GI problems in EB are very common with subtype specificity for some of these complications. The occurrence of diarrhoea, PLE and colitis in the context of EB has not been highlighted previously, and may arise secondarily to antigenic exposure in the gut lumen as a result of mucosal fragility.

Epidermolysis bullosa (EB) encompasses a group of diseases characterized by extreme fragility of skin and mucous membranes, resulting in blister formation following minimal injury. There are 4 types of EB, with epidermolysis bullosa simplex (EBS) being the most common. We report our experience with the care of a parturient woman diagnosed with EBS. There is little literature on pregnancy in women with this condition. Special precautions are necessary during diagnostic and therapeutic interventions to avoid bullae formation or exacerbation of existing lesions. Frictional or shearing forces are typically more damaging than compressive forces. Multidisciplinary planning was done for our patient to ensure uneventful labor and delivery. Elective induction of labor was started at 40 weeks of gestation. She eventually underwent a cesarean delivery after failed trial of labor. We present this case to highlight the obstetric and anesthetic implications of caring for a parturient with EBS.

Acne may continue from adolescent to adult age or newly develop in adults. Data also suggest rising prevalence of acne among post-adolescent patients. 4 Based on the age, patients with acne can be divided into three types: preadolescent, adolescent, and post-adolescent groups. [5][6][7] An extensive review involving 1,013 men and women reported acne among 50.9%, 35.2%, 26.3%, and 15.3% women in third decade, fourth decade, fifth decade of life, and beyond 50 years of age, respectively. 6

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<p class="abstract"><strong>Background: </strong>To study clinical and epidemiological characteristics and hormonal profile of adult females with acne</p><p class="abstract"><strong>Methods: </strong>Adult female patients of &gt;25 years of age with acne were enrolled. Demographic profile, habits, location of acne lesions, associated disease and acne flare association with menstrual cycle were noted. Prevalence of abnormalities in testosterone, dihydroepiandrosterone-sulfate (DHEAS), prolactin, luteinizing hormone (LH), follicle stimulating hormone (FSH), LH:FSH ratio, anti-mullerian hormone (AMH), and serum insulin were noted. Ultrasound (abdomen and pelvis) was performed for screening the presence of any abnormality.</p><p class="abstract"><strong>Results:</strong> Fifty one patients [mean (SD) age 30.96 (4.93) years] were included in the study. Thirty six (70.59%) patients had persistent type of acne. Grade 2 acne was present in 40 (78.43%) patients. Oily skin was seen in 27 (52.94%) patients. Hirsuitism and menstrual irregularity was present in 24 (47.06%) and 13 (25.49%) patients respectively. Pigmentation and scarring was present in 27 (52.94%) and 35 (68.63%) patients respectively. Acne lesions were seen on cheeks in 36 (70.59%) patients. Eight (15.69%) patients had elevated testosterone. DHEAS and prolactin levels were normal in all patients. Elevation of LH and decreased FSH levels were seen in five (9.80%) and three (5.88%) patients respectively. Five (9.80%) patients had elevated LH:FSH level. Raised insulin level was seen in 8 (15.69%) patients.</p><p class="abstract"><strong>Conclusions: </strong>Derangement of hormonal profile is not very common among adult female patients with acne. However, in some patients laboratory markers of hyperandrogenism are seen.  </p>

Photosensitive lichenoid eruption is a morphologically distinct photodermatoses that is commonly seen in Indian patients with pathological features showing mostly spongiotic changes and in some cases lichenoid changes.

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