Background:Fetal ventriculomegaly is a common antenatally detected central nervous system abnormality with diverse etiologies and outcomes. The severity and laterality of ventriculomegaly, along with associated anomalies, play a critical role in determining prognosis. This study aimed to assess the severity-wise distribution of ventriculomegaly, its correlation with gestational age, laterality, associated structural anomalies, and postnatal outcomes using antenatal ultrasound in a tertiary care setting.

Methods:This retrospective cross-sectional study was conducted at a tertiary care hospitals, including 137 singleton pregnancies diagnosed with fetal ventriculomegaly between 18 and 36 weeks of gestation from January 2020 to December 2023. Antenatal ultrasound data were analyzed to classify ventriculomegaly as mild (10–12 mm), moderate (13–15 mm), or severe (>15 mm). Laterality, associated anomalies, follow-up progression, and pregnancy outcomes were recorded and statistically analyzed using Chi-square tests.

Results:Mild, moderate, and severe ventriculomegaly were observed in 40.8%, 29.2%, and 30.0% of cases, respectively. Bilateral involvement was significantly associated with severe cases (85.4%, p < 0.001), while unilateral ventriculomegaly predominated in mild cases (73.2%). Structural anomalies were present in 57.7% of fetuses, with hydrocephalus (15.3%) and cardiac defects (13.1%) being the most common. The incidence of associated anomalies increased significantly with severity (p < 0.001). On follow-up, 43.9% of mild cases resolved, while severe cases showed a higher rate of progression and termination of pregnancy (28.9%, p < 0.001). Live births with normal outcomes were highest in the mild group (41.5%).

Conclusion:The severity and laterality of ventriculomegaly are significant predictors of associated anomalies and fetal outcomes. Mild, isolated, unilateral ventriculomegaly is associated with favorable prognosis, whereas severe and bilateral forms often correlate with CNS anomalies and adverse outcomes. Detailed anomaly evaluation and longitudinal follow-up are essential for prognostication and counseling.

Background:White matter hyperintensities (WMHs) on MRI have been increasingly reported in migraine patients, but their association with specific migraine patterns—such as chronicity, frequency, and aura—remains incompletely understood. This study aimed to evaluate the relationship between migraine subtypes and the prevalence, distribution, and severity of WMHs using MRI brain imaging.

Methods:This cross-sectional observational study included 93 adult migraine patients (aged 18–55 years) diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). Participants were categorized into migraine with aura (MA, n=28) and without aura (MO, n=65), and into chronic (n=27) and episodic (n=66) migraine groups. All subjects underwent 1.5T MRI brain scans. WMHs were evaluated using T2-FLAIR sequences and graded using the Fazekas scale. Clinical and demographic data were collected and analyzed. Associations were assessed using chi-square tests, t-tests, Spearman’s correlation, and multivariate logistic regression.

Results:WMHs were observed in 38 patients (40.9%). Their prevalence was significantly higher in MA (57.1%) compared to MO (33.8%) (p=0.031), and in chronic migraine (66.7%) compared to episodic migraine (30.3%) (p=0.001). Deep white matter and bilateral WMHs were more frequently seen in chronic migraine patients. Fazekas scores were significantly higher in MA (1.32 ± 0.89) and chronic migraine groups (1.48 ± 0.62). Spearman’s correlation showed significant positive associations between WMH severity and duration of illness (ρ=0.382, p=0.001), frequency of attacks (ρ=0.415, p<0.001), and duration of episodes (ρ=0.336, p=0.004). Multivariate analysis identified chronic migraine (OR: 3.39, p=0.012), ≥5 years duration (OR: 2.87, p=0.021), and ≥4 attacks/month (OR: 3.14, p=0.014) as independent predictors of WMHs.

Conclusion:The presence and burden of WMHs are significantly associated with migraine chronicity, attack frequency, and aura status. These findings suggest that higher migraine burden may contribute to structural brain changes and underscore the importance of early and sustained migraine control to prevent potential long-term neurovascular consequences.

Background: Vitiligo is a chronic depigmenting disorder characterized by the destruction of melanocytes, resulting in progressive hypopigmented macules. Although oral corticosteroids and immunomodulators are widely used for disease control, their comparative efficacy and safety profiles require further evaluation.

Aim: This study aimed to compare the efficacy, safety, and cost-effectiveness of oral Levamisole and Betamethasone in the management of localized vitiligo.

Methodology: A prospective, randomized, open-label study was conducted on 80 patients with localized vitiligo at a tertiary care center in India. Patients were randomly assigned to receive either Levamisole 150 mg or Betamethasone 5 mg, both administered orally on two consecutive days per week for six months. Clinical response was assessed monthly using VASI (Vitiligo Area Scoring Index), VIDA (Vitiligo Disease Activity), and standardized digital photography. Statistical analysis was performed using Student’s t-test and Chi-square test; p < 0.05 was considered statistically significant.

