Hypopigmented MF presents as hypopigmented asymptomatic patches without any erythema or infiltration in its early stage and mimics Hansen's disease. Skin biopsy clinches the diagnosis.

Background:Androgenetic alopecia (AGA) is a condition, which is an important psychosocial problem. The hormonal variations causing AGA are known, but whether behavioral patterns and lifestyle influence the condition and which age groups they influence is uncertain and such factors have not been studied in detail.Objectives:To compare association of lifestyle patterns with androgenetic alopecia, prevalence of psychiatric symptoms and resulting quality-of-life (QoL) between two age groups of males with AGA.Materials and Methods:Male subjects in each of the two age groups attending the hair clinic diagnosed with AGA were administered a questionnaire on lifestyle patterns. HAIRDEX and symptom checklist-90 (SCL-90) to study the presence of psychosocial problems and QoL were used. The stress experienced by such patients was studied by a stressful life events scale.Results:Of the 37 patients studied, 23 were in younger age group (average age) and 14 were in the older age group (average age). No significant difference was found in lifestyle, as far as eating habits, physical activity, occupational activity and leisure time were concerned. However, the younger age group had a significantly better psychological health. (P=0.013). On assessing the QoL, self-assurance seemed better in younger age group (P=0.014), reflecting changing societal trends, causing better acceptance of hair loss. On the other subscales, emotions seemed to be more affected in the younger age group, while older patients had worse functioning, more symptoms and more sense of stigmatization. On assessing SCL-90, no significant psychopathological difference was found between both the groups; however the older patients appeared to have more psychological symptoms on almost all scales scoring highly on obsessive–compulsive, interpersonal sensitivity and depression subscales. No significant difference in stressful life events at the time of onset of alopecia was noticed although older patients scored higher on this scale. Family history was found to be significantly associated with the onset of alopecia (P=0.0448).Conclusions:We concluded that lifestyle factors and stressful life events are not significantly affected by the onset of AGA. Only heredity seems to be associated with hair loss. Quality-of-life is affected in both the age groups but younger patients seem to have better self-assurance as well as better psychological health.

Skin biopsy is a safe, easy and out-patient procedure of diagnostic and academic relevance. There are various methods of performing skin biopsy depending on the size of lesion, suspected clinical diagnosis and site of lesion. Although biopsy is usually a safe procedure, complications such as bleeding, infection and scarring may occasionally be encountered while performing biopsy in an out-patient with basic infrastructure. This article details the various techniques of skin biopsy, their indications and practical steps to curtail complications arising from the procedure.

Trichoscopy is the term coined for dermoscopic imaging of the scalp and hair. This novel diagnostic technique, both simple and non-invasive, can be used as a handy bed side tool for diagnosing common hair and scalp disorders. Trichoscopic observations can be broadly grouped as hair signs, vascular patterns, pigment patterns and interfollicular patterns. In this article, we have briefly described the trichoscopic findings in the common categories of cicatricial and non-cicatricial alopecias such as androgenetic alopecia, alopecia areata, telogen effluvium, tinea capitis, trichotillomania, lichen planopilaris, discoid lupus erythematosus and hair shaft disorders. Besides diagnosing alopecia, it has the potential for obviating unnecessary biopsies and when a biopsy is still needed it is helpful in choosing an ideal biopsy site. Moreover, trichoscopy is a valuable tool for evaluating the treatment response photographically at each follow-up. The last statement here is deleted as asked.

Pigmentary network changes, and perifollicular and perilesional hyperpigmentation on polarized light examination, and a diffuse white glow on ultraviolet light examination were noted in evolving vitiligo lesions. Histopathological examination was comparatively less reliable. Dermoscopy appears to be better than routine histopathology in the diagnosis of evolving lesions of vitiligo and can obviate the need for a skin biopsy.

Methicillin resistance is uncommon in community-acquired primary pyodermas in Mumbai. Treatment with antibacterials active against MRSA is probably unwarranted for community-acquired primary pyodermas.

Antiretroviral therapy (ART) has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen's pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression), lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.

The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life.