Indian Dermatology Online Journal最新文献

Vitamin K deficiency is a common entity in infancy characterized by bleeding from various sites, intracranial bleeding being the most commonly reported feature. Nodular purpura is an uncommon manifestation of vitamin K deficiency in infancy with a few reported cases in literature. We present four cases of infants presenting with nodular purpura as a manifestation of late-onset vitamin K deficiency bleeding (VKDB). All four children presented with asymptomatic bluish-gray nodules, along with symptoms of hepatic dysfunction. Coagulation profile was deranged in all four children and symptoms improved with the administration of parenteral Vitamin K. The case series details the clinical course, treatment response, and follow-up for each patient. To conclude, nodular purpura can be a rare presentation of late-onset VKDB. "Warning bleeds" of VKDB are known to precede dangerous intracranial bleeds. Late-onset VKDB cannot be prevented by routine neonatal vitamin K prophylaxis and requires repeated vitamin K treatments. The case series is an attempt to highlight the unusual manifestation of a bleeding disorder that can be easily prevented by early intervention.

Background: Trichoscopy is a simple, noninvasive tool to help in the diagnosis of various hair and scalp disorders. There is paucity of data on the normal trichoscopic parameters of hair density and diameter in the Indian population.

Aim: The aim of this study was to establish the trichoscopic patterns of hair and scalp in healthy Indian males and to provide a framework for future reference.

Materials and methods: Quantitative trichoscopic analysis using a videodermoscope was done on healthy Indian males with no hair/scalp complaints. Images were taken from four areas: frontal, occipital, and both temporal areas, under 20x and 70x magnification. The following parameters were analyzed by the software: hair density and thickness; percentage of thin, medium, and thick hairs; percentage of anagen and telogen hairs; vellus hair density and hair count; follicular unit density; percentage of follicular hair units; single, double, triple, and four hairs per follicular unit; and distribution and pattern of scalp vasculature.

Results: A total of 120 healthy males were recruited in the study with a mean age of 24.6 years. The hair density was the highest in the frontal and occipital areas, while the hair thickness was similar in all the sites evaluated. The follicular unit density was the highest in the frontal and occipital areas with the temporal area having the highest number of single hair follicular units. The scalp vasculature varied with the area examined, the most common pattern being the pin-point type.

Limitations: It was a hospital-based study with a relatively small sample size. The software used in the study cannot detect gray hairs.

Conclusion: Our study has attempted to fill the gaps in the medical literature by proposing comparable reference values for trichoscopy in healthy Indian males.

Background: Diaper dermatoses broadly refer to skin disorders that occur in the diaper area. Dermoscopy is a non-invasive diagnostic tool that magnifies subsurface structures of the skin that are invisible to the unaided eye.

Aim: To identify and describe the dermoscopic features of dermatoses in the diaper area.

Materials and methods: A cross-sectional clinical study was conducted, which included 100 children below five years of age with dermatoses in the diaper area. The lesions were initially observed clinically and then under a dermoscope (Dermlite 4, 3GEN Inc., San Juan Capistrano, CA, USA). Findings were recorded and photographed.

Results: Of the 100 enrolled children, infectious dermatoses were observed in 46 cases, predominantly comprising scabies and tinea cruris, followed by intertrigo, molluscum contagiosum, and varicella. The most common dermoscopic feature of scabies was a jet wing with a contrail, whereas scaling, red-brown, and grey-brown dots and globules were observed in tinea cruris. Of the non-infectious dermatoses, contact dermatitis and vitiligo were the most common. Dermoscopy revealed irregular-dotted vessels and white structureless areas in cases of contact dermatitis. An absent pigment network and white structureless areas with leukotrichia and white glow were seen in vitiligo, which helped differentiate it from nevus depigmentosus.

Limitations: Single-center study with a limited sample size for each condition and histopathological confirmation could not be performed.

Conclusion: This study highlights the dermoscopic features of diaper dermatoses and demonstrates the potential of dermoscopy to enhance diagnostic accuracy and optimize patient care without invasive investigations, underscoring its unique role in pediatric dermatology.

Topical sunscreens decrease the quantity of ultraviolet (UV) light from the sun reaching the skin by either blocking or scattering it and help protect the skin from dyspigmentation, photoaging, DNA damage, and photocarcinogenesis, especially in photosensitive individuals. The significant role played by visible light and infrared light in skin pigmentation and photoaging has been recognized in recent years. The majority of broad-spectrum sunscreens protect against UV-B (290-320nm) and UV-A (320-400nm) radiation. Allergic reactions to sunscreens were relatively uncommon compared to their widespread use in the last more than four decades. With growing awareness of problems associated with excessive sunlight exposure, their use has increased exponentially, especially that of cosmetics and other personal grooming products containing UV filters. In recent years, sunscreen agents have been commonly identified as causing allergic contact dermatitis and photodermatitis. Thus, allergic contact dermatitis, photo-irritation, photo-allergenicity, and photo-toxicity (acute/subacute effects) are of immediate concern in the assessment of topical sunscreens for their optimal use. Sunscreen chemicals such as p-aminobenzoic acid (PABA) and PABA esters, the cinnamates, benzophenones, oxybenzone, and dibenzoylmethane that absorb UV radiation are common contact sensitizers capable of producing both allergic contact dermatitis and photodermatitis. The excipients in sunscreen formulations by themselves may also cause allergic reactions. Herein, we review potential allergens, clinical evaluation, and management aspects of topical sunscreen contact sensitivity for their optimal use in clinical practice.