Cancer metastases represent the most devastating aspect of malignancy, since the mortality of cancer patients is mainly related to the metastatic behavior of the primary neoplasm. Skin metastases are usually late events in the course of tumor progression. Excluding melanoma, the most common tumor to metastasize to the skin is breast cancer. Patients who develop cutaneous metastases rarely present with a zosteriform distribution. Herein, we present a 60-year-old female, an undiagnosed case of breast cancer, with zosteriform metastases along her right T2-T3 dermatome.

Background:The relationship between impaired quality of life (QoL) due to melasma and its clinical severity remains equivocal despite several studies.Aim:The aim was to study the correlation, if any, between the clinical severity and the impairment in QOL due to melasma.Methods:This cross-sectional, questionnaire-based study was conducted on a cohort of 141 patients of melasma attending the outpatient department of our referral hospital. A physician measured the severity of melasma using the melasma area and severity index (MASI), while melasma-related QoL (MELASQOL) score was calculated utilizing the validated Hindi version of the MELASQOL questionnaire filled by the patients. Correlations of these two scores with each other and with components of the demographic data were attempted using the Statistical Package for the Social Sciences, version 20.Results:Significantly greater impairment in QoL was found in patients with a history of prior use of triple combination therapy and in patients with hirsutism and/or polycystic ovarian disease. The severity of melasma was found to be significantly higher in patients with a history of recurrence and tobacco chewing.Limitations:The sample size could have been larger. Ultrasonography could have been carried out in all cases of hirsutism.Conclusion:The severity of melasma does not correlate with the impairment in QoL.

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Pyoderma gangrenosum is a rare noninfective neutrophilic dermatosis, characterized by progressive painful ulceration. It is frequently associated with systemic disorders like inflammatory bowel disease, rheumatoid arthritis and myeloproliferative diseases. However, its association with infectious diseases in particular with tuberculosis is extremely rare. Diagnosis is based on the history of an underlying disease, a typical clinical presentation, histopathology and exclusion of other diseases leading to ulcerations of similar appearance. Immunosuppression with corticosteroids remains the mainstay of treatment. We report a case of a 49-year-old male with long-standing ulcerative colitis, associated with tuberculosis of hip, who presented with nonhealing ulcers over the lower extremity.

<p><strong>Background: </strong>Quality of life in patients with premature graying of hair is an under studied topic in Indian population. Its onset in adolescence may have a significant effect on the developing psyche of an individual sufferer impairing academic and work related performance and can be associated with low self esteem, low confidence which can further be associated with depression. Aim was<strong> </strong>to objectively evaluate the impact of premature canities on QoL and early identification of patients in need of medical and psychological intervention.</p><p><strong>Methods: </strong>The impact on QoL was calculated with the help of a modified and prevalidated questionnaire based on the dermatology life quality index proposed by Finley and Kahn. One hundred patients with onset of canities before the age of 25 years were enrolled, after approval by the institutional ethical committee.</p><p><strong>Results: </strong>The mean modified DLQI score recorded was 14.3±6.76. Total of 71% patients were found to have a very large to extremely large effect on the QoL. Guilt, mood fluctuation and need for medical intervention were reported frequently. The comparison between DLQI scores of boys and girls was not significant.</p><p><strong>Conclusions: </strong>Patients of premature canities were found to have profound impact on their QoL, attributable to their perception of the disease. Considering the age group affected, it could have a long‑term detrimental effect on their psychological and social wellbeing.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background:</strong> The high burden of menopausal symptoms notwithstanding, there is a paucity of published work evaluating its impact specifically on the skin and mucosa. With high incidence of underreported cases in developing countries, active screening of all women is essential for accurate assessment of prevalence of cutaneous features, as highlighted by this study. The objective of this study is to assess clinical patterns of dermatosis in menopausal women.</p><p class="abstract"><strong>Methods:</strong> A cross‑sectional study conducted in the dermatology department conducted on postmenopausal patients below 65 years having dermatoses after taking their written consent. Data analysis using SPSS 20.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of 350 postmenopausal women, 165 had genital involvement, atrophic vaginitis (41.21%) being the most common manifesting typically as vaginal dryness. Of 82 women having oral complaints, 42.7% women had complaints of pain or difficulty swallowing in the absence of mucosal lesions. Of the total sample size, 34% women had had female pattern hair loss, maximum women with grade I-2 (45.4%) and I-3 (36.13%). Two key findings which we did not find previous records of included incidence of keratoderma climactericum (2.29%) and hirsutism in early menopause which we found to be 8%. It is important to note that only 28% of women were aware that their complaints were related to menopause or chose to seek active treatment for existing complaints.</p><p class="abstract"><strong>Conclusions:</strong> This study highlights the various clinical patterns of postmenopausal dermatoses to raise awareness in dermatologists and gynecologists for prompt diagnosis, treatment and patient education.</p><p class="abstract"> </p>

Introduction: Neurofibromatosis type 1 (NF1) is an inherited neuroectodermal abnormality with multisystem effects, which can have heavy psychological and physical burdens, especially in countries like India, wherein skin disease is significantly stigmatized. This study was performed to understand the clinical and epidemiological trends of NF1 at a tertiary care center in India and evaluate the association between clinical severity and quality of life in these patients.Methods: We conducted a cross-sectional study of 40 patients with NF1 over a period of two years at a tertiary hospital in western India. After obtaining consent, demographic and clinical information was collected from the patients and recorded in a pre-designed proforma. Quality of life was assessed by a validated Dermatology Life Quality Index (DLQI) questionnaire in languages understood by the patients and subsequently analyzed.Results: This study included 40 patients at a mean age of 28.6 years, with a slight male predominance. The most frequently occurring lesions were café-au-lait macules, followed by neurofibromas and intertriginous freckling. The mean DLQI score was 12.35, implying a large effect on most patients' lives. Questions related to self-consciousness, embarrassment, and the influence of skin lesions on clothing choices had the highest scores, indicating a significant effect on social perception.Conclusion: NF1 has a profound impact on a patient's quality of life, as evidenced by the high DLQI scores in our patient cohort. The early identification and management of such patients can help prevent further deterioration of their quality of life.