Management of psoriasis is a challenge to the treating physician. The chronic inflammatory state of psoriasis with exacerbations and remissions necessitate “on-and-off” treatment schedules. The safety profiles of drugs and tolerability issues for patients are important factors to be considered during treatment. Various biological agents targeting T-cells and the inflammatory cytokines are available for systemic treatment of psoriasis. However, major causes of concern while using these drugs are risk of susceptibility to infection and development of anti-drug antibodies, which will affect the pharmacokinetic properties, efficacy, and safety profile of the drug. Itolizumab, a humanized anti-CD6 monoclonal antibody, is a new molecule that acts by immunomodulating the CD6 molecule. CD6 is a co-stimulatory molecule required for optimal T-cell stimulation by the antigen-presenting cells. This step is crucial in T-cell proliferation to form Th1 and Th17 cells, which play a major role in the pathogenesis of psoriasis. This article deals with the properties of Itolizumab and its role in the treatment of psoriasis. Based on the available published data, Itolizumab seems to have a better adverse effects profile and at the same time comparatively less efficacy when compared to other biological agents available for treating psoriasis. Larger studies with longer duration are required to clearly depict the long-term side effects profile.

These 3D models can be reliably used for teaching/training and preoperative planning purposes.

Onychoscopy, being handy, inexpensive, and noninvasive, has the potential to reduce the invasive procedures. Statistically significant patterns in DLSO and total dystrophic onychomycosis (TDO) are described in our study. Few new patterns have been described whose significance has to be tested by conducting larger sample size studies.

No abstract

INTRODUCTIONFacial concerns have been the major reason for dermatological consultations in the last few years. 1 Besides the common alterations related to the intrinsic and extrinsic aging processes, there is one that affects individuals of any age, both sexes, and all races the so called dark circles, periorbital darkening or periorbital melanosis (POM).2,3 Studies had shown that many factors had contributed to this condition like melanin deposition, increased vascularity, chronic inflammation, skin redundancy and genetic causes. [4][5][6] Recently, Huang et al classified POM as pigmented, vascular, structural and mixed POM clinically. 7Pigmented type (P) appears as infraorbital brown hue, vascular (V) type appears as infraorbital blue, pink, or ABSTRACT Background: Besides the common alterations related to the intrinsic and extrinsic aging processes, there is one that affects individuals of any age, both sexes, and all races the so called dark circles, periorbital darkening or periorbital melanosis. There is scarcity of data regarding the incidence and prevalence of periorbital melanosis due to its transitory nature and lack of reasonable etiological explanation. Aim: To assess the prevalence of periorbital melanosis and to study the epidemiological factors responsible for the occurrence of periorbital melanosis. Methods: A single centred, cross-sectional, descriptive study was conducted in patients attending the skin OPD of our teaching hospital from Jan 2016 -Dec 2016. A total of 250 patients were included in our study. Patients with hyperpigmentation around the orbital area of all ages and both genders were included in the study. A careful physical examination to detect involvement of upper or lower or both eyelids and extension beyond the periorbital region, colour of hyperpigmented areas (light brown/dark brown/red/blue), presence of any dermatological disease or scar in periorbital region were assessed. A detailed history was taken including duration of the condition, family history, history of atopy or drug intake, associated faulty habit or lifestyle. Results: Based on the type of POM, vascular POM (44%) was found to be the most common type among our patients followed by constitutional (33.2%), post-inflammatory (13.6%) and shadow type (9.2%). Among the various factors for POM watching TV for more than 8 hours/day, usage of spectacles, sleeping habit of less than 6 hours/day, habit of regularly rubbing the eye, family history of POM, associated systemic disease like anaemia and irregular menstruation and associated skin lesion like atopic dermatitis had shown a strong association (odds ratio >0.8) in the development of POM. Conclusions: It is very much essential to classify and grade the peri-orbital melanosis and to determine the causative factors which would help us to intervene earlier and that would result in a better prognosis.