Results: Both groups demonstrated statistically significant improvement in VASI scores: Levamisole group (0.87 ± 0.79 to 0.67 ± 0.65, p < 0.004) and Betamethasone group (1.07 ± 0.61 to 0.86 ± 0.54, p < 0.002). The response rate was slightly higher with Betamethasone (64.86%) versus Levamisole (59.45%). Lesion progression was arrested in 59.5% (Levamisole) and 61.5% (Betamethasone) of patients. Adverse effects were more common with Betamethasone (28.2%) compared to Levamisole (18.9%). Treatment cost was significantly lower with Betamethasone.

Conclusion: Both Levamisole and Betamethasone were effective in controlling vitiligo progression and inducing repigmentation. While Betamethasone was more cost-effective, Levamisole exhibited a better safety profile. Individualized therapy selection is recommended based on cost, tolerability, and patient-specific factors.

Background
The supratrochlear foramen (STF) is an anatomical variation located in the distal humerus, formed by the resorption of the septum between the olecranon and coronoid fossae. Its incidence, morphology, and morphometry vary among populations and carry clinical relevance in orthopedic surgeries and radiological interpretations. This study aims to analyze the incidence, shape, and morphometric characteristics of the STF in a central Indian population.

Methods
A descriptive osteological study was conducted on 127 dry, adult human humeri of unknown sex collected from the Department of Anatomy. Each bone was examined for the presence, side, and shape of STF. Measurements were taken using digital vernier calipers to determine distances from anatomical landmarks (medial epicondyle, lateral epicondyle, and lower trochlear margin) and diameters (transverse and vertical) of the STF. In humeri without STF, septal thickness was measured and categorized as opaque or translucent. Data were analyzed using descriptive statistics and unpaired t-tests, with p < 0.05 considered significant.

Results
The STF was present in 39 out of 127 humeri (30.7%), more frequently on the left side (33.3%) than the right (28.1%). Among humeri without STF, 51.2% showed an opaque septum and 18.1% had a translucent septum. The most common STF shape was oval (41.0%), followed by round (25.6%) and reniform (12.8%). Morphometric measurements revealed mean distances of 24.8 ± 1.6 mm (right) and 25.1 ± 1.3 mm (left) from the medial epicondyle to the STF, and 4.6 ± 0.8 mm (right) and 4.4 ± 0.9 mm (left) from the lower trochlear margin. The transverse and vertical diameters of the foramen averaged 5.9–6.2 mm and 3.7–3.9 mm, respectively. Septal thickness in humeri without STF averaged 5.1 ± 0.9 mm. No statistically significant side-wise differences were found.

Conclusion
The supratrochlear foramen was present in nearly one-third of humeri in this central Indian sample, with oval being the most prevalent shape. The findings reinforce the importance of recognizing STF variants in surgical and radiological contexts and highlight the inverse relationship between septal thickness and foramen formation. These results contribute valuable regional data for anatomical and clinical reference.

Background

Diabetic foot ulcers (DFUs) represent a major cause of morbidity and

lower limb amputations in diabetic patients, particularly in low- and

middle-income countries like India. Chronicity, infection, and delayed

intervention often complicate healing. This study aimed to evaluate clinical

outcomes of plastic surgical reconstruction following systemic

optimization and local infection control in patients with complicated

diabetic foot ulcers.

Methods

A prospective observational study was conducted at a tertiary care center in

India, including 67 patients with Wagner grade II–IV DFUs. All patients

underwent systemic infection control, targeted antibiotic therapy based on

culture sensitivity, and glycemic optimization. Depending on wound

characteristics, patients were treated surgically using split-thickness skin

grafting (STSG), local flaps, reverse sural artery flaps, or negative pressure

wound therapy

(NPWT)-assisted

closure. Clinical parameters,

microbiological profiles, infection markers, graft/flap take, and healing

outcomes at 8 weeks were recorded and analyzed.

Results

The mean age of participants was 56.4 ± 9.2 years; 67.2% were male and

94.0% had Type 2 diabetes. Most ulcers were Wagner grade III/IV and

located on the forefoot (53.7%). Culture positivity was observed in 86.6%,

with Staphylococcus aureus and Pseudomonas aeruginosa as predominant

isolates. Post-treatment, CRP and procalcitonin levels showed significant

reductions (p < 0.001). STSG was performed in 47.8% of patients, with a

mean graft take of 95.2%. Complete wound healing at 8 weeks was

achieved in 76.1% of patients, while the mean hospital stay was 11.7 ± 2.9

days. Surgical site infection and partial graft/flap necrosis occurred in

13.4% and 8.9% of patients, respectively.

Conclusion

Plastic surgical reconstruction, when preceded by systemic treatment and

adequate local infection control, offers favorable healing outcomes in

diabetic foot ulcers. Early intervention, appropriate microbial management,

and individualized surgical planning are essential for limb salvage and

reducing re-ulceration rates.

Background
Post-burn sequelae, including contractures, hypertrophic scars, and non-healing ulcers, continue to pose significant functional and psychosocial challenges in burn survivors, especially in low- and middle-income countries like India. Despite advances in acute burn care, delayed presentation and limited access to reconstructive surgery contribute to a high burden of preventable deformities. This study aimed to evaluate the clinical patterns, surgical management, and functional outcomes of post-burn sequelae in a tertiary care center.

