Background: Polyethylene glycol (PEG) is commonly used in dermatology due to its excellent solubility, nontoxic nature, and compatibility with various therapeutic agents. Its applications extend from moisturizing creams to chemical peels, improving skin hydration and facilitating drug delivery. Despite its broad utility, PEG is associated with hypersensitivity reactions, including rare cases of anaphylaxis, that necessitates a thorough assessment of its safety profile. This review evaluates PEG’s therapeutic roles, safety, and dermatological applications, focusing on its pharmacokinetics, chemical properties, and potential adverse effects. Methods: A comprehensive literature search was conducted in PubMed, SciVerse, and EMBASE databases to identify studies on PEG’s dermatological uses, including its role in treating psoriasis, acne, ichthyosis, fungal infections, wound healing, and cosmeceuticals. Studies addressing PEG’s allergenic potential were also reviewed, focusing on cutaneous reactions and rare anaphylactic events. Articles in English, published until June 2024, were included in this narrative review. Results: PEG’s emollient and humectant properties make it valuable in treating psoriasis, where it enhances corticosteroid delivery and reduces erythema and scaling. In acne, PEG-based salicylic acid peels offer controlled exfoliation with minimal irritation. PEG’s hydrating properties also benefit ichthyosis and wound healing by maintaining moisture and delivering antibacterial agents. In cosmetics, PEG functions as an emulsifier, surfactant, and conditioner. However, hypersensitivity risks, including urticaria and anaphylaxis, require cautious use, especially for allergy-prone individuals. Conclusion: PEG’s properties make it a useful dermatological component, though awareness of hypersensitivity risks is essential for safe clinical use. Further studies are needed to understand PEG-induced hypersensitivity and to guide safety protocols.

White piedra is a superficial fungal infection of hair caused by Trichosporon species. It presents clinically as white nodules encasing the hair shafts and may lead to increased fragility. It can usually be differentiated easily from clinically similar conditions based on clinical and microbiologic features. We report a case of white piedra of scalp hair in a 32-year-old female caused by T. ovoides, diagnosed using clinical, trichoscopic, microbiologic and molecular methods. In this case, trichoscopy acted as an interface between clinical and microbiologic examination, obviating the need for hair shaft microscopy. The genus Trichosporon contains 6 species of clinical significance viz., T. asahii, T. asteroides, T. cutaneum, T. inkin, T. mucoides, and T. ovoides, which cannot be differentiated based on their morphologic characteristics. A genotypic identification using molecular methods helped determine the causative species. It was treated successfully with oral itraconazole and topical ketoconazole.

Introduction: Acrokeratosis paraneoplastica of Bazex (APB) is a rare paraneoplastic dermatosis having definite association with malignancy, most commonly squamous cell carcinomas (SCC) of the upper aerodigestive tract. It is characterized by psoriasiform plaques involving the ears, nose, hands, and feet. Nail changes are commonly encountered, including onychauxis, subungual hyperkeratosis, xanthonychia, onycholysis, and onychorrhexis. Case Presentation: We report the details of a 40-year-old male who presented with cutaneous changes involving both ears, palms, and soles and multiple nails, suggestive of APB. These typical changes were succeeded by an SCC of the lip. Discussion/Conclusions: In 70% cases of APB, nail changes precede the diagnosis of the underlying neoplasm by up to 10 months, offering a good lead-time for early suspicion of malignancy. Our case highlights the importance of recognizing these changes early. An atypical location of malignancy (lower lip) and rare presentations, including painful acrokeratosis, melanonychia striata, and chloronychia, as seen in our case, should also be kept in mind.

Introduction: Onychomatricoma is a fibroepithelial tumor derived from the nail matrix and onychodermis. Many clinical and histological variants have been described. Pigmented onychomatricoma is a rare variant which presents as longitudinal pachymelanonychia. Case Presentation: We report the details of a 41-year-old female who presented with blackening and thickening involving more than half of the left middle fingernail for the past 10 years. Dorsal plate onychoscopy revealed longitudinal parallel white, gray, and black bands, while onychoscopy of the distal free edge demonstrated a thickened nail plate with “wood worm” cavities. The histopathological examination of the excised tumor revealed a pigmented onychomatricoma. Conclusions: Onychomatricoma is one of the nail tumors presenting as pachyonychia striata apart from onychocytic matricoma and onychocytic carcinoma. A pigmented onychomatricoma may closely mimic fungal melanonychia, pigmented onychopapilloma, pigmented ungual Bowen’s disease, and ungual melanoma. Noninvasive techniques like onychoscopy and imaging studies like ultrasonography and magnetic resonance imaging are helpful in differentiating it from pigmented ungual Bowen’s disease and ungual melanoma, even though diagnostic confirmation requires an excisional biopsy.

Introduction: Periarticular thenar erythema with onycholysis (PATEO) syndrome is a rare subtype of hand-foot syndrome seen in patients undergoing taxane-based chemotherapy. It presents as erythematous to violaceous plaques on the dorsum of hands, feet, and around the Achilles tendon along with nail changes, particularly onycholysis. Case Presentation: A 39-year-old female on paclitaxel chemotherapy for stage IIIA (T3N2aM0) invasive ductal breast carcinoma, presented with mildly tender erythematous to violaceous plaques involving the dorsa of bilateral hands and feet, in the periarticular areas of the Achilles tendon, with facial involvement. All fingernails showed shortening, orange-red chromonychia, Beau’s lines, onychoschizia, and subungual debris. The toenail involvement was relatively less severe, with distal onycholysis being the predominant finding. The patient showed significant improvement in cutaneous lesions with topical steroid therapy and was advised cold water immersion during subsequent chemotherapy infusions. Discussion: A shorter interval between cycles and a higher cumulative number of cycles correlate with severity of dermatitis and nail involvement. Rarely, periocular and facial involvement can occur concurrently with PATEO syndrome. This case is being reported to increase awareness about this entity facilitating early diagnosis and treatment.