Ramesh Marne Bhat

Syphilis is known to run its natural course unless intervened, and the severity of clinical presentation in human immunodeficiency virus (HIV) co-infection is well established. Here, we report the case of a 47-year-old male on antiretroviral therapy for 9 years, who presented with a persistent serpiginous plaque over the neck, along with painless g...

Epidermodysplasia verruciformis (EV), linked to weakened immunity against specific human papillomavirus strains, poses a heightened risk of cutaneous dysplasia and malignancy. EV often leads to malignancies like squamous cell carcinoma. This case details a 25-year-old immunocompromised male presenting furfuraceous lesions and a peculiar scalp nodul...

Neglected tropical skin diseases (NTDs) are a group of overlooked afflictions that affect marginalized populations and hinder the advancement of global health in the right direction. India, a significant hotspot, suffers immensely from these diseases, with South India providing a conducive environment for the spread and persistence of causative pat...

Background The issue of antibiotic resistance in acne vulgaris has emerged as a significant concern in recent times. Though the ability of Cutibacterium acnes to form biofilms have been established, its role in acne vulgaris has yet to be ascertained. Aims This descriptive cross-sectional study was aimed to investigate the ability of C. acnes to f...

Vitiligo is a depigmenting disorder characterized by melanocyte loss, which results in pigment dilution of the skin. Vitiligo is commonly associated with thyroid disorders and thyroid stimulating hormone (TSH) is a sensitive marker to detect thyroid disorders. S100B is damage associated molecular pattern (DAMP) molecule released when there is melan...

BACKGROUND Chronic spontaneous urticaria (CSU) is a persistent immune-inflammatory condition. The urticaria activity score 7 (UAS7) evaluates its disease activity. The neutrophil-to-lymphocyte ratio (NLR) is recognized as a dependable marker for inflammation in various conditions. AIM The aim of the study was to examine the NLR in CSU patients and...

Context The wide range of antifungal agents available poses a difficulty in choosing an effective medication to avoid drug resistance. There is a need for a standard antifungal susceptibility testing method that would guide a practicing dermatologist to prescribe antifungal agents effectively. Aims The aim of the study was to determine the prevale...

Histopathology is the cornerstone for diagnosis of dermatological conditions, with developments in immunopathology; direct immunofluorescence is a proven adjunct in bullous and non-bullous disorders. Here we emphasize the role of direct immunofluorescence in non-bullous diseases encountered in clinical practice. This is a descriptive, ambispective...

A much is known about the cutaneous side effects of topical corticosteroids (TCs) often neglecting their potential systemic adverse events, including Cushing’s syndrome (CS). Although cases of CS following TCs abuse are a well-documented entity in the pediatric population, similar instances in adults are less common and less discussed. Here, we des...

Painful skin tumors present a diagnostic challenge due to their diverse presentations. The acronym blue rubber bleb nevus, leiomyoma, eccrine spiradenoma, neuroma, dermatofibroma, tufted angioma, angiolipoma, neurilemmoma, endometrioma, granular cell tumor, and glomus tumor (BLEND TAN EGG) encompasses some of the common causes of painful skin tumor...

Rapid progress made in the management of atopic dermatitis (AD) in recent years and the differences in patient journey between Asian and non-Asian populations call for a review of current atopic dermatitis landscape in Asia. A roundtable meeting with nine regional dermatological experts was held in June 2023 to discuss the optimal management approa...

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, usually to drugs, characterized by blistering and epithelial sloughing. SCORTEN is an established prognosticator index employed in SJS/TEN patients to evaluate their severity degree and mortality risk. Many studies done in the recent past have in...

Background: Pityriasis versicolor (PV) is an asymptomatic, superficial fungal infection caused by the Malassezia species and causes discolouration of the skin leading to altered pigmentation. It is usually a clinical diagnosis, but in doubtful cases wherein potassium hydroxide (KOH) mount is unavailable, alternative modalities like dermoscopy aid i...

Limited evidence is available on real-world management of atopic dermatitis (AD) among Asian adults. This cross-sectional study aimed to assess current approaches in AD diagnosis and management in Asia. Practising dermatologists regularly treating patients with moderate-to-severe AD were recruited from eight Asia–Pacific territories, namely Mainlan...

Background Pityriasis versicolor (PV) is an asymptomatic, superficial fungal infection caused by the Malassezia species and causes discolouration of the skin leading to altered pigmentation. It is usually a clinical diagnosis, but in doubtful cases wherein potassium hydroxide (KOH) mount is unavailable, alternative modalities like dermoscopy aid in...