Methods
This prospective observational study included 103 patients presenting with post-burn sequelae over a two-year period. Detailed demographic, etiological, and anatomical data were recorded. Surgical interventions included split-thickness skin grafts (STSG), local flaps, regional flaps, and composite procedures. Functional outcomes were assessed using joint range of motion (ROM) at baseline and six months postoperatively. Complications and patient satisfaction were also documented. Statistical analysis included ANOVA and chi-square/Fisher’s exact test with a significance threshold of p < 0.05.

Results
The mean age of patients was 24.6 ± 13.1 years, with 56.3% males. Flame burns (67%) were the most common etiology, and contractures were the predominant sequela (86.4%), mainly involving the neck, hand, and elbow. A total of 119 surgical procedures were performed; STSG (n = 67) was the most common technique. Mean take rate was highest for STSG (94.6 ± 7.1%), followed by local flaps (92.3 ± 6.9%). Functional outcomes showed significant improvement in ROM across all joints (p < 0.001). Postoperative complications were low, and overall patient satisfaction was high, with 74.8% rating outcomes as good to excellent.

Conclusion
Tailored surgical management of post-burn sequelae, particularly with early intervention and appropriate reconstruction techniques, results in significant functional recovery and high patient satisfaction. The findings underscore the need for integrated burn care systems encompassing acute management, rehabilitation, and long-term reconstructive services to reduce disability from burn injuries in resource-limited settings.

Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is linked to a range of extraintestinal symptoms, with skin issues being both common and important. These skin manifestations can indicate how active the disease is and often require coordinated care from both dermatologists and gastroenterologists.

Objective: The goal of this study was to explore the different skin manifestations associated with IBD, assess how often they occur, their clinical characteristics, how they respond to treatment, and their relationship with disease activity based on existing literature and compiled data.

Methods: To achieve this, we conducted a thorough review of peer-reviewed articles and clinical studies focusing on the mucocutaneous aspects of IBD. We organized the data to categorize skin conditions into specific, reactive, associated, or treatment-related categories. We also analyzed the clinical responses to various therapies, presenting our findings through tables and graphs for clarity.

Result: Our findings revealed that reactive skin conditions, especially erythema nodosum and pyoderma gangrenosum, were the most common, with erythema nodosum often linked to active intestinal disease. We also noted an increase in treatment-related skin issues, such as biologic-induced eczema and paradoxical psoriasis, as biologic therapies have become more prevalent. Biologics showed great effectiveness in treating stubborn lesions, particularly pyoderma gangrenosum. Skin involvement was notably more frequent during active IBD phases.

Conclusion: In conclusion, skin manifestations in IBD are varied and often mirror the overall disease activity. Recognizing these signs early and managing them with a multidisciplinary approach is essential for achieving the best outcomes. Targeted treatments, especially biologics, are crucial for addressing severe or resistant skin lesions.

Background: Minimally invasive endovascular techniques have revolutionized varicose vein treatment, with cyanoacrylate glue ablation (VenaSeal™) and microwave ablation emerging as promising alternatives to traditional thermal ablation methods.

Methods: This retrospective comparative study evaluated 66 patients with symptomatic varicose veins treated between January 2022 and December 2023. Thirty-two patients underwent cyanoacrylate glue ablation, while 34 received microwave ablation. Primary outcomes included technical success, complications, and quality of life improvements. Secondary outcomes encompassed patient satisfaction, return to work, and cost-effectiveness.

Results: Technical success was achieved in 30/32 (93.8%) patients in the cyanoacrylate group and 33/34 (97.1%) in the microwave group (p = 0.58). The cyanoacrylate group demonstrated significantly lower overall complication rates (15.6% vs 44.1%, p = 0.01), fewer recurrences (6.3% vs 26.5%, p = 0.04), and no thermal injury complications. Patients treated with cyanoacrylate glue experienced faster return to work (2.6 ± 1.0 vs 3.9 ± 1.2 days, p < 0.001) and higher satisfaction scores (4.8 ± 0.4 vs 4.3 ± 0.7, p = 0.02). However, cyanoacrylate treatment was significantly more expensive (₹112,500 ± 8,200 vs ₹44,800 ± 7,600, p < 0.001).

Conclusion: Both techniques demonstrated high efficacy in treating varicose veins. Cyanoacrylate glue ablation offers superior safety profile and patient experience but at higher cost. Treatment selection should consider patient preferences, clinical factors, and economic constraints.

Background:Connective tissue disorders (CTDs) are a group of autoimmune diseases characterized by the presence of circulating antinuclear antibodies (ANA), which serve as critical biomarkers for early diagnosis. Indirect immunofluorescence (IIF) on HEp-2 cells remains the gold standard for ANA detection and enables interpretation of distinct fluorescence patterns that are often disease-specific.

Objective:To evaluate the seroprevalence of ANA and to analyze the distribution and clinical significance of fluorescence patterns observed by IIF in patients clinically suspected of CTDs.

