The COVID-19 pandemic caused by the SARS-CoV-2 virus, has changed the homeostasis of the medical world. In this critical phase, in addition to the general recommendations issued by World Health Organization (WHO) for medical practitioners and health care givers, certain other precautions and safe care practices need to be emphasized which are unique to each branch of medicine. Aesthetic dermatology is no exception. With aesthetic treatments on the rise, it is pertinent to formulate safe practices for aesthetic dermatology to protect the doctor, health staff and the patients from getting exposed during this phase and in the aftermath of the pandemic. Recommendations for surgical and dental procedures advice to defer such procedures. This can be extrapolated to aesthetic dermatology also, but once health care services start, there should be some safety recommendations to be followed until we have definitive management or a vaccine for it.

Context:Hair plays an important role in one's personality and builds confidence. Now-a-days, chemical hair relaxers are used very commonly in the society. We document the adverse effects reported by the sample that have used any one of the professional chemical hair relaxers.Aim:To study the adverse effects reported by the sample who underwent repeated chemical hair relaxing.Settings and Design:Cross-sectional questionnaire based study done on a sample taken from a medical college and hospital campus in Mangalore.Materials and Methods:The sample was restricted to females and to those who underwent it more than once. A questionnaire was given to a sample of 90, which matched our criteria.Statistical Analysis:SPSS software 17.Results:Adverse effects reported by the sample after undergoing the procedure were found to be a high 95.56%, out of which the following are the common adverse effects reported; frizzy hair in 67%, dandruff in 61%, hair loss in 47%, thinning and weakening of hair in 40%, greying of hair 22%, and split ends in only 17%.Conclusions:Very few studies have been conducted on the adverse effects of hair straightening products in India. From our study, it can be stated that most of the samples had adverse effects, which was as high as 95.56%. Hence from the details elicited from this study, we can conclude that, usage of chemical hair relaxers does cause adverse effects and is “not a myth.” Thus, it is necessary to make available a less harmful chemical hair relaxer to the society.

INTRODUCTIONMelasma is an acquired, symmetrical hypermelanosis of the face and is particularly seen in women with skin types IV to VI living in areas with intense UV radiation. The exact etiopathogenesis is unknown. However, various etiological factors proposed in the literatureinclude sun exposure, pregnancy, hormonal therapy, genetic factors and vascular factors. Various treatment modalities such as topical depigmenting agents, chemical peels, dermabrasion and laser therapies have been utilised with varying, not so satisfactory outcomes. [2][3][4][5] Tranexamic acid, (TXA) a plasmin inhibitor, is now gaining popularity as a depigmenting agent. TXA prevents the binding of plasminogen to the keratinocytes, which ultimately results in less free arachidonic acids and thus inhibits UV-induced plasmin activity in keratinocytes.6 Oral TXA also produces significant decrease in the mMASI in melasma patients.7 TXA administered intradermally is effective for dermal and mixed variants of melasma. TXA is a safe and well ABSTRACT Background: Melasma is an acquired hypermelanosis affecting the sun-exposed areas of the skin, most commonly the face and neck. Different treatment modalities have been utilized in different studies with varying, not so satisfactory outcomes. The aim of the study was to compare the efficacy of localized intradermal microinjection of tranexamic acid with oral tranexamic acid in melasma patients. Methods: It is a prospective comparative study. All patients enrolled in the study were divided into 2 groups -twenty in each treatment group. In group A, patients were given intradermal injections of tranexamic acid (4 mg/ml) once at three week intervals (0, 3, 6, 9, 12 weeks) for 12 weeks. Group B patients were given oral tranexamic acid 250 mg twice a day for 12 weeks. Following parameters were evaluated before and after 12 weeks of treatment: a) digital photographs b) MASI score c) patient subjective assessment d) dermoscopic photographs. Software (SPSS, version 16.0 statistical packages) was used. Results: Clinical efficacy of the treatment in 2 different groups showed higher efficacy with intradermal microinjection (35.6%) compare to oral tranexamic acid (21.7%). Patient's subjective assessment showed good improvement in 63.15% of cases in group A, whereas in group B 27.8% of cases showed good improvement. Conclusions: Intralesional localized microinjection of tranexamic acid is a promising new therapeutic modality for the treatment of resistant melasma.

Summary Background Platelet‐rich plasma is rich in growth factors that promote differentiation and growth of dermal papilla cells by various signaling pathways. Dermoscopy is handy, bedside tool that helps to improve diagnostic accuracy in various hair disorders. Objectives To evaluate and study the role of dermoscopy in patients with androgenetic alopecia (AGA) pre‐ and posttreatment with platelet‐rich plasma (PRP). Methods It is a prospective comparative study. Twenty male patients with AGA, aged 18‐45 years with modified Norwood‐Hamilton classification grade II‐VI were included in this study. Patients were given platelet‐rich plasma injections every 3 week for a period of 3 months. Dermoscopy was performed with 10 x magnifications in polarized mode at baseline and at 3 months from the baseline and photographs were taken. Patients were evaluated based on following dermoscopic findings (a) hair count, (b) hair density, (c) hair diameter diversity, perifollicular pigmentation, yellow dots, multi‐hair follicular units, honeycomb pigment pattern and white dots, (d) patient's hair growth assessment score. Results Posttherapy, patients showed significant improvement in hair count (27.4%), hair diversity (84.2%), increase in number of thick, terminals hairs, reduction in yellow dots (60%), perifollicular pigmentation (92.3%) was appreciated. Hair pull test negative after treatment in 10 patients (50%). Patient's hair growth assessment score showed 50%‐75% improvement in 7 (35%) patients. Conclusion Dermoscopy helps to easily evaluate and compare the therapeutic response pre‐ and posttreatment which can be easily documented and visualized at every visit.

