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   2008| November-December  | Volume 74 | Issue 6  
    Online since January 16, 2009

 
 
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RESIDENTíS PAGE
Guidelines for writing a research project synopsis or protocol
Jayadev Betkerur
November-December 2008, 74(6):687-690
DOI:10.4103/0378-6323.45136  PMID:19172017
  256,840 1,542 1
FOCUS
Clinical applications of Q-switched NdYAG laser
Apratim Goel
November-December 2008, 74(6):682-686
DOI:10.4103/0378-6323.45135  PMID:19172016
  33,949 986 -
LETTERS TO EDITOR
Subcision in rolling acne scars with 24G needle
Jignesh B Vaishnani
November-December 2008, 74(6):677-679
DOI:10.4103/0378-6323.45133  PMID:19172014
  17,355 461 8
SEMINAR: CHRONIC ARSENICOSIS IN INDIA
Pathogenesis, clinical features and pathology of chronic arsenicosis
Sujit Ranjan Sengupta, Nilay Kanti Das, Pijush Kanti Datta
November-December 2008, 74(6):559-570
DOI:10.4103/0378-6323.45097  PMID:19171978
Arsenicosis is a multisystem disorder, with virtually no system spared from its vicious claw; though its predominant manifestations are linked to cutaneous involvement. Cutaneous effects take the form of pigmentary changes, hyperkeratosis, and skin cancers (Bowen's disease, squamous cell carcinoma, and basal cell epithelioma). Peripheral vascular disease (blackfoot disease), hypertension, ischemic heart disease, noncirrhotic portal hypertension, hepatomegaly, peripheral neuropathy, respiratory and renal involvement, bad obstetrical outcome, hematological disturbances, and diabetes mellitus are among the other clinical features linked to arsenic toxicity. The effects are mediated principally by the trivalent form of arsenic (arsenite), which by its ability to bind with sulfhydryl groups present in various essential compounds leads to inactivation and derangement of body function. Though the toxicities are mostly linked to the trivalent state, arsenic is consumed mainly in its pentavalent form (arsenate), and reduction of arsenate to arsenite is mediated through glutathione. Body attempts to detoxify the agent via repeated oxidative methylation and reduction reaction, leading to the generation of methylated metabolites, which are excreted in the urine. Understandably the detoxification/bio-inactivation process is not a complete defense against the vicious metalloid, and it can cause chromosomal aberration, impairment of DNA repair process, alteration in the activity of tumor suppressor gene, etc., leading to genotoxicity and carcinogenicity. Arsenic causes apoptosis via free radical generation, and the cutaneous toxicity is linked to its effect on various cytokines (e.g., IL-8, TGF-β, TNF-α, GM-CSF), growth factors, and transcription factors. Increased expression of cytokeratins, keratin-16 (marker for hyperproliferation) and keratin-8 and -18 (marker for less differentiated epithelial cells), can be related to the histopathological findings of hyperkeratosis and dysplastic cells in the arsenicosis skin lesion.
  14,269 814 18
Arsenicosis: Diagnosis and treatment
Nilay Kanti Das, Sujit Ranjan Sengupta
November-December 2008, 74(6):571-581
DOI:10.4103/0378-6323.45098  PMID:19171979
Diagnosis of arsenicosis relies on both clinical and laboratory criteria, but principally it can be diagnosed on the basis of its cutaneous manifestations. Cutaneous manifestations (melanosis, keratosis, and cutaneous cancers) are essential clues in the diagnosis, and trained dermatologists or arsenic experts are able to clinically confirm a case even without laboratory backup. Although systemic manifestations are not considered as diagnostic hallmarks, yet their presence serves as important telltale signs in arriving at the diagnosis. In countries where laboratory facilities are available, measuring the level of arsenic in drinking water (consumed in the last 6 months), urine, hair, and nails is of immense value. Newer biomarkers of arsenic exposure are being explored to provide early information about arsenic intoxication, of which urinary porphyrin level, blood metallothionein have shown promising results. Controlling the problem of arsenicosis depends on various factors, of which the most important is cessation of intake of arsenic-contaminated water. Deep wells, traditional dug wells, treatment of surface water, rainwater harvesting, and removing arsenic from the contaminated water by arsenic removal plant or arsenic treatment unit are the available options for providing arsenic-free drinking water. The role of nutrition and antioxidants in preventing the onset of symptoms of arsenicosis is also of importance. Nonspecific therapies (e.g., keratolytics for hyperkeratosis) cannot also be ignored and serve as palliative measures. The persons affected need to be followed up at regular intervals to detect the onset of cancers (if any) at the earliest. Role of counseling and education should never be underestimated since absence of public awareness can undermine all efforts of mitigation measures.
