Management of chronic/recurrent erythema nodosum leprosum (ENL) is challenging.The majority of these patients become steroid-dependent and suffer from the adverse effects of long-term corticosteroid use. Minocycline has shown promising results in a small series of chronic/recurrent ENL patients. The aim of this study was to compare the efficacy and safety of minocycline and clofazimine in patients with chronic/recurrent ENL. In this prospective randomized clinical trial, 60 participants with chronic/recurrent ENL were randomized (1:1) to receive either minocycline 100 mg once daily or clofazimine 100 mg thrice daily for 12 weeks along with prednisolone according to WHO protocol and followed up for 6 months. The outcome

Nevoid acanthosis nigricans: a case series of nine patients Dear Editor, Acanthosis nigricans (AN) is a keratinizing disorder that usually presents as symmetric hyperpigmented plaques with a velvety surface over folds. It is usually associated with intake of medication or systemic diseases like metabolic syndrome, diabetes, or malignancy. 1 Nevoid AN is a rare and benign form, which usually presents as asymmetric hyperpigmented plaques in a segmental distribution and appears not to be associated with any systemic illness.

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A 6-month-old girl presented with a 4-month history of multiple, discrete, soft to firm, nontender, yellowish-red papulonodules clustered over the left anterolateral aspect of her chest, with some papules having superficial ulceration and crusting (Fig. 1a). The child's parents were not consanguineous, and the child had received her scheduled immunizations. She had achieved age-appropriate developmental milestones and had no systemic conditions. Results of general physical examination and mucocutaneous examination elsewhere were unremarkable, and there was no lymphadenopathy or organomegaly. Dermatoscopy showed yellowish structureless areas surrounded by a rim of erythema and telangiectasia (Fig. 1b).

Background Palmoplantar psoriasis (PPP), a troublesome variant, does not have any validated scoring system to assess disease severity. Objective To validate modified Palmoplantar Psoriasis Area and Severity Index (m-PPPASI) in patients affected with PPP and to categorise it based on Dermatology Life Quality Index (DLQI). Methods In this prospective study, patients with PPP aged > 18 years visiting the psoriasis clinic at a tertiary care centre were included and requested to complete DLQI during each visit at baseline, 2nd week, 6th and 12th week. m-PPPASI was used by the raters to determine the disease severity. Results Overall, 73 patients were included. m-PPPASI demonstrated high internal consistency (α = 0.99), test-retest reliability of all three raters, that is, Adithya Nagendran (AN) (r = 0.99, p < 0.0001), Tarun Narang (TN) (r = 1.0, p < 0.0001) and Sunil Dogra (SD) (r = 1.0, p < 0.0001) and inter-rater agreement (intra-class correlation coefficient = 0.83). Face and content validity index for items I-CVI = 0.845 were robust, and the instrument was uniformly rated as easy to use (Likert scale 2) by all three raters. It was found to be responsive to change (r = 0.92, p < 0.0001). Minimal clinically important differences (MCID)-1 and MCID-2 calculated by receiver operating characteristic curve using DLQI as anchor were 2 and 35%, respectively. DLQI equivalent cutoff points for m-PPPASI were 0–5 for mild, 6–9 for moderate, 10–19 for severe, and 20–72 for very severe disease. Limitation Small sample size and single-center validation were the major limitations. m-PPPASI doesn’t objectively measure all characteristics of PPP such as “fissuring” and “scaling” which could also be taken into consideration. Conclusion m-PPPASI is validated in PPP and can be readily utilized by physicians. However, further large-scale studies are needed.