Expert opinion on pre and post procedure care in aesthetic dermatology

In clinical practice, the number of aesthetic dermatology procedures carried out in India is increasing. Nonsurgical or minimally invasive cosmetic dermatology encompasses a variety of procedures, such as chemical peels, laser therapies, dermal fillers, derma rollers and microneedling radiofrequency, which are known to be safe and effective. Despite enormous advances in the field of aesthetic dermatological procedures, many clinicians seem to have limited knowledge about the potential benefits and risks associated with aesthetic procedures. To ensure successful outcome of an aesthetic procedure and to minimise complications, one should be aware of the pre- and post-procedural care involved. This review summarized expert opinion on pre and post-procedural care needed with chemical peels, laser therapies, dermal fillers, derma rollers and microneedling radiofrequency

A Delphi consensus on the nomenclature and diagnosis of lichen planus pigmentosus and related entities

Background: Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. Aims and Objectives: Delphi exercise to define and categorise acquired dermal pigmentary diseases. Methods: Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. Results: Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term ‘acquired dermal macular hyperpigmentation’. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis, lichen planus pigmentosus and pigmented contact dermatitis. Limitations: A wider consensus involving representatives from East Asian, European and Latin American countries is required. Conclusion: Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation

Borrelial lymphocytoma cutis: A diagnostic dilemma

Lymphocytoma cutis (LC) is one of the most common types of cutaneous B cell pseudolymphoma. Borrelial LC occurs most commonly in areas endemic for Ixodes ricinus tick in Europe, and it is rare in North America. The disease is rarely seen in India and may cause diagnostic difficulties for dermatologist residing in parts of the world that are not endemic for Lyme disease. The diagnosis is critical as LC may present as the only early manifestation of Lyme disease. Herein, we have presented a case of borrelial LC in an 11-year-old boy of German descent, residing in India

Ingrown toenails

Onychocryptosis or ingrown toenail is a very common pathology of the toenail unit, chiefly affecting adolescents and young adults. The ingrown toenail is responsible for disabling complaints like pain and difficulty in walking. It is associated with significant morbidity, hampering the quality of life as it interferes with sporting activities, school, or work. It principally occurs in the hallux. It is ascribed to poor trimming of the nails in combination with local pressure due to ill-fitting footwear, hyperhidrosis, poor foot hygiene and nail abnormalities. Pain, swelling and discharge are the main clinical features. Four stages of the condition have been described. Diagnosis is usually evident, but it should be differentiated from subungual exostosis and tumors of the nail bed. The current standard of care focuses on conservative treatment like the gutter splint technique in the initial stages, and in cases that are resistant to medical management or recurrent, surgical correction is the treatment of choice. There are various surgical techniques that are described in literature. Although there is no ideal technique, lateral nail plate avulsion with lateral matricectomy by phenol is commonly used and reported to be more effective in reducing recurrences. The aim of this review article is to focus on this common pathology of the nail, the various techniques employed in management and aid in the selection of treatment according to the stage and severity of the disease

A generalized, non-pruritic variant of lichen amyloidosis: A case report and a brief review

Lichen amyloidosis (LA) has been considered a highly pruritic dermatosis, and the deposition of fibrillar material has generally been considered to be secondary to the scratching. Focal epidermal damage and chronic scratching have been implicated as the pathogenetic factors in the occurrence of LA, although they may not be able to explain the occurrence of a widespread variant of this dermatosis. There are few case reports describing the occurrence of a non-pruritic variant of LA. We hereby report a case of non-pruritic, generalized variant of lichen amyloidosis

Glomeruloid hemangioma in normal individuals

Glomeruloid hemangioma is a rare, histologically distinctive, cutaneous, benign vascular tumor, originally described by Chan et al. Glomeruloid hemangioma appears specific to polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome (POEMS), and is usually, but not always, related to Castleman′s disease. We herein report two cases with glomeruloid hemangioma, without any features of the POEMS syndrome. Glomeruloid hemangioma requires a high index of suspicion for diagnosis. It could rarely present as a solitary finding, without any evidence of an underlying POEMS syndrome