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  Citation statistics : Table of Contents
   2006| March-April  | Volume 72 | Issue 2  
 
 
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ORIGINAL ARTICLE
Cutaneous manifestations in patients with chronic renal failure on hemodialysis
P Udayakumar, S Balasubramanian, KS Ramalingam, Chembolli Lakshmi, CR Srinivas, Anil C Mathew
March-April 2006, 72(2):119-125
DOI:10.4103/0378-6323.25636  PMID:16707817
Background: Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis. Methods: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%), followed by pallor (60%), pruritus (53%) and cutaneous pigmentation (43%). Other cutaneous manifestations included Kyrle's disease (21%); fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%); purpura (9%); gynecomastia (1%); and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.
  44 37,194 1,473
Disulfiram and low nickel diet in the management of hand eczema: A clinical study
Ashimav Deb Sharma
March-April 2006, 72(2):113-118
DOI:10.4103/0378-6323.25635  PMID:16707816
Background: Hand eczema due to nickel sensitivity is a challenging task for the dermatologist. The average human diet provides sufficient amount of nickel, which acts as a provocating factor in nickel-sensitive individuals. When such patients are treated with steroid or other immunosuppressives, only short-term remission is obtained. This is because unless the dietary intake of nickel is minimized and the existing amount of nickel in the body of the sensitized individual is depleted, long-term remission is unlikely. Aim: To evaluate the efficacy of oral disulfiram, a nickel-chelating agent and low nickel diet (LND) in reducing the clinical symptoms and preventing frequent relapse of hand eczema in nickel-sensitive individuals. Methods: A total of 21 patients with chronic vesicular hand eczema with nickel sensitivity were taken for this study. Patients were randomly divided into two groups: (a) Study group consisting of 11 patients (8 females and 3 males). They were prescribed disulfiram orally for a period of 4 weeks; they started LND 2 weeks prior to initiation of disulfiram therapy and continued till the end of follow-up period. (b) Control (placebo) group consisting of 10 patients (7 females and 3 males). They were allowed to continue with normal diet. Each of them received lactose tablet daily as placebo for 4 weeks. It was a comparative study and participants were not aware if they belonged to study group or control group (single blind trial). Results: Hand eczema healed completely in 10 (90.9%) out of 11 patients treated with disulfiram and LND during the treatment period in the study group, compared with 1 out 10 patients in control (placebo) group (non significant). Mild relapse was noted in 5 patients in between 2-12 weeks of follow-up period. Conclusion: Low nickel diet and short course of oral disulfiram therapy can be considered a good option for the control of chronic hand eczema in nickel-sensitive individuals.
  16 11,853 334
Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in community-acquired primary pyoderma
Rahul Patil, Sujata Baveja, Gita Nataraj, Uday Khopkar
March-April 2006, 72(2):126-128
DOI:10.4103/0378-6323.25637  PMID:16707818
Background: Although prevalence of MRSA strains is reported to be increasing, there are no studies of their prevalence in community-acquired primary pyodermas in western India. Aims: This study aimed at determining the prevalence of MRSA infection in community-acquired primary pyodermas. Methods: Open, prospective survey carried out in a tertiary care hospital in Mumbai. Materials and Methods: Eighty-six patients with primary pyoderma, visiting the dermatology outpatient, were studied clinically and microbiologically. Sensitivity testing was done for vancomycin, sisomycin, gentamicin, framycetin, erythromycin, methicillin, cefazolin, cefuroxime, penicillin G and ciprofloxacin. Phage typing was done for MRSA positive strains. Results : The culture positivity rate was 83.7%. Staphylococcus aureus was isolated in all cases except two. Barring one, all strains of Staphylococcus were sensitive to methicillin. Conclusions: Methicillin resistance is uncommon in community-acquired primary pyodermas in Mumbai. Treatment with antibacterials active against MRSA is probably unwarranted for community-acquired primary pyodermas.