Methods:A cross-sectional study was conducted over a five-month period involving 90 patients with clinical suspicion of CTDs. Serum samples were tested for ANA using a commercial HEp-2 IIF assay at a screening dilution of 1:80. Positive samples were further categorized based on fluorescence patterns, and the results were analyzed in relation to age, gender, and probable clinical diagnosis.

Results:Of the 90 samples tested, 59 (65.6%) were positive for ANA. ANA positivity was significantly higher in females (73%) compared to males (48%) (p < 0.05). The most common fluorescence pattern was speckled (35.6%), followed by homogenous (27.1%), nucleolar (15.2%), peripheral (10.1%), centromere (6.8%), and cytoplasmic (5.1%). The homogenous pattern was primarily associated with suspected systemic lupus erythematosus, while nucleolar and centromere patterns were linked with systemic sclerosis. ANA positivity was highest in the 31–50 years age group.

Conclusion:IIF remains a highly sensitive and informative method for ANA detection in suspected CTD patients. The interpretation of fluorescence patterns provides valuable diagnostic clues and aids in the clinical stratification of autoimmune diseases. These findings support the continued use of IIF as a frontline serological tool in the diagnostic workup of CTDs.

Vitiligo is a common pigmentary disorder with a potential link to metabolic syndrome (MS).This study investigates the prevalence and clinical implications of MS among vitiligo patients. A case-control study was conducted atPost graduate department of Dermatology, Venereology & Leprosy, SMGS Hospital, Government Medical College, Jammu from November 2019 to October 2020 after obtaining approval from institutional ethical committee. This study involving 60 vitiligo patients and 60 matched controls. Key parameters such as lipid profile, fasting blood sugar, blood pressure, and abdominal circumference were assessed. Statistical analysis revealed significant variations in HDL, triglyceride levels, and fasting blood sugar between the groups. The prevalence of MS in vitiligo patients was 18.3%, with increased severity correlating with metabolic risk factors. These findings suggest that early screening and management are crucial for vitiligo patients with metabolic disturbances.

Lichen planus pigmentosus (LPP) is an infrequent variant of lichen planus (LP), marked by dark brown to gray macular pigmentation affecting sun-exposed regions. While typically exhibiting diffuse or reticular patterns, LPP can manifest in various forms, including the

rare linear or blashkoid configuration. The description of linear or Blaschkoid-patterned LPP on the face are relatively even rarer. This report, thus, describes the case of a 37-year-old female presenting with LPP exhibiting a unilateral blashko-linear pattern across her cheek.

Background: Nail involvement is frequently observed in various dermatoses and can serve as an important clinical clue to underlying systemic or dermatological conditions. Dermoscopy (onychoscopy) enhances visualization of subtle nail changes that may not be evident on clinical examination alone.

Objectives:To evaluate dermoscopic features of nail lesions in different dermatoses and correlate them with clinical and demographic profiles.

Materials and Methods: A cross-sectional observational study was conducted on 53 patients presenting with nail changes associated with dermatoses. A detailed history, clinical examination, and dermoscopic evaluation were performed using a polarized handheld dermoscope. Findings were recorded and analyzed in terms of dermatoses type, nail changes, dermoscopic patterns, associated symptoms, and disease duration.

Results:The most common dermatoses were systemic lupus erythematosus (22.6%), alopecia areata (18.9%), eczema (15.1%), and psoriasis (13.2%). Nail pitting (24.5%) was the most frequent dermoscopic finding, followed by splinter hemorrhages (20.8%) and red lunula (18.9%). Brittle nails (34%) and thickening (32.1%) were the predominant gross nail changes. Notably, 60.4% of patients had dermatoses lasting more than 2 years, and 30.2% reported no associated nail symptoms.

Conclusion:Dermoscopy is a valuable non-invasive diagnostic tool for identifying nail involvement in various dermatoses, often detecting subclinical changes. Early dermoscopic evaluation can aid in prompt diagnosis and better management of underlying dermatological conditions.

Background: Psoriasis is a chronic, immune-mediated skin disorder influenced by environmental and metabolic factors, including vitamin D status. Vitamin D plays a key role in immune regulation and keratinocyte proliferation, both central to psoriasis pathogenesis. Objective: To evaluate serum vitamin D levels in psoriasis patients and assess their association with disease severity. Methods: A cross-sectional study was conducted on 100 clinically diagnosed psoriasis patients. Demographic details, clinical characteristics, and sun exposure patterns were recorded. Serum 25(OH) vitamin D levels were measured and psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI). Statistical analysis included correlation and ANOVA to evaluate associations between vitamin D levels and PASI scores. Results: The study population consisted of 59% males and 41% females, with the majority (34%) aged between 31–45 years. Plaque psoriasis was the most common type (68%), and 48% had the disease for 1–5 years. Vitamin D levels were insufficient in 51%, sufficient in 39%, and deficient in 10% of patients. A statistically significant inverse correlation was observed between vitamin D levels and psoriasis severity (r = -0.68, p < 0.001). Patients with mild psoriasis had the highest mean vitamin D levels (33.84 ng/mL), while those with severe psoriasis had the lowest (14.48 ng/mL). Conclusion: Vitamin D insufficiency is common among psoriasis patients and is significantly associated with greater disease severity. Routine screening and correction of vitamin D levels may benefit the overall management of psoriasis.

