Abstract Capecitabine, an oral prodrug of 5-fluorouracil, is a widely used agent in the treatment of metastatic breast cancer, including as first-line therapy in appropriate patients, but its use is often associated with palmar-plantar erythrodysesthesia (PPE). We report a case of Grade 2 PPE in a 39-year-old female on capecitabine monotherapy for recurrent breast carcinoma. She presented with painful erythema, burning sensation, and desquamation on her palms and soles, which were aggravated by prolonged standing as part of her occupational activity. Significant symptom relief was achieved with topical corticosteroids, antihistamines and moisturizers containing urea and lactic acid. This case highlights how mechanical stress like prolonged standing, can exacerbate capecitabine-induced PPE. Identifying such exacerbating factors and implementing early, targeted interventions can avoid treatment disruption and improve patient outcomes. Patient education on preventive and early prophylactic measures continues to be an important part of the comprehensive management of PPE.

Mycosis fungoides (MF) is the most prevalent type of cutaneous T-cell lymphoma. Cutaneous lymphomas are a rare and diverse group of non-Hodgkin lymphomas originating from T- and B-cells, with the skin being the primary site of involvement. This case report describes the case of a 52-year-old male with chronic kidney disease on hemodialysis who developed MF. The present case highlights the diagnostic challenges and the importance of a multidisciplinary approach in managing patients with concurrent systemic and dermatological conditions.

Background: Intertrigo is a common inflammatory dermatosis affecting skin folds with significant impact on quality of life. Limited data exist on its microbiological profile and clinical presentation, especially in the Indian context. Objective: To evaluate the clinical presentation and microbial etiology of intertrigo in adults and assess antimicrobial susceptibility patterns. Materials and Methods: This cross-sectional study included 80 adult participants with clinically diagnosed intertrigo attending the dermatology department at a tertiary hospital in north Karnataka from July 2022 to December 2023. Demographic data, clinical features, and predisposing factors were recorded. Specimens were collected for direct microscopy, bacterial and fungal cultures, and antimicrobial susceptibility testing. Results: The study population had female predominance (58%) with a mean age of 45 years. Lower middle socioeconomic class (53.75%) and homemakers (33.75%) were most commonly affected. Itching was the predominant symptom (53.75%). The groin (31.25%) was the most frequent site of involvement. Diabetes mellitus (32.5%) and obesity (42.5%) were the major predisposing factors. Positive cultures were obtained in 71.25% of cases. Staphylococcus aureus (20%) was the most common bacterial isolate, followed by Klebsiella species (8.75%). Among fungi, Candida albicans (12.5%) predominated, followed by nonalbicans C andida species (11.25%). S. aureus showed high sensitivity to amoxicillin–clavulanic acid (75%) but considerable resistance to ciprofloxacin (87.5%). Conclusion: Intertrigo presents with diverse clinical and microbiological profiles influenced by various factors including anatomical location, occupation, and comorbidities. The microbial spectrum and antibiotic sensitivity patterns identified in this study provide valuable insights for clinicians in selecting appropriate treatment strategies for intertrigo management.

Background: Androgenetic alopecia (AGA) significantly impacts patients’ psychological well-being, with conventional treatments showing limited efficacy and potential adverse effects. Platelet-rich plasma (PRP) therapy, utilizing growth factors (GFs) including vascular endothelial GF, platelet-derived GF, and transforming GF-β, represents a promising regenerative approach. This study evaluated PRP efficacy in AGA management through a comprehensive multimodal assessment. Materials and Methods: This prospective controlled study enrolled 35 AGA patients using split-scalp methodology. PRP was administered to one scalp hemisphere with placebo injections to the contralateral side as within-subject controls. Assessments included trichoscopic evaluation of hair density and diameter, histopathological analysis of follicular morphology and perifollicular inflammation, and CD34 immunohistochemical staining for neovascularization and stem cell activation. Results: Twenty-six patients (74.3%) demonstrated statistically significant improvement on PRP-treated hemispheres, with substantial increases in hair density and diameter. Histopathological examination revealed reduced perifollicular inflammation and increased follicular dimensions. Enhanced CD34 immunoexpression indicated improved microvascular networks and stem cell activation. Nine patients (25.7%) showed no differential response, highlighting individual variability in treatment responsiveness. Conclusion: This multimodal investigation provides robust evidence supporting PRP efficacy in AGA management, demonstrating superior outcomes versus placebo across trichoscopic, histomorphological, and immunohistochemical parameters. PRP represents a safe, regenerative alternative to conventional pharmacological approaches. However, heterogeneous treatment responses and limited follow-up duration necessitate protocol standardization and extended multicenter trials to optimize therapeutic strategies and identify predictive factors for treatment success.