Platelet-rich plasma (PRP) is being used as a treatment modality for skin rejuvenation since the last decade. There has been a lot of ambiguity regarding the ideal protocol to be followed and the specific indications where its use should be promoted. The use of PRP as monotherapy for skin rejuvenation, acne scars, periorbital rejuvenation, lipofilling and in combination with fractional CO 2 and other resurfacing modalities is increasing rapidly. In this article, we have reviewed the current scientific evidence available and the IADVL national task force for PRP has come up with standard recommendations for use of PRP in esthetics along with the grade of evidence and strength of recommendation for each indication. The aim of this review is to provide a standard protocol for use of PRP in esthetics, for clinicians and academicians, leading to excellent results with this promising treatment modality.

<p class="abstract"><strong>Background:</strong> Psoriasis is a chronic, inflammatory systemic disease. Methotrexate acts by inhibiting dihydrofolic reductase enzyme. Apremilast is an oral PDE4 inhibitor approved by US Food and Drug Administration for treatment of psoriasis.</p><p class="abstract"><strong>Methods:</strong> This is hospital based comparative study conducted from February 2018 to August 2018. Seventy patients above 18 years of age with chronic plaque psoriasis were divided into 35 patients in each group and were treated with oral Apremilast (30 mg twice daily) and oral methotrexate (15 mg per week in three divided doses with a 12-hour interval between doses and tab folic acid on methotrexate free days) and were evaluated every 4 weeks for a period of 16 weeks and followed-up at 24th week. Outcome was assessed on basis of psoriasis area-and-severity index score (PASI), psoriasis disability index (PDI) and clinical photographs.<strong></strong></p><p class="abstract"><strong>Results:</strong> % of improvement in Group-A patients (76.8%) after 16 weeks of treatment was relatively more (p&lt;0.05) as compared to group B (71.5%). At the end of 16 weeks PASI score in methotrexate group was statistically significant (p&lt;0.05) as compared to group B, PDI became 17.90±3.87 in group A and was statistically significant (p&lt;0.05) as compared to group B which was 20.34±2.98. Side effects observed were comparatively less in group A patients.</p><p class="abstract"><strong>Conclusions:</strong> On comparing the two drugs, methotrexate was comparatively better tolerated and had better efficacy and safety. More studies are required to further prove the efficacy of Apremilast in treatment of psoriasis.</p>

<p class="abstract"><strong>Background:</strong> Contact dermatitis (CD) is an altered state of reactivity; occur due to direct contact with noxious agents in our environment. Face is a very common site for CD.</p><p class="abstract"><strong>Methods:</strong> Prospective hospital based study was conducted at A. J. Institute of Medical Sciences, Mangalore from June 2018 to November 2018. Fifty cases aged above 18 years with suspected allergic contact dermatitis (ACD) over face who gave written informed consent were enrolled. A complete history was taken and detailed clinical examination was done. Patch testing was done over the back in all patients which was removed after 48 hours and positive result was recorded based on the recommendation of the international Contact Dermatitis Research Group (ICDRG).<strong></strong></p><p class="abstract"><strong>Results:</strong> The most common clinical pattern observed was pigmented contact dermatitis(PCD) (70%), followed by irritation (6%), acneiform eruptions (5%) and contact urticaria (2%). Out of 50 patients, 20 patients developed CD to fragrances and perfumes. 14 patients developed to soaps and shampoos. On patch testing, most common allergen in fragrances/perfumes was fragrance mix (52.9%). In soaps and shampoos it was triclosan (68.4%), parabens (31.5%). Sesquiterpene lactone in parthenium plant (4%), Paraphenylenediamine in hair dye (8%). In face creams were gallate mix and cetrimide among metals, nickel and chromium (6%). In case of kumkum it was paraphenylenediamine (4%).</p><p class="abstract"><strong>Conclusions:</strong> Amongst the various patterns of contact dermatitis, PCD to cosmetics, fragrances and daily care products was most common pattern observed and the main allergens were triclosan, fragrance mix and balsum of Peru.</p>

<div class="WordSection1"><p class="abstract"><strong>Background:</strong> <span lang="EN-IN">A thorough knowledge of the skin changes, physiological as well as acquired, in neonates is of prime importance for the dermatologist as well as paediatrician.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total of 430 randomly selected live-born neonates delivered and admitted to the postpartum ward or to the Neonatal Intensive Care Unit and neonates attending the Dermatology Outpatient Department of a tertiary care institute were included in this study after taking written informed consent. A detailed assessment of history was performed and a detailed dermatological examination of each neonate was carried out. Laboratory procedures were performed to confirm diagnosis if required. Data was analyzed using SPSS ver. 20</span>.</p><p class="abstract"><strong>Results:</strong> Most common physiological skin change observed was Mongolian spot (65.35%) followed by Erythema Toxicum Neonatorum (51.63%), Epstein’s pearls (46.97%) and Sebaceous gland hyperplasia (45.81%). Lanugo hair was seen in 16.74% neonates. Among congenital skin lesions, Salmon patch was seen in 15.58% of the neonates whereas congenital melanocytic nevi are seen in 4.19% of the neonates. <span lang="EN-IN">Diaper dermatitis was the most common acquired skin manifestation seen in 5.81% of cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Neonates are prone to suffer from a wide range of dermatological problems, physiological as well as pathological. These manifestations are unique to the neonates. A detailed history and awareness of the clinical presentation facilitates the confirmation of the diagnosis.</span></p></div>