Dowling-Degos disease (DDD) and Reticulate Acropigmentation of Kitamura (RAPK) are two distinct groups of rare genodermatoses, which fall under an umbrella of reticulate pigmentory dermatoses. Both are inherited as autosomal dominant trait with variable penetrance. Few studies have described DDD and RAPK in a single patient hypothesising that two conditions belong to a single complex disease. We describe a 32 years old male patient with hyperpigmented macules on neck, axillae, chest, lower back, forearms, hands and feet along with palmar pits and acneiform scars over face and comedo-like lesions over back since 10 years of age. The idea that both DDD and RAPK are distinct aspects of a single entity with variable phenotypic expression is further strengthened as our patient had features of both conditions. In addition, our patient had early onset DDD which is a rare feature.

Background: Acne vulgaris is a common dermatological condition with multifactorial etiology, including hormonal, metabolic, and inflammatory factors. Emerging evidence suggests that lipid profile abnormalities and altered liver function may play a role in the pathogenesis or progression of acne.

Objective: To evaluate the correlation between lipid profiles, liver function tests (LFTs), and the severity of acne vulgaris.

Methods: A cross-sectional study was conducted on 100 patients diagnosed with acne vulgaris and 50 age- and sex-matched healthy controls. Lipid profile (Total cholesterol, HDL, LDL, Triglycerides) and LFTs (ALT, AST, ALP, and Total bilirubin) were measured. Acne severity was graded using the Global Acne Grading System (GAGS).

Results: Acne patients exhibited significantly elevated triglycerides (p<0.001), LDL (p=0.004), and reduced HDL (p=0.006) compared to controls. Mild elevations in ALT and ALP were noted in moderate-to-severe acne patients. A positive correlation was found between acne severity and triglyceride levels (r=0.49), while a negative correlation was observed with HDL (r=-0.35).

Conclusion: Alterations in lipid metabolism and mild liver dysfunction may contribute to the pathogenesis and severity of acne vulgaris. Monitoring these parameters may be beneficial for holistic acne management.

Background: Cutaneous warts caused by human papillomavirus (HPV) are often resistant to conventional destructive therapies. Intralesional immunotherapy has emerged as a novel treatment modality that stimulates the host immune system to clear both local and distant lesions

Objective: To compare the efficacy and safety of intralesional Vitamin D3 and MMR vaccine in the treatment of cutaneous warts.

Methods: This prospective interventional study was conducted at SS hospital, SSIMS, Davangere from January 2022 to July 2023. This study enrolled 50 patients with cutaneous warts, of whom 40 completed the treatment protocol. Patients were randomly divided into two groups: Group 1 received intralesional Vitamin D3 (0.2 mL), and Group 2 received intralesional MMR vaccine (0.5 mL). Injections were repeated at regular intervals.

Results: In the MMR vaccine group, 60% of patients achieved complete response, 20% showed partial response, and 20% had no response. In the Vitamin D3 group, complete response was observed in 8.33% of patients after one or two doses, and in 41.67% of patients after three to four doses. Both groups showed resolution of distant, non-injected warts. No significant adverse effects were reported in either group.

Conclusion: It is concluded that both the intralesional MMR vaccine and Vitamin D3 are effective and safe options for the treatment of cutaneous warts. MMR vaccine produced a faster and higher clearance rate, while Vitamin D3 showed a slower, dose-dependent response. Both agents induced systemic immunity capable of clearing distant lesions, making them valuable immunotherapeutic alternatives to destructive treatments.

Keywords: Warts, Intralesional,  Vitamin D3, MMR vaccine

Background: Alopecia areata (AA) is a chronic, immune-mediated, non-scarring hair loss disorder with a wide range of clinical symptoms and etiological associations. Assessing the etiological causes, therapeutic outcomes, and clinical patterns of individuals with alopecia areata in Western Uttar Pradesh was the aim of this study.

Methods: 102 patients with alopecia areata were the subjects of a cross-sectional clinico-etiological investigation. Comprehensive laboratory, clinical, and demographic information was gathered, including endocrine and immunological profiles. The severity of the condition was used to assess treatment responses.

Results: The majority of patients were between the ages of 21 and 30 (mean: 22 ± 9.61 years), urban (61.8%), and unmarried (64.7%). The condition lasted an average of 11 months, with an average beginning age of 21 years. With 34.3% of cases displaying a single lesion and 42.2% displaying multiple lesions, the scalp was the most frequently affected area. In addition to exclamation mark hair (24.5%) and nail abnormalities (19.5%), systemic correlations were noted, including thyroid dysfunction (8.8%) and hypothyroidism (16.6%). Immunoglobulin levels were decreased (p < 0.05). Steroid pulse + azathioprine generated the best results in severe cases (64.2%), while ILS + tacrolimus produced the best results in localised instances (66.6%).

Conclusion: Alopecia areata mainly affects young individuals in this area, and it manifests in a range of clinical patterns and systemic links, especially with thyroid problems and immunological imbalance. Early identification and tailored treatment strategies are essential, especially for severe and resistant variants.