The burden of atopic dermatitis (AD) is significant, with a substantial impact on quality of life (QoL). This cross-sectional study aimed to ascertain the burden of AD, its impact on QoL, and associated costs. Patients with moderate-to-severe AD were enrolled from eight territories, namely Hong Kong, India, Japan, Mainland China, Singapore, South K...

Background Dermatophytosis impacts a significant portion of the global population. Recent shifts in the disease's presentation, severity and response to treatment, primarily due to emerging drug resistance, underscore the need for reliable assessment tools. The Dermatophytosis Severity Score (DSS) aims to standardise the evaluation of the disease's...

It remains unclear how patients with atopic dermatitis (AD) and clinicians perceive the level of patient–clinician communication and if there could be potential lapses. This cross-sectional study aims to compare perspectives between patients with AD and dermatologists regarding communication and treatment expectations in Asia. Moderate-to-severe pa...

Dapsone, once a fabric dye, is a versatile pharmaceutical for treating diseases like leprosy, malaria, and HIV-AIDS-related pneumonia. Discovered in 1908 but not utilized for its antimicrobial properties until the 1930s, dapsone faced initial setbacks due to toxicity, prompting the development of a safer derivative, Promin. Chemically, dapsone's li...

Background Dermatophytosis has assumed epidemic proportions with rising resistance, recalcitrance and recurrence, especially in tropical regions. While various factors contribute to high prevalence worldwide, yet little is known about the interactions between host defence mechanisms and dermatophytes, particularly in chronic and recalcitrant dermat...

Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several tre...

Bowen’s disease is a slowly progressive squamous cell carcinoma (SSC) in situ with high potential for malignant transformation. In this case, we describe a patient with multicentric Bowen’s disease for the past 26 years, developing growths over his left buttock. The patient had a previous history of growth developing over his right thigh, and was d...

Objective: The objective of the study was to evaluate the spectrum of skin diseases among older patients in a coastal city of Southern India and its association with systemic illness. Materials and Methods: In this retrospective, cross-sectional study, medical records from the dermatology outpatient clinics were assessed. Patients over 60 years old...

Background: The rising prevalence of dermatophytosis in tropical countries coupled with drug resistance necessitate an objective scoring system to define the severity, monitor therapeutic response and predict prognoses. We attempted to establish and validate a new scoring system -Dermatophytoses Severity Score (DSS), for dermatophytoses affecting...

In the current era of modern medicine, neglected tropical disorders though rare, still remain a cause of significant morbidity in the sufferers. Actinomycetoma is one such disease commonly seen in the rural population of the tropical countries. Due to the presence of other infectious diseases with similar presentation and low yield on cultures, the...

Pyoderma gangrenosum is a rare neutrophilic inflammatory skin disorder commonly seen over lower limbs. Involvement of penile area is rare. We report this rare case of occurrence of ulcerative type of pyoderma gangrenosum over penis with pustular type elsewhere over the body, healing with keloids in an immunocompetent young man with no systemic asso...

ackground: Leprosy is a public health problem because it potentially affects social life. In 2018, World Health Organisation (WHO) reported that Indonesia ranks third of new cases leprosy. Leprosy significantly influences patients' quality of life. Until now, there is still no specific questionnaire to assess the quality of life for leprosy patient...

Genital elephantiasis is associated with sexually transmitted infections such as lymphogranuloma venereum. Here we present an unusual and rare non-venereal cause of Saxophone penis.

A 60-year-old female patient, housewife, belonging to the upper-middle class, hailing from Kerala, India, presented with complaints of itching and scaling, solely involving the left hand for 3 months. She gave a history of aggravation of symptoms after exposure to detergents. There was no contact with other irritants/allergens prior to the onset of...

Background The use of virtual platforms for clinical meetings has become the default approach during this pandemic era. Organising an offline conference during a pandemic is a challenge and is possible if the participating crowd is vaccinated and is willing to follow appropriate pandemic protocols. Objective To determine the feasibility of conduct...

Context: Keloids are defined as scars that invade the adjacent tissues and rarely regress. In recent years, antimitotic drugs have been used in the management of keloids with promising results. This study highlights the effectiveness of 5-fluorouracil (5-FU) in keloids. Aims: To study the efficacy of intralesional 5-FU in keloids as a solo agent...

Atypical variants of leprosy

case report

a rare case of epidermodysplasia verruciformis

Transepidermal water loss is seen in psoriatic skin..in the lesions as well as unaffected skin in psoriatics compared to normal individuals

Desquamative gingivitis in dermatological disorders

The entire world seems to have responded to COVID-19 pandemic in a knee-jerk manner with a short mindset without building on the existing strengths of public health infrastructure. National governments cannot be blamed for this as we are dealing with a crisis that comes once in a lifetime. Realising this, the Organized Medicine Academic Guild (OMAG...

