Chewing areca nuts can cause Oral Submucous Fibrosis (OSMF), a chronic, sneaky illness that is thought to be a precancerous condition with substantial morbidity. This report describes a case of Grade IV OSMF in a [demographic information], which is characterized by dysplastic alterations, reduced oral opening, and noticeable fibrosis. This case emphasizes early intervention and preventive measures while highlighting the difficulties and approaches for managing advanced OSMF through a multidisciplinary approach comprising clinical evaluation, imaging, and histology. This study set intended to assess the nasolabial flap's effectiveness in treating oral submucous fibrosis (OSMF). This suggests that the Nasolabial flap produced positive outcomes in terms of helping the patients and restoring normal mouth opening. The Nasolabial flap was shown to be a feasible surgical alternative for treating oral submucous fibrosis based on the results of this study because of its low post-operative complication rate, dependable flap vascularity, and ease of operation. The existence of a surgical scar was the only disadvantage noted; this can be rectified by secondary correction techniques. One of the first documented surgical procedures is the open tracheostomy. It entails making a stoma at the anterior neck's skin surface that leads to the trachea. Such a technique has several indications. It can be used to protect the airways during another surgical procedure, in situations of extended artificial breathing where endotracheal intubation must be replaced, and for upper airway obstruction of multiple aetiology.

Mucus build-up in the major and minor salivary glands causes mucoceles, which are nonneoplastic cystic lesions. Children are the most common age group for these lesions. Although local surgical excision is typically an option for treating these lesions, in this instance, a diode laser with a wavelength of 940 nm was used for excision in order to prevent intraoperative surgical problems including haemorrhage and oedema and to promote better healing.

Myiasis is a frequent dermatological condition among travelers returningfrom tropical and subtropical regions, with Cordylobia anthropophagabeing endemic mainly in Sub-Saharan Africa. We report a caseoffuruncular myiasis in a 39-year-old man following travel to SãoToméand Príncipe. The patient presented with painful furuncular lesions onthetrunk that evolved from erythematous patches. Surgical removal revealedlive larvae, which were morphologically identified as transitional second/third instar C. anthropophaga. This case provides detailedimagesof C. anthropophaga instar morphology helpful in their identification. Additionally, the case highlights the importance of consideringfuruncular myiasis in travelers even outside the rainy season.

Delayed pressure urticaria usually presents with painful swelling after sustained mechanical pressure, whereas frank blistering is exceptional. We report a 44-year-old woman with a more than 10-year history of recurrent pressure-induced oedema, angioedema, and bullous lesions, with marked worsening over the preceding two years. During hospitalization, erythematous-oedematous changes on the right forearm evolved into tense serous bullae after mechanical loading, supporting that this was not typical pressure urticaria but a bullous variant. Diagnostic evaluation excluded several alternative causes of blistering, including autoimmune bullous disease, and provocation testing confirmed delayed pressure urticaria together with symptomatic dermographism. Because the patient declined skin biopsy, the diagnosis relied on the characteristic pressure dependence of lesions, supportive provocation testing, and clinical response. The patient improved with short-term systemic corticosteroids and high-dose bilastine, and long-term disease control was subsequently achieved with gradual antihistamine dose adjustment and structured follow-up using UCT and AECT assessments. This case highlights delayed bullous pressure urticaria as a rare and potentially misleading presentation of chronic inducible urticaria, underscores the need to distinguish it from more common oedematous forms of pressure urticaria and from primary bullous dermatoses, and emphasizes early recognition, trigger avoidance, and minimization of prolonged corticosteroid exposure.