Background: Alopecia refers to “baldness” or loss of hair. Various methods used for the evaluation of hair loss are hair pull test, wood's lamp examination, light and electron microscopy of hair, scalp biopsy, and dermoscopy. The present study was conducted to study trichoscopy findings of scalp and hair shafts in different types of Alopecia at tertiary care centre.

Material and Methodology:

 The present study was cross-sectional observational study carried out at tertiary institute conducted at Department of Dermatology, Venereology and Leprology. The study was conducted from May 2024 to April 2025. A total of 118 patients consenting male and female patients, with complaints of hair loss over scalp, attending the Department were enrolled for the study. Permission from the Ethical Committee was taken prior to commencement of the study and informed written consent was taken from the participants of the study. The data was filled in excel sheet and the results were described as frequency and proportion.

Results: The mean age of the patients was 27.36 ±13.52 years. It was observed that majority of patients were in male (63.56%) and females were 36.44%. It was observed that majority of patients had Alopecia areata (34.75%) followed by AGA (27.11%), Female patterned hair loss (8.47%), Tinea capitis (6.78%) and Telogen effluvium (4.24%)

Conclusion: Trichoscopy is a very valuable and useful tool to diagnose various hair disorders by understanding the various trichoscopic patterns specific for each disease.

Background & Methods: The aim of the study is to compare the effect of combination of oral Tranexamic acid with modified Kligman regimen and modified Kligman regimen alone in the treatment of melisma. All the patients with melasma, satisfying the inclusion criteria were enrolled and written consent was obtained from them. Detailed history regarding sociodemographic data such as name, age, sex, address etc. was obtained and entered and proforma. Date of admission was noted along with detailed history regarding presenting complaints, past history, drug history, family history, personal history.

Results: Erythema was the only adverse effect observed in 4.7% cases in group 1 whereas in group 2, erythema, hypomenorrhea and burning were the adverse effects noted in 7.1%, 4.7% and 1.2% cases respectively. Although adverse effects were observed in higher proportions of cases in group 2 (12.9%) as compared to group 1 (4.7%), the observed difference was statistically insignificant (p>0.05).

Conclusion: Based upon the findings of present study, it could be concluded that modified Kligman regimen with or without oral tranexamic acid is effective in reducing the severity of melasma after 4 weeks of treatment. However, addition of oral Tranexamic acid to modified Kligman regimen resulted in faster therapeutic effect as compared to modified Kligman regimen alone after 8 weeks of treatment.

Autoimmune Polyglandular Syndrome Type 1 (APS-1), or APECED, is a rare autosomal recessive disorder caused by mutations in the AIRE gene, critical for establishing central immune tolerance. We present a case of an 8-year-old female exhibiting classic APS-1 manifestations: chronic mucocutaneous candidiasis, hypoparathyroidism, ectodermal dystrophy, and confirmed AIRE mutation (c.607C>T, p.Arg203Ter). Clinical evaluation revealed hypocalcemia, hyperphosphatemia, low PTH, and vitamin D deficiency. Management included oral calcium and calcitriol with close biochemical monitoring. The case underscores the importance of genetic testing for accurate diagnosis and long-term management. Due to risks of nephrocalcinosis from calcium therapy, renal ultrasound was planned. This report highlights the very rare mutation of AIRE gene which is c.607C>T (p.Arg203Ter) it also highlights the and discusses the potential renal complications in the context of calcium homeostasis. Early identification and targeted management are crucial in preventing disease progression and complications in pediatric APS-1 patients

Background: Striae distensae, or stretch marks, are common dermal lesions resulting from skin stretching and are often associated with aesthetic concerns and psychological distress. Fractional CO₂ laser therapy has been mostly used as a promising treatment for promoting collagen remodeling and improving skin texture with minimal time. Method: A prospective observational study was done in the Department of Dermatology at Sri Siddhartha Medical College, Tumkur, to evaluate the efficacy of fractional CO₂ laser in treating striae distensae. Patients with >18 years and clinically diagnosed with striae alba were enrolled for the study. Each patient underwent up to three sessions of fractional CO₂ laser at four-week intervals. Clinical improvement was assessed using a global improvement scale, changes in striae surface area, and a Visual Analog Scale (VAS) for patient satisfaction. Adverse effects were also recorded. Results: Most patients showed significant clinical improvement post-treatment, with reductions in striae surface area and high patient satisfaction. The majority reported moderate to good improvement, and only a few experienced minimal changes. Adverse effects were generally mild and self-limiting. Conclusion: Fractional CO₂ laser therapy is an effective, safe, and well-tolerated modality for the treatment of striae distensae, offering substantial clinical and cosmetic benefits.

Background:Telogen effluvium (TE) is a common, non-scarring alopecia characterized by diffuse hair shedding resulting from a shift of hair follicles into the telogen phase. Platelet-rich plasma (PRP) and Growth Factor Concentrate (GFC) therapies have individually shown promise in stimulating hair regrowth. However, limited evidence exists on the synergistic effect of combining PRP and GFC. This study aimed to evaluate the effectiveness of combined PRP and GFC therapy on hair density and thickness in patients diagnosed with TE.