  13,903 741 17
ORIGINAL ARTICLES
Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria
SK Malhotra, Vivek Mehta
November-December 2008, 74(6):594-599
DOI:10.4103/0378-6323.45100  PMID:19171981
Background: The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Previous reports addressing its influence on skin psoriasis and chronic urticaria have been mainly anecdotal. Objective: The aim of this study was to evaluate the stressful events of life within 1 year preceding onset or exacerbation of skin disease in patients of psoriasis vulgaris and chronic urticaria. Method: Fifty consecutive clinically diagnosed psoriasis patients and 50 consecutive clinically diagnosed chronic urticaria patients were examined clinically and administered Gurmeet Singh's presumptive stressful life events scale. Results: Stressful life events were seen in 26% of the patients in the psoriasis vulgaris group and 16% of the patients in the chronic urticaria group within 1 year preceding onset or exacerbation of skin disease. In the psoriasis vulgaris group, the most common stressful life event seen was financial loss or problems (8%), followed by death of close family member (4%), sexual problems (4%), family conflict (2%), major personal illness or injury (2%),and transfer or change in working conditions (2%), failure in examinations (2%), family member unemployed (2%), illness of family member (2%), getting married or engaged (2%), miscellaneous (2%). In the chronic urticaria group, the most common stressful life event seen was death of a close family member (6%), followed by family conflict (2%), financial loss or problems (2%), sexual problems (2%), illness of family member (2%), getting married or engaged (2%), trouble at work with colleagues, superiors, or subordinates (2%), going on a pleasure trip (2%) and extramarital relations (2%). Conclusion: Psychological stress plays a significant role in triggering or exacerbating dermatological diseases. Our study indicates the role of relaxation therapies and stress management programs in chronic diseases such as psoriasis and chronic urticaria. Psychological interventions can help individuals to reinterpret events and develop strategies to cope with stressful events, thus decreasing morbidity due to these diseases.
  9,596 479 22
SEMINAR: CHRONIC ARSENICOSIS IN INDIA
Epidemiology and prevention of chronic arsenicosis: An Indian perspective
Pramit Ghosh, Chinmoyi Roy, Nilay Kanti Das, Sujit Ranjan Sengupta
November-December 2008, 74(6):582-593
DOI:10.4103/0378-6323.45099  PMID:19171980
Arsenicosis is a global problem but the recent data reveals that Asian countries, India and Bangladesh in particular, are the worst sufferers. In India, the state of West Bengal bears the major brunt of the problem, with almost 12 districts presently in the grip of this deadly disease. Recent reports suggest that other states in the Ganga/Brahmaputra plains are also showing alarming levels of arsenic in ground water. In West Bengal, the majority of registered cases are from the district of Nadia, and the maximum number of deaths due to arsenicosis is from the district of South 24 Paraganas. The reason behind the problem in India is thought to be mainly geogenic, though there are instances of reported anthropogenic contamination of arsenic from industrial sources. The reason for leaching of arsenic in ground water is attributed to various factors, including excessive withdrawal of ground water for the purpose of irrigation, use of bio-control agents and phosphate fertilizers. It remains a mystery why all those who are exposed to arsenic-contaminated water do not develop the full-blown disease. Various host factors, such as nutritional status, socioeconomic status, and genetic polymorphism, are thought to make a person vulnerable to the disease. The approach to arsenicosis mitigation needs be holistic, sustainable, and multidisciplinary, with the 2 main pillars being health education and provision of 'arsenic-free water.' In the state of West Bengal, the drive for arsenic mitigation has been divided into 3 phases using various methods, including new hand pumps/tube wells at alternative deep aquifers, dug wells, arsenic removal plants, arsenic treatment units, as well as piped and surface water supply schemes. The methods have their own limitations, so it is intended that a pragmatic approach be followed in the arsenicosis prevention drive. It is also intended that the preventive measures be operationally and economically feasible for the people living in the affected areas.
