<p class="abstract"><strong>Background:</strong> Medical students are more prone to self-medication because of background knowledge and easy availability of medication. Dermatological disorders are affecting quality of life in adolescent and can motivate self-medication behaviour. The objective of the study was to study the prevalence and patterns of self-medication for skin conditions in among medical students.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional questionnaire based study was carried out in medical students in western India. A self-administered questionnaire included information on socio-demographic details, general aspects of self-medication behaviour like used for which disease, drugs used, source of knowledge, reason for use etc. and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Self-medication was prevalent in 90.09% participants for skin conditions. Mean age of participants was 20.35±1.23 years with male predominance. Most common skin conditions/symptoms for self-medication were acne (82.46%), sun tan (52.11%) followed by superficial fungal infections while common hair conditions were hair fall (80.10%) and dandruff (57.07%). The most commonly used drugs for self-medication were topical antifungal drugs (96.07%), sunscreen lotions (91.10%) and topical antimicrobials (80.10%). Most common source of information for self-medication was medical staff and seniors (92.67%) followed by internet (81.15%). Most common reasons for favoring self-medication were perceived the illness as minor/non-serious (62.83%) and time constraint (26.70%). 3.14% participants reported to have some adverse events with the drugs used by self-medication.</p><p class="abstract"><strong>Conclusions:</strong> Prevalence of self-medication for dermatological disorders was alarming high. Self-medication practices are highest for acne, superficial fungal infections, hair fall and dandruff. Proper training of medical undergraduates in diagnosis and treatment of dermatological problems with special emphasis on drug usage aspects are needed.</p>

Lipoid proteinosis is a very rare autosomal recessive disorder characterized by deposition of hyaline material in the skin and the upper aerodigestive tract. Hoarseness of voice occurs very early in life and airway obstruction may occur. Characteristic skin lesions include multiple brown atrophic scars over face and distal extremities, beaded papules over the margins of the eyelids and verrucous nodules over the friction bearing areas (elbows, knees). The overall prognosis is good. There is no definitive treatment.

Palmoplantarkeratodermas (PPKs) are a heterogeneous group of hereditary and acquired disorders with underlying gene defects, and characterized by hyperkeratosis of palms and soles with or without other ectodermal and systemic abnormalities. Huriez syndrome is a rare autosomal dominant transgradient type of PPK with high frequency of squamous cell carcinoma in the affected skin. We hereby describe a case of a very rare autosomal dominant PPK in a 40-year-old male patient presenting since birth with PPK extending onto the dorsal aspects of hands and feet with peeling of the skin. The complaints were associated with sclerodactyly, hyperhidrosis, and nail abnormalities. Also superadded dermatophyte infection was observed involving abdomen. No history of loss of any digit. No mucosal, dental, or any systemic involvement was present. No sign of malignancy was noted. Baseline investigations, including ultrasonography of abdomen were normal. Histological findings were nonspecific with only orthohyperkeratosis and acanthosis. Diagnosis was mainly done on clinical grounds. The patient is better with oral retinoids and topical emollients and keratolytics along with antifungal treatment for dermatophyte infection. He is under follow up.

<p class="abstract"><strong>Background:</strong> To evaluate and compare the profile of adverse drug reaction, its causality, severity and preventability in patients of acne prescribed with either topical benzyl peroxide or topical retinoic acid in a tertiary care teaching hospital.</p><p class="abstract"><strong>Methods:</strong> Two hundred patients attending to dermatology department with acne and prescribed with either topical benzyl peroxide or topical retinoic acid were observed for occurrence of adverse drug events (ADEs). ADEs were either spontaneously reported or elucidated from personal interviews and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 200 patients, 110 (55%) were given benzoyl peroxide gel (2.5%) and remaining 90 (45%) were given retinoic acid cream (0.025%). Total 54 adverse events were reported in 47 (23.5%) patients. Highest number of patients having ADR was from 16-20 years (35, 74.46%) with male predominance (59.57%). Number of adverse events reported was significantly higher (p &lt;0.05) in retinoic acid group (34, 62.96%) as compare to benzyl peroxide group (20, 37.03%). Most common ADRs were exfoliation (14, 25.92%) and burning sensation (13, 24.07%). Most of the ADRs fell in category of ‘probable’ and ‘possible’ in causality assessment by both WHO-UMC method and Narenjo’s scale. All the ADRs were of mild (44, 81.48%) and moderate (10, 18.52%) severity. Majority of ADRs were not preventable (24, 44.44%) followed by definitely preventable 22(40.74%) and 8 (14.81%) probably preventable.</p><p><strong>Conclusions:</strong> ADRs is a common problem associated with topically used medications for acne and its occurrence is significantly higher with retinoic acid as compare to benzyl peroxide. Early diagnosis and proper education about use of topical drugs can prevent some of the ADRs. </p>