  12 11,297 646
CASE REPORTS
Epidermolytic hyperkeratosis with rickets
Surajit Nayak, Samira Kumar Behera, Basanti Acharjya, A Sahu, D Mishra
March-April 2006, 72(2):139-142
DOI:10.4103/0378-6323.25641  PMID:16707822
A 6-year-old child presented with generalized hyperkeratosis, most marked over the flexures; windswept deformity of the legs; and limping since 3 years. On the basis of the clinical, histopathologic and biochemical findings, he was diagnosed as a case of epidermolytic hyperkeratosis with rickets. He was treated with parenteral vitamin D3 and calcium supplements orally. Nutritional rickets has been reported in children with various types of ichthyosis like lamellar and X-linked types. We report this case of epidermolytic hyperkeratosis with rickets for its rarity.
  10 7,401 217
ORIGINAL ARTICLE
Pattern of skin diseases among migrant construction workers in Mangalore
Maria Kuruvila, S Dubey, Pratik Gahalaut
March-April 2006, 72(2):129-132
DOI:10.4103/0378-6323.25638  PMID:16707819
Background: With increasing industrialization, the construction industry provides employment to a large number of skilled and nonskilled workers, many of them migrant workers. Aim: This study was undertaken to provide epidemiological data regarding various dermatoses among migrant construction workers in India as currently there is a paucity of the same. Methods: One thousand construction workers, including 467 migrant laborers, were examined for various dermatoses. Results: Most (88%) workers were males and 51.17% were in their third decade. Infective and noninfective dermatoses were seen in 89.72% and 53.74% of laborers respectively. Among infective dermatoses, fungal infections were the most common (46.25%) ones, followed by bacterial infections (24.83%), scabies (8.56%) and viral infections (6.42%). Contact dermatitis to cement was seen in 12.48% of the laborers. Masons had a significantly higher incidence of contact dermatitis to cement, viral infections and scabies than helpers. Conclusions: The pattern of dermatoses is an expression of poverty, overcrowding and the occupational hazards of the construction industry.
  8 7,268 334
EDITORIAL
Systemic contact dermatitis
AK Bajaj, A Saraswat
March-April 2006, 72(2):99-102
DOI:10.4103/0378-6323.25633  PMID:16707814
  7 18,090 834
NET CASE
Acquired smooth muscle hamartoma
Arfan ul Bari, Simeen Ber Rahman
March-April 2006, 72(2):178-178
DOI:10.4103/0378-6323.25660  PMID:16707840
Smooth muscle hamartoma is an uncommon, usually congenital, cutaneous hyperplasia of the arrectores pilorum muscles. When it is acquired, it may be confused with Becker's nevus. We report a case of this rare tumor in a 19-year-old man. The disease started several years ago as multiple small skin-colored papules that subsequently coalesced to form a large soft plaque on the back of the left shoulder. The diagnosis of acquired smooth muscle hamartoma was confirmed on histopathology. The patient was reassured about the benign nature of the lesion and was not advised any treatment.
  7 8,226 187
LETTER TO EDITOR
Efficacy of steroid oral mini-pulse therapy in lichen planus: An open trial in 35 patients
M Ramesh, C Balachandran, SD Shenoi, Vandana Mehta Rai
March-April 2006, 72(2):156-157
DOI:10.4103/0378-6323.25650  PMID:16707830
  5 6,184 261
CASE REPORTS
Ichthyosis follicularis with alopecia and photophobia (IFAP) syndrome
Vandana Mehta Rai, SD Shenoi
March-April 2006, 72(2):136-138
DOI:10.4103/0378-6323.25640  PMID:16707821
A 12-year-old boy born of a nonconsanguineous marriage presented with dry rough skin and photophobia since birth. His growth and developmental milestones were normal and there was no history of any neurological problem, hearing deficit or scarring around the hair follicles. Cutaneous examination revealed diffuse thinning of scalp hair with loss of eyebrows and eyelashes and a sandpapery texture of the skin all over the body, suggestive of ichthyosis follicularis with alopecia and photophobia syndrome.