  9,346 450 9
ORIGINAL ARTICLES
An open, nonrandomized, comparative study of imiquimod 5% cream versus 10% potassium hydroxide solution in the treatment of molluscum contagiosum
Amol Metkar, Sushil Pande, Uday Khopkar
November-December 2008, 74(6):614-618
DOI:10.4103/0378-6323.45104  PMID:19171985
Background: There are numerous therapeutic modalities available for treatment of molluscum contagiosum. However, the ablative modalities are painful and not suitable for children. Aim: We aimed to evaluate and compare the safety and efficacy of 2 of the painless modalities, viz., 5% imiquimod cream and 10% potassium hydroxide (KOH) solution, in the treatment of molluscum contagiosum. Methods: Out of a total of 40 patients of molluscum contagiosum in the study, 18 patients in the imiquimod group and 19 patients in the KOH group completed the study. The given medication was applied by the patient or a parent to mollusca at night, 3 days per week. Imiquimod was continued till clinical cure; and 10% KOH, till lesions showed signs of inflammation. Assessments of response and side effects were performed at the end of week 4, week 8, and week 12. Significance was tested by Student's t test and Mann-Whitney test. Results: The mean lesion count decreased from 22.39 to 10.75 with imiquimod and from 20.79 to 4.31 with KOH at the end of 12 weeks. We found complete clearance of lesions in 8 (44%) patients with imiquimod and in 8 (42.1%) patients with 10% KOH. Minor side effects were seen in 15 (78.9%) patients on KOH and 10 (55.5%) patients on imiquimod. Conclusions: The results of this study suggest that both 5% imiquimod cream and 10% KOH solution are equally effective in molluscum contagiosum though KOH has a faster onset of action. However, KOH solution is associated with a higher incidence of side effects.
  8,651 392 14
NET LETTERS
Clinical and sociodemographic study of vitiligo
Hita Shah, Anil Mehta, Bhavesh Astik
November-December 2008, 74(6):701-701
DOI:10.4103/0378-6323.45144  PMID:19177701
  7,929 499 9
BRIEF REPORTS
Keratinocyte-Melanocyte graft technique followed by PUVA therapy for stable vitiligo
Dilip Kachhawa, Gyaneshwar Kalla
November-December 2008, 74(6):622-624
DOI:10.4103/0378-6323.45106  PMID:19171987
Background: Various surgical procedures for correcting stable vitiligo exist but these have their own limitations. Autologous, non-cultured, non-trypsinized, melanocyte plus keratinocyte grafting is a new and simple method of vitiligo surgery. Objective: The study aimed to evaluate efficacy of a new grafting technique in vitiligo patches. Methods: Eighteen vitiligo patches underwent this procedure. The upper layer of epidermis was removed by superficial dermabrasion using a dermabrader micromotor until the epidermis appeared wet and shiny. Then, antibiotic ointment was applied and dermabrasion was continued up to the whitish area of the upper dermis. The paste-like material (ointment with entangled epidermal particles) was collected and spread over the dermabraded recipient site. Results: Pigmentation usually started at 4-6 weeks. Complete uniform pigmentation took 16-20 weeks. Conclusion: For smaller vitiligo patches this method gives cosmetically acceptable results. It is easy to perform and does not require specific laboratory setup.
