JDA IJCD Indian Journal of Clinical Dermatology ` 800 - Jaipur Volume 2 | Issue 1 | May 2019 Four Monthly HIGHLIGHTS Sunscreens: The Current Scenario Trichoscopic Findings in Various Scalp Alopecias Unilateral Truncal Acne Aer Laminectomy Armoured Keloid Werner's Syndrome: A Rare Enty Clin of ica al l D rn e u r o m J a t n o a l i o d g n y I A Publication of Jaipur Dermatology Association Clin of ica JDA al l D rn e u r o m J a t n o INDIAN JOURNAL OF a l i o d g n y I CLINICAL DERMATOLOGY A Publication of Jaipur Dermatology Association EDITORIAL BOARD EDITORS DR. DINESH MATHUR DR. U S AGARWAL Prof & Head, Dept. of Skin, JNU Medical College Senior Professor, Ex. Sr. Prof & Head, Dept. of Skin, Dept. of Skin, STD & Leprosy STD & Leprosy, SMS Medical College Ex. Principal & Controller, Ex. Pro VC, RUHS SMS Medical College & Hospital, Jaipur Email: [email protected] Email: [email protected] EXECUTIVE EDITOR Dr. Puneet Agarwal Assistant Professor, Dept. of Skin, STD & Leprosy, SMS Medical College & Hospital, Jaipur Email: [email protected] ASSISTANT EDITORS Dr. Naushin Aara Assistant Professor Dept. of Skin, STD & Leprosy, SMS Medical College & Hospital, Jaipur Email: [email protected] Dr. Taniya Mehta Ex. Senior Resident Dept. of Skin, STD & Leprosy, SMS Medical College & Hospital, Jaipur Email: [email protected] JDA Indian Journal of Clinical Dermatology | Volume 02 | Issue 01 | May 2019 i Clin of ica JDA al l D rn e u r o m J a t n o INDIAN JOURNAL OF a l i o d g n y I CLINICAL DERMATOLOGY A Publication of Jaipur Dermatology Association Volume 02 | Issue 01 | August 2019 COPYRIGHT The entire contents of the Indian Journal of Clinical Dermatology are protected under Indian and International copyrights. The Journal, however, grants to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, perform and display the work publicly and to make distribute derivative works in any digital medium for any reasonable non-commercial purpose, subject to proper attribution of authorship and ownership of the rights. The journal also grants the right to make small numbers of printed copies for their personal non-commercial use. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-ShareAlike 4.0 License. DISCLAIMER The information and opinions presented in the Journal reflect the views of the authors an not of the Journal or its Editorial Board or the Publisher. Publication does not constitute endorsement by the journal. Neither the Indian Journal of Clinical Dermatology nor its publisher nor anyone else involved in creating, producing or delivering the Indian Journal of Clinical Dermatology or the materials contained therein, assumes any liability or responsibility for the accuracy, completeness, or usefulness of any information provided in the Indian Journal of Clinical Dermatology, nor shall they be liable for any direct, indirect, incidental, special, consequential or punitive damages arising out of the use of the Indian Journal of Clinical Dermatology. The Indian Journal of Clinical Dermatology, nor its publishers, nor any other party involved in the preparation of material contained in the Indian Journal of Clinical Dermatology represents or warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such material. Readers are encouraged to confirm the information contained herein with other sources. Printed and Published by Dr. Dinesh Mathur on behalf of Jaipur Dermatology Associaon and Printed at Popular Printers, Fateh Tiba Marg, Mo Doongri Road, Jaipur (Raj.) Published From : Indian Journal of Clinical Dermatology, D-712, Park Avenue Road, Malviya Nagar, Jaipur (Raj.) Editor : Dr. Dinesh Mathur *Available online at : www.e-ijcd.in ISSN (Online): 2582-7612 ISSN (Print): 2581-7604 JDA Indian Journal of Clinical Dermatology | Volume 02 | Issue 01 | May 2019 iii Clin of ica JDA al l D rn e u r o m J a t n o INDIAN JOURNAL OF a l i o d g n y I CLINICAL DERMATOLOGY A Publication of Jaipur Dermatology Association CONTENTS 1. REVIEW Sunscreens: The Current Scenario 01-06 Kumari Pramila, Suvirya Swastika, Verma Parul, Pathania Sucheta, Shukla Prakriti 2. ORIGINAL ARTICLE Trichoscopic Findings in Various Scalp Alopecias 07-13 Dr Rita V Vora, Dr Abhishek P Pilani, Dr.Rahul Krishna S Kota, Dr. Rochit R Singhal, Dr. Trusha M Patel, Dr.Namrata D Bhavsar 3. LETTER TO EDITOR Armoured Keloid 14 Dr. Jyoti Budhwar, Dr. Chetna Singla Unilateral Hypertrophic Lichen Planus on Sole- A Rare Case Report Anand Sharma, Manmohan, Shivi Nijhawan, Subhash Bishnoi, Manisha Nijhawan, Savita Agarwal 15-17 Unilateral Truncal Acne After Laminectomy Dr. Puneet Agarwal, Dr. Uma Shanker Agarwal 18 4. CASE REPORTS Hand, Foot and Mouth Disease in an Immunocompetent Adult- A Rarity 19-21 Dr. Khushboo Modasia, Dr. Aishini Shah, Dr. Trisha Patel, Dr. Jinal Tandel, Dr. Rita Vora A Case Of Dermatopathia Pigmentosa Reticularis 22-23 Dr. Tulika Rai, Dr. Bandana Jha, Dr. Nidhi Singh, Dr. Sermili Rini Singnarpi Werner's Syndrome: A Rare Entity 24-25 Dr. Megha