  4 9,183 238
GET SET FOR NET
EndNote 7.0
Bell Raj Eapen
March-April 2006, 72(2):165-166
DOI:10.4103/0378-6323.25654  PMID:16707834
EndNote is a useful software for online literature search and efficient bibliography management. It helps to format the bibliography according to the citation style of each journal. EndNote stores references in a library file, which can be shared with others. It can connect to online resources like PubMed and retrieve search results as per the search criteria. It can also effortlessly integrate with popular word processors like MS Word. The Indian Journal of Dermatology, Venereology and Leprology website has a provision to import references to EndNote.
  4 8,041 220
LETTER TO EDITOR
Diagnosis of delayed pressure urticaria
KV Godse
March-April 2006, 72(2):155-156
DOI:10.4103/0378-6323.25649  PMID:16707829
  4 6,451 176
QUIZ
Pericardial effusion with vesiculobullous lesions in a young female
R Dhir, PLK Desylva, Neetu Gehi, A Malik, YD Singh, H Jagannayakulu, PS Tampi, R Ramasethu
March-April 2006, 72(2):175-177
DOI:10.4103/0378-6323.25657  PMID:16707837
  4 5,880 201
BRIEF REPORT
Chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) in psoriasis
J Sridhar, PLK Desylva, YD Singh
March-April 2006, 72(2):133-135
DOI:10.4103/0378-6323.25639  PMID:16707820
Background: Insights into the pathogenesis of psoriasis have provided opportunities to target key steps in the disease process. Tumor necrosis factor-alpha (TNF-a) being crucial to the pathogenesis of psoriasis, monoclonal antibodies against this cytokine have proved useful in its treatment. Aim: To study the efficacy of chimeric monoclonal antibody to TNF-a (infliximab) in Indian patients with recalcitrant psoriasis vulgaris. Materials and Methods: Three patients with recalcitrant psoriasis vulgaris were studied. Baseline haemogram, biochemical parameters, chest radiograph and Mantoux skin test were performed. A loading dose regimen of 5 mg/kg infliximab was administered at weeks 0, 2 and 6. PASI assessment, adverse drug event monitoring and laboratory assessments were carried out at 2-week intervals until week 10. Patients were followed up until week 22 for relapse. Results: Infliximab was well tolerated. The mean PASI was 25.4 at presentation and declined to 5.5 at 10 weeks. PASI 75 was attained at a mean of 9.6 weeks. Relapse occurred at a mean of 18.6 weeks after the first infusion. Conclusions: This study on Indian patients brings out the importance of cytokine-based therapies in psoriasis. Indigenous production could make these therapies a viable therapeutic option for psoriasis patients in the near future.
  3 5,981 228
FOCUS
Acitretin
Balkrishna P Nikam, Sangeeta Amladi, SL Wadhwa
March-April 2006, 72(2):167-172
DOI:10.4103/0378-6323.25655  PMID:16707835
  3 8,155 628
LETTER TO EDITOR
Modified combined methotrexate PUVA therapy in the treatment of recalcitrant psoriasis: A preliminary report
C Laxmisha, Vinod Kumar P, DM Thappa
March-April 2006, 72(2):153-155
DOI:10.4103/0378-6323.25648  PMID:16707828
  3 4,310 191
Nickel nuisance: A clinical observation
AD Sharma
March-April 2006, 72(2):150-151
DOI:10.4103/0378-6323.25645  PMID:16707826
  3 5,178 112
NET LETTER
Actinomycotic mycetoma of the hand: A rare occurrence
Vandana Mehta Rai, C Balachandran
March-April 2006, 72(2):178-178
DOI:10.4103/0378-6323.25661  PMID:16707839
  3 4,201 156
CASE REPORTS
Mycetoma sans sinuses
Sudipta Saha, Anita Dhar, AK Karak
March-April 2006, 72(2):143-144
DOI:10.4103/0378-6323.25642  PMID:16707823
Mycetoma is a chronic suppurative infection involving the skin, subcutaneous tissue and bone. The hallmark of mycetoma is tumefaction, draining sinuses and the presence of microcolonies called grains. Sinuses develop in all patients with mycetoma within a year of the appearance of the lesion. The following case is reported as no sinuses had developed despite the presence of the lesion for 9 years, posing a diagnostic dilemma.