  7,996 383 6
ORIGINAL ARTICLES
Quality of life in psoriasis: A study from south India
SV Rakhesh, Mariette D'Souza, Ajith Sahai
November-December 2008, 74(6):600-606
DOI:10.4103/0378-6323.45101  PMID:19171982
Background: Psoriasis can have a profound impact on a patient's quality of life. Very few Indian studies have examined this aspect of Indian patients of psoriasis. Aims: This study was conducted to assess the clinical severity, as well as physical and psychosocial disability, and stress incurred and to analyze their interrelationship in psoriasis patients aged more than 18 years. Methods: This hospital-based cross-sectional study was conducted in the Department of Dermatology, JIPMER, Pondicherry, India. Clinical severity, physical and psychosocial morbidity, and the stress incurred were measured using psoriasis area severity index (PASI), psoriasis disability index (PDI), and psoriasis life stress inventory (PLSI) respectively, the latter two of which were suitably modified and translated into the local language, viz., Tamil. Appropriate tests were conducted using SPSS for Windows (Release 7.5.1) statistical software. Results: Fifty patients (34 males, 16 females) were included in the study. The clinical PASI scores correlated significantly with the overall physical disability (PDI), individual aspects of the PDI (except the treatment-related activities), and the measurement of stress incurred (PLSI). A PASI score of more than 18 delineated a subgroup of patients with higher overall physical disability and higher stress rating. Among the physical and psychosocial factors investigated, daily activities, employment, and treatment were reported to be affected the most. Psoriasis sufferers are also most likely to feel self-conscious, be disturbed / inconvenienced by the shedding of the skin, live in a constant fear of relapse, and avoid social interactions. Conclusions: The present study provides compelling evidence that psoriasis affects the quality of life, and it highlights the importance of adopting a multidimensional assessment of psoriasis.
  7,568 731 8
NET CASE
From darkening urine to early diagnosis of alkaptonuria
Erdal Peker, Zafer Yonden, Sadik Sogut
November-December 2008, 74(6):700-700
DOI:10.4103/0378-6323.45142  PMID:19180686
Alkaptonuria is a rare disorder of metabolism characterized by deficiency of homogentisic acid oxidase. Characteristic features include darkening of urine, ochronosis, and arthropathy. Darkening of urine is the only sign of the disorder in the pediatric age group, and it occurs at very early stage of the disorder, as reported by the parents. A 4-year-old boy presented to our clinic with the complaint of dark urine and bluish black staining of clothes. This darkening pointed to a positive physical history of bluish discoloration of sclerae which occurred off and on. We initiated treatment with ascorbic acid and a protein diet with restriction of phenylalanine and tyrosine (1.6 g/kg/d). This case report is significant because of the early diagnosis made.
  8,061 202 2
CASE REPORTS
Nocardial mycetoma: Diverse clinical presentations
Nand Lal Sharma, Vikram K Mahajan, Santwana Agarwal, Vishwa Mohan Katoch, Ram Das, Meera Kashyap, Poonam Gupta, Ghanshyam K Verma
November-December 2008, 74(6):635-640
DOI:10.4103/0378-6323.45110  PMID:19171991
Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis), mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules), tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.
  7,147 374 4
CASE REPORTS
Brooke-Spiegler syndrome
Pouran Layegh, Nourieh Sharifi-Sistani, Mohammad Abadian, Toktam Moghiman
November-December 2008, 74(6):632-634
DOI:10.4103/0378-6323.45109  PMID:19171990
The Brooke-Spiegler syndrome (BSS) is an uncommon autosomal dominant disorder characterized by a high affinity to form multiple adnexal neoplasia (skin appendage tumors), especially trichoepitheliomas and cylindromas, and occasionally spiradenomas, which usually appear in the second or third decade of life. To date, only a few cases with this syndrome have been reported. This case report describes a 26-year-old woman who presented to the dermatology department of Qaem Hospital with tumoral lesions on her scalp, face, and forearm. Her father and younger brother were also affected. On examination, several round-to-oval skin-colored papules with a smooth pearly surface measuring 2 to 6 mm in diameter were seen on the mid-face, particularly in the nasolabial folds, the upper lip. Tumors and nodules seen on the scalp were pinkish red, dome-shaped, and to some extent, pedunculated with surface telangiectasia and induration. Histopathology of the facial papules showed trichoepithelioma while that of a scalp nodule showed cylindroma.
  7,181 301 1
NET STUDY
Life quality assessment among patients with vitiligo: Comparison of married and single patients in Iran
Marjan Dolatshahi, Payam Ghazi, Vida Feizy, Mohsen Rezaei Hemami
November-December 2008, 74(6):700-700
DOI:10.4103/0378-6323.45141  PMID:19177700
Background and Aims: Vitiligo is known to affect the quality of social and personal life in some countries. This study aims to assess the quality of life (QOL) in vitiligo sufferers among the Iranian population and to evaluate its relation with different variables. Methods: One hundred vitiligo patients answered a questionnaire based on the Dermatology Life Quality Index (DLQI). Results: The mean DLQI score was 8.16. There were statistically significant relationships between DLQI scores and marital status, skin phototype, and disease extension independently. Conclusions: This study shows that vitiligo has a major impact on the QOL of patients in Iran. Hence dermatologists should pay attention to the psychological effects of this cosmetic disease and try to decrease its extension and disfiguring effects by various treatments.
