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   Table of Contents - Current issue
Coverpage
May-June 2015
Volume 81 | Issue 3
Page Nos. 237-336

Online since Monday, May 04, 2015

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EDITORIAL  

Missing issues p. 237
M Ramam
DOI:10.4103/0378-6323.156189  
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REVIEW ARTICLE Top

Nocebo effect in dermatology p. 242
Sidharth Sonthalia, Kinshuk Sahaya, Rahul Arora, Archana Singal, Ankur Srivastava, Ritu Wadhawan, Hamed Zartab, Kripa Shankar Gupta
DOI:10.4103/0378-6323.155573  PMID:25900939
Nocebo effect, originally denoting the negative counterpart of the placebo phenomenon, is now better defined as the occurrence of adverse effects to a therapeutic intervention because the patient expects them to develop. More commonly encountered in patients with a past negative experience, this effect stems from highly active processes in the central nervous system, mediated by specific neurotransmitters and modulated by psychological mechanisms such as expectation and conditioning. The magnitude of nocebo effect in clinical medicine is being increasingly appreciated and its relevance encompasses clinical trials as well as clinical practice. Although there is hardly any reference to the term nocebo in dermatology articles, the phenomenon is encountered routinely by dermatologists. Dermatology patients are more susceptible to nocebo responses owing to the psychological concern from visibility of skin lesions and the chronicity, unpredictable course, lack of 'permanent cure' and frequent relapses of skin disorders. While finasteride remains the prototypical drug that displays a prominent nocebo effect in dermatologic therapeutics, other drugs such as isotretinoin are also likely inducers. This peculiar phenomenon has recently been appreciated in the modulation of itch perception and in controlled drug provocation tests in patients with a history of adverse drug reactions. Considering the conflict between patients' right to information about treatment related adverse effects and the likelihood of nocebo effect stemming from information disclosure, the prospect of ethically minimizing nocebo effect remains daunting. In this article, we review the concept of nocebo effect, its postulated mechanism, relevance in clinical dermatology and techniques to prevent it from becoming a barrier to effective patient management.
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ORIGINAL ARTICLES Top