  2 4,160 186
LETTER TO EDITOR
Localised bullous pemphigoid in the breast
C Balachandran, Vandana Mehta Rai
March-April 2006, 72(2):158-159
DOI:10.4103/0378-6323.25651  PMID:16707831
  2 3,565 110
REVIEW ARTICLES
Changing trends in hair restoration surgery
Mysore Venkataram
March-April 2006, 72(2):103-111
DOI:10.4103/0378-6323.25634  PMID:16707815
Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy of this condition remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article discusses the latest trends in hair restoration surgery.
  2 21,104 808
WHATíS NEW IN DERMATOLOGY
Anti-CD20 monoclonal antibody (rituximab) in the treatment of pemphigus
J Sundharam
March-April 2006, 72(2):173-174
DOI:10.4103/0378-6323.25656  PMID:16707836
  2 6,907 443
CASE REPORTS
Hurler syndrome with a tuft of hair
Binodini Behera, DK Jena, R Chhetia, J Vijayashree
March-April 2006, 72(2):147-149
DOI:10.4103/0378-6323.25644  PMID:16707825
A 2-year-old girl presented with coarse, thick hairy skin all over the body, a tuft of hair in the parietal region, coarse facial features and a prominent forehead with a large tongue, hepatosplenomegaly and skeletal deformities. Mucopolysaccharides excretion spot test of the urine was positive; and an assay for glycosaminoglycans in the urine was also high, which confirmed the clinical diagnosis of Hurler syndrome. We present this rare case to discuss the possibility of the association of mental retardation with a tuft of hair in this syndrome.
  1 7,528 149
LETTER TO EDITOR
Final push of leprosy: It is prudent to pause before declaration!
Binod K Khaitan, T Tejasvi, Komal Aggarwal, Neena Khanna
March-April 2006, 72(2):151-153
DOI:10.4103/0378-6323.25646  PMID:16707827
  1 3,427 134
Split-thickness skin grafting: A novel approach in the treatment of Fournier's gangrene
SN Nikhare, MM Kura
March-April 2006, 72(2):159-160
DOI:10.4103/0378-6323.25652  PMID:16707832
  1 5,719 171
NET QUIZ
Periumbilical keratotic papules
S Veeranna, Kushalappa , J Betkerur, Savitha
March-April 2006, 72(2):178-178
DOI:10.4103/0378-6323.25662  PMID:16707838
  1 4,091 105
QUIZ
A patch of alopecia on chin
Manjunath M Shenoy, BS Girisha, S Teerthanath
March-April 2006, 72(2):179-181
DOI:10.4103/0378-6323.25658  PMID:16707841
  1 4,913 189
RESIDENTíS PAGE
Scaly signs in dermatology
Satyajeet Kangle, Sangeeta Amladi, S Sawant
March-April 2006, 72(2):161-164
DOI:10.4103/0378-6323.25653  PMID:16707833
  1 51,650 2,529
BOOK REVIEW
Illustrated synopsis of dermatology and sexually transmitted diseases
Bhushan Kumar
March-April 2006, 72(2):182-182
  - 14,620 123
CASE REPORTS
Giant cell tumor of skin
Sunil Kumar Y, AR Raghupathi, Chidananda
March-April 2006, 72(2):145-146
DOI:10.4103/0378-6323.25643  PMID:16707824
Giant cell tumor of the skin is a rare entity showing gross and histological features similar to those of giant cell tumor of the bone. We report a case of malignant giant cell tumor of the thigh in a 55-year-old man. Histological features showed a biphasic population of mononuclear cells admixed with osteoclast-like giant cells. The nuclei of the giant cells were similar to those of the mononuclear cells. This tumor should be distinguished from a variety of cutaneous neoplasms that contain multinucleated giant cells.
  - 6,387 153
LETTER TO EDITOR
Elimination of leprosy in India: Response by authors
Narasimha P Rao, TSS Lakshmi
March-April 2006, 72(2):153-153
DOI:10.4103/0378-6323.25647  
  - 3,185 122
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