  6,951 336 14
BRIEF REPORTS
Clinicopathologic analysis of 21 cases of nevus sebaceus: A retrospective study
CM Simi, T Rajalakshmi, Marjorie Correa
November-December 2008, 74(6):625-627
DOI:10.4103/0378-6323.45107  PMID:19171988
Background: Nevus sebaceus (NS), otherwise designated as 'organoid nevus', involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion's age. Aims: To study the histopathological features of NS and correlate these with clinical findings. Methods: All skin biopsy specimens over a 12-year period from 1995 to 2007 which had a diagnosis of NS were included. Clinical data with follow-up notes and histopathology were reviewed. Results: Half of the cases had a verrucous clinical appearance, while the rest presented as papules, plaques, or patches. All the cases showed immature hair follicles, and 24% of cases showed immature sebaceous glands. Normal terminal hair follicles were characteristically absent in the lesion. Nineteen percent of the cases showed dilated apocrine glands, and 14% showed hyperplasia of eccrine glands. Epidermal changes in the form of acanthosis, papillomatosis, and hyperkeratosis were seen in 86% of cases. Dilated keratin-filled infundibula were observed in 24% of cases. One case was associated with a squamous cell carcinoma. Conclusions: Nevus sebaceus is a cutaneous hamartoma, consisting of various elements indigenous to the organ. Normal terminal hair follicles are characteristically absent in the lesion although the same may be seen in rest of the epidermis, a feature of diagnostic importance, not usually highlighted in literature. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculosebaceous-apocrine unit and should not mislead the pathologist.
  6,876 296 7
NET LETTERS
Scrofuloderma: A clinicopathological and epidemiological study
L Padmavathy, Lakshmana Rao, N Ethirajan, U Manohar, BK Krishnaswamy
November-December 2008, 74(6):700-700
DOI:10.4103/0378-6323.45143  PMID:19180687
  6,731 236 2
RESEARCH METHODOLOGY
Basics of statistics for postgraduates
RP Nerurkar
November-December 2008, 74(6):691-695
DOI:10.4103/0378-6323.45137  PMID:19172018
  6,258 444 -
CASE REPORTS
Diffuse cutaneous leishmaniasis: Co-infection with human immunodeficiency virus (HIV)
Raju G Chaudhary, Freny E Bilimoria, SK Katare
November-December 2008, 74(6):641-643
DOI:10.4103/0378-6323.45111  PMID:19171992
Cutaneous leishmaniasis is a disease caused by intracellular protozoal parasites belonging to the genus Leishmania. Immune suppression caused by HIV infection is an important factor for atypical presentation and widespread progression of cutaneous leishmaniasis. Diffuse (disseminated) cutaneous leishmaniasis and HIV co-infection is emerging as an extremely serious new disease. A 38-year-old HIV-positive man presented with a 12-month history of a progressive papule and nodular eruptions on face and extremities with infiltrations of nasal and oral mucosa. We report the case due to its atypical, widespread muco-cutaneous presentation masquerading as lepromatous leprosy.
  5,945 316 10
ORIGINAL ARTICLES
An uncontrolled, open label study of sulfasalazine in severe alopecia areata
Shahin Aghaei
November-December 2008, 74(6):611-613
DOI:10.4103/0378-6323.45103  PMID:19171984
Background: Alopecia areata (AA) is an autoimmune disease mediated by T lymphocytes. Many treatments have been used but their results remain disappointing. There is a need to propose new therapeutic alternatives. Methods: During a period of 3 years, 26 patients with recalcitrant or severe AA (>40% hair loss) were enrolled in an open-label uncontrolled clinical trial. According to the response to sulfasalazine, patients were grouped into 3 categories: no hair regrowth (<10% terminal hair), partial hair regrowth (10%-90% terminal hair), and complete hair regrowth (90%-100% terminal hair). Efficacy evaluation was performed with clinical examination. Results: Twenty-two patients completed the treatment. Overall, 68.2% (15 of 22 patients) responded to therapy: 27.3% (6 of 22 patients) achieved complete hair regrowth, and 40.9% had partial hair regrowth. Seven (31.8%) patients had no hair regrowth. Of the 22 patients with complete and partial remission, 10 (45.5%) suffered a partial or complete relapse. Side effects following treatment were seen in 7 (31.8%) patients. Conclusion: Sulfasalazine could be considered as a therapeutic alternative in the treatment of AA, because of its safety profile, cosmetically acceptable efficacy, and good tolerability.
