Journal of Dermatology

Skin grafting is a time-honored surgical technique that has been widely utilized for wound coverage and reconstruction. Depending on the clinical scenario and the requirements of the defect, skin grafts can be classified into different types, such as partial-thickness and full-thickness grafts, based on the amount of dermis included along with the epidermis. Despite being a well-established procedure, several factors can influence the success of graft uptake, including graft immobility, wound bed nutrition, and prevention of infection. Various techniques and adjuncts have been developed over time to improve graft take rates and overall healing outcomes. In this article, we report a case of post-burn raw area successfully covered using a split-thickness skin graft (SSG). The graft take was further enhanced by the application of autologous platelet-rich plasma (APRP), which acted as a biological adhesive and promoted early healing through the release of growth factors.

Effective initial management of burn injuries is essential for minimizing tissue damage, reducing pain, and improving long-term outcomes. The increasing integration of mobile technology in healthcare has led to the development of innovative digital tools designed to support emergency care. A Burnaid mobile application is a specialized tool aimed at assisting first responders, healthcare professionals, and laypersons in the early assessment and treatment of burns. This app provides real-time, evidence-based guidance on burn first aid, including cooling protocols, burn size estimation, severity classification, and referral criteria aligned with clinical guidelines. Its features also support education, documentation, and communication between prehospital providers and receiving facilities. Preliminary studies and user feedback suggest that the app improves adherence to burn first aid standards and enhances triage accuracy, particularly in resourcelimited or remote settings. This article explores the clinical utility, educational role, and integration of the Burnaid mobile app within existing burn care frameworks and discusses future directions for its development and implementation in global digital health strategies.

Background: Hypoalbuminemia is prevalent in patients undergoing major abdominal surgeries and is associated with adverse postoperative outcomes, including prolonged hospital stays, higher infection rates, and increased mortality. The clinical impact of albumin supplementation in these patients remains under scrutiny. Objective: This study evaluates whether albumin supplementation in hypoalbuminemic patients (≤3.0 g/dL) improves postoperative outcomes. Methods: This retrospective study included patients who underwent major abdominal surgery between January 2021 and December 2024 at a tertiary care hospital. Patients with hypoalbuminemia were divided into two cohorts of 250 each: those who received postoperative albumin supplementation and those who did not. Outcomes measured included length of hospital stay (LOS), infection rates, ICU admission rates, and 30-day mortality. Results: The albumin supplementation group had a significantly shorter LOS (8.1 vs. 11.4 days, p < 0.001) and lower infection rates (10% vs. 17%, p = 0.02). There was no statistically significant difference in ICU admissions or 30-day mortality between the two groups (p = 0.58 and p = 0.19, respectively). Multivariate regression identified albumin supplementation as an independent predictor of reduced LOS and infection rates. Conclusion: Albumin supplementation in hypoalbuminemic patients post-major abdominal surgery improves recovery metrics by reducing LOS and infection rates without influencing short-term mortality. Future randomized controlled trials are necessary to validate these findings.

Introduction: Herpes zoster (HZ) is the prototypical cause of zosteriform dermatoses. Additionally, many infectious, inflammatory, and neoplastic conditions may mimic this distribution pattern. Immuno compromised patients, such as those with end-stage renal disease (ESRD), are predisposed to both infectious and reactive skin conditions. In these cases, HZ may present with atypical morphologies, leading to diagnostic challenges. This report presents a case of atypical herpes zoster in a patient with chronic kidney disease (CKD) showing dimorphic ulcerative ecthymatous lesions and crusted umbilicated papulonodules mimicking reactive perforating collagenosis (RPC). This report highlights the importance of histopathology in distinguishing these conditions. Case Report: A 48-year-old male with stage - VCKD on haemodialysis, presented with acute onset of unilateral, multiple painful papulonodules culminating into ulcers over the right lower back and abdomen. The lesions were diverse ranging from punched out ulcersto umbilicated papules with central keratotic crusting. This evoked the differentials of ecthyma or segmental RPC. None of the past or present lesions were vesicular. Investigations revealed anaemia, deranged sugar levels and renal function parameters. Bacterial cultures showed no growth, while Tzanck smear demonstrated multinucleated giant cells. Skin biopsy revealed viral cytopathic changes and follicular involvement typifying herpes viral infection. The patient responded well to renal-adjusted acyclovir therapy, with significant improvement in symptoms and healing of ulcers. Conclusion: Atypical morphologies of herpes zoster, such as ecthymatous and that mirroring RPC, should be considered in immunosuppressed patients. Misdiagnosis as ecthyma or perforating dermatosis can delay appropriate antiviral treatment. Histopathology plays a crucial role in distinguishing HZ from its mimickers. This case underscores the need for heightened clinical suspicion while diagnosing atypical zoster and early intervention to prevent further complications in CKD patients.

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