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   2011| March-April  | Volume 77 | Issue 2  
    Online since March 8, 2011

 
 
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ORIGINAL ARTICLES
Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients
Abir Saraswat, Koushik Lahiri, Manas Chatterjee, Shyamanta Barua, Arijit Coondoo, Asit Mittal, Saumya Panda, Murlidhar Rajagopalan, Rajeev Sharma, Anil Abraham, Shyam B Verma, CR Srinivas
March-April 2011, 77(2):160-166
DOI:10.4103/0378-6323.77455  PMID:21393945
Background: Abuse of topical corticosteroids (TC), especially over the face, is prevalent worldwide, including in India. Data about the magnitude of this problem in our country is lacking. Aims: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face in the dermatology outpatient department (OPD) attendees in order to raise awareness about this problem and to analyze its causes. Methods: This was a prospective multicenter questionnaire-based clinical study conducted at 12 dermatology centers nationwide. Patients with relevant facial dermatoses reporting to the investigator were asked about their current use of over-the-counter topical formulations and a structured questionnaire applied in case the same was confirmed to be TC. Results: A total of 2926 patients with facial dermatoses were screened, of which 433 (14.8%) were using TC. TC was used as a fairness/general purpose cream or aftershave in 126 (29%) and in 104 (24%) for acne. Steroid combinations were used by 258 (59.6%). Potent and super-potent TC were significantly (P = 0.05) more frequently used by the rural/suburban population. The younger age groups used more potent formulations. A non-physician recommendation for TC use was obtainable in 257 (59.3%) patients. Of these, 232 (90.3%) were for potent/super-potent steroids. Among 176 physician prescriptions, 78 (44.3%) were from non-dermatologists. All non-physician prescriptions and 146 (83%) physician prescriptions for TC were inappropriately refilled. Adverse effects were seen in 392 (90.5%) TC users. Acne/exacerbation of acne was the most common adverse effect. Conclusions: TC misuse in patients with facial dermatoses is quite common, and most of this use is unwarranted. Use as a fairness cream is the most common indication in this cohort. Limitations: This was an OPD-based study and, therefore, it may or may not accurately reflect the community data.
  27,220 836 5
RESIDENT’S PAGE
Sunscreens
Sowmya Kaimal, Anil Abraham
March-April 2011, 77(2):238-243
DOI:10.4103/0378-6323.77480  PMID:21393968
  22,214 2,580 -
DERMATOSURGERY SPECIALS
Standard guidelines for care: Sclerotherapy in dermatology
Niti Khunger, S Sacchidanand
March-April 2011, 77(2):222-231
DOI:10.4103/0378-6323.77478  PMID:21393966
Definition: Sclerotherapy is defined as the targeted elimination of small vessels, varicose veins and vascular anomalies by the injection of a sclerosant. The aim of sclerotherapy is to damage the vessel wall and transform it into a fibrous cord that cannot be recanalized. It is a simple, cost-effective, efficacious and esthetically acceptable modality for both therapeutic and esthetic purposes. Indications: Therapeutic indications include varicose veins and vascular malformations. Esthetic indications include telangiectasias and reticular veins. In the management of varicose veins, it may need to be combined with other surgical methods of treatment, such as ligation of the saphenofemoral junction, stab ligation of perforators and stripping. A surgical opinion may be necessary. Methodology: A thorough knowledge of the anatomy and physiology of the venous system of the legs, basic principles of venous insufficiency, methods of diagnosis and, in addition, uses, mechanisms of action and complications of sclerosing agents and proper compression techniques are important pre-requisites to successful sclerotherapy. Although various sclerosing agents are available, polidoconal and sodium tetradecyl sulfate are most commonly used. More recently, these sclerosants have been used in microfoam form for increased efficacy. The basic principle of a successful sclerotherapy technique is the use of an optimal volume and concentration of the sclerosant according to the size of the vessel. The sclerosant is injected carefully into the vessel and compression is applied. Contraindications: Contraindications include superficial and deep venous thrombosis, sapheno-femoral junction incompetence, pregnancy, myocardial decompensation, migraine, hypercoagulable state, serious systemic illness, dependency edema, immobility, arterial disease, diabetes mellitus and allergic reactions to sclerosants. Complications: While sclerotherapy is usually a safe procedure, complications may occur due to inappropriate patient selection or improper injection techniques. The complications may be acute or delayed. Complications include hyperpigmentation, matting, local urticaria, cutaneous necrosis, microthrombi, accidental intra-arterial injection, phlebitis, deep vein thrombosis, thromboembolism, scintillating scotomas, nerve damage and allergic reactions. Physician Qualification: Sclerotherapy may be administered by a surgeon or dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to sclerotherapy. He should have an adequate knowledge of the anatomy of the venous system, be able to diagnose and manage venous disease and its associated consequences as well as possess the necessary skills to perform the procedures, understand the appropriate indications and limitations, technique modifications and management of the potential adverse sequelae associated with sclerotherapy and also understand the pharmacology of the sclerosing solutions. Facility: The procedure may be performed in the physician's procedure room.