  5,585 331 8
Cutaneous manifestations in 404 Iranian patients with inflammatory bowel disease: A retrospective study
Hamideh Moravvej, Gita Meshkat Razavi, Mehdi Farshchian, Reza Malekzadeh
November-December 2008, 74(6):607-610
DOI:10.4103/0378-6323.45102  PMID:19171983
Background: Cutaneous manifestations of inflammatory bowel disease are relatively common, although they vary widely. Aims: The aim of this study was to determine the prevalence of cutaneous manifestations in inflammatory bowel disease according to their location, age, gender, activity, and type of underlying disease in an Iranian population during a 10-year period. Methods: The medical records of 404 inpatients with inflammatory bowel disease were extracted retrospectively to detect cutaneous manifestations. Results: In this study, the prevalence of cutaneous manifestations was 5.9%. These manifestations were higher in Crohn's disease (7.29%) than in ulcerative colitis (4.07%), and more frequent in females (52%) than in males (48%). Aphthous stomatitis was observed more frequently in Crohn's disease; however, pyoderma gangrenosum was seen more often in ulcerative colitis. Erythema nodosum was diagnosed only in female patients with Crohn's disease. Manifestations secondary to nutritional deficiency or associated conditions including psoriasis and other autoimmune disorders were less frequent. Conclusions: Aphthous stomatitis, pyoderma gangrenosum, and erythema nodosum were the most common skin disorders related to inflammatory bowel disease (IBD), which mainly occurred in women.
  5,503 274 7
LETTERS TO EDITOR
Type IV Ehlers-Danlos syndrome associated with factor VIII deficiency
Feroze Kaliyadan, Sheela Namboothiri
November-December 2008, 74(6):664-666
DOI:10.4103/0378-6323.45124  PMID:19172005
  5,432 150 1
Linear verrucous hemangioma on the leg
Vijay K Jain, Kamal Aggarwal, Sarika Jain
November-December 2008, 74(6):656-658
DOI:10.4103/0378-6323.45119  PMID:19172000
  5,243 194 5
CASE REPORTS
Berardinelli-Seip syndrome in a 6-year-old boy
Priya Babu, Rakesh Sharma, Elizabeth Jayaseelan, Divya Appachu
November-December 2008, 74(6):644-646
DOI:10.4103/0378-6323.45112  PMID:19171993
A 6-year-old boy presented with abnormal habitus since birth, delayed language development, history of frequent falls since 9 months, and fever since 1 week. He was found to have hyperandrogenic features, generalized paucity of fat, generalized muscular overdevelopment, and brownish pigmentation over the flexural creases. Skin biopsy demonstrated features suggestive of acanthosis nigricans with an absence of subcutaneous tissue. After further investigation, a diagnosis of Berardinelli-Seip syndrome with bilateral pneumonia and generalized tonic clonic seizures was made. Clinical features, histopathology, differential diagnosis, and prognosis of this rare disorder have been discussed.
  4,989 191 2
BRIEF REPORTS
Immune reconstitution inflammatory syndrome
Ajay Sharma, Smita Makrandi, Megha Modi, Archana Sharma, Yogesh Marfatia
November-December 2008, 74(6):619-621
DOI:10.4103/0378-6323.45105  PMID:19171986
Background: Immune reconstitution inflammatory syndrome (IRIS) is a paradoxical deterioration in clinical status in a patient on antiretroviral treatment (ART) despite satisfactory control of viral replication and improvement of CD4 count. Aim: To study development of IRIS as a part of ART. Methods: Hundred patients on antiretroviral treatment were studied prospectively in the Department of Skin and VD over a period of 2 years. Patients were asked to come if they developed any symptoms or on a monthly basis. They were screened clinically and investigated suitably for evidence of opportunistic infections. Results: Out of 100 patients, 10 patients did not come for follow-up. Twenty (22.2%) out of the 90 patients developed IRIS. Herpes zoster (HZ), herpes simplex virus (HSV), and tuberculosis (TB) were the cases of IRIS seen in the present study. Conclusions: IRIS in terms of HSV/TB is known to accelerate HIV disease progression. Hence early detection and prompt treatment, along with continuation of highly active ART, are of utmost importance.
