Sorafenib and sunitinib are inhibitors of tumor angiogenesis have recently generated curiosity regarding its role in cutaneous toxicities, which has severely affected the daily activities resulting in interruption or dose modification of therapy in renal cell carcinoma and hepatocellular carcinomas. We discuss the pathophysiology, adverse cutaneous effects and their grading, potential high risk factors, role of gene polymorphism, critical period of hand-foot skin reaction development and their management.

Publication is both an art and a science. For the beginner, not knowing the intricacies of publication, choice of subject and the appropriate journal to get their work published are major obstacles. In this article, the authors share their experience on how to go about getting an article published and selecting the most suitable journal for publication. They hope this article stimulates medical writing.

Lupus erythematosus (LE) is a chronic, autoimmune, multisystem disease that displays many diverse symptoms in which localized cutaneous LE (CLE) is on one end of the spectrum and severe systemic LE (SLE) on the other end. The underlying cause of LE is unknown but the etiology is thought to be multifactorial and polygenic. CLE is a disfiguring, chronic skin disease, with a significant impact on the patients' everyday life. CLE are further divided into three main subsets: Acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE), where classic discoid LE (DLE) is the most common form. These subsets are defined by clinical symptoms, average duration of symptoms and histological and serological findings, although, the three subtypes can have overlapping clinical features. CLE patients display well-defined skin lesions, often in sun-exposed areas. The disease often has a chronic and relapsing course that can be induced or aggravated by UV light. It is important to confirm a CLE diagnosis histopathologically by a biopsy and in that there are several differential diagnoses and because CLE is a chronic disease in which regular follow-up is important and systemic treatment is sometimes indicated.

Context: Therapeutic wounding includes wounding the skin to induce pigmentation of the depigmented skin patches that was earlier used for repigmenting small patches of stable vitiligo. In this study, we have used the same principle to induce pigmentation in idiopathic guttate hypomelanosis (IGH) by spot peel with 88% phenol. Aims: To study the efficacy of phenol in causing repigmentation in IGH and its adverse effect profile. Settings and Design: Open prospective study. Materials and Methods: Twenty patients with 139 IGH macules were subjected to spot peel. Eighty-eight percent phenol was applied with an ear bud once a month for two sittings. Patients were assessed both subjectively and objectively after every session and at the end of 3 months of initiation of therapy. Results: Repigmentation was noted in 64% of IGH macules. More than 75% improvement was seen in 45% of the total IGH macules, while 41.5% showed 50-75% improvement at the end of three months. Persistent scabbing was the common adverse effect noted in 17.26% of lesions. Conclusion: Spot peel with 88% phenol is a safe, simple, cost-effective, outpatient procedure for IGH, which can be combined with other medical therapies.

Introduction: Skin diseases are a common problem among young adults. There is paucity of data about it among medical students. This study aimed to find out the pattern of skin disorders and to describe their association with various socio-demographic factors among medical students. Materials and Methods: This cross-sectional study was conducted in June 2011 in a medical college in Mangalore, Karnataka. Two-hundred and seventy eight medical students were chosen from the 4 ^th , 6 ^th and 8 ^th semester through convenient sampling method. Data on hair and skin morbidities suffered over past 1 year and its associated factors were collected using a self-administered questionnaire. Results: Most of the participants 171 (61.5%) were of the age group 20-21 years and majority were females 148 (53.2%). The most common hair/skin morbidities suffered in the past one year were acne 185 (66.6%), hair loss 165 (59.3%), and sun tan 147 (52.9%). Fungal infection (P = 0.051) and severe type of acne (P = 0.041) were seen significantly more among males while hair morbidities like hair loss (P = 0.003), split ends of hairs (P < 0.0001) and dandruff (P =0.006) were seen significantly more among female students. Patterned baldness (P = 0.018) and sun tan (P < 0.0001) were significantly more among non-Mangalorean students than native Mangaloreans. Presence of dandruff was significantly associated with hair loss (P = 0.039) and usage of sunscreen was found to protect from developing sun tans (P = 0.049). Conclusion: Skin disorders, particularly the cosmetic problems are very common among medical students. Gender and place of origin were found to significantly influence the development of certain morbidities.

