Shreya K Gowda’s research while affiliated with All India Institute of Medical Sciences Bhubaneswar and other places

NUM can resemble nodular melanomas, appearing suddenly as an ulcerated nodule that grows quickly. ² NUM is usually misdiagnosed and notoriously mimics other tumors (such as periungual pyogenic granuloma in our case). Herein we are presenting a rare case of nail unit melanoma in a 52-year-old female who presented with insidious onset, slowly progressive soft to firm, non-tender, red nodule with a proximal nail fold showing bluish-black pigmentation over the left thumb area associated with bleeding since 1 year. Histopathology and immunohistochemistry are suggestive of melanoma. Surgical oncology reference was sought and digital amputation was considered.

Introduction Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India. Aim and Objectives The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases. Materials and Methods The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification. Results A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background. Limitations In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed. Conclusion Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated.

Lipodystrophies can be generalized and partial/localized lack of subcutaneous tissue, which are uncommon heterogeneous illnesses that can be hereditary or acquired. Acquired partial lipodystrophy’ (APL) is the new name for lipodystrophia progressiva, also known as Barraquer–Simons syndrome (BSS). It could come after a severe viral infection like the measles. Young people and children both experience it. Typically, BSS or APL starts between the ages of 5 and 15. The principal feature of BSS is cephalothoracic lipodystrophy, which affects the face, neck, arms, thorax, and upper abdomen in a cephalocaudal pattern. Alternate complement pathway activation and C3 hypocomplementemia with adipocyte lysis brought on by complement 3 nephritic factor (C3NeF) have been suggested as potential causes of fat loss in individuals with APL, even though the precise process is still mostly understood. Therapeutic options for lipodystrophy include fat fillers. Different types of autologous fat transplants are possible. Autologous free fat graft where a mass of tissue harvested from any discrete subcutaneous location and implanted at a recipient site. Dermofat grafts are made from tissue that has been removed from a region, allowing for the removal of full-thickness skin grafts and the primary closure of defects. The dermofat graft can be employed as a spacer between gliding tissues or as a filler. Omental flaps, which are revascularized fat flaps, can be utilized for microvascular transfer, soft-tissue filler for hemifacial atrophy, or to cover any significant skin defects. When fat is extracted, processed, and transplanted in liquid injectable form for a variety of purposes, it is known as free fat injection.

Granulomatosis with polyangiitis, a form of necrotizing vasculitis can present as a limited variant with the involvement of a single organ system. The superficial protracted form can present as face and scalp ulceration for chronic periods of time. Diagnosis can be established histopathologically by examining the involvement of blood vessels. Here, we present a case of scalp ulceration that was diagnosed as a limited variant and started on steroids and immunosuppressants with excellent response.

Introduction Lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) are primary scarring alopecias that pose diagnostic challenges clinically, where trichoscopy features may provide benefit in delineating these two cicatricial alopecia, and also helps in assessing the evolution and therapeutic response. To date, there are few reviews on dermoscopic findings in differentiating these two alopecias. Methods A systematic literature review was conducted using the PubMed and Google Scholar databases. The search terms included for scalp DLE were ‘lupus’ OR ‘discoid lupus’ OR “scalp lupus” and for scalp LPP were “lichen planopilaris” OR “scalp follicular lichen planus” OR “lichen planus follicularis” and were combined with “dermoscopy” OR “dermatoscopy” OR “videodermoscopy” OR “video dermatoscopy” OR “trichoscopy”. The differences in the prevalence of dermoscopic features in scalp DLE and LPP were calculated using the Chi-square test. Results Of 52 articles, 36 (17 LPP, 19 DLE) were eligible for quantitative analysis. We found predominant peripilar tubular casts and perifollicular erythema with the presence of arborizing vessels in the vicinity of these changes, indicating early LPP. In contrast, follicular red dots, speckled brown pigmentation, and hair diameter variability indicated active DLE. Shiny white areas were common in both the groups in late stages. The target pattern of distribution of blue-grey dots, milky red areas, and irregular white fibrotic dots were seen in LPP, and pink-white background, follicular plugs, perifollicular and interfollicular scale, rosettes, chrysalides, and red spider on yellow dots were detected in DLE. Features such as yellow dots and blue-grey structureless areas were nonspecific and did not have a major role in differentiating DLE from LPP. Conclusion This article provides a comprehensive review of the literature and delineates the trichoscopic differences and peculiarities of scalp DLE and LPP, including the correlation of dermoscopic features with histopathological findings.