Karalikkattil T. Ashique

Terra firma-forme dermatosis: report of a series of 11 cases and a brief review of the literature

Terra firma‐forme dermatosis (TFFD) is a benign, yet little known disorder with very few cases reported in the literature. TFFD is considered to be only a cosmetic problem but can be a cause of embarrassment for the patients.

Optimizing the efficacy of targeted phototherapy by marking early vitiligo lesions after visualizing under a Wood's lamp.

SOLUTION We have been practicing a simple addition to the technique of targeted phototherapy where the vitiligo lesions are first visualized under a Wood’s lamp (Fig 1) and then marked with a skin marker. The targeted ultraviolet B light phototherapy session is started after the area is marked (Lumera; Daavlin, Bryan, OH). This method ensures that early vitiligo lesions, especially those in the periphery of active lesions, are targeted early, thereby increasing the efficacy of the procedure.

Radiofrequency device for tick removal

KIMS AL SHIFA Super Specialty Hospital, Perinthalmanna, rala, and Faculty of Dermatology, College of Medicine, King isal University, Al Ahsa. ing sources: None. licts of interest: None declared. int requests: Karalikkattil T. Ashique, MBBS, DDVL, KIMS Al ifa Super Specialty Hospital, Perinthalmanna, Kerala 679322, dia. E-mail: drashique@gmail.com. J Am Acad Dermatol 2015;72:e155-6. 0190-9622/

Mudi-chood: an interesting dermatological entity

36.00 a 2015 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2015.01.046

A survey on the pattern of dermoscopy use among dermatologists in India.

Mudi-chood, which means heat of the hair in the local dialect (Malayalam), is an interesting skin condition reported predominantly from Kerala, one of the southern states of India. The women in this state traditionally apply substantial quantities of oil to their hair, which they wear long. This oil leaves a residue, even after hairwashing, which comes into contact with the skin, especially over the upper back and pinna (Fig. 1). The extremely hot and humid climate in this area also contributes to the formation of peculiar hyperkeratotic papules that are sometimes pruritic and may show koebnerization. The condition, which should not be confused with acanthosis nigricans, responds well to treatment with simple keratolytic ointments or topical steroids.

Nail transillumination combined with dermoscopy for enhancing diagnosis of subungual hematoma

Introduction and Background: Dermoscopy is being increasingly used for improving dermatological diagnosis. Use of dermoscopy in the early recognition of skin malignancies, especially melanoma, is well established. Of late, its use in general clinical dermatology is growing with the recognition of new and specific patterns in conditions such as hair disorders, inflammatory disorders, and infections/infestations. This cross-sectional survey aims to assess the common patterns of dermoscopy use by Indian dermatologists. Methods: This was across-sectional survey. An online questionnaire was used to collect data. The questionnaire focused on the frequency of dermoscopy use by Indian dermatologists, reasons for using it or not, and the training they had received on dermoscopy. Results: Of the total 150 valid responses, eighty two (54.7%) participants reported that they were using dermoscopy routinely in their clinical practice. Lack of familiarity and lack of proper training were the important reasons cited for not using dermoscopy regularly. Among the dermatologists using dermoscopy, consensus on effectiveness was highest for hair disorders. Conclusions: Dermoscopy use by dermatologists in India is mainly in the context of inflammatory dermatosis and hair disorders rather than skin tumors. Lack of familiarity with the technique appears to be main factor limiting the use of dermoscopy in India. Limitations: Small sample size is the major limitation of this study. It is possible that a large number of dermatologists who do not use dermoscopy might not have responded to the survey, there by affecting the results and their interpretation.

Dermabrasion in earlobe repair

We used a combination of standard contact dermoscopy and transillumination in a 40‐year‐old male patient who presented to us with dark pigmentation of the left thumb [Figure 1]. There was history of trauma to the nail a few days before. Clinically, a diagnosis of subungual hematoma was made, which was confirmed by contact dermoscopy (Dermlite® foto II pro, 10×, nonpolarized, contact dermoscopy, attached to Canon 650D digital

Assembling a make-shift light source for a radio frequency device for skin ablation

SURGICAL CHALLENGE Earlobe repair is a simple, office-based procedure. In a near-total tear, the ideal method is to slit open the defective area with the use of a scalpel or scissors, creating a raw area along the full length of the defect, before end-to-end closure with interrupted sutures. One of the challenges in earlobe repair is taking a thin enough slice on both sides to achieve a free-bleeding margin without taking too much of the ear itself. The procedure also becomes cumbersome in a smaller earlobe.

An innovative approach for separating the toes to manage interdigital dermatoses

Radio frequency‐based procedures are frequently performed in dermatology offices.1,2 The presence of brighter light in the operating field adds to the precision of the procedure and improves results. Lesions such as small skin tags or dermatosis papulosa nigra are better treated when there is optimal lighting. Adjusting light sources can be difficult in small‐practice settings, where there is a single dermatologist. We have devised a “piggy back apparatus” with a light‐emitting diode light source for making radio frequency machines (for skin ablation) useable even in a very dark room. A commercially available Chinese light‐emitting diode light with a goose neck to make it flexible (predominantly marketed for lighting laptop keyboard with USB power), is used for this purpose. The apparatus basically works on 5 volts, deriving electricity from a USB source. The light‐emitting end where the light‐emitting diode is located is fixed with a tape as piggy back, which adds only 20 g to the weight of the hand piece [Figure 1]. The USB end of the goose neck is extended by cutting the USB male jack which adds 1.25 m of wire in between. This makes the distance to the power source more versatile. The USB end is connected to any mobile phone charger or a portable energy bank (which works in the 5 Volt range) [Figure 2a and b]. The advantage of the devise over commercially available light‐emitting diode headgear is that in situations when the opposite side of the neck, axilla, abdomen of the patient is to be illuminated for procedure, the latter may not be able to throw adequate light as much as the illumination directly on the hand piece. The limitation of the modification is that the life of the light‐emitting diode source is unpredictable which may warrant frequent replacement.

Reinventing the Chalazion clamp: Modification of the instrument for the procedural dermatologist.

CHALLENGE Many interdigital dermatoses, such as candidiasis, intertrigo, tinea pedis, and macerated soft corns, worsen when the area is moist. Because of the proximity of the toes, keeping the area dry even for a short period of time an uphill task. This is more difficult in elderly, debilitated, or mentally retarded patients and patients who wear shoes for prolonged periods of time. In addition, in patients with warts, the chances of autoinoculation are high if the toes are held in proximity. The response to therapy is much better and the recovery time is shorter if the affected toe spaces are kept separated, at least while at rest and when asleep.