Background: Erythroderma is a morphological reaction pattern of skin having many underlying causes and finding the etiology helps in the proper management of erythroderma cases. Aim: To evaluate the clinical profile, etiology of erythroderma and to correlate clinical diagnosis with histopathology. Materials and Methods: This study was performed at the department of dermatology, Father Muller Medical College and Hospital, Mangalore, South India. We studied 30 consecutive cases of erythroderma with respect to the epidemiological, clinical and histological data. Clinico-histological correlation was analyzed for etiology of erythroderma. Results: The mean age of onset was 52.3 years with a male to female ratio of 14:1. In addition to erythroderma, other co-existent features included pruritus, fever, lymphadenopathy, and edema. Of the pre-existing dermatoses, psoriasis was the most common (33.3%) disease followed by eczema (20%), atopic dermatitis (6.6%), pityriasis rubra pilaris (3.3%) and drug-induced erythroderma (16.6%). In 16.6% of cases, etiology could not be ascertained. Clinico-histopathological correlation could be established in 73.3% of cases. Conclusion: Clinical features were identical irrespective of etiology. Detailed clinico-histopathological examination helps to establish the etiology of erythroderma.

Aquagenic keratoderma has been described as a transient condition affecting predominantly young females and defined clinically by the appearance of palmar hyper-wrinkling accentuated after immersion in water. We present two new cases with aquagenic palmoplantar acrokeratoderma - a child and a young male. A significant clinical improvement was achieved after topical treatment with aluminum salts. Aquagenic palmar keratoderma may be a clue to cystic fibrosis in adolescents and young adults. We developed a new hypothesis on its pathogenesis.

Cutis verticis gyrata is a rare skin condition characterized by swelling of scalp resembling the surface of the brain. Various conditions, like cerebriform intradermal nevus (CIN), may give rise to this clinical entity. Moreover, its association with cellular blue nevus is extremely rare and has not been reported so far. Here, we report a 28-year-old male with a huge cerebriform swelling covering the occipital lobe along with multiple nodules all over the body. Histology of the scalp swelling showed solitary or clusters of nevus cells in the dermis and from the body lesions showed features of cellular blue nevus. The diagnosis of CIN with cellular blue nevus was confirmed

Here we report a case of a healthy 30-year-old male who presented to us with progressively increasing reticulate pigmented lesions following lines of Blaschko on the right side of abdomen and back. Skin biopsy revealed increased basal layer pigmentation without nevus cells. A diagnosis of progressive cribriform and zosteriform hyperpigmentation (PCZH) was made on clinicopathological correlation. We also discuss clinicopathological differentials of this peculiar pigmentary disorder.

Crohn's disease, first described in 1922, is characterized by segmental granulomatous inflammation of the intestinal tract and frequently involves the cutaneous tissues as well. Cutaneous Crohn's disease (CCD) is synonymous with metastatic Crohn's disease (MSD). A case of CCD, without any gastrointestinal involvement is reported for its rarity.

Epidermolysis bullosa (EB) pruriginosa is a very rare pattern of dystrophic EB caused by type VII collagen gene mutation, with distinctive clinico-pathological features. It is characterized by nodular prurigo-like lichenified lesions, nail dystrophy, and variable presence of albopapuloid lesions. We report two such cases.

Erythema elevatum diutinum (EED) is a rare skin disease that initially presents as leucocytoclastic vasculitis and later resolves with fibrosis. Dermatitis herpetiformis is an autoimmune blistering disease characterized by granular deposits of immunoglobulin A (IgA) in dermal papillae. We report a rare association of these two disorders.

Zygomycosis is an acute or chronic infection caused by several fungal agents belonging to the phylum Zygomycota. These are saprophytic fungi and are found ubiquitously in the environment. These are emerging highly opportunistic pathogenic organisms. Basidiobolus ranarum (B. haptosporus, B. meristoporus) is a fungus belonging to the order Entomophthorales under the family Zygomycota. Basidiobolomycosis is a predominantly subcutaneous infection involving the trunk and limbs in immunocompetent hosts. We hereby report a case of Basidiobolomycosis from the Department of Microbiology, Siddhartha Medical College, Vijayawada in a 6 month old child who presented to us with a painless swelling over her left knee following an insect bite.

Epidermodysplasia verruciformis (EV) is a rare, inherited disorder that predisposes patients to widespread human papillomavirus (HPV) infection and cutaneous squamous cell carcinomas. There is still no definitive therapeutic modality for EV. A 24 year old male patient with EV was treated with oral zinc sulphate, one of the cheapest and safe immuno-modulator available as therapeutic agent with satisfactory result.