  4,678 482 3
LETTERS TO EDITOR
Clinicoepidemiological study of pityriasis rosea
Lata Sharma, K Srivastava
November-December 2008, 74(6):647-649
DOI:10.4103/0378-6323.45113  PMID:19171994
  4,686 244 3
BRIEF REPORTS
Topical immunotherapy with diphenylcyclopropenone in vitiligo: A preliminary experience
Shahin Aghaei, Gholamreza Safaee Ardekani
November-December 2008, 74(6):628-631
DOI:10.4103/0378-6323.45108  PMID:19171989
Background: Despite recent significant therapeutic advances, vitiligo remains a clinical conundrum. Topical immunotherapy has been extensively tested in the treatment of various dermatologic disorders, especially those believed to have an immunologic basis. Aim: To evaluate the role of topical diphenylcyclopropenone (DPCP) in the treatment of vitiligo. Methods: Nineteen patients with limited vitiligo lesions were enrolled in this study. After sensitization with 2% lotion of DPCP in acetone, progressively higher concentrations beginning at 0.001% up to 2% were applied weekly for 6 months to the depigmented skin lesions. Results: Thirteen of the 19 patients were evaluated at the end of 6 months. Four patients with focal vitiligo, one patient with vitiligo vulgaris, and three patients with segmental vitiligo showed marked (grade 3) repigmentation. Conclusion: Marginal and central repigmentation with hyperpigmented borders was seen in the majority of lesions. Further controlled trials should be undertaken to evaluate the use of topical DPCP in vitiligo.
  4,642 283 2
LETTERS TO EDITOR
Lafora's disease diagnosed on axillary skin biopsy in 3 patients
PR Malur, RS Davanageri, HB Bannur, VV Suranagi
November-December 2008, 74(6):672-673
DOI:10.4103/0378-6323.45129  PMID:19172010
  4,034 122 -
Granulomatous contact dermatitis to palladium following ear piercing
MJ Fernandez-Acenero, P Fernandez-Lopez
November-December 2008, 74(6):651-652
DOI:10.4103/0378-6323.45115  PMID:19171996
  3,888 97 6
Erythrokeratodermia variabilis: Successful palliative treatment with acitretin
Didem Didar Balci, Mehmet Yaldiz
November-December 2008, 74(6):649-650
DOI:10.4103/0378-6323.45114  PMID:19171995
  3,801 148 4
Aggravation of psoriasis by antimalarials: A comment on the pathogenic mechanism
MR Namazi
November-December 2008, 74(6):675-676
DOI:10.4103/0378-6323.45131  PMID:19172012
  3,794 129 1
EDITORIAL
Non-compliance in dermatologic diseases
RG Valia
November-December 2008, 74(6):553-557
DOI:10.4103/0378-6323.45095  PMID:19171976
  3,527 184 1
LETTERS TO EDITOR
Furuncular myiasis mimicking pyoderma
Parikshit Sharma, Harsha S Pai, Ganesh S Pai
November-December 2008, 74(6):679-681
DOI:10.4103/0378-6323.45134  PMID:19172015
  3,544 99 2
Basal cell carcinoma occurring in a lesion of lichen planus: Coincidence or causation?
