Although the impairment of quality of life (QoL) in individuals with keloids is profound, it has neither been well quantified nor correlated with severity in people with skin of colour. This cross-sectional, questionnaire-based study comprised 110 patients with keloid(s). A physician measured the severity of keloids using the Vancouver Scar scale and impairment of QoL using the patient-filled Hindi version of Dermatology Life Quality Index questionnaire. The relationship among QoL and severity score as well as with components of demographic data was analysed using SPSS. Our study found the severity of keloid(s) to be moderately but significantly correlated with the QoL of its sufferers.Individuals with multiple keloids were found to be significantly younger than those with solitary ones. Itching, pain, along with restricted mobility significantly impacted the QoL as well as severity of keloids. Individuals who had undergone prior treatment were found to have a worse QoL than the treatment naive. Recurrence was found to be associated with lower scar severity, multiple keloids, and younger age. Increasing age, though associated with greater scar severity, lacked any relationship with the QoL. Our study also found that individuals with bigger keloids sought treatment earlier and more often. Hyperpigmented keloid(s), more common in individuals with skin of colour, were associated with a significantly worse QoL and a higher scar severity.keloid, quality of life, severity, skin of colour | INTRODUCTIONKeloidsclaw-like irregular deposition of dense fibrous tissue beyond the edges of the original injuryrepresent an exaggerated healing response in predisposed individuals. 1 Located most often on the chest, shoulders, upper back, posterior neck, and earlobes, keloids occur more commonly in people with darker skin -African Americans, Hispanics, and Asians. 2,3,4 However, treatment options of this relatively common condition continue to focus on improving cosmesis and alleviating symptoms, such as pruritus, pain, and loss of function, rather than on a complete cure. 5 Individuals with visible keloids often experience stigmatisation, reduced body esteem, and some degree of social isolation. 6 In the current era of heightened aesthetic awareness, keloidal scarring can greatly affect the self-perception of patients and impair their quality of life (QoL); thus, measuring the latter, is becoming increasingly important in contemporary clinical dermatology. However, little is known about the impact of these scars on the QoL of its patients; some Western studies that have Abbreviations: ANOVA, analysis of variance test

Lowlanders working at high altitude are at high risk to develop HZ in comparison with persons working at plains. However, a large population-based study is required to investigate and establish the same.

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Background: Alopecia areata (AA) is a chronic inflammatory disease characterized by nonscarring hair loss involving any hair-bearing surface of the body. The current therapy for AA is not curative but rather aimed at controlling or limiting the pathogenic process. Corticosteroids are the most popular drugs used, however localized atrophy is a common complication, particularly with triamcinolone. Promoting hair growth by application of autologous blood extracted platelet rich plasma (PRP) is a simple, yet effective procedure. The aim of the study was to evaluate and compare the efficacy of intralesional triamcinolone acetonide (5 mg/ml) with intralesional PRP in the treatment of two different scalp AA patches of same individual. Methods: A total of 30 patients having ≥2 patches of AA were randomized and given two separate modalities of treatment in two different patches and divided in Group I, treated with intralesional triamcinolone acetonide (5 mg/ml) and Group II, treated with PRP. Interval time between every follow-up was 3 weeks and four such follow-ups were done. Hair regrowth was calculated according to Mac Donald Hull and Norris grading system at every follow-up and was compared with the initial grading. Results: Group I patches, treated with triamcinolone acetonide have the significantly higher mean grading score than the group II patches, treated with PRP at each follow up. Conclusions: Intralesional triamcinolone acetonide is more efficacious than intralesional PRP in the treatment of scalp alopecia areata with no recurrences and very few adverse effects like atrophy and hypopigmentation.

<p class="abstract"><strong>Background:</strong> The dropout of outpatients on antifungal therapy for recalcitrant tinea incognito is attributable to the flare on withdrawal of topical corticosteroids and the virulence of pathogens. The objective of the study was to evaluate the role of topical tacrolimus in adherence to antifungal therapy in recalcitrant tinea incognito.</p><p class="abstract"><strong>Methods:</strong> 28 cases of topical corticosteroid induced tinea incognito of more than 6 months duration were enrolled and topical and systemic antifungal therapy instituted for 8 weeks. Topical tacrolimus was also instituted in the test cohort. The end point for resolution was the absence of raised margins, erythema, induration and scaling.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 patients were male while 11 were female and their age ranged from 16-45 years (mean 26.5). Two patients were from upper-middle; 5 from lower-middle and 21 from upper-lower socioeconomic class. Their occupations included shop assistants, security guards, drivers and labourers and the duration of illness ranged from 7-36 months. Topical corticosteroids were obtained on prescription by 5 and over the counter by 23 patients. Out of the test cohort of 14, all lesions had resolved in 10 patients who had adhered to therapy and were reviewed at the end of 8 and 10 weeks. While 5 reported burning on application of tacrolimus 1 developed folliculitis. Out of the control cohort of 14, though 5 had adhered to therapy all lesions had resolved only in 3 patients at the end of 8 and 10 weeks.</p><p class="abstract"><strong>Conclusions:</strong> Topical tacrolimus facilitates adherence to antifungal therapy in recalcitrant tinea incognito.</p>

Herein, we report a rare presentation of erythema multiforme following Covishield/ ChAdOx1 vaccination. A 25-year-old female presented to the department of dermatology with multiple, erythematous, targetoid plaques, distributed symmetrically over both arms, face and upper back without any systemic complaints (Figure 1A-D). Mucosae as well as palms and soles were uninvolved. Dermoscopy of a welldefined lesion on the arm revealed a dusky centre, an outer pale ring and peripheral erythema. The patient denied history of any recent illness, reactions to previous vaccines or intake of any medication. She

BackgroundUrticaria, a vascular reaction of the skin, is marked by the transient appearance of erythematous papules or plaques (wheals) of varying sizes that are blanchable and associated with severe pruritus which lasts from a few hours to days. The etiological factors for urticaria include food, drugs, bacterial foci, pollen, fungi, dust, worms, physical stimuli, stress, anxiety, insect stings, etc. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose immunoglobulin E-mediated type 1 allergic reactions such as urticaria. A history suggestive of clinical sensitivity supported by a positive test strongly implicates the allergen in the disease process. In this study, we aimed to detect the common allergens and correlate the findings of SPTs with various epidemiological characteristics of urticaria patients. MethodologyA total of 100 patients with urticaria were included in this study. After receiving written and informed consent from patients, SPTs using a battery of 45 allergens were performed. ResultsIn our study, SPT positivity was seen in 88 (88%) patients. The highest sensitization was noted toward Dermatophagoides pteronyssinus (house dust mite) (30%), followed by D. farinae, Cynodon dactylon, and peanuts (each comprising 24%), and Ailanthus excelsa (20%). ConclusionsFinding the causative allergen in urticaria is often a difficult and long-drawn process, both for the physician and the patient. Our study identified an allergen in 88% of patients with urticaria, thereby showing that the SPT is a cost-effective, easy, and reliable tool for diagnosing and guiding treatments in urticaria patients.

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