Geeti Khullar

Skin malignancies in individuals with skin of color (SOC) present distinct epidemiologic, clinical, and prognostic characteristics compared to lighter-skinned individuals. Although the incidence of many skin cancers is lower in SOC, outcomes are often worse due to atypical presentations, delayed diagnosis, and the scarcity of research focused on SOC. This review summarizes the current evidence on skin malignancies in SOC – covering epidemiology, tumor biology, risk factors, major cancer types (squamous cell carcinoma [SCC], basal cell carcinoma [BCC], and malignant melanoma), diagnostic pitfalls, and management considerations. Major skin cancers – SCC, BCC, and malignant melanoma – are discussed with emphasis on their unique clinical presentations in SOC, such as acral involvement and pigmentary variations that may obscure early detection. Diagnostic challenges, including under-recognition, limitations of conventional clinical criteria, and reduced sensitivity of emerging diagnostic technologies in darker skin types, are also examined. In addition, current management strategies are reviewed, with attention to treatment-related pigmentary and scarring complications that are particularly relevant in SOC. Preventive strategies, public health implications, and the need for culturally sensitive education and improved representation in research are emphasized. Awareness of unique features of skin cancers in SOC is critical for dermatologists and oncologists practicing in diverse populations so as to maximize the likelihood of early detection of these cancers.

Was not provided for this article.

Cutaneous mucinosis clinically masquerading as cutaneous lymphoma and associated with undifferentiated connective tissue disease

Coronavirus disease 2019 (COVID-19) affected epidemiology of sexually transmitted diseases (STDs) across the world due to decreased clinic attendance and hampered delivery of services. This retrospective study was undertaken from January 2020 to December 2021 to assess epidemiological trends of patients attending STD clinic of Apex Regional STD centre in North India. Correlation between COVID-19 and STD cases was assessed and numbers of various STD cases during pandemic were compared to pre-pandemic numbers. 1653 patients were included in the study. The most common presentation was vaginal discharge, followed by genital warts and genital ulcer. Correlation between STD and COVID-19 cases was not statistically significant. Statistically significant decrease in cases of non-gonococcal urethritis and syphilis was noted. This decrease could be either due to reduced disease transmission during COVID-19 or reduced clinic attendance which needs further evaluation.

Skin biopsy is an indispensable diagnostic modality for a dermatologist and dermatopathology is an important part of the dermatology residency curriculum. Clinicopathological correlation is often required to reach a diagnosis in dermatological disorders and therefore it is imperative that basic dermatopathology is learnt during residency to facilitate patient management. This article aims to provide insights on the importance of learning the subject, what a resident is expected to know at the end of residency programme, and how to master the basic skills including reading the slide and describing the histopathological features. The available reading resources have also been suggested.

Background: Severe acute respiratory virus syndrome coronavirus 2 (SARS-CoV-2) was responsible for coronavirus disease (COVID-19) pandemic. As patients recovered from COVID-19 infection, hair loss was increasingly observed as a distressing symptom. Methods: This was a prospective cross-sectional study of patients with post COVID-19 hair loss between July to December 2021 at a tertiary care centre. Detailed history, clinical examination, trichoscopy and biochemical tests were performed and recorded. COVID-19 disease severity was assessed based on duration of COVID-19 infection and place of management. Results: The study included 120 patients with mean age being 39.6 years. Majority of the patients were females, treated at home and had COVID-19 infection for >2 weeks. Mean visual analog scale (VAS) score for stress was 5.25. Vitamin D deficiency was present in 56.7% and low ferritin in 30% of cases. Mean time of onset of hair loss post COVID-19 was 49 days. Patients mainly presented with diffuse hair loss. Trichodynia was present in 15.8% of cases. The degree of hair loss was severe in 55.8% of the subjects. Positive hair pull test was seen in 65% of patients. Most common trichoscopic features included single hair follicles’ (81.7%) and vellus hair >10% (60%). Conclusions: The mean time of onset of hair loss post COVID-19 infection was less than 2 months. Majority patients had diffuse pattern and severe degree of hair loss. Trichoscopy can aid in unmasking co-existing patterned hair loss in patients presenting clinically with diffuse hair loss.

Background: Cysts, primarily epidermal and trichilemmal, are commonly seen in clinical practice. Rupture, infection, inflammation, and rarely malignant transformation may complicate the cysts. This study aims to analyze the clinicohistological features of cutaneous cysts. Materials and Methods: A retrospective review of patients with the diagnosis of cyst confirmed on histopathology over the past two years (2020–2021) was performed. Clinical details comprised of age, gender, site of involvement, size, duration, and associated symptoms. Histological examination included cyst wall lining, type of keratinization, complications like rupture, inflammation, foreign body giant cell reaction, calcification, and malignant change. Results: A total of 324 cases with mean age of 37.9 years and equal gender distribution were identified. Most frequent diagnosis was epidermal cyst in 89.8%, followed by trichilemmal cyst in 8.9% of cases. Rare types included follicular hybrid cyst, verrucous cyst, vellus hair cyst, and steatocystoma. Most common complication was cyst rupture in 54.3% of epidermal cysts. Proliferating epidermal and proliferating trichilemmal cysts were noted in one and two cases, respectively. Two cases revealed malignancy arising in the wall of epidermal cyst. Limitations: The retrospective study design and non-availability of follow-up data, especially for proliferating cysts and cysts with malignant transformation were the main limitations of this study. Conclusion: Histopathologic examination of excised cutaneous cysts is paramount in reaching accurate diagnosis of the type of cyst and associated secondary changes to enable appropriate management.