  20,978 1,044 5
BRIEF REPORT
A study of clinicopathologic profile of 15 cases of hypopigmented mycosis fungoides
Uday Khopkar, Bhavana R Doshi, Atul M Dongre, Sumeet Gujral
March-April 2011, 77(2):167-173
DOI:10.4103/0378-6323.77456  PMID:21393946
Background: Mycosis fungoides (MF) is cutaneous lymphoma of the T-cell lineage. Hypopigmented MF is a clinical variant of MF, described mainly in Asians. This is a retrospective clinicopathologic analysis of hypopigmented MF at a tertiary care center. Aims: To describe the clinicopathologic profile of hypopigmented MF. Methods: Records of clinicopathologic notes over a 5-year period ranging from January 2005 up to December 2009 were reviewed over a period of 3 months, of which 15 cases were diagnosed with hypopigmented MF based on clinicopathologic correlation. Results: Hypopigmented MF was found to be more common in males, and between second and fourth decades of life. The latent period between onset and diagnosis was around 3.83 years. Most of the patients were asymptomatic 80% (12/15), with skin changes of subtle atrophy in 46.66% (7/15), scaling in 20% (3/15) and focal changes of poikiloderma in 26.66% (4/15) patients. Most common sites of distribution of the lesions were the trunk and extremities. Many of the cases had been clinically mistaken for Hansen's disease prior to correct diagnosis. Marked epidermotropism and tagging of epidermis by large lymphocytes characterizes the condition histopathologically. Of the 15 cases, immunohistochemistry was possible in 10 cases, of which 8 showed predominant CD8 positive epidermotropic infiltrates and two cases showed absence of CD8 positive and CD4 positive lymphocytic infiltrate in the epidermis. Conclusion: Hypopigmented MF presents as hypopigmented asymptomatic patches without any erythema or infiltration in its early stage and mimics Hansen's disease. Skin biopsy clinches the diagnosis.
  21,729 227 10
FOCUS
Symmetrical peripheral gangrene
Sudip Kumar Ghosh, Debabrata Bandyopadhyay
March-April 2011, 77(2):244-248
DOI:10.4103/0378-6323.77481  PMID:21393969
  20,504 530 3
REVIEW ARTICLES
Spa therapy in dermatology
Najeeba Riyaz, Faiz Riyaz Arakkal
March-April 2011, 77(2):128-134
DOI:10.4103/0378-6323.77450  PMID:21393940
Spa therapy constitutes the use of mineral springs and thermal mud to soothe and heal various ailments. Like the mineral springs, seas and oceans are also important centers for spa therapy of which the most important is Dead Sea (DS). DS has been famous for thousands of years for its miraculous curative and cosmetic properties. Intensive research is going on using DS minerals in a wide range of dermatological conditions especially psoriasis, atopic dermatitis, vitiligo and other eczemas and several papers have been published in various international and pharmacological journals.
  15,811 663 7
DERMATOSURGERY SPECIALS
Position paper on mesotherapy
Rashmi Sarkar, Vijay Kumar Garg, Venkataram Mysore
March-April 2011, 77(2):232-237
DOI:10.4103/0378-6323.77479  PMID:21393967
Mesotherapy is a controversial cosmetic procedure which has received publicity among the lay people, in the internet and in the media. It refers to minimally invasive techniques which consist of the use of intra- or subcutaneous injections containing liquid mixture of compounds (pharmaceutical and homeopathic medications, plant extracts, vitamins and other ingredients) to treat local medical and cosmetic conditions. This position paper has examined the available evidence and finds that acceptable scientific evidence for its effectiveness and safety is lacking. IADVL taskforce, therefore would like to state that the use of this technique remains controversial at present. Further research and well-designed controlled scientific studies are required to substantiate the claims of benefit of this mode of therapy.
