A case report on generalized pemphigus vulgaris treated with rituximaba

Background: Pemphigus vulgaris has an obscure etiology; the presence of autoantibodies is coherent with an autoimmune disease. Rituximab a monoclonal antibody that specifically targets the CD20 antigen of B lymphocytes, has arisen as a novel treatment approach for pemphigus vulgaris.  Case presentation: A 39-year-old male patient presented with a three-month history of mouth ulcers, poor oral hygiene accompanied with heavy tobacco smoking and alcohol consumption. He was diagnosed with pemphigus vulgaris. The disease gradually progressed to involve other body parts. The patient had shown partial improvement after conventional therapy (oral cefuroxime, oral prednisolone with azathioprine) and was later on successfully treated with rituximab. After 90 days of follow-up, no future recurrence was observed. Conclusion: With this case, the authors would like to aware other clinicians of the potential use of rituximab in treating pemphigus vulgaris, especially when the conventional therapy fails

Expert consensus on the management of acne in India

Acne, a common cutaneous disorder, is estimated to affect a significant proportion of the population at some point in their lifetime. It is one of the most common presentations reported in dermatological consultations in India. Treatment options for acne include topical, oral and procedural therapies. Patients with mild acne can be treated with topical therapies; however, those with moderate to severe acne require systemic cure. Oral antibiotic treatment, hormonal therapies and isotretinoin are the mainstay systemic therapies for acne. Additionally, procedural therapeutic modalities in dermatology include chemical peels, laser therapy, micro needling techniques, to name a few. Scientific advances are continually improving knowledge of acne and contributing to refinement of treatment options. Hence, it is vital for clinicians to regularly update their clinical practice patterns to reflect current standard. An experts’ panel discussion involving dermatologists from across India was conducted, to outline a practical approach for the management of acne. The present consensus document focuses on the assessment of acne, use of topical treatments, role of systemic therapy and procedures in treating acne and post-inflammatory hyperpigmentation. It also emphasizes the role of patient education and counselling on prophylactic and treatment strategies in acne management

Complications of medium depth and deep chemical peels

Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging. Results and complications are generally related to the depth of wounding, with deeper peels providing more marked results and higher incidence of complications. Complications are also more likely with darker skin types, certain peeling agents, and sun exposure. They can range from minor irritations, uneven pigmentation to permanent scarring. In very rare cases, complications can be life-threatening

Development of consensus recommendations on the management of vitiligo and the role of decapeptide in vitiligo by the delphi method

Background: Treatment of vitiligo is still a challenge in dermatology. Literature is sparse on the definitive clinical role of basic fibroblast growth factor (bFGF) in vitiligo patients. Aims: We decided to generate a consensus in an attempt to answer some critical questions related to the management of vitiligo and the role of bFGF. Materials and Methods: A Delphi method among 21 experts across India was conducted. A consensus (agreement was 75% or greater) was taken on 27 statements on the prevalence, epidemiology, and treatment of vitiligo and the role of bFGF in the management of vitiligo. The consensus process was completed after two rounds. Results: Topical corticosteroid therapy is the first-line therapy for vitiligo; however, its adverse effects are widely known, especially in sensitive areas. Topical calcineurin inhibitors are preferred in stable vitiligo of the face, neck, genitals, or intertriginous regions as an alternative to topical corticosteroids. Topical bFGF is a relatively newer therapy with a promising role in stable vitiligo. bFGF is safe and effective in inducing repigmentation of vitiligo lesions. Combination therapy of bFGF with other topical therapies, phototherapy, and surgical procedures can be beneficial in patients of vitiligo. Conclusion: This consensus would complement the currently available literature on bFGF and help the practitioner to recognize the unmet need in the treatment of vitiligo