Weekly azathioprine pulse versus daily azathioprine in the treatment of Parthenium dermatitis: A non-inferiority randomized controlled study p. 251
Kaushal K Verma, G Sethuraman, M Kalavani
DOI:10.4103/0378-6323.154788  PMID:25851756
Background: Azathioprine in daily doses has been shown to be effective and safe in the treatment of Parthenium dermatitis. Weekly pulses of azathioprine (WAP) are also effective, but there are no reports comparing the effectiveness and safety of these two regimens in this condition. Aims: To study the efficacy and safety of WAP and daily azathioprine in Parthenium dermatitis. Methods: Sixty patients with Parthenium dermatitis were randomly assigned to treatment with azathioprine 300 mg weekly pulse or azathioprine 100 mg daily for 6 months. Patients were evaluated every month to assess the response to treatment and side effects. Results: The study included 32 patients in the weekly azathioprine group and 28 in the daily azathioprine group, of whom 25 and 22 patients respectively completed the study. Twenty-three (92%) patients on WAP and 21 (96%) on daily azathioprine had a good or excellent response. The mean pretreatment clinical severity score decreased from 26.4 ± 14.5 to 4.7 ± 5.1 in the WAP group, and from 36.1 ± 18.1 to 5.7 ± 6.0 in the daily azathioprine group, which was statistically significant and comparable (P = 0.366). Patients on WAP had a higher incidence of adverse effects (P = 0.02). Limitations: The study had a small sample size and the amount of clobetasol propionate used in each patient was not determined, though it may not have affected the study outcome due to its comparable use in both groups. Conclusions: Azathioprine 300 mg weekly pulse and 100 mg daily dose are equally effective and safe in the treatment of Parthenium dermatitis.
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Evaluation of the effect of Block Level Awareness Campaign on performance indicators of National Leprosy Elimination Program in Vadodara district, Gujarat, India p. 257
Lipy K Shukla, Rashendu N Patel, Sangita V Patel, Rajendra K Baxi
DOI:10.4103/0378-6323.154793  PMID:25851761
Background: Leprosy is probably the oldest disease afflicting mankind and a public health problem for centuries. Many cases are hidden or undiagnosed, especially due to social stigma, and neglect of painless patches. Between years 2001 and 2005, during which time active surveillance for detection of leprosy was in practice, a steep fall in the prevalence rate (PR) of leprosy was observed. However, during later years, leprosy program discontinued active surveillance for detection of leprosy cases. Presently block level awareness campaign (BLAC) is a special measure undertaken in a campaign mode during September-November in priority areas, (PR > 1/10000 population), during which information, education and communication (IEC) activities and active surveillance of leprosy cases is done. Aims: To evaluate the effect of Block Level Awareness Campaign on performance indicators of national leprosy elimination program (NLEP) in Vadodara district. Methods: The campaign was carried out for 6 days in 12 talukas of Vadodara district by the district leprosy office, Vadodara. Trained teams of health workers carried out information, education and communication (IEC) activity and active surveillance by undertaking house to house survey in each primary health centre (PHC) area. Suspected cases were identified by the team and confirmed clinically by medical officers in the primary health centre of the corresponding areas. A district nucleus team (DNT) validated these confirmed cases. These data were compared with the district's national leprosy eradication programme (NLEP) data for the same year, 2012 and the previous year, 2011. Results: A total of 1,574,586 persons, comprising 76%of the population surveyed, were screened for leprosy, which resulted in detection of 358 clinically confirmed new cases of leprosy, out of which 225 (62.8%) were paucibacillary (PB) and 133 (37.2%) were multibacillary (MB) leprosy. Of these cases, 14 (4%) had deformities, and 37 (10.3%) were children. Limitations: Only 76% of the population could be covered. Histopathological confirmation of the diagnosis was not undertaken. Because of the large number of health workers invovled, variations in their skills may have influenced the diagnosis of suspected cases. Conclusions: Active surveillance linked to focused block level campaigns can be useful tools to detect new hidden leprosy cases.
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Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma p. 263
Woo Jin Lee, Joon Min Jung, Chong Hyun Won, Sung Eun Chang, Jee Ho Choi, Kee Chan Moon, Mi Woo Lee
DOI:10.4103/0378-6323.154795  PMID:25851763
Background : Dermatofibroma sometimes clinically presents as a nodular lesion without gross skin surface change. Clinicopathologic features of this variant of dermatofibroma have not been evaluated. Aims : To assess clinicopathologic features of dermatofibroma presenting as a subcutaneous nodule. Methods : This study reviewed the clinical and histological features of 42 cases of subcutaneous dermatofibromas and compared them with 95 cases of conventional dermatofibroma. Results : Dermatofibroma without gross skin surface change was associated with a shorter pre-diagnosis duration than conventional dermatofibroma. Increase in size during the pre-diagnosis period was significantly more frequent in the conventional type. In addition, these dermatofibromas were more likely than the conventional type to occur in the head and neck region. Although tumor depth was deeper than in the conventional type, less than half of the dermatofibromas without gross skin surface change were found histologically to be "subcutaneous" or "deep-penetrating dermatofibroma". Subcutaneous extension was more frequent in these dermatofibromas while focal stromal hyalinization and hemosiderin deposits were more common in the conventional type. Limitations: This study is a retrospective, single center design. Conclusion : The present study suggests that dermatofibroma without gross skin surface change is a variant type with distinct clinical and histological features that distinguish them from conventional dermatofibroma.
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BRIEF REPORT Top

Onychomycosis: A study of self-recognition by patients and quality of life p. 270
Sumanas Bunyaratavej, Penvadee Pattanaprichakul, Charussri Leeyaphan, Onjuta Chayangsu, Supapat Bunyaratavej, Kanokvalai Kulthanan
DOI:10.4103/0378-6323.154796  PMID:25851764
Background: Onychomycosis accounts for approximately half of all nail disorders and is usually asymptomatic. Objectives: To evaluate patients' recognition of fungal nail disease, concomitant fungal skin diseases, complications, and quality of life. Methods: Patients from the fungal nail clinic were enrolled between May 2011 and April 2012. Patients' awareness of diseased nails was evaluated and the Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate the impact of dermatologic disease on quality of life. Results: A total of 110 patients with onychomycosis were enrolled in the study, of which 64 (58.2%) were female and the mean age was  60.8 years. The number of patients who were able to recognize the presence of onychomycosis was 71 (64.5%), while 32 (29.1%) and 7 (6.4%) were diagnosed by a dermatologist and other physicians, respectively. Multivariate analysis showed that patient recognition of the disease was significantly associated with female sex and young age. The mean DLQI score was  3.6. Limitation:   Patient recall bias including the duration of fungal nail infection, long-term past history and previous treatment was a limitation of this study that affected DLQI scores. Conclusion: About half of onychomycosis patients, especially elderly males, could not recognize the disease by themselves. It is important for physicians to educate patients with risk factors for onychomycosis to recognize this condition early to prevent concomitant infection and complications, and to improve patients' well-being.
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CASE REPORT Top

Cutaneous mucormycosis of scalp and eyelids in a child with type I diabetes mellitus p. 275
Kamran Zaman, Harsimran Kaur, Shivaprakash M Rudramurthy, Meenu Singh, Atul Parashar, Arunaloke Chakrabarti
DOI:10.4103/0378-6323.152740  PMID:25784223
Scalp mucormycosis in children is extremely rare. We present a case of pediatric scalp mucormycosis caused by Rhizopus oryzae in a 9-year-old diabetic girl who was successfully diagnosed and treated with amphotericin B deoxycholate and wound debridement. At 3 months follow up, the patient was stable although she had lost her vision.
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IMAGES IN CLINICAL PRACTICE Top

Accidental occupational fireworks tattoo p. 279
Domenico Bonamonte, Michelangelo Vestita, Gianni Angelini
DOI:10.4103/0378-6323.155574  PMID:25900940
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RESIDENT’S PAGE Top

Chalazion clamp in dermatology revisited p. 280
Abhijeet Kumar Jha, Satyaki Ganguly
DOI:10.4103/0378-6323.154797  PMID:25851765
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LETTERS TO THE EDITOR Top

Pancreatic panniculitis p. 282
Sarita Kalwaniya, Pradeep Choudhary, Yashant Aswani, Suresh Jain
DOI:10.4103/0378-6323.155578  PMID:25900941
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Transparency imaging: A new complementary tool for the assessment of melanocytic nevi p. 283
Felipe Valdés-Pineda, José Manjón-Haces, Celia Gómez de Castro, Ashfaq A. Marghoob, Francisco Vázquez-López
DOI:10.4103/0378-6323.155571  PMID:25900938
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In vitro antimicrobial susceptibility of Mycoplasma hominis genital isolates p. 286
Salvatore Pignanelli, Giovanna Pulcrano, Pasqua Schiavone, Vita Dora Iula, Maria Rosaria Catania
DOI:10.4103/0378-6323.153520  PMID:25791859
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Histopathological evidence of efficacy of microneedle radiofrequency for treatment of axillary hyperhidrosis p. 288
Farahnaz Fatemi Naeini, Ali Saffaei, Mohsen Pourazizi, Bahareh Abtahi-Naeini
DOI:10.4103/0378-6323.154789  PMID:25851757
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Scar examination in sporotrichosis: An additional tool for clinical diagnosis p. 290
Marcelo R Lyra, Antonio C. F. Valle, Maria I. F. Pimentel, Liliane F Antonio, Janine P. M. Lyra, Renata C. C. Araújo, Armando O Schubach
DOI:10.4103/0378-6323.152746  PMID:25784228
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Novel transglutaminase 1 mutations in a Chinese patient with severe lamellar ichthyosis phenotype p. 292
Juan Bai, Ying-guo Ding, Yin-hua Wu, Jian-jun Qiao, Hong Fang
DOI:10.4103/0378-6323.154786  PMID:25851754
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Prepubertal onset of hidradenitis suppurativa in a girl: A case report and literature review p. 294
Jelena M Stojkovic-Filipovic, Mirjana D Gajic-Veljic, Milos Nikolic
DOI:10.4103/0378-6323.152741  PMID:25784224
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Pemphigus vulgaris localised exclusively to the penis p. 298
Ozlem Su, Didem Dizman, Dilek Biyik Ozkaya, Pelin Yildiz, Cuyan Demirkesen, Nahide Onsun
DOI:10.4103/0378-6323.154794  PMID:25851762
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Pemphigus vulgaris associated with surgery: A rare association p. 299
Abid Rashid, Jinrong Wang, Ping Fu, Wenfang Wang, Hong Xie
DOI:10.4103/0378-6323.155566  PMID:25900935
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Bullous eosinophilic cellulitis with subcorneal pustules p. 301
Taisuke Kamiyama, Hideaki Watanabe, Hirohiko Sueki
DOI:10.4103/0378-6323.154791  PMID:25851759
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Oculocutaneous tyrosinemia: A case report with delayed diagnosis and excellent response to dietary modification p. 303
Burak Tekin, Deniz Yucelten, Cigdem A Zeybek, Ertugrul Kiykim, Maria Wehner, Regina C Betz, Ayse E Toker
DOI:10.4103/0378-6323.152744  PMID:25784227
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Histiocytoid sweet syndrome related to bortezomib: A mimicker of cutaneous infiltration by myeloma p. 305
Mar Llamas-Velasco, Maria J Concha-Garzón, Javier Fraga, M Aragüés
DOI:10.4103/0378-6323.152743  PMID:25784226
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Generalized lichen planus following tattooing with involvement of old hypertrophic scars: Is it 'Koebner recall?' p. 306
Kinjal D Rambhia, Siddhi B Chikhalkar, Uday S Khopkar
DOI:10.4103/0378-6323.155561  PMID:25900932
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Clinical and dermoscopic features of eccrine poroma p. 308
Bruno Simão dos Santos
DOI:10.4103/0378-6323.154787  PMID:25851755
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Recurrent cutaneous leiomyosarcoma of the inner thigh p. 309
Domenico Bonamonte, Michelangelo Vestita, Angela Filoni, Giuseppe Ingravallo, Pasquale Sportelli
DOI:10.4103/0378-6323.155565  PMID:25900934
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Cutaneous involvement of marginal zone B-lymphoma noted after topical imiquimod; more than a coincidence? p. 311
Tamara Gracia-Cazaña, Anastasia Aulés-Leonardo, Miguel Ángel Marigil-Gómez, Yolanda Gilaberte
DOI:10.4103/0378-6323.155567  PMID:25900936
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Peripheral T-cell lymphoma, not otherwise specified presenting with multiple tender cutaneous nodules and plaques p. 313
Vishal Gupta, Divya Seshadri, Binod K Khaitan, Debojit Nath, Asit R Mridha
DOI:10.4103/0378-6323.152742  PMID:25784225
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Angioimmunoblastic T-cell lymphoma p. 315
Rashmi S Mahajan, Ashwin P Vaghani, RK Pasle, Freny E Bilimoria
DOI:10.4103/0378-6323.153523  PMID:25791860
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Extramammary Paget disease secondary to a transitional cell carcinoma of the bladder p. 318
Adriana Martín-Fuentes, Consuelo Sánchez-Herreros, Jesús Cuevas-Santos, Esther De Eusebio-Murillo
DOI:10.4103/0378-6323.153513  PMID:25791858
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Leser-Trelat sign with primary hepatic carcinoma p. 320
Jiu-Hong Li, Hao Guo, Bo Li, Xing-Hua Gao
DOI:10.4103/0378-6323.154792  PMID:25851760
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Progressive cribriform and zosteriform hyperpigmentation p. 321
Anupam Das, Debabrata Bandyopadhyay, Vivek Mishra, Ramesh C Gharami
DOI:10.4103/0378-6323.154790  PMID:25851758
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IMAGES IN CLINICAL PRACTICE Top

Ocular involvement in lamellar Ichthyosis p. 324
Amit Gupta, Aniruddha Agarwal, Jagat Ram
DOI:10.4103/0378-6323.155569  PMID:25900937
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QUIZ Top

Multiple vegetating lesions over the genitalia p. 325
Celia S Saldanha, Manjunath M Shenoy, PR Shanthala, Vishal B Amin
DOI:10.4103/0378-6323.155563  PMID:25900933
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E-IJDVL - NET LETTERS Top

"Goat eyes": Horizontal rectangular pupils: An unusual clinical presentation of orf p. 327
Enver Turan, Sila Seremet
DOI:10.4103/0378-6323.153511  PMID:25791857
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A novel missense mutation in ADAR1 gene causing dyschromatosis symmetrica hereditaria in a Chinese patient p. 327
Zhi-Liang Li, Guo-Yi Zhang, Yun Hui, Rui-Xing Yu, Qi Li, Hao-Xiang Xu, Cheng-Rang Li
DOI:10.4103/0378-6323.155560  PMID:25900931
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Interstitial granulomatous dermatitis due to borreliosis p. 327
Nicola di Meo, Giuseppe Stinco, Giusto Trevisan
DOI:10.4103/0378-6323.154783  PMID:25851752
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Sclerodermoid plaques: A riddle of 'H' p. 327
Kinjal D Rambhia, Atul M Dongre, Uday S Khopkar
DOI:10.4103/0378-6323.152748  PMID:25784229
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Acquired linear Becker's nevus on lower limb in blaschkoid pattern p. 328
Khushbu Goel, Vineet Relhan, Shivani Bansal, Vijay K Garg
DOI:10.4103/0378-6323.154784  PMID:25851753
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RESIDENTS CORNER Top

Viva Questions from the IJDVL p. 329
Vishalakshi Viswanath, Resham Vasani
DOI:10.4103/0378-6323.156208  
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ANNOUNCEMENTS Top

Post-doctoral international fellowship in Dermatopathology p. 334
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Post-doctoral international fellowships in Dermatopathology p. 336
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