R. Generalized Morphea in a Child – A Rare Entity Dr. Sonal Jain, Dr. Liza Mohapatra, Dr. Prasenjeet Mohanty, Dr.Jiss Elizabeth Sebastian 26-27 6. QUIZ Rohit Garg, Ketki Chaudhary, Kritika Agrawal, Puneet Bhargava, Deepak Mathur, U S Agarwal 28 JDA Indian Journal of Clinical Dermatology | Volume 02 | Issue 01 | May 2019 v Clin of ica JDA al l D rn e u r o m J a t n o INDIAN JOURNAL OF a l i o d g n y I CLINICAL DERMATOLOGY A Publication of Jaipur Dermatology Association FROM THE DESK OF EDITOR 01-05 Greetings to all the readers !! I present to you another issue of Indian Journal of Clinical Dermatology. With your love and support we have entered second year of publication. We started with a goal to give space to maximum research publications in our journal so that they reach the people. However maintaining the quality of publications has also been taken care of. We sincerely thank our authors for entrusting us with their valuable research work. Without their support this journey would not have been possible. I also thank our reviewers for sparing their precious time to evaluate our articles. I hope you like our issue. I also request everyone to contribute towards journal with their valuable research work. Dr. Dinesh Mathur Editor JDA Indian Journal of Clinical Dermatology | Volume 02 | Issue 01 | May 2019 vii REVIEW Year: 2019 • Volume: 2 • Issue: 1 • Page: 01-06 SUNSCREENS: THE CURRENT SCENARIO Kumari Pramila1, Suvirya Swastika1, Verma Parul1, Pathania Sucheta1, Shukla Prakriti1 1 Department of Dermatology, King George's medical university (KGMU), Lucknow, Uttar Pradesh Corresponding Author:: Dr. Swastika Suvirya Department of Dermatology, Venereology and Leprosy, K.G. Medical University, Sitapur, Lucknow, Uttar Pradesh, India Email : [email protected] Abstract The increasing incidence of cutaneous malignancies and detrimental effects caused by ultraviolet radiation (UV) has increased the use of sunscreens. Many organic and inorganic filters are used as a measure of photoprotection, but their efficacy and safety profile still raise questions. Concerns have been raised regarding safety of nanotechnology in sunscreen, detrimental effects on environment, photocarcinogenic potential of UV filter to name a few. New developments in formulations of sunscreens along with changes in the guidelines of the regulatory bodies like The United States Food and Drug Administration and European Union have prompted us to revisit this topic. Continuous public education is still needed about proper application technique of sunscreen along with behavioral measures. In this article, the authors try to shed light on classification, pharmacological actions, various related terminologies, indications, emerging concerns and correct application technique as well as usefulness of oral sunscreens. Key Words - Ultraviolet radiation, sunscreen, photoprotection, controversies. Introduction Table 1: Effects of ultraviolet radiations on skin. Photoprotection is crucial to prevent detrimental effects of Ultraviolet radiation spectrum (200-400nm) ultraviolet (UV) radiations like photo-carcinogenesis, UVC UVB UVA photoageing and photosensitivity. Sunscreens have become an Wavelength 200-290 290-320 UVA1=340-400 integral part of not only the dermatologists' therapeutic (in UVA2=320-340 armamentarium but are also distributed as over the counter and nanometers) cosmetic products because of increasing awareness against Sea level 0% solar harmful impact of radiations. Nevertheless, we need to continue radiation (Completely Approximately 95-98% educating the general population about photo protective absorbed by 2-5% measures as there are concerns of inadequate application of ozone) sunscreen. In this article we attempt to compile basic aspects of Molecular • Cyclobutane • Reactive oxygen sunscreens along with an effort to understand debatable issues and cellular pyrimidine dimer species associated with it. effects • 6-4 pyrimidine- • Immuno- pyrimidone dimer suppression Why do we need photo protection? • Epidermal sunburn • Cyclo butane Ultraviolet radiations (wavelength 200-400nm) are a small part cell pyrimidine dimer of electromagnetic radiation spectrum, classified as UVA, UVB • Skin hyperplasia (weak) and UVC. Most detrimental and probably extensively studied • Vitamin D synthesis part of UV radiations is its role as a major causal factor of skin Clinical • Erythema (peaks • Immediate [1] effects 24 hours), Oedema pigment darkening cancer. Unprotected chronic sun exposure leads to development Acute • Pigment darkening (fades within of non melanoma skin cancers.[2] Direct photochemical damage • Delayed tanning 15 minutes) to DNA is caused by UVB leading to gene mutations by means of pyrimidine dimers and development of precancerous and Chronic • Photocarcinogenesis • Photoageing cancerous lesions while UVA penetrates deeper into skin; acting • Photoageing • Immunosuppression [3] indirectly at cellular level by generation of free radical species.