anti-coagulants and centrifuged at 1500 rpm for 14 minutes as early as possible as per advanced PRF protocol. Middle layer of PRFM was applied to the clean ulcer followed by a secondary dressing. All patients received PRFM sittings every 7-10 days or till ulcer healed. Baseline photographs and measurements of length, breadth and depth were taken to calculate the area of ulcer at every sitting.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average percentage reduction in area and volume of the ulcer was 95.84% and 98.18% respectively at the end of six sittings. Twelve out of fifteen ulcers showed complete healing by 6 weeks, while three ulcers showed significant improvement but did not heal completely. The procedure was safe, well tolerated without any side effects.</p><p class="abstract"><strong>Conclusions:</strong> Platelet rich fibrin matrix is a novel modality and an ideal, safe, affordable therapeutic option for non-healing wounds of varied causes.</p>

Context: Enzyme-linked immunosorbent assay (ELISA) for BP 180 and 230 antibodies is commonly done in patients with bullous pemphigoid. We could not find much data regarding the usefulness of this test to predict the disease severity in Indian population. Aims: We studied the correlation of IgG anti BP180 and anti BP230 antibody titer with disease severity and clinical features in bullous pemphigoid. Settings and Design: This cross-sectional study was conducted at a tertiary care center in western India. Materials and Methods: Forty-two clinically diagnosed treatment-naive cases of bullous pemphigoid were enrolled and investigated with skin punch biopsy, IgG anti BP180, and anti BP230 ELISA, direct immunofluorescence, and indirect immunofluorescence tests. Disease severity was assessed by calculating modified Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) score. Thirty patients with a final diagnosis of bullous pemphigoid were included in the statistical analysis. Pearson's correlation coefficient (r) was used to study correlation. Results: The mean ABSIS skin score was 32.81 when both tests were negative, 42.13 when only BP230 was positive, 76.28 when only BP180 was positive, and 78.16 when both were positive. Pearson's correlation coefficient (r) for BP180 and ABSIS skin score was 0.6 (P value: 0.0005), and for BP230 was -0.055 (P value: 0.600). Conclusions: BP antibody titers correlate partially with disease severity. Anti-BP180 antibody is associated with more severe disease. Anti-BP230 antibody titer does not correlate with disease severity.

Linear and unilateral basaloid follicular hamartoma (BFH) is a rare disease that manifests with papules and plaques with distribution along lines of Blaschko. It runs a benign course but with the risk of basal cell carcinoma (BCC) in long term course. BCC can be differentiated from BFH with histopathology and immunohistochemistry. Dermoscopic features of BCC are well studied. Dermoscopic features of BFH are not yet described in literature in detail probably due to rarity of the disease. Here, we present a case of extensive linear and unilateral BFH with its clinicohistopathological and dermoscopic features. The lesions were extensive to involve scalp, face, neck, upper, and lower trunk. Dermoscopy revealed features similar to that of BCC including brown-grey globules and dots, in focus dots, brown linear and arciform structures, crown vessels, short fine telangiectasias, spoke wheel like structures without central dark point, white structureless areas with telangiectasias and keratotic plug. Other dermoscopic features of BCC like arborizing vessels, blue-grey ovoid nests, maple leaf-like areas, concentric structures, ulcerations, erosions and white streaks were absent in this case.

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Background: Crusted scabies results from a failure of the host immune response to control the proliferation of the scabies mite in the skin, with resulting hyperinfestation and a concomitant inflammatory and hyper-keratotic reaction. However, it has also been recognised in people with no evident immunological deficit. Case history:We present a case report of apparently immunocompetent 16-year-old female presenting with multiple hyperkeratotic vegetating plaques over limbs, excoriated papules over trunk with minimal itching since 2 years without any positive family history. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites and eggs. Histopathology showed hyperkeratosis with multiple mites in stratum corneum. Numerous mites were seen on biopsy of lesion. X-ray showed osteolysis of distal phalanges secondary to chronic pressure. Repeated topical treatments with permethrin and oral ivermectin led to the considerable resolution of her lesions. Conclusion:We present a rare case of crusted scabies with osteolysis in an immunocompetent female.