A 58-year-old male experienced gustatory sweating on the left side of his face for 2 years following a left parotidectomy a decade prior. He was clinically diagnosed with Frey syndrome, confirmed by a starch-iodine test. To treat the condition, intracutaneous botulinum toxin A injections were administered at 1 cm intervals across the affected area. Each site received two units, with follow-up assessments at 2 weeks, 3 months, and biannually over 2 years. The treatment successfully mitigated sweating without complications, such as localized muscle weakness or skin changes. Frey syndrome, though benign, can socially impact patients due to its noticeable symptoms. Botulinum toxin A proves to be an effective treatment with minimal invasiveness and a high success rate, surpassing alternative topical therapies such as aluminum chloride and glycopyrronium bromide, which lack supporting randomized study data. Consequently, botulinum toxin A remains the preferred therapeutic approach for Frey syndrome.

Background: Syphilis is a sexually transmitted infectious disease caused by a spirochaete Treponema pallidum. Untreated syphilis may pass through four stages: primary, secondary, latent, and tertiary syphilis. Aim: The aim was to study the clinic-demographic aspects of syphilis patients for the last 12 years pre- and postcoronavirus disease 2019 (COVID-19) era in a tertiary care institution. Materials and Methods: This is a retrospective analysis of all syphilis patients who visited our tertiary care hospital for treatment and referred cases suspected of syphilis from blood bank and antenatal clinic. Details of all these patients were analyzed for age, gender, education, occupation, marital status, staying with family or away from home, high-risk behavior, clinical manifestations in symptomatic patients, stage of syphilis, serology, and treatment given. Results: A total of 97 adult and 2 congenital syphilis patients were diagnosed and treated for syphilis. Latent syphilis was the most common (63, 64.9%) stage of syphilis, followed by secondary syphilis (23, 23.7%). The most common age group involved was 15–30 years, with a median age of 28 years and a male/female ratio of 4/3. Most of the patients (42.2%) were of lower educational status and secondary education or less, followed by higher secondary (39.1%). Extramarital, premarital, and homosexual behavior was reported by 49.4%, 40.2%, and 3.09% of cases, respectively. Twenty (20.6%) patients had other associated sexually transmitted infections in the form of human immunodeficiency virus (7.2%), genital herpes (5.1%), genital warts (6.1%), and genital molluscum and genital warts with candidal balanoposthitis (1%) each. Conclusion: Rising syphilis trends of our institution paralleled the national and global trends with post-COVID-19 surge. Early diagnosis, treatment, and effective counseling are key measures to control syphilis propagation.

Haim–Munk syndrome (HMS) is an uncommon autosomal recessive condition characterized by germline mutations in the lysosomal protease cathepsin C (CTSC) gene, which is also implicated in disorders such as Papillon–Lefèvre syndrome and prepubertal periodontitis. We report the case of a 31-year-old male, born out of second-degree consanguineous marriage, presenting with palmoplantar keratoderma, severe periodontitis, onychogryphosis, and psoriasiform plaques. Whole exome sequencing confirmed the diagnosis of HMS, identifying a missense homozygous mutation in the CTSC gene on exon 1 of chromosome 11. This report contributes to the limited literature on HMS, emphasizing the phenotypic variability, need for thorough clinical evaluation, and the comprehensive approach to its diagnosis and care.

Introduction: Vulval skin disorders significantly impact individuals, affecting physical well-being, mental state, and sexual health. There is limited research on vulvar dermatoses (VD) affecting the sexual function, especially in the Indian population. Materials and Methods: This pilot study, spanning from September 2021 to April 2023, includes female patients within the age group of 18–65 years who were sexually active with genital dermatoses. Patients with chronic systemic illness and sexual transmitted disease were excluded. A questionnaire comprising of 7 questions were formed including domains such as difficulties in sexual activity, satisfaction, worry, embarrassment, pain, partner issue, and change in frequency of sexual intercourse. The questionnaire was validated by four subject experts. The details were recorded in a prestructured pro forma. Independent t-test and ANOVA were used to find the statistical association. Results: In the study involving 86 females with vulvar conditions, 17 exhibited an impact on the sexual function impairment (SFI) scale, with 82.35% reporting a small effect and 17.64% a moderate effect. None reported a large effect. The average SFI score among patients having disease duration of 1–3 months, 3–6 months, and >6 months was 3.83 ± 2.14, 7.67 ± 3.78, and 4.87 ± 5.54, respectively. Maximum average SFI score associated with warts and lichen planus was 12 followed by 5.5 ± 2.12 in candidiasis, 5 ± 4.76 in tinea cruris/corporis, and 5 in cutaneous metastasis. Discussion and Conclusion: A small, superficial, asymptomatic lesion over genitals may cause significant impact on the nature of sexual activity. Compared to previous questionnaires, it is simpler questionnaire, easy to understand, and less time-consuming for both the patient and physician. Limitations: Small sample size.