No abstract

BACKGROUND Acne scars cause significant psychosocial stress. Despite a wide armamentarium, there is a constant search for an effective modality. Autologous injectable platelet-rich fibrin (i-PRF) is a promising novel option in the management of atrophic scars. OBJECTIVE To compare efficacy of autologous i-PRF with microneedling against microneedling alone in atrophic acne scars. MATERIALS AND METHODS A split-face prospective interventional study was conducted on 40 patients with atrophic acne scars. Autologous i-PRF and normal saline were injected into each scar on right (study) and left (control) sides, respectively, followed by microneedling on both sides. Four sessions were performed at monthly intervals with follow-up at 2 months. For assessment, Goodman and Baron (GB) scale, physician subjective score, and patient satisfaction scores were used. RESULTS Mean baseline GB grade on each side was 3.45. At 24 weeks, mean GB grade was significantly reduced on the study side (1.47, SD 0.56) than control side (3.33, SD 0.53). Mean patient satisfaction score was significantly higher on the right side (5.95) compared with the left side (5.35). Rolling scars responded the best followed by boxcar and ice-pick scars. CONCLUSION Autologous i-PRF and microneedling act synergistically to improve acne scars.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It can be a great imitator with varied manifestations, which unless identified and treated appropriately in a timely manner can lead to significant disabilities and deformities associated with profound psychological and social stigma. Vasculitis-like lesions in leprosy are seen in type 2 lepra reactions (erythema nodosum leprosum [ENL]), Lucio phenomenon, and Lazarine leprosy. Here, we report a patient who presented with palpable purpura-like and lichenoid lesions. On extensive enquiry of his history with correlation of clinical features and histopathology, he was diagnosed as lepromatous leprosy (? relapse or? reinfection or? persistent infection) with ENL. He was started on hepatosafe regimen, in view of his deranged liver and renal function tests. This form of presentation is rarely reported in the literature.

Background: Sexually transmitted infections (STIs) constitute a major public health problem in both developed and developing countries. Human immunodeficiency virus (HIV) and STIs are linked in their similar mode of transmission, with STIs facilitating the acquisition and transmission of HIV. The prevalence pattern of individual STIs may evolve over time necessitating a corresponding change in management strategies. Objectives: The study was conducted to determine the burden and any change in the etiological trend among attendees of an STIs clinic at a tertiary care hospital. Methods: This retrospective study analyzed data retrieved from consecutive patients attending an STIs clinic over two years (July 2018 to July 2020). Results: Overall, 1916 patients were diagnosed with STIs. The predominant age group was 25 - 44 years (59.23%). Genital ulcer disease was the foremost syndrome (1213, 63.3%). Overall, herpetic genital ulcer was the most common (682, 35.6%), followed by non-herpetic ulcers (531, 27.7%). Vaginal discharge, lower abdominal pain, and urethritis were found in 461 (24%), 219 (11.43%), and 23 (1.27%) of the patients, respectively. Amongst 237 (12.36%) In HIV seropositive attendees, genital ulcer disease (herpetic) was the most common syndrome (179, 75.53%), followed by vaginal discharge (42, 17.72%), lower abdominal pain (9, 3.8%), and urethritis (7, 2.9%). Conclusions: A definite change in the profile of STIs was observed with ulcerative STIs (particularly herpes genitalis) constituting the major burden against a discernible back drop of decreasing non-herpetic STIs. A systematic, regional, periodic synopsis would not only help to follow and document the dynamic trends, but also can help to assess the effectiveness of control programs.

Background: Alopecia is one of the most common reasons for consulting dermatologists, and the clinical diagnosis can become confusing. In light of the inclination of patients and doctors toward non-invasive diagnosis, along with the vogue of non-invasive diagnostic modalities, trichoscopy has become a promising tool. Objectives: To study various dermoscopic patterns of alopecia. Methods: After obtaining informed consent, this cross-sectional study was conducted among 100 patients with alopecia attending a tertiary health care center. A detailed history and clinical photographs were taken. Relevant investigations were done whenever indicated. Dermoscopy was done using illuco IDS- 1100 with 10x magnification. Statistical analysis used: Data was analyzed using SPSS 22 version software. The chi-square test, Kolmogorov-Smirnov test, and Shapiro-Wilk test was used for assessment with a significant P-value of < 0.05. Kappa statistics were used to assess agreement between the two modalities. Results: Overall, vellus hair (65%) and yellow dots (65%) were the most common findings among all types of alopecia. The most common findings on trichoscopy in androgenetic alopecia were vellus hair (90.48%); in alopecia areata, vellus hair, and exclamation mark hair (86.67% each); in tinea capitis, corkscrew hair, and black dots; and in trichotillomania, splaying of hair. Discoid Lupus erythematosus had absent follicular opening, scaling, and perifollicular pigmentation. Clinical and dermoscopic diagnoses were significantly associated with a kappa agreement of 0.776 (i.e., substantial agreement). Out of 15 cases of difficult-to-diagnose alopecia, further investigations showed that dermoscopic diagnosis was accurate in 7 cases (46.67%). Conclusions: Trichoscopy is a reliable, non-invasive, and faster method of diagnosis in ambiguous cases of alopecia.