Intralesional vitamin D in multiple recurrent plantar warts - A single, blind, prospective, placebo-controlled study

Introduction: Warts or verrucae, caused by the human papillomavirus (HPV), are a benign epidermal proliferation of the skin. Most patients seek medical advice as warts are cosmetically unacceptable and can be painful. Plantar warts, in particular, are typically refractory to treatment requiring multiple treatment sessions. High recurrence rates, pain, and scarring limit the available therapeutic modalities. In contrast, immunotherapeutic approaches stimulate the host immune system by enhancing cellular immunity to eliminate the virus. Objective: To assess the safety and efficacy of intralesional vitamin D3 injection to treat multiple recurrent plantar warts. Methods: 60 patients with multiple recurrent warts were divided into two groups of 30 each. Group 1 received 0.5 ml intralesional vitamin D in the base of the largest wart, and Group 2 received 0.5 ml of normal saline. The sessions were repeated every two weeks for a maximum of four sessions, and patients were followed up for 12 months to detect any recurrences. Results: The study group showed complete clearance in 73.3% (22) individuals, while most controls (70%) showed no response. Conclusion: Intralesional vitamin D3 is a safe and effective treatment option for multiple recurrent plantar warts

Intense pulsed light: A promising therapy in treatment of acne vulgaris

Background: Medical treatment of acne vulgaris includes a variety of topical and oral medications. Poor compliance, lack of durable remission, potential side effects are common drawbacks to these treatment. Therefore, there is a growing demand for a fast, safe and side effect free novel therapy. Light-based therapies are an attractive alternative acne therapy because they potentially offer more rapid onset and better patient compliance with a low incidence of adverse events. Aim: To study the efficacy of intense pulsed light in treatment of acne vulgaris. Materials and Methods: Twenty five patients with acne vulgaris were subjected to IPL. Baseline grading of acne was done. IPL was administered every 2weeks for 4 sessions. Grading was done after the end of treatment. Clinical photographs were taken for evaluation. Results: All patients showed a reduction in the number of acne lesions after 4 sessions of IPL. No significant side effects were noted. Patients also noted an improvement in skin texture. Conclusion: IPL showed beneficial effects in the treatment of acne

Pigmented basal cell carcinoma: A rare clinical variant treated with excision and grafting

Basal cell carcinoma (BCC) is a most common malignant tumour of skin. It develops on sun-exposed skin of lighter skinned individuals. It is a slow growing, locally invasive tumor. It is rare in dark skin because of the inherent photoprotection of melanin and melanosomal dispersion. The frequency of pigmented variant of BCC can reach up to 6% of total BCC in Hispanics. A 62yr old female came with the complaint of hyperpigmented plaque over the right lateral wall of the nose at the osseo-cartilagenous junction since 2yrs with evidence of central ulceration and bleeding. A wide local excision was planned with 5mm margins and covered with a full thickness graft obtained from the right retroauricular area. Post operation photographs taken. BCC is the most common non-melanoma skin cancer in the world. Though, pigmented BCC is the rare variant, it is becoming increasingly common in Asian population. UV radiation is the most important preventable risk factor for BCC. With increasing awareness and advent of newer treatment modalities, better cosmetic outcome with improved survival are expected

Pathogenesis, Immunology and Management of Dermatophytosis

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations