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   Table of Contents - Current issue
Coverpage
March-April 2018
Volume 84 | Issue 2
Page Nos. 131-250

Online since Friday, February 16, 2018

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REVIEW ARTICLES  

Elimination of leprosy in India: An analysis p. 131
Utpal Sengupta
DOI:10.4103/ijdvl.IJDVL_1070_16  PMID:29451189
India attained the elimination figure of less than 1 case of leprosy per 10,000 people during December 2005. Despite this, India still accounts for the largest number of new leprosy cases in the world, maintaining more than 50 per cent of the leprosy burden of the world, notwithstanding over three decades of use of multidrug therapy. The present review analyzes the process of execution of the elimination program, identifies any lacunae therein and presents corrective measures that could be taken up for elimination of the disease from the country.
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Antihypertensives in dermatology Part II - Cutaneous adverse reactions to antihypertensives p. 137
P. S. S. Ranugha, Jayadev B Betkerur
DOI:10.4103/ijdvl.IJDVL_992_16  PMID:29405133
Antihypertensive drugs are prescribed frequently and can cause cutaneous adverse reactions. The exact incidence and frequency of these reactions are unknown. Multiple antihypertensive drug consumption has contributed to a substantial increase in the number of cutaneous adverse reactions to them. Thus, there is a need for dermatologists and physicians to be aware of the wide range of available antihypertensives and the type of reactions that can be expected. This review article focuses on the various clinical presentations that have been implicated or associated with them. The diagnosis and management have been discussed in brief.
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ORIGINAL ARTICLES Top

Total serum immunoglobulin E level and specific allergens in adults with skin diseases p. 148
Byung Gon Choi, Yang Won Lee, Yong Beom Choe, Kyu Joong Ahn
DOI:10.4103/ijdvl.IJDVL_27_17  PMID:29376509
Background: Immunoglobulin E (IgE) plays an important role in allergic diseases. Although several studies have shown the association of serum total IgE and allergen-specific IgE levels with allergic dermatological diseases such as atopic dermatitis, there are few studies addressing this association for skin diseases in general. Aims: We sought to evaluate IgE levels in skin diseases and investigate the differences based on the disease type and clinical factors such as gender and age. Methods: Data from 2836 patients who visited the dermatologic clinic of the Konkuk University Hospital, Seoul, Republic of Korea for 4 years were reviewed to document IgE levels and clinical information. IgE levels were collated with the type of skin disease, gender, and age. Results: Patients with atopic dermatitis had a much higher total IgE level and were more susceptible to allergens as compared to other disease groups. Patients in other disease groups showed no significant differences in IgE levels. Men showed higher total IgE levels but the gender differences decreased with increasing age. Limitations: The data were collected from patients at a referral centre and thus may not represent the general population of dermatologic patients. There was a lack of information regarding factors that could potentially influence IgE levels such as smoking history and disease severity. Conclusions: The results suggest that there are physiological or environmental differences in IgE-mediated immune responses between males and females. Also, except for atopic dermatitis, there were no clinical differences in the IgE levels among various skin diseases.
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Kumkum-induced allergic contact dermatitis: Are we missing the actual culprit? p. 153
Ashwini Annabathula, S Priya, CR Srinivas
DOI:10.4103/ijdvl.IJDVL_45_17  PMID:29393081
Background: Kumkum, made with turmeric and slaked lime along with colour enhancing dyes is known to cause allergic contact dermatitis. The possible contact allergens in kumkum include turmeric, Sudan-1, 4-aminoazobenzene, brilliant lake red R and cananga oil. We report patch test results among patients with suspected contact hypersensitivity to kumkum. Objective: To identify the allergen causing kumkum induced allergic contact dermatitis by patch testing and to advise patients about organic kumkum which doesnot contain colour enhancing dyes. Methods: Eighteen patients with suspected contact hypersensitivity to kumkum were patch tested with undiluted kumkum, undiluted turmeric, Sudan-1 (95%), 4-aminoazobenzene and allergens of the Indian Standard Series. Results: Of the 18 patients, 14 patients had patch test positivity to kumkum and 4 had a negative reaction to kumkum. Patch test with other suspected contact allergens showed positive reaction to turmeric in 4 patients, Sudan-1 in 3 patients and 4-aminoazobenzene in 2 patients. Among the allergens of the Indian Standard Series, positivity to nickel and fragrance mix was seen in 5 and 2 patients respectively. Positive reaction to PPD, chlorocresol and parthenium was seen in 1 patient each. Limitation: Small sample size. Conclusion: Allergic contact dermatitis to kumkum occurs both due to the dyes (added for enhancing the colour) and turmeric. All patients with suspected allergic contact dermatitis should be patch tested with kumkum, turmeric and dyes, based on which alternative non-allergic material could be advised. Kumkum dermatitis can also occur due to various other allergens, for which too patch testing should be done.
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Percutaneous ethanol injection as a promising and minimally invasive treatment for axillary osmidrosis: Double-blinded randomized controlled trial p. 157
Ali Asilian, Masoom Shahbazi, Bahareh Abtahi-Naeini, Nazila Poostiyan, Mohammad Ali Nilforoushzadeh
DOI:10.4103/ijdvl.IJDVL_704_16  PMID:29393079
Background: Axillary osmidrosis is a common problem with a strong negative impact on the professional and social quality of life. Several options are available for its treatment. But there are no treatment guidelines. The objective of this study was to evaluate efficacy and safety of percutaneous ethanol injection for treatment of axillary osmidrosis. Methods: A randomized, double-blind, placebo-controlled clinical trial to assess clinical efficacy and postoperative complications of percutaneous ethanol injection was performed among 60 patients (12–35 years of age) with axillary osmidrosis. The active agent used in the experimental group (n = 30) was sterile 90% ethanol and the placebo used in the control group (n = 30) was sterile normal saline administered in an identical syringe. The results of malodor elimination were graded by the patients as excellent, good, fair, and poor. All patients were followed-up for 10 months. Results: Malodor elimination was graded as good by 15 (50%) patients treated with percutaneous ethanol injection. A significant difference in the improvement of axillary osmidrosis was found between the experimental and control groups (P < 0.001). The most common post-procedure complication was transient subjective skin stiffness in the experimental group, which regressed spontaneously. There were no serious permanent side effects. Limitations: Relatively short duration of follow-up; and lack of histopathological evidence of destruction of the apocrine glands after treatment in most patients. Conclusions: Percutaneous ethanol injection is an effective and safe treatment method for axillary osmidrosis and does not have permanent side effects.
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Effectiveness of topical green tea against multidrug-resistant Staphylococcus aureus in cases of primary pyoderma: An open controlled trial p. 163
Nagaraju Umashankar, Belliappa Pemmanda, P Gopkumar, AJ Hemalatha, Priya K Sundar, HV Prashanth
DOI:10.4103/ijdvl.IJDVL_207_16  PMID:29146890
Background: Antimicrobial activity of green tea against Staphylococcus aureus both in vitro and in vivo has been reported recently. Studies on clinical efficacy and safety of green tea as antibacterial agent against S. aureus in human cases are rare. Objectives: To evaluate the clinical effectiveness and safety of topical green tea on primary pyoderma caused by S. aureus. We also attempted to determine the minimum inhibitory concentration of green tea against S. aureus and methicillin-resistant S. aureus. Methods: Open label, prospective, placebo-controlled study included community-acquired primary pyoderma cases caused by S. aureus. Severity grading was done on a scale of 1–5. Green tea ointment 3% and placebo ointment were used. Cure was defined on the basis of negative culture and assessment of clinical improvement. Minimum inhibitory concentration was determined by agar dilution method. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 16. Results: Of the 372 patients, 250 received green tea and 122 received placebo. Multidrug-resistant S. aureus was isolated in 89.1% in green tea group and 81.1% in placebo group, respectively. Methicillin-resistant S. aureus was isolated in 24 patients. Cure was seen in 86% in green tea group and 6.6% in placebo group which was statistically very significant. The number of days for comprehensive cure in green tea group was 9.2 ± 6.4 days. All patients with methicillin-resistant S. aureus infection in the green tea group were cured. Minimum inhibitory concentration of green tea against S. aureus was 0.0265 ± 0.008 μg/ml and against methicillin-resistant S. aureus was 0.0205 ± 0.003 μg/ml. Limitations of the Study: Comparative trial was not conducted in the same patient with different lesions; children less than seven years were not considered as the school authorities did not permit for younger children to be included in the study and true randomization and blinding of investigators were not done. Conclusions: Green tea has a significant antibacterial effect against multidrug-resistant S. aureus. Minimum inhibitory concentration of green tea is established and is promising in methicillin-resistant S. aureus infections.
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CASE REPORT Top

Granulomatous slack skin syndrome: Report of a unique case p. 169
S Uma Maheswari, V Sampath, A Ramesh
DOI:10.4103/ijdvl.IJDVL_727_16  PMID:29067930
Granulomatous slack skin syndrome is a rare variant of cutaneous T-cell lymphoma (mycosis fungoides). It is characterized clinically by redundant skin folds, which show a predilection towards flexural areas such as the axilla and the groin. Histologically, it shows a granulomatous T-cell infiltrate and loss of elastic tissue. It has an indolent but progressive course; and is usually refractory to treatment. We report a unique case of slack skin syndrome, sparing the classical sites with rapid and unusual involvement of non-intertriginous areas.
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BRIEF REPORT Top

Effect of intravenous pulse dexamethasone versus daily oral prednisolone on bone mineral density in dermatology patients: Is it a site-specific response? Highly accessed article p. 174
Sanjeev Handa, Gurjeet Singh, Amanjot Kaur Arora, Niranjan Khandelwal, Vivek Gupta
DOI:10.4103/0378-6323.204202  PMID:28397714
Background: The use of glucocorticoids in various forms of administration is complicated by their systemic side effects. Although intravenous pulse therapy is considered to have lesser systemic side effects, there are few studies in literature comparing the effects of intravenous pulse glucocorticoids versus oral daily glucocorticoids on bone mineral density. Aim: To compare the effects of intravenous pulse glucocorticoids and oral daily glucocorticoids on bone mineral density with the aim of finding any site-specific osteopenic side effect. Methods: The study was conducted by the department of dermatology of Postgraduate Institute of Medical Education and Research, Chandigarh, India. The study comprised of two groups of patients. Group A consisted of 28 patients with pemphigus vulgaris who received intravenous pulses of dexamethasone at 4 weekly intervals. Group B consisted of 21 patients with airborne contact dermatitis who received oral daily prednisolone therapy. All the patients had a dual X-ray absorptiometry scan at baseline, and at 3 and 6 months of follow-up. The results were analyzed as changes in bone mineral density. Results: There was loss of bone mineral density at lumbar spine and the head of radius in both the groups. At the lumbar spine, Group B showed more reduction in bone mineral density at 3 months whereas in Group A it was more at the head of radius. In patients on oral steroids, the lumbar spine was significantly more affected than the head of radius at both 3 and 6 months of follow-up. However, in patients on intravenous pulse steroids, both the sites were equally affected at 3 and 6 months. Limitations: In our study, we used different glucocorticoids in the two groups: prednisolone in the oral daily group and dexamethasone in the intravenous pulse steroids group. A similar reduction in bone mineral density in both the groups may have been due to a longer half-life or more bone-directed side effects of dexamethasone as compared to prednisolone. Conclusion: Dermatologists need to be aware of the detrimental effects of high-dose intravenous pulsed glucocorticoids on bone mineral density and assessment of this parameter should be done before the initiation of therapy and also at regular intervals thereafter. During follow up, either the lumbar spine or the head of radius can be used to assess the osteopenic effect of intravenous pulse steroids, whereas the lumbar spine is a better site for this evaluation in patients on oral steroids.
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QUIZ Top

Recurrent painful lesions on the lower lip p. 179
Paula Hasbún Acuña, Ana Castro Pardo, Mauricio Aspée Roa
DOI:10.4103/ijdvl.IJDVL_430_16  PMID:28513481
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IMAGES IN CLINICAL PRACTICE Top

Music box spine keratoderma p. 182
Tasleem Arif, Mohammad Adil, Suhailur Rehman
DOI:10.4103/ijdvl.IJDVL_178_17  PMID:29451190
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LETTERS TO THE EDITOR: LETTERS IN RESPONSE TO THE PREVIOUSLY PUBLISHED ARTICLES Top

Actinomycotic osteomyelitis p. 184
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/ijdvl.IJDVL_516_17  PMID:29451191
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Author reply p. 184
Supriya Kheur
DOI:10.4103/ijdvl.IJDVL_936_17  PMID:29451192
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LETTERS TO THE EDITOR - CASE LETTERS Top

Primary cutaneous CD4 positive small/medium T cell lymphoma p. 186
Gaurav Jain, Hema Malini Aiyer
DOI:10.4103/ijdvl.IJDVL_91_17  PMID:29363627
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Sarcomatoid lung carcinoma presenting as alopecia neoplastica p. 188
Naveena Jose, Celine Machiyanickal Isac, Sobhanakumari Kunjumani, Letha Vilasiniamma
DOI:10.4103/ijdvl.IJDVL_959_16  PMID:29327696
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Madelung's disease: A benign symmetric lipomatosis p. 190
Prasenjeet Mohanty, K Vivekanandh, Gaurav Dash, Liza Mohapatra
DOI:10.4103/ijdvl.IJDVL_126_17  PMID:29405131
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Familial gigantic melanocytosis p. 192
Kinjal D Rambhia, K Sushma Chowdhary, G Venkateswara Rao, Uday S Khopkar
DOI:10.4103/ijdvl.IJDVL_154_17  PMID:29393076
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A rare case of multiple Becker's nevi without systemic involvement p. 194
Fan Li, Tingting Wang, Lin Wang
DOI:10.4103/ijdvl.IJDVL_137_17  PMID:29393075
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Linear orofacial lichen sclerosus p. 197
Jiao Zhang, Ruzeng Xue, Eryi Lin, Huiqin Pan, Yongfeng Chen
DOI:10.4103/ijdvl.IJDVL_856_16  PMID:29405132
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Penile Mycobacterium avium complex spindle cell pseudotumor p. 199
Pablo Fonda-Pascual, Arantxa Arana-Raja, Oscar M Moreno-Arrones, Diego Buendia-Castaño, Carmen M Garcia Del Real, Sergio Diz-Fariña
DOI:10.4103/ijdvl.IJDVL_403_17  PMID:29405130
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LETTERS TO THE EDITOR - STUDY LETTERS Top

Efficacy of topical 5% fluorouracil needling in vitiligo p. 203
AR Shashikiran, Sneha Gandhi, SB Murugesh, Mamatha Kusagur, Sugareddy
DOI:10.4103/ijdvl.IJDVL_386_16  PMID:29380751
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Clinical experience of adalimumab in the treatment of psoriasis - A 10-year journey in a tertiary dermatology centre p. 205
Wai Man Mandy Chan, Hazel Hweeboon Oon, Wei-Sheng Chong
DOI:10.4103/ijdvl.IJDVL_163_17  PMID:29451193
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LETTERS TO THE EDITOR - OBSERVATION LETTERS Top

Calciphylaxis as cutaneous marker of hyperparathyroidism and successful outcome with parathyroidectomy followed by hyperbaric oxygen therapy p. 209
Ruchi Hemdani, GR Rajput, J Sridhar, Manas Chatterjee, Dipali Rathod
DOI:10.4103/ijdvl.IJDVL_252_17  PMID:29451194
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Disseminated herpes simplex virus and varicella zoster virus co-infection in an immunocompetent patient p. 212
Ziying Vanessa Lim, Hongliang Tey
DOI:10.4103/ijdvl.IJDVL_423_17  PMID:29451195
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Cutaneous angiosarcoma in a patient with systemic sclerosis: First case from India p. 214
Vibhu Mendiratta, Shiwangi Rana, Shanthini Manickavasagam, Anita Nangia, Ram Chander
DOI:10.4103/ijdvl.IJDVL_962_16  PMID:29376512
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Wolf's isotopic nonresponse in healed herpes zoster in erythroderma p. 217
Surabhi Sinha, Gunjan Verma, PK Sharma, Arvind Ahuja
DOI:10.4103/ijdvl.IJDVL_1170_16  PMID:29393080
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PubMed indexing: Misconceptions p. 220
Sandeep Lahiry, Shouvik Choudhury, Ayan Mukherjee, Dwaipayan Sarathi Chakraborty
DOI:10.4103/ijdvl.IJDVL_555_17  PMID:29350204
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Atypical generalized morphea-like scleroderma occurring in a patient exposed to organic solvents and having chronic hepatitis C virus infection p. 221
Amina Aounallah, Ines Lahouel, Sana Mokni, Mehdi Ksiaa, Marouen Hayouni, Colandane Belajouza, Feten Kotti, Wafa Saidi, Lobna Boussofara, Olfa El Maalel, Marwa Guerfala, Badreddine Sriha, Mohamed Denguezli, Nejet Ghariani, Rafiaa Nouira
DOI:10.4103/ijdvl.IJDVL_248_17  PMID:29451196
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Eosinophilic fasciitis associated with Raynaud's phenomenon, esophageal dysmotility, positive antinuclear antibody and anti-neutrophil cytoplasmic antibody p. 224
Biswanath Behera, Nidhi Singh, Laxmisha Chandrashekar, Arjuna Babu Sathya, Devinder Mohan Thappa, Pampa Ch Toi
DOI:10.4103/ijdvl.IJDVL_306_16  PMID:29393078
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Bulla formation at the tuberculin skin test site in a patient with bullous pemphigoid: Koebnerization or severe delayed-type hypersensitivity? p. 227
Anuradha Bishnoi, Dipankar De, Sanjeev Handa, Rahul Mahajan, Debajyoti Chatterjee, Uma Nahar Saikia
DOI:10.4103/ijdvl.IJDVL_170_17  PMID:29376506
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A subungual angiokeratoma with characteristic clinical and dermoscopic features p. 230
Ki Min Sohn, Young Jun Woo, Jung Eun Kim, Hoon Kang
DOI:10.4103/ijdvl.IJDVL_138_17  PMID:29376508
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IMAGES IN CLINICAL PRACTICE Top

Subungual exostosis on index finger in a child p. 232
Piyush Kumar, Ghuncha Alam
DOI:10.4103/ijdvl.IJDVL_492_17  PMID:29350203
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RESIDENTSí PAGE Top

Nicotinamide: Mechanism of action and indications in dermatology p. 234
Pooja Bains, Manpreet Kaur, Jasleen Kaur, Saurabh Sharma
DOI:10.4103/ijdvl.IJDVL_286_17  PMID:29405129
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FOCUS Top

Silymarin: An interesting modality in dermatological therapeutics p. 238
Konchok Dorjay, Tasleem Arif, Mohammad Adil
DOI:10.4103/ijdvl.IJDVL_746_16  PMID:29350205
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QUIZ Top

An annoying mass of the nail bed p. 244
Emi Dika, Marco Adriano Chessa, Pier Alessandro Fanti, Aurora Alessandrini, Michela Starace, Bianca Maria Piraccini
DOI:10.4103/ijdvl.IJDVL_417_16  PMID:28836509
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E-IJDVL - NET STUDY Top

Distribution of killer immunoglobulin-like receptor genes in HIV infected long-term non-progressors from Mumbai, India p. 247
Vijay R Chavan, Zakiya Ansari, Preeti Mehta, Jayanti Mania-Pramanik
DOI:10.4103/ijdvl.IJDVL_518_16  PMID:29327701
Background: Few reports suggest the association of killer immunoglobulin-like receptors of natural killer cells with human immunodeficiency virus infection. India with world's third largest population of human immunodeficiency virus / acquired immunodeficiency syndrome, offers scope to study such association. Objective: Current study (2010-2015) was designed to evaluate if killer immunoglobulin-like receptors gene polymorphisms are associated with HIV infection outcomes specifically, with long term non progressors. Methods: Killer immunoglobulin-like receptors genotyping was done using polymerase chain reaction - sequence-specific primer method. Viral load was measured by Cobas Taqman HIV-1 test. Estimation of CD4 counts was done using BD FACS CD4 count reagent. Results: The activating gene frequencies identified were 3DS1 (53.8%), 2DS3 (69.2%), 2DS4 (76.9%), 2DS5 (69.2%), 2DS1 (76.9%) and 2DS2 (92.3%). The inhibitory gene frequencies were 2DL2 (92.3%), 2DL5 (76.9%), 2DL3 (69.5%), 3DL1 (84.6%), 3DL2 (92.3%) and 2DL1 (100%). The results highlight high frequency of 3DS1/3DL1 heterozygote and killer immunoglobulin-like receptor 2DS1, among these long term non progressors indicating their possible association with slow progression. Genotype analysis shows total 13 genotypes, of which 8 genotypes were identified for the first time from India. Two genotypes were unique/novel, which were unreported. All genotypes observed in this study were considered to be Bx genotype (100 %). Limitations: A small sample size (n=13, due to a rare cohort) and the absence of control group were the limitations of this study. Conclusions: The present study highlights the distribution of killer immunoglobulin-like receptor genes in a very rare group of human immunodeficiency virus -1 infected individuals - long term non progressors. All the long term non progressors tested show the presence of Bx haplotype and each long term non progressors has a different killer immunoglobulin-like receptor genotype.
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E-IJDVL - NET LETTERS Top

Clinicoepidemiologic study of verruca plana at a tertiary care center Highly accessed article p. 247
Vaishali Masatkar, Lalit Kumar Gupta, Ashok Kumar Khare, Sharad Mehta, Asit Mittal
DOI:10.4103/ijdvl.IJDVL_1028_15  PMID:28440228
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Congenital hypertrichosis lanuginosa Highly accessed article p. 248
Iffat Hassan Shah, Sumaya Zeerak, Peerzada Sajad, Safia Bashir, Yasmeen J Bhat, Syed Mubashir
DOI:10.4103/ijdvl.IJDVL_525_16  PMID:28566560
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Extensive milia formation in a young woman with bullous pemphigoid Highly accessed article p. 248
Subramanian Kumudhini, Raghavendra Rao, Kanthilatha Pai, Sricharith Shetty, Sathish Pai
DOI:10.4103/ijdvl.IJDVL_402_16  PMID:28440230
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ERRATUM Top

Erratum: Extranodal natural killer/T cell lymphoma, nasal type presenting as recurrent facial cellulitis p. 249

DOI:10.4103/0378-6323.218818  PMID:29451197
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ANNOUNCEMENT Top

IJDVL International Awards 2017 p. 250
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Online since 15th March '04
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