Demodex mite is an obligate human ecto-parasite found in or near the pilo-sebaceous units. Demodex folliculorum and Demodex brevis are two species typically found on humans. Demodex infestation usually remains asymptomatic and may have a pathogenic role only when present in high densities and also because of immune imbalance. All cutaneous diseases caused by Demodex mites are clubbed under the term demodicosis or demodicidosis, which can be an etiological factor of or resemble a variety of dermatoses. Therefore, a high index of clinical suspicion about the etiological role of Demodex in various dermatoses can help in early diagnosis and appropriate, timely, and cost effective management.

SummaryBackground. Tulip, belonging to the genus Tulipa and family Liliaceae, is a spring-blooming perennial that grows from bulbs. Owing to manual handling, contact dermatitis can occur in professionals at any stage of the growth cycle of the tulip plant. Objectives. To determine the clinical pattern of contact dermatitis resulting from tulip plant cultivation, and to assess contact allergy in workers coming into contact with this plant. Methods. One hundred and sixty-four tulip workers were screened, and 48 patients with suspected contact dermatitis were patch tested with 39 allergens, including haptens from the Indian baseline series, a plant series, and extracts from different parts of the tulip plant. Results. Thirty-nine positive patch test reactions were observed in 21 patients. Seventeen patients showed positive reactions to either -methylene--butyrolactone or to tulip plant extract. Clinical relevance was observed for 13 of 17 positive patch test reactions. Conclusions. Contact dermatitis is an important health hazard in workers dealing with tulip bulbs. Further studies to identify and isolate other possible tulip allergens, and to quantify the amounts of allergens in different parts of the tulip plant, are recommended.

Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 had grade VI AGA. Among AGA patients, 60 of patients had mild-moderate AGA and 40 patients had severe AGA. Metabolic syndrome was statistically significantly more common in patients with AGA compared to controls. Among patients of AGA, metabolic syndrome was statistically significantly present in severe AGA compared to mild-moderate AGA. Among the evaluated parameters, like blood pressure, fasting blood sugar, dyslipedemia, abdominal obesity, all were significantly more common in AGA patients compared to controls except abdominal obesity.Conclusions: In the present study, metabolic syndrome was found to be 4.6 times more common in patients of androgenetic alopecia as compared to controls, being statistically significant, and more common in those with severe grades. This suggests that androgenetic alopecia patients especially with severe grades are at risk of metabolic syndrome and other cardiovascular diseases.

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Introduction:Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on day-to-day basis. Patch testing is a reliable method for detecting the causative antigens in suspected cases.Aims and Objectives:To assess the demographic profile, pattern of ACD, and patch test profile of suspected cases of ACD attending contact dermatitis clinic of our department.Materials and Methods:It was a retrospective study in which all the data enrolled in the contact dermatitis clinic of our department over a 7-year period were analyzed. Patch testing was done using the Indian Standard Series of 20 antigens primarily, and other batteries were used depending on patient requirement and availability.Results:A total of 582 patients were enrolled in the contact dermatitis clinic over a period of 7 years. Hand eczema was the most common pattern seen in 268 cases followed by feet eczema, hand and foot eczema, facial eczema, forearm and leg eczema and photoallergic contact eczema. A total of 177 patients (30.4%) gave positive patch test results, with nickel sulfate being the most common allergen identified followed by potassium dichromate, cobalt sulfate, paraphenylenediamine, neomycin sulfate, and fragrance mix.Conclusion:Common allergens identified in our study were more or less similar to studies from other parts of India. However, due to the unique climate of the valley, the profile of parthenium sensitivity was low in our study when compared to the rest of the country.

Lichen myxoedematosus (LM), a form of primary cutaneous mucinosis, may present either as localized less severe form called papular mucinosis or diffuse more severe form called scleromyxoedema. The diffuse form is almost always associated with monoclonal gammopathy, whereas localized form is not. We report an atypical case of localized form of LM associated with multiple myeloma in a 66-year-old male, who presented with asymptomatic waxy papular eruption on extremities, which on histopathological examination confirmed the diagnosis of cutaneous mucinosis. After initially being put on steroids and hydroxychloroquine with minimal improvement, patient subsequently presented with encephalopathy and on evaluation revealed hypernatremia, hypercalcemia, hypergammaglobulinemia, reversal of albumin-globulin (A/G) ratio, azotemia, and lytic lesions in skull X-ray. Bone marrow aspiration and biopsy confirmed multiple myeloma. Patient was successfully treated with standard treatment regimen for multiple myeloma with bortezumib and dexamethasone and his skin lesions subsided completely.

Lichen planus (LP) is common acquired dermatoses with several morphological forms. Linear lichen planus is frequently seen but cases of zonal/ zosteriform/ dermatomal/ blaschkoid LP are rare. We report a case of blaschkoid LP along with scalp LP in a 42 year old adult Kashmiri male. We report the case to add one more case to the list of this rare form of LP, with the peculiarity in our case of late onset of presentation and coexisting scalp LP, and review the literature to address to the confusion about the various related terms.

Background: Possible relationship between dermatoglyphic patterns and other diseases, including dermatological diseases, especially those with genetic and hereditary basis such as vitiligo, psoriasis, alopecia areata, have been found in various studies but there is paucity of data from India to uphold the association. Aims and Objectives: To study the relationship between dermatoglyphic patterns with various dermatoses such as psoriasis, vitiligo, alopecia areata, and pemphigus vulgaris. Material and methods: This hospital based study involved 140 patients with psoriasis, 76 with vitiligo, 84 with alopecia areata and 30 pemphigus vulgaris patients, compared to 1838 age and sex matched control patients. Rolled finger and hand prints of palmar surfaces of both hands were obtained by the ink method. Results and observations: In the control group, loop pattern of dermatoglyphics was the commonest, found in 54.52%, followed by whorls in 36.78% and arch in 8.70%. In psoriasis patients, whorl pattern was the commonest (44.29%), followed by 31.43% loop, 21.43% arch and 2.86% composite pattern. In vitiligo patients, loop and whorl pattern was found in 44.74% patients each, followed by arch pattern in 10.53%. In patients of alopecia areata, whorl pattern was found in 45.24% patients followed by loop in 30.95% and arch pattern in 23.81% while in pemphigus vulgaris patients, loop pattern was found in 50% patients, followed by whorl in 40% and arch in 10% patients. Conclusion: There was statistically significant difference between psoriasis patients and controls regarding loop, arch and composite patterns, but no significant difference with respect to whorl pattern. Similarly, there was a significant difference between alopecia areata patients and controls for loop and arch patterns, but no significant difference regarding whorl pattern. There was, however, no