Materials and Methods:A prospective clinical study was conducted on 40 patients aged 18–45 years clinically diagnosed with telogen effluvium. Patients were randomly assigned to receive four sessions of combined PRP and GFC therapy at 3-week intervals. PRP was prepared using a standard double-spin method, and GFC was obtained from commercial kits activated prior to injection. Hair density (hairs/cm²) and shaft thickness (μm) were assessed at baseline and 12 weeks post-treatment using dermoscopic imaging and trichoscopic analysis. Data were analyzed using paired t-tests with a significance level set at p < 0.05.

Results:At baseline, the mean hair density was 92.5 ± 7.8 hairs/cm², which significantly increased to 124.3 ± 9.1 hairs/cm² post-treatment (p < 0.001). Similarly, the average hair shaft thickness improved from 41.6 ± 5.2 µm to 56.7 ± 4.9 µm (p < 0.001). No severe adverse effects were reported. Mild transient erythema and swelling were observed in 12.5% of participants.

Conclusion:Combined PRP and GFC therapy significantly improves hair density and thickness in patients with telogen effluvium, suggesting a synergistic regenerative effect. This treatment modality offers a promising, safe, and minimally invasive approach for managing TE.

Introduction: Tinea, or dermatophytosis, is a common superficial fungal infection affecting the skin, hair, and nails. Among non-venereal genital dermatoses in females, Tinea cruris is a leading cause of morbidity, often presenting with varied clinical features that may mimic other dermatoses, making early diagnosis essential. Dermoscopy has emerged as a valuable adjunct in differentiating tinea from other inflammatory conditions.

Methodology: This prospective observational study was conducted on 100 female patients with genital dermatoses attending the dermatology outpatient department. Patients were clinically evaluated and subjected to dermoscopic examination. Relevant investigations such as KOH mount were conducted to confirm fungal etiology. Dermoscopic features were documented, and cases were categorized into venereal and non-venereal groups.

Results: Out of 100 cases, 85% were diagnosed with non-venereal dermatoses. Among these, Tinea cruris accounted for the highest proportion (27%). Common clinical features included itching with dark lesions (31%) and chronicity ranging from 1 month to 1.5 years. The most frequently involved sites were the labia majora and inguinal folds. Dermoscopic findings in Tinea cruris revealed peripheral scaling, reddish-brown pigmentation, and pseudonetworks. A significant proportion of patients (22%) with Tinea cruris were diabetic.

Conclusion:Tinea cruris is the most prevalent non-venereal genital dermatosis in females, frequently presenting with chronic itching and hyperpigmented plaques. Dermoscopy, coupled with clinical evaluation, significantly improves diagnostic accuracy, especially in differentiating fungal infections from other dermatoses. Routine use of dermoscopy can reduce misdiagnosis and facilitate timely, targeted therapy.

Background: Melasma is a chronic, acquired hyperpigmentation disorder primarily affecting sun-exposed areas of the skin. While ultraviolet radiation and hormonal influences are well-established triggers, recent literature suggests systemic associations, particularly with thyroid function.

Objective: To evaluate thyroid-stimulating hormone (TSH) levels in patients with melasma and determine if any association exists between TSH levels and the clinical types or severity of melasma.

Methods: A hospital-based, prospective, cross-sectional study was conducted over two years. Fifty adult patients (age >18 years) clinically diagnosed with melasma were recruited from the dermatology outpatient department of MVJ Medical College and Research Hospital. Patients with pre-diagnosed thyroid disorders or on medications influencing thyroid function were excluded. Melasma severity was assessed using the modified Melasma Area and Severity Index (mMASI), and Wood's lamp examination was employed to classify melasma as epidermal, dermal, or mixed. TSH levels were measured using standard chemiluminescent immunoassay techniques. Statistical analysis was performed using SPSS v23.

Results: The mean age of the study population was 37.4 ± 7.9 years, with 83% being female. Mixed melasma was the most prevalent type (39%), followed by epidermal (32%) and dermal (29%). The mean TSH level among all participants was 3.05 ± 1.52 mIU/L. Mean TSH levels by melasma type were: dermal (3.39 ± 1.57 mIU/L), epidermal (2.80 ± 1.56 mIU/L), and mixed (3.02 ± 1.44 mIU/L). No statistically significant difference was observed in TSH levels among melasma types (p = 0.313). A weak, non-significant negative correlation was found between TSH levels and mMASI scores (r = -0.025; p = 0.807).

Conclusion: While elevated TSH has been previously proposed as a potential contributor to melasma pathogenesis, this study did not demonstrate a statistically significant relationship between TSH levels and the type or severity of melasma. Further multicentric studies with larger sample sizes and inclusion of healthy controls are necessary to validate any potential endocrine linkage.

Background: Dermoid sinus disease typically arises from congenital inclusion of ectodermal elements and can occur in various anatomical locations. Infraclavicular dermoid sinus is exceedingly rare, with very few cases documented in the literature.