Debabrata Bandyopadhyay, Saumya Panda
November-December 2008, 74(6):662-664
DOI:10.4103/0378-6323.45123  PMID:19172004
  3,466 120 2
Segmental vitiligo and twenty-nail dystrophy: An unusual association
TS Rajashekar, Gurcharan Singh, V Rajkumar
November-December 2008, 74(6):661-662
DOI:10.4103/0378-6323.45122  PMID:19172003
  3,079 164 2
Langerhans cell histiocytosis presenting with hypopigmented macules
Kaliyadan Feroze, Manoj Unni, MG Jayasree, NV Seethalekshmy
November-December 2008, 74(6):670-672
DOI:10.4103/0378-6323.45128  PMID:19172009
  2,898 145 -
Primary cutaneous B-cell lymphoblastic lymphoma
Ruchika Gupta, Sangeeta Borkataky, Deepti Aggarwal, Sompal Singh, Kusum Gupta, Madhur Kudesia
November-December 2008, 74(6):652-654
DOI:10.4103/0378-6323.45116  PMID:19171997
  2,763 156 1
NET QUIZ
Hairy plaque on the thigh
Pelin Ustuner, Ulku Askin, Deniz Seckin, Ozlem Ozen
November-December 2008, 74(6):701-701
DOI:10.4103/0378-6323.45145  PMID:19180688
  2,757 128 -
LETTERS TO EDITOR
Osler-Weber-Rendu syndrome associated with vitiligo
Feroze Kaliyadan
November-December 2008, 74(6):659-661
DOI:10.4103/0378-6323.45121  PMID:19172002
  2,726 124 -
Number of authors of single case reports in Indian Journal of Dermatology, Venereology and Leprology and Journal of the American Academy of Dermatology
Sanjay Singh, Swastika Suvirya, Rahul Chaudhary
November-December 2008, 74(6):673-675
DOI:10.4103/0378-6323.45130  PMID:19172011
  2,745 95 2
Persistent atypical varicella in two renal transplant patients and its relation to mycophenolic acid
Dipankar De, Sunil Dogra, Ashish Sharma, Mukut Minz, Sanjeev Handa, Arindam Dutta
November-December 2008, 74(6):666-668
DOI:10.4103/0378-6323.45125  PMID:19172006
  2,590 116 2
Plica neuropathica: Different etiologies in two cases
Prashant K Palwade, Aniket A Malik
November-December 2008, 74(6):655-656
DOI:10.4103/0378-6323.45118  PMID:19171999
  2,534 125 -
Complete recovery from juvenile pemphigus vulgaris
N El Fekih, M Kharfi, A Karaa, MR Kamoun
November-December 2008, 74(6):654-655
DOI:10.4103/0378-6323.45117  PMID:19171998
  2,513 137 1
SEMINAR: CHRONIC ARSENICOSIS IN INDIA
From the desk of the guest editor
Sujit Ranjan Sengupta
November-December 2008, 74(6):558-558
DOI:10.4103/0378-6323.45096  PMID:19171977
  2,527 104 2
LETTERS TO EDITOR
Inflammatory nevus comedonicus in an infant
N Asokan, PK Sridevi
November-December 2008, 74(6):658-659
DOI:10.4103/0378-6323.45120  PMID:19172001
  2,424 105 -
BOOK REVIEW
Handbook on health professional education - Shashidhar C. Mestri., B. Manjunatha
Urmila Thatte
November-December 2008, 74(6):696-696
  2,416 63 -
QUIZ
An unusual periumbilical plaque
Bijal Mehta, Sangeeta Amladi, Chitra Nayak, Shankar Savant
November-December 2008, 74(6):697-698
DOI:10.4103/0378-6323.45139  PMID:19172019
  2,278 120 -
LETTERS TO EDITOR
Scientific and linguistic precision in titles of papers published as original articles in Indian Journal of Dermatology, Venereology and Leprology
Sanjay Singh, Swastika Suvirya, Rahul Chaudhary
November-December 2008, 74(6):668-669
DOI:10.4103/0378-6323.45126  PMID:19172007
  2,288 100 1
OBITUARY
Obituary - Dr. B. C. Lahiri
Arijit Coondoo
November-December 2008, 74(6):699-699
PMID:19172020
  2,308 67 -
LETTERS TO EDITOR
Predicted B-cell epitopes on 18 kDa antigen of Haemophilus ducreyi
Viroj Wiwanitkit
November-December 2008, 74(6):676-677
DOI:10.4103/0378-6323.45132  PMID:19172013
  2,194 84 1
Precision or Message: An editor's dilemma
Uday Khopkar
November-December 2008, 74(6):669-670
DOI:10.4103/0378-6323.45127  
  1,351 58 -
Online since 15th March '04
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