Background and aims: Dermatophytosis has always been a common superficial mycosis in India. However, the past 6-7 years have seen an unprecedented increase in the number of patients affected by recurrent, chronic, recalcitrant and steroid modified dermatophytosis involving the glabrous skin (tinea corporis, tinea cruris and tinea faciei). Importan...

Erythema nodosum leprosum (ENL) is a manifestation of type II lepra reaction, seen in lepromatous or borderline lepromatous leprosy. Although it is a common reaction encountered in clinical practice, there are an increasingly large number of newer updates in the pathophysiology and management of this condition.The treatment options have expanded fa...

Extramammary Paget's disease (EMPD) of the vulva is a rare disease that occurs mainly in postmenopausal women. It can be primary or secondary. Prognosis of primary EMPD is good, but when secondary, we need to find the underlying malignancy as the prognosis depends on it. Very few cases of secondary EMPD of the vulva have been reported till now. We...

Covid-19 has once again brought into focus our limited preparedness to deal with epidemics. Most nations, across the globe, have responded with a resolve to come stronger out of this crisis and leaderships across the world have shown great commitment to protecting its people from Covid-19. Covid-19 has also taught us a few things for the future. On...

Dermatophytosis due to Trichophyton mentagrophytes/ interdigitale complex is being increasingly reported across India. Reports of therapeutic failure have surfaced recently but there are no clinical break points (CBP) or epidemiological cutoffs (ECV) available to guide the treatment of dermatophytosis. In this study, a total of 498 isolates of the...

Introduction: Rituximab is a chimeric monoclonal antibody targeted against CD20 T-cells. It acts by the destruction of autoreactive B-cells. It is a common biologic agent widely used for the treatment of B-cell lymphoma, lymphoproliferative disorders, and inflammatory conditions that are refractory to conventional treatment, such as rheumatoid arth...

Stevenrsquos- Johnson syndrome SJS is a severe muco-cutaneous reaction precipitated mostly by medications. It affects skin and mucous membranes. In this era of modern medicine a thorough knowledge of drug reaction will be helpful for early identification and effective patient management. The practice of poly-pharmacy has increased the incidence of...

p align="center">The term epidermolysis bullosa (EB) encompasses a group of inherited mechano-bullous disorders, clinically characterized by blisters over skin and mucosae following minor frictional trauma. The diagnosis is predominantly clinical, but further classification is carried out by defining the histological level of the split. Histopathol...

Context Psoriasis is a common papulosquamous disorder characterized by increased epidermal turnover resulting in excessive skin shedding and a compromised barrier function of the skin. Transepidermal water loss (TEWL) is an effective and non-invasive way to measure the barrier function in this condition. Aims To measure the physiological changes i...

Organized medicine is the academic guild of professional medical organizations in India. It was founded at the annual conference of Indian Academy of Pediatrics (PEDICON) on January 7, 2018. Organized medicine is constituted by leading professional medical organizations and mandated to support the sustainability of health agenda of the Government o...

Angiokeratomas are benign tumors characterized by proliferation and dilatation of blood vessels in the upper dermis. They are divided into widespread and localized forms. The localized forms are further classified as angiokeratoma of Fordyce, angiokeratoma circumscriptum neviforme, circumscribed angiokeratoma, and angiokeratoma of Mibelli, of which...

Background: Although dermatology is largely considered as an outpatient specialty, dermatological conditions comprise 5-8% of cases presenting to the emergency department. The need for a dermatological intensive care unit is widely acknowledged due to the increasing incidence of acute skin failure. Very few studies have been done to characterize t...

Background Lichen planus pigmentosus (LPP), a rare variant of lichen planus, is reported in various ethnic groups, more often from the Indian subcontinent and the Middle East. Aims Although the condition is encountered quite often by dermatologists of this region, the data on the clinical, pathological, and immunohistochemical (IHC) aspects of LPP...

Background: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing c...

Background: Dermatosis papulosa nigra (DPN) is a benign cutaneous condition which commonly occurs in dark-skinned people, especially Asians and African Americans. Owing to its benign nature and rarity, very few studies have been conducted to date, and dermoscopic studies are practically nonexistent. Objectives: To study the clinical and epidemio...

