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and one-third (33.9%) were 'not confident' or 'not at all confident' in managing skin conditions in patients with SOC (Fig. 1c). Lack of exposure to patients with SOC was cited by 60.7% of participants as the biggest challenge to looking after these patients (Fig. 1d), which was not an unexpected finding, as 67.9% of respondents estimated that < 5% of their patients had SOC. Specific conditions that were noted to be difficult to diagnose or manage included (i) inflammatory dermatoses (n = 29) such as atopic dermatitis and lupus, (ii) pigmentary disorders (n = 16) such as melanocytic naevi and vitiligo, and (iii) keloid scarring (n = 4). Suggested solutions to improving knowledge included dedicated study days, online resources, cultural training and dedicated teaching clinics.This study shows that Irish dermatologists have low confidence in diagnosing and managing conditions in people with SOC. This is consistent with a previous study showing that only 56% of Australian dermatologists were confident in diagnosing and 75% confident in managing common dermatoses in patients with SOC. 2 This discrepancy in confidence between skin types is important as patients with more darkly pigmented skin are more likely to have negative outcomes from dermatological disease, including melanoma. 3 It has recently been shown that white skin is over-represented in images of COVID-19associated eruptions. 4 With growing awareness of racial equity in medicine, 5 efforts are being made to increase the availability of clinical images highlighting the appearance of dermatoses in SOC. Resources to improve education in SOC include the Skin Diversity Subcommittee of the British Association of Dermatologists, and the associations Skin Deep (https://dftbskindeep.com/) and Skin of Color Society (https://skinofcolorsociety.org/).In conclusion, Irish dermatologists have low confidence with skin pathology in SOC, and specific training could reduce this disparity.

Lichen planus pigmentosus inversus is a rare subtype of lichen planus and can be seen with or without lichen planus lesions. Dark brown, gray-colored reticular macules and patches are mainly present in intertriginous areas. Although T cell-mediated autoimmunity has been implicated in the etiopathogenesis of the disease, it has not been elucidated. Here, we present a 48-year-old man with lichen planus pigmentosus inversus and type 2 diabetes. The diagnosis of the disease which was established based on clinical appearance and histopathology. Other reported cases of lichen planus pigmentosus are also discussed.

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Demodex, a type of mite, lives in human hair follicles. They can multiply very quickly in some conditions and then start to irritate the skin by causing skin disorders. This study aims to compare if working conditions affect the workers' Demodex prevalence so their skin health. A cross-sectional, multicentre study was conducted with three different occupational groups: Mine, Textile and Food Factory Workers (n=102). Determined industry workers who applied to our outpatient dermatology clinics with the complaint of dermatosis in three different cities were included in the study. Demodex positivity was checked by dermoscopy. Differences between categorical variables examined with Chi-square analysis and T test was used to compare continuous variables between groups. 50% Demodex positivity was found in mine workers, %45,3 in food factory workers and 66,7% in textile manufacturing workers. A high rate of Demodex positivity was observed in all three occupational groups. Although the highest positivity rate was observed in textile manufacturing workers, no significant difference was found between the groups (p=0.320). The overall prevalence of Demodex in female workers was statistically significantly higher than in male workers (p=0.029). Exposure of workers to a wide variety of factors in work environments such as textile factories and the fact that women are more sensitive to external factors may have caused the prevalence of Demodex to be higher in these groups. So, a change in the work environment or the use of suitable protective equipment may benefit the treatment of diseases caused by Demodex. But, further studies are needed with larger and various industry groups to make more certain views.

Eosinophilic pustular folliculitis (EPF) of infancy (EPFI), as a rare variant of EPF, is an inflammatory dermatosis characterized by recurrent outbreaks, itchy papulopustules and involvement of scalp and other body areas. In our case, we present a 3-month-old boy with persistent itchy vesiculopustular rashes on the scalp, hands and feet, eosinophilia in the peripheral blood test, widespread eosinophil clusters in the swab of the pustule and egg allergy in the skin prick test. This is the first case of EPFI associated with food allergy that is permanently suppressed by elimination diet with the limited use of cetirizine.

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