  13,941 547 7
CASE REPORTS
Porokeratotic eccrine ostial and dermal duct nevus
Deeptara Pathak, Raj Kubba, Asha Kubba
March-April 2011, 77(2):174-176
DOI:10.4103/0378-6323.77457  PMID:21393947
Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare variant of porokeratosis with characteristic histological feature of cornoid lamella involving the acrosyringium. We report a classic case of a 20-year-old male, who clinically presented to us with keratotic papules and plaque with pits, few having comedo like plugs, on right palm and sole since 1 year of age. A punch biopsy from palm was diagnostic as well as confirmatory showing cornoid lamella involving an eccrine duct which is the characteristic histopathological feature of PEODDN.
  12,136 197 3
LETTERS TO THE EDITOR
Primary benign hypergammaglobulinemic purpura of waldenstrom masquerading as disseminated schamberg's purpura
Balkrishna P Nikam, Nishita J Singh, Deepa D Shetty
March-April 2011, 77(2):205-208
DOI:10.4103/0378-6323.77470  PMID:21393959
  11,937 93 -
CASE REPORTS
Coexistence of two types of clinical lesions in childhood-onset mastocytosis
Lidia Pérez-Pérez, Francisco Allegue, José Luis Caeiro, José María Fabeiro, Alberto Pérez Rodríguez, Ander Zulaica
March-April 2011, 77(2):184-187
DOI:10.4103/0378-6323.77460  PMID:21393950
The vast majority of mastocytosis appear in childhood, urticaria pigmentosa (UP) and mastocytomas being the most common types. Terms such as "xanthelasmoid mastocytosis", "pseudoxanthomatous mastocytosis" or "nodular mastocytosis" have been introduced in the literature to describe the presence of yellowish papular or nodular lesions. We describe two children with cutaneous mastocytosis showing yellowish lesions in combination with other skin lesions. A 10-year-old girl presented with asymptomatic lesions in her vulva at birth, and developed brownish macules on her trunk years after. An eight- year-old boy presented with multiple yellowish papular lesions on his trunk, neck and limbs coexisting with a few clinically anetodermic lesions. No systemic involvement was found and the skin biopsy confirmed a cutaneous mastocytosis in both cases. The two patients are currently asymptomatic and are being periodically followed up. Mastocytoses may show a variety of clinical lesions, sometimes leading to misdiagnosis. Although there are previous reports, involvement of the mucosae and secondary anetoderma are not common findings in cutaneous mastocytoses. We consider that cutaneous manifestations of mastocytoses compose a clinical spectrum, thus explaining the coexistence of different clinical lesions and the development of uncommon presentations.
  10,053 104 4
ORIGINAL ARTICLES
Evaluation of photopatch test allergens for Indian patients of photodermatitis: Preliminary results
Nidhi Jindal, Nand Lal Sharma, Vikram Kumar Mahajan, Vinay Shanker, Gita Ram Tegta, Ghanshyam Kumar Verma
March-April 2011, 77(2):148-155
DOI:10.4103/0378-6323.77453  PMID:21393943
Background: There is a strong need to develop a photopatch test tray suitable for Indian patients of photodermatitis as European/Scandinavian photopatch test trays may not be wholly relevant for them. Aim: We carried out this study using photoallergens relevant in the Indian context to determine their relevance in patients of photodermatitis. Methods: Thirty patients (M:F, 23:7) between 19 and 76 years of age of photodermatitis and 10 controls were patch- and photopatch tested with 20 common photoallergens. In addition, the patients were also (photo) patch tested with articles of daily use as and when these were suspected to be the cause. Results: Forty-three positive reactions to one or more antigens were seen in 22 (74%) patients. Fourteen positive photopatch tests to seven allergens were observed in 10 (33%) patients, and nine (30%) of them had a definite relevance. The most common contact allergen was fragrance mix (FM) (30%), followed by p-phenylenediamine (20%) and Parthenium hysterophorous (17%). The definite relevance of the patch- and photopatch tests could be correlated in 47% of these patients. Conclusions: FM is the most common contact and photocontact allergen among the various photopatch test antigens. Although differences in technique and evaluation make direct comparison between different centers difficult, still photopatch testing remains an integral part and gold standard for the work-up of the photosensitive patients.