Case Presentation: A 7-year-old child presented with a recurrent, purulent discharge containing hair from the right infraclavicular region for one year. Clinical examination and imaging revealed a subcutaneous sinus tract extending from 3 cm below the right clavicle down to the infraclavicular area. Surgical excision of the entire tract was performed successfully, followed by primary closure. Histopathological examination confirmed the presence of hair shafts and chronic inflammatory changes consistent with a dermoid sinus. Postoperative recovery was uneventful, with no signs of recurrence at the six-month follow-up.

Conclusion: Atypical locations of dermoid sinus can pose diagnostic dilemmas and may be mistaken for other chronic sinus or abscess formations. Complete excision of the sinus tract is necessary to prevent recurrence. This case underscores the importance of including dermoid sinus in the differential diagnosis of persistent subcutaneous sinus tracts, even in uncommon sites.

Introduction:

Congenital syphilis, an infection caused by Treponema pallidum, remains a significant cause of morbidity and mortality in newborns worldwide. While preventable, the disease continues to affect many infants due to inadequate antenatal care and missed screenings. This case report highlights an atypical presentation of congenital syphilis with unusual dermatological manifestations.

Case Description: A 2-month-old female infant was brought to the pediatric intensive care unit (PICU) with symptoms including abdominal bloating, yellowing of the skin, blood-tinged nasal discharge (snuffles), and peeling skin lesions. The infant's mother had insufficient prenatal care and had experienced genital lesions during pregnancy, which were untreated. Born at full term with a birth weight of 1.8 kg, the infant was healthy at birth, crying immediately after delivery without needing NICU support. On examination, the infant presented with microcephaly, pale skin, keratoderma with peeling skin, and hepatosplenomegaly. Laboratory tests confirmed a positive RPR titer in both the infant and mother, confirming a diagnosis of congenital syphilis. The infant was treated with intravenous benzylpenicillin, resulting in resolution of the skin lesions after 14 days.

Discussion: Congenital syphilis often goes undiagnosed due to a lack of clinical awareness and insufficient prenatal screening. Early identification and treatment are crucial for preventing severe outcomes. The most common dermatological signs of congenital syphilis include rashes and desquamation, typically on the palms and soles. This case is unique in its presentation of keratoderma and fissures along with hepatosplenomegaly. It emphasizes the importance of comprehensive prenatal care, early detection, and effective treatment in preventing the long-term effects of congenital syphilis.

Conclusion: Congenital syphilis is a preventable disease that is often overlooked. Clinicians must remain vigilant in diagnosing the condition, particularly in infants presenting with skin eruptions and a history of inadequate maternal care. Prompt antibiotic treatment is essential for improving outcomes and preventing lasting complications.

Categories: Family/General Practice, Pediatrics, Dermatology

Background: Chronic Kidney Disease (CKD) is a progressive disorder associated with multiple systemic complications, including dermatologic changes. However, hair alterations in CKD patients remain poorly characterized. This study aimed to evaluate the spectrum of hair changes in CKD patients and correlate them with disease severity, dialysis status, and biochemical parameters.

Methods: A cross-sectional study was conducted over 24 months at Sri Siddhartha Medical College, Tumkur, involving 102 CKD patients aged ≥18 years. Participants underwent detailed clinical and dermatological evaluations, with hair assessed for changes in texture, density, and color. Relevant biochemical and hematological parameters were recorded. Statistical analysis was performed using SPSS v22, with p < 0.05 considered significant.

Results: The most common hair changes observed were diffuse hair thinning (66.7%), brittle and dry hair (53.9%), premature graying (39.2%), and telogen effluvium (34.3%). These changes were significantly associated with advanced CKD stages and dialysis status. Diffuse thinning and brittle hair were notably higher among dialysis patients (p = 0.004 and p = 0.003, respectively). Hair abnormalities also correlated with elevated serum creatinine and urea levels (p = 0.003).

Conclusion: Hair changes are prevalent in CKD patients, especially in advanced stages and those on dialysis, and correlate with biochemical markers of renal dysfunction.

Background: Androgenetic alopecia (AGA) is a common progressive hair loss condition in men, with early-onset cases (<30 years) increasingly linked to systemic risk factors like hyperlipidemia and smoking. This studywas done tofind the association between these modifiable factors and early-onset male AGA.

Method: A hospital-based observational study was conducted at Sri Siddhartha Medical College, Tumkur, over 24 months, involving 75 male patients with early-onset AGA and 75 age-matched controls. Clinical diagnosis was based on the Hamilton-Norwood classification. Smoking history and fasting lipid profiles were documented. Statistical analyses included t-tests, chi-square, and logistic regression.

Results: Participants with AGA had significantly higher levels of total cholesterol, LDL, triglycerides, and lower HDL compared to controls (p < 0.005). Severe AGA grades (IV-V+) were more prevalent among smokers and those with hyperlipidemia (p < 0.05). Logistic regression showed smoking (OR=3.42, p<0.001) and hyperlipidemia (OR=2.18, p=0.008) as independent risk factors for early-onset AGA.

Conclusion: Smoking and hyperlipidemia are significantly associated with increased severity and risk of early-onset AGA, showing the need for lifestyle modification and metabolic screening in affected individuals.