Background: Chemical peeling is increasingly used in dermatology nowadays. Salicylic acid peels have been widely used in Asian patients since long ago, but very few published literature is there focusing on the efficacy and safety of it in Asian population. This study was planned to compare the efficacy of salicylic acid (SA) peel either commercially available or freshly prepared in treatment of acne. Methods: A prospective, randomized, open-label, parallel-group study was carried out in patients with acne. A total of 126 patients were randomized to receive 30% salicylic acid peel either commercially available (group A, n = 60) or freshly prepared (group B, n = 63). Assessment of acne lesions was done at baseline and at 2, 4, 6, 8, 10, and 12 weeks. Objective assessment was carried out using total acne score and subjective assessment using visual analog scale and were compared. Results: Mean age of patients was 22.4 ± 3.1 years with female predominance. After six sessions with commercially available SA peel, reduction in average number of comedones was 88.45% (P = 0.002), in inflammatory papules 89.16% (P = 0.01), in pustules 31.47% (P = 0.06), and in nodules/cyst 50% (P = 0.5). After six sessions with freshly prepared SA peel, reduction in average number of comedones was 89% (P = 0.0001), in inflammatory papules 90.36% (P = 0.0001), in pustules 28.3% % (P = 0.05), and in nodules 96% (P = 0.05). Significant reduction of both non-inflammatory and inflammatory acne was seen in both groups (P < 0.05). Both of the agents led to a highly significant (P < 0.001) improvement in the total acne score; freshly prepared SA peel showed improvement significantly earlier at 6 weeks onwards. VAS score was significantly high for the freshly prepared SA group (P = 0.05). Conclusion: This study has shown equivalence in therapeutic efficacy of both commercially available and freshly prepared SA peels both in terms of objective and subjective assessments in acne treatment with more patient satisfaction with freshly prepared peel.

Introduction: Salicylic acid is increasingly used as a superficial peeling agent for acne. Widespread use has caused increasing awareness about the adverse events associated with SA like erythema, exfoliation, itching, redness etc. Appropriate use of priming agents like retinoids, hydroquinone etc., can help in reduction of ADRs and can affect final treatment result. Aim: Evaluation of efficacy and safety of salicylic acid (SA) peel with or without priming agents in patients of acne. Methodology: A prospective, randomized, open-label, parallel-group study was carried out in patients with acne. Total 72 patients were randomized in to three groups A, B and C to receive 30% salicylic acid (SA) peel with either 0.05% tretinoin or 4% hydroquinone or without any priming agent. Objective and subjective assessment in improvement in acne was compared. For safety analysis, all reported adverse drug events were compared. Results: Mean age of patients was 22.46±5.32 years. Both non-inflammatory and inflammatory acne lesions reduced with SA peel in all three groups. Improvement in total acne score is significantly higher in SA peel with priming agents (p<0.05). The change in total acne score (Week 0-12) was 81.45% with SA alone, 94.3% with isotetinoin and 90.2% with hydroquinone priming (p<0.05). Total adverse event reported were 10(58.82%), 4 (23.53%) and 3(17.65%) in SA peel without priming agent, with isotetinoin and with hydroquinone respectively. Rate of occurrence of adverse events was significantly high in SA without priming agent (p<0.05). Mean visual analogue score was 91.47, 94.31 and 83.46 in group A, B and C respectively. SA peel with priming agent was rated as significantly more effective by patients rather than SA without priming agent (p<0.05). Conclusion:Appropriate priming agents should always be used with superficial peeling agents like SA in management of acne which enhances the effectiveness and reduces the adverse effects of therapy.

Various chemical peeling agents and strategies are used to repair the effects of photodamage and acne such as acne wrinkles, dyschromia, and actinic keratosis [5]. Salicylic acid peel has been established as an effective treatment modality of treatment of acne