  8,970 364 3
NET STUDY
Retrospective analysis of basal cell carcinoma
Sibel Hakverdi, Didar D Balci, Cigdem A Dogramaci, Serhat Toprak, Mehmet Yaldiz
March-April 2011, 77(2):251-251
DOI:10.4103/0378-6323.77483  PMID:21393972
Background: Basal cell carcinomas (BCCs) are the most prevalent cancer type among white-skinned populations worldwide. Aims: To analyze the gender and age-related incidence of basal cell carcinoma (BCC) histopathologic subtypes, to classify BCCs according to their anatomical location, invasion depth, and size, and to determine the relationship between BCC subtypes and margin of surgical excision. Methods: All BCCs analysed in our center between 2005 and 2010 were studied retrospectively. The samples, which were totally excised, were included on the basis of histopathological diagnosis of BCC, and confirmed by two pathologists. Patient data included sex, age at diagnosis, tumor location, histological subtypes, invasion depth, and size. Results: We recorded 197 BCCs obtained from 181 white patients (80 females, 101 males). The mean age among males was 64.11, and 59.33 among females. Of the cases, 45.17% were nodular, 22.33% were mixed, and 15.22 were infiltrative type. 91.84% of the cases were located on the head and neck, 3.04% were on the limbs, and 1.52 % were on the trunk. In 32 cases, the margin of surgical excision was positive (17.7%): nodular 12%, infiltrative 43.3%, mixed 20.6%, micronodular 10%, and superfacial multicentric 5.5%. Of these total 32 cases, 34.4% were located on the eyes region, 28.1% were found on the nose, and 15.6% were on the ears. Invasion depth of tumors varied from 0.5 to 22.125 mm. Conclusions: The results of our study exhibit differences in anatomical distribution, sex and mean age, invasion depth, and size of BCC subtypes. The recurrence rate for incompletely excised tumors varies according to the location and type of the tumor. Infiltrative tumors are more likely to recur and have positive margin of surgical excision. The highest positive margin of surgical excision is in infiltrative BCC. Tumors at difficult-to-treat sites and large and/or deeply invasive tumors are more liable to recur.
  8,676 151 3
REVIEW ARTICLES
Medical literature search dot com
Vivek Jain, Deepak K Raut
March-April 2011, 77(2):135-140
DOI:10.4103/0378-6323.77451  PMID:21393941
The Internet provides a quick access to a plethora of the medical literature, in the form of journals, databases, dictionaries, textbooks, indexes, and e-journals, thereby allowing access to more varied, individualized, and systematic educational opportunities. Web search engine is a tool designed to search for information on the World Wide Web, which may be in the form of web pages, images, information, and other types of files. Search engines for internet-based search of medical literature include Google, Google scholar, Yahoo search engine, etc., and databases include MEDLINE, PubMed, MEDLARS, etc. Commercial web resources (Medscape, MedConnect, MedicineNet) add to the list of resource databases providing some of their content for open access. Several web-libraries (Medical matrix, Emory libraries) have been developed as meta-sites, providing useful links to health resources globally. Availability of specific dermatology-related websites (DermIs, DermNet, and Genamics Jornalseek) is useful addition to the ever growing list of web-based resources. A researcher must keep in mind the strengths and limitations of a particular search engine/database while searching for a particular type of data. Knowledge about types of literature and levels of detail available, user interface, ease of access, reputable content, and period of time covered allow their optimal use and maximal utility in the field of medicine.
  7,776 265 3
EDITORIAL
Why your manuscript was rejected and how to prevent it?
Sunil Dogra
March-April 2011, 77(2):123-127
DOI:10.4103/0378-6323.77449  PMID:21393939
  7,405 375 2
ORIGINAL ARTICLES
Clinicoepidemiologic features of chronic urticaria in patients having positive versus negative autologous serum skin test: A study of 100 Indian patients
Surbhi Vohra, Nand Lal Sharma, Vikram K Mahajan, Vinay Shanker
March-April 2011, 77(2):156-159
DOI:10.4103/0378-6323.77454  PMID:21393944
Background: Chronic urticaria patients who demonstrate autoantibodies against the high-affinity receptor of IgE (FceRI) or IgE itself tend to have a high itch and wheal score, and systemic symptoms may have a significant bearing on their management in terms of super pharmacologic doses of antihistamines needed or use of immunomodulators. Most studies have used histamine release assays rather than autologous serum skin tests (ASSTs) for correlating urticaria severity and histamine releasing activity. Methods: An ASST was performed in 100 (M:F, 31:69) chronic urticaria patients aged between 14 and 63 (mean, 32.69 ± 13) years with an objective to study the clinicoepidemiologic features like age, sex, age of onset and duration, frequency and distribution of wheals, urticaria severity, angioedema and systemic manifestations in ASST-positive and ASST-negative patients. Results: ASST was positive in 46% of the patients and negative in 54% of the patients, respectively. Both groups showed no statistically significant difference for epidemiological details. However, the ASST-positive patients had a higher mean urticaria activity score, frequent involvement of more body sites, particularly palms and soles, presence of throat angioedema and general constitutional, respiratory or gastrointestinal symptoms in comparison with the ASST-negative patients. Conclusions: Apparently, ASST-positive patients have more severe clinical manifestations of chronic urticaria. The knowledge will be useful for the treating dermatologists and patients alike in view of its therapeutic implications.