Title: Secukinumab efficacy and safety in Indian patients with moderate-to-severe plaque psoriasis: sub-analysis from FIXTURE (Full Year Investigative Examination of Secukinumab vs. Etanercept Using Two Dosing Regimens to Determine Efficacy in Psoriasis), a randomized, placebo-controlled, phase 3 study. Background: Evidence has suggested Interle...

Background: Blister beetle dermatitis an irritant vesiculobullous disorder caused by rove beetles when it comes in contact with or is crushed on the skin. Their hemolymph consists of pederin, a potent vesicant responsible for the classical morphology of lesions. Materials and Methods: This was a descriptive study of 42 such cases was seen in a resi...

Background: The proportion of childhood leprosy has been gaining importance of late as a performance indicator of the National Leprosy Eradication Program. A sizable proportion of the newly detected cases comprises children. The prevalence rate has been used as a measure of existence of infection though leprosy has attained elimination levels in th...

Background: Seborrheic keratosis (SK) is the most common benign epidermal tumor of the skin. Even though SK has been well characterized clinically, dermoscopically, and histopathologically, data regarding clinical dermoscopic and histopathological correlation of different types of SK are inadequate. Aim: We carried out this study to establish an...

Background: Tumors of the skin may be encountered by a dermatologist either as presenting complaints or as incidental findings. Certain tumors are easily recognized clinically, while others can only be diagnosed by histopathology. Aims and objectives: To analyze the pattern of skin tumors through clinical and histopathological correlation and to...

Background: Skin infections caused by coryneform bacteria are common dermatological conditions. However, to the best of our knowledge, no studies are available on the clinical characteristics and epidemiological features of this group of disorders as one entity from India and abroad. Aims: To study the clinical and epidemiological features of co...

Mastocytosis is a disorder characterized by the clonal proliferation of mast cells and their accumulation in skin, bone marrow, liver, and spleen. Cutaneous mastocytosis presents in children in over 90% of the cases and any cutaneous manifestation in an adult is the earliest sign of the systemic disease. A 45-year-old patient presented with itchy d...

Background: The current standard recommendation is to avoid surgical interventions in patients taking oral isotretinoin. However, this recommendation has been questioned in several recent publications. Aim: To document the safety of cosmetic and surgical interventions, among patients receiving or recently received oral isotretinoin. Materials a...

Background Transepidermal water loss (TEWL) is the normal, constitutive loss of water vapor from the skin in the absence of sweat gland activity. It is regarded as one of the most important parameters for characterizing skin barrier function, and the values are dependent on multiple variables. The objective of this study was to evaluate TEWL in neo...

Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic disorder of the skin. Atypical variants of PG such as vegetative PG, bullous PG, and pustular forms are described in literature. Occasionally, granulomatous reaction in dermis may be seen on histology when PG is associated with Crohn's disease or in the vegetative variant of PG. We report...

Lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely. A 40 year old female patient presented with a 1 year history of developing multiple, itchy, pigmented lesions over both lower legs which gradually spread to involve the whole body...

Subcutaneous mycoses are chronic, localized infections of the skin and subcutaneous tissue which occur following traumatic implantation of the etiological agent. The causative organisms are soil saprophytes of regional epidemiology with varying ability to adapt to the tissue environment and elicit disease. This study was conducted to evaluate the v...

Cutaneous leishmaniasis and leprosy are diseases both caused by intracellular pathogens that represent a major health predicament even today. Both these diseases have some characteristics in common, such as the involvement of mucocutaneous tissue, a course with a chronic granulomatous response, a broad clinical spectrum in relation to the host's im...

The new targeted anticancer drugs as well as the older traditional chemotherapy agents are associated with adverse effects on skin, hair, nails and mucosa. These toxic effects can cause great distress to the patient leading to decreased quality of life and interruption in treatment. Aims: To study the mucocutaneous adverse effects of both single an...

Cutaneous manifestations in antiphospholipid antibody syndrome (APS) though common, are extremely diverse and it is important to know which dermatological finding should prompt consideration of antiphospholipid syndrome. The cutaneous manifestations of APS vary from livedo reticularis to cutaneous necrosis, and systemic involvement is invariably an...

Churg-Strauss syndrome is a rare disease manifested by hypereosinophilia, vasculitis and tissue infiltration. This report describes the case of a 45-year-old man who presented with a history of fever, difficulty in breathing, reddish lesions over the extremities and inability to walk since two weeks. The cutaneous features prompted us to conduct se...

Although Molluscum contagiosum (MC) is a self-limiting condition, active therapy could prevent further spread and improve cosmesis. Most of the available treatment modalities traumatize the lesions and have to be undertaken in the hospital, therefore evoking panic in children. In the quest for an alternative therapy, this study comparing 10% potass...