Palmoplantar hyperkeratosis and early-onset aggressive periodontitis are the hallmarks of Papillon–Lefèvre syndrome (PLS), a rare autosomal recessive condition caused by pathogenic variants in the CTSC gene. We report a 9-year-old girl who was born to consanguineous parents and presented with progressive periodontal disease, nail dystrophy, and transgradient palmoplantar keratoderma. Based on clinical and histopathologic findings, she was initially misdiagnosed with psoriasis. Topical and systemic treatments were administered, with only mild improvement observed. A homozygous CTSC variant (c.899G>A; p.Gly300Asp) was subsequently found by whole-exome sequencing, confirming PLS. Partial clinical improvement was achieved with supportive dermatological care and multidisciplinary dental treatment. Early genetic diagnosis allows for appropriate management, and prevents unnecessary systemic immunosuppression. This case highlights the importance of considering PLS in children presenting with early-onset keratoderma and periodontal disease.

Acquired reactive perforating collagenosis (ARPC) is a rare perforating dermatosis characterized by transepidermal elimination of altered collagen fibers. It is most commonly associated with diabetes and chronic kidney disease and may be underrecognized in patients with chronic pruritus. We report two cases of ARPC in women aged 74 and 60 years with type 2 diabetes who presented with severe chronic pruritus and multiple hyperkeratotic umbilicated papules. In the first patient, dermoscopy demonstrated crateriform lesions with a central keratotic plug, and histopathology revealed transepidermal elimination of degenerated collagen fibers. In the second patient, the diagnosis was suspected clinically and confirmed histologically using special stains. Clinicopathological correlation established the diagnosis in both cases. Treatment with systemic and topical therapies resulted in symptomatic improvement. ARPC is an uncommon and probably underdiagnosed dermatosis strongly associated with metabolic disorders, particularly diabetes and chronic kidney disease. These cases emphasize the importance of integrating clinical, dermoscopic, and histopathological findings to distinguish ARPC from other causes of chronic pruritus. ARPC should be considered in diabetic patients presenting with chronic pruritus and crateriform hyperkeratotic papules. Early recognition may facilitate timely diagnosis and optimization of associated systemic diseases.

Aim: To estimate the frequency of metabolic syndrome and insulin resistance in patients of chronic plaque psoriasis and to evaluate their association with psoriasis severity.

Materials and Method: 110 patients aged 18–70 years with chronic plaque psoriasis were included in the study. Patients were subjected to blood testing for serum lipid profile, fasting blood glucose and fasting insulin level. Metabolic syndrome was diagnosed according to the NCEP ATP III criteria. Psoriasis severity was classified as mild or moderate to severe according to Psoriasis Area Severity Index (PASI) and body surface area (BSA). When PASI was ≥10 and BSA was >10, psoriasis was designated as moderate to severe.

Results: The prevalence of metabolic syndrome was 42.7% and prevalence of insulin resistance was 43.6%. Mean values for all variables anthropometric measurements, age and Extent of disease were higher in patients with metabolic syndrome as compared to those without metabolic syndrome and this difference was statistically significant. 28.2% of participants had increased Total cholesterol level, 21.8% of participants had increased LDL levels, 47.3% of participants had increased VLDL levels, 48.2% of participants had increased triglycerides level and 30% had reduced HDL levels. The mean triglyceride level was raised in participants (177.6 + 102.2) and mean HDL levels were within normal limits (47.3 + 13).

Conclusion: Chronic plaque psoriasis should not be regarded merely as a cutaneous disorder but as a systemic inflammatory condition with significant metabolic implications. Early identification and management of metabolic syndrome and insulin resistance in psoriatic patients can aid in reducing long-term cardiovascular morbidity and improving overall patient outcomes.

Background: Tinea faciei is a superficial dermatophyte infection of the face that commonly presents as an annular erythematous scaly lesion with active margins and central clearing. However, atypical presentations are increasingly encountered due to inappropriate topical steroid use, over-the-counter medication, cosmetic application, and delayed diagnosis. Such altered morphology may mimic eczema, seborrheic dermatitis, rosacea, acneiform eruptions, photosensitive dermatoses, or lupus-like lesions, making clinical recognition difficult.