Hansen's disease, though considered to be at the verge of elimination in many countries including India, still continues to surprise patients and dermatologists alike. This is mainly due to its varying and unconventional presentations which may lead to initial misdiagnosis and prolongation of treatment. Here we describe an unusual case presenting with erythematous photosensitive facial lesions associated with erythromelalgia of the finger tips, provisionally diagnosed as SLE. A subsequent histopathology examination proved it to be Hansens' disease Borderline Tuberculoid variety. Hansen's disease can be termed as the modern great imitator, displacing the traditional great imitator, syphilis.

Erythroderma in children is an uncommon, yet striking entity with an incidence of 0.11%. Psoriatic erythroderma accounts for 1.4% of psoriasis cases in children. Follicular psoriasis is an underdiagnosed variant of psoriasis, with only about 15 cases reported till date, characterized by scaly follicular papules on the trunk and extremities. Although two thirds of these reported occurred in adults, cases have been described in children under the age of 10 years. Follicular lesions may present without psoriasis vulgaris elsewhere. We report here a 13-year-old boy who presented with severe erythrodermic psoriasis that started as dark, rough, horny, discrete, follicular papules over knees and elbows, associated with nail and joint involvement. Such a presentation of follicular psoriasis causing erythroderma is uncommonly seen in children and has not yet been reported in literature.

Lichen sclerosus commonly affects the genitalia of post-menopausal women. We describe a woman with painful, disseminated, bullous, extragenital lichen sclerosus that responded to oral acitretin and topical calcitriol and triamcinolone.

Hyper IgE syndrome (HIES) is a rare disorder characterized by eczema, recurrent infections of the skin and lungs, typically with Staphylococcus aureus, Candida albicans and certain viruses, and elevated levels of serum IgE. Other clinical manifestations include characteristic facies (prominent forehead, broad nasal bridge and facial asymmetry), chronic eczematous dermatitis, retained primary dentition, recurrent pathological fractures, hyper-extensibility and scoliosis. The central nervous system (CNS) involvement in HIES has been rarely reported. Here we presented a case of HIES with rare associations of epilepsy in a young patient to raise awareness for this disorder.

A 55-year-old male presented with recurrent crops of crusted papular lesions and boils over buttocks for 1month along with a short history of productive cough. The diagnosis of papulonecrotictuberculid (PNT) with pulmonary tuberculosis was made based on history, clinical features, laboratory investigations, and response to antitubercular treatment.

Multiple cutaneous reticulohistiocytoma (MCR) and multicentric reticulohistiocytosis (MR) are rare, idiopathic histiocytic granulomatous disorders presenting in a spectrum. A 35-year-old female presented with multiple, firm, discrete, asymptomatic nodules, 1-2 cm in size over face, back, abdomen, thighs, and legs. There were no systemic symptoms. Histopathology of a nodule over trunk showed diffuse, dense infiltrate of large histiocytes, and histiocytic giant cells. The histiocytes had rounded vesicular nuclei and abundant pink homogenously stained ground glass cytoplasm. The diagnosis of MCR was made. Systemic evaluation did not reveal any abnormality. Considering the cosmetic appearance of facial lesions, patient was referred to the plastic surgeon. No treatment was advised for rest of lesions and patient was asked to review every 6 months or if any new complaints develop.

Cutaneous sarcoidosis presents with a wide range of clinical presentations. An uncommon cutaneous manifestation is infiltration of old cutaneous scars with non-caseating granulomas known as scar sarcoidosis. Most of the patients with this clinical entity have other systemic manifestations, particularly pulmonary changes. We report a case of a 50 years old man, presenting with cutaneous sarcoidosis overlying scars of healed herpes zoster.

Cutis marmorata telangiectatica congenita (CMTC) is an uncommon, congenital, vascular malformation, characterised by a fixed, generalised or localised, reticulate erythematous rash. We report an eighty day old male child who presented with the above lesion involving the left upper and lower limbs with underlying atrophic changes.

A 38-year - old female came to us with sudden eruptions of painful edematous lesions which appeared pseudovesicular on cutaneous examination. Histopathology supported the diagnosis of sweet's syndrome and she responded to a combination of dapsone and oral steroids, after having relapsed on self-discontinuation of monotherapy with dapsone.