Aim: The aim of the study was to assess the atypical presentation of tinea faciei and its occurrence across different age groups among patients attending a tertiary care hospital.

Material and Methods: A hospital-based observational study was conducted among 60 patients clinically diagnosed with tinea faciei at a tertiary care hospital & private clinic. Patients of all age groups and both sexes were included. Detailed history regarding demographic profile, duration of disease, symptoms, recurrence, topical steroid use, over-the-counter medication, cosmetic use, family history, contact history, and associated dermatophytosis was recorded. Clinical examination assessed site, number, morphology, scaling, erythema, pigmentation, papules, pustules, and extent of facial involvement. Skin scrapings were examined by potassium hydroxide mount. Data were analyzed using SPSS version 27.0. Frequencies, percentages, Chi-square test, and Fisher’s exact test were applied, with p<0.05 considered statistically significant.

Results: Among 60 patients, atypical presentation was observed in 41 patients (68.33%), while classical annular scaly lesions were seen in 19 patients (31.67%). The highest proportion belonged to the 21–40 years age group (36.67%), followed by 41–60 years (21.67%). Males constituted 56.67% and females 43.33%. Atypical presentation was most frequent among patients aged >60 years (80.00%), followed by 21–40 years (72.73%), though age-wise association was not significant (p=0.777). Steroid-modified or ill-defined erythematous plaques were the most common atypical pattern (26.67%). Visible scaling was significantly more common in classical lesions (p=0.025), whereas pigmentary changes were significantly associated with atypical lesions (p=0.022). Topical steroid use (p=0.001) and over-the-counter medication use (p=0.020) were significantly associated with atypical presentation. KOH mount was positive in 80.00% of patients.

Conclusion: Atypical tinea faciei was more common than classical presentation across all age groups. Steroid misuse and over-the-counter medication were major associated factors. Careful clinical assessment with KOH confirmation is essential for early diagnosis and appropriate treatment. 

Background: Autoimmune vesiculobullous disorders (AVBDs) are a heterogeneous group of immune-mediated blistering diseases characterized by considerable clinical overlap, making accurate diagnosis challenging. Clinicohistopathological correlation plays a crucial role in establishing the diagnosis, particularly in settings where direct immunofluorescence is not routinely available.

Methods: This hospital-based cross-sectional observational study was conducted in the Department of Dermatology, Venereology and Leprosy, Amaltas Institute of Medical Sciences, Dewas, Madhya Pradesh. Ninety-two patients with clinically suspected, untreated autoimmune vesiculobullous disorders presenting with fresh lesions were enrolled. All patients underwent detailed clinical evaluation, Tzanck smear examination, and skin biopsy for histopathological assessment. Clinical diagnoses were compared with histopathological findings to determine clinicohistopathological concordance.

Results: The majority of patients were females (73.91%) and belonged to the 41–50-year age group (27.17%). Oral mucosal involvement (55.43%), vesicular lesions (76.09%), and positive Nikolsky's sign (79.34%) were the predominant clinical findings. Pemphigus vulgaris was the most common clinical (64.13%) and histopathological (60.87%) diagnosis, followed by pemphigus foliaceus and bullous pemphigoid. Suprabasal cleft formation (60.87%) and acantholysis (65.22%) were the principal histopathological findings. Tzanck smear was positive in 86.96% of cases, with acantholytic cells identified in the majority. Overall clinicohistopathological concordance was 93.48%, with excellent agreement between clinical and histopathological diagnoses (Cohen's κ = 0.823; p < 0.001).

Conclusion: Pemphigus vulgaris was the predominant autoimmune vesiculobullous disorder in this cohort. A combined approach incorporating clinical examination, Tzanck smear, and routine histopathological evaluation demonstrated excellent diagnostic accuracy and remains a practical, reliable, and cost-effective strategy for diagnosing autoimmune vesiculobullous disorders, particularly in resource-limited settings.