  6,442 353 4
NET CASES
Haim Munk syndrome: Report of two siblings of Northern India treated with acitretin
Raviprakash Sasankoti Mohan, Sankalp Verma
March-April 2011, 77(2):252-252
DOI:10.4103/0378-6323.77487  PMID:21393975
Haim Munk Syndrome (HMS) is the allelic mutation of exon 6 codon in cathepsin C gene. Here, we present two cases of same family with HMS having all the cardinal features of HMS which includes palmo plantar keratoderma and periodontitis along with arachnodactyly, acroosteolysis, onychogryphosis, and marked osteopenia on hand wrist radiographs. Both the siblings were treated with cotrimoxazole, acetretin and topical keratolytics and followed up over a period of one year, showed remarkable improvement in palmo plantar keratoderma and periodontitis.
  6,138 118 2
LETTERS TO THE EDITOR
Bilateral oral melanoacanthoma in an Indian boy
T Geetha, G Geetha Rani, AS Krishnaram
March-April 2011, 77(2):210-212
DOI:10.4103/0378-6323.77472  PMID:21393961
  6,089 92 -
Exacerbation reaction (Hypersensitivity) in Post-kala-azar dermal leishmaniasis with Miltefosine
Sheena Bansal, Smita Sunil Ghate, Hemangi Jerajani
March-April 2011, 77(2):214-217
DOI:10.4103/0378-6323.77475  PMID:21393963
  5,981 106 -
Different morphological variants of hypertrophic porokeratosis and disseminated lesions of porokeratosis of Mibelli: A rare co-existence
Sankha Koley, Jyotirindranath Sarkar, Sanjiv Choudhary, Suparna Dhara, Manoj Choudhury, Swagata Bhattacharya
March-April 2011, 77(2):199-202
DOI:10.4103/0378-6323.77467  PMID:21393956
  5,880 111 1
NET LETTERS
Lupus erythematosus tumidus
Jaheersha Pakran, Mamatha George, Uma Rajan, T Lekha, K Muhammed
March-April 2011, 77(2):253-253
DOI:10.4103/0378-6323.77492  PMID:21393980
  5,572 132 -
CASE REPORTS
Ichthyosiform mycosis fungoides with alopecia and atypical membranous nephropathy
Qiang Zhou, Kejian Zhu, Haiyan Yu, Hao Cheng
March-April 2011, 77(2):180-183
DOI:10.4103/0378-6323.77459  PMID:21393949
We describe here a rare case of variant of mycosis fungoides (MF): ichthyosiform MF with alopecia and atypical membranous nephropathy. The diagnosis was made based on the following findings: generalized ichthyosis-like eruption, alopecia, enlarged superficial lymph nodes, proteinuria, and hematuria, the histological features of the skin biopsy from both ichthyotic and alopecic lesions with immunohistochemical staining, and the renal biopsy examination with immunofluorescence. The histological examination of ichthyotic and alopecic lesions displayed a predominant infiltration of atypical lymphocytes in the upper dermis with the characteristics of epidermotropism and folliculotropism. Immunohistochemical studies demonstrated that most infiltrated atypical lymphocytes were CD3, CD4, and CD45RO positive, whereas negative for CD5, CD7, CD20, CD30, and CD56. A renal biopsy examination revealed atypical membranous nephropathy with deposition of immunoglobulin G (IgG), IgM, IgA, C1q, and C3. In this case atypical membranous nephropathy was involved, which is very uncommon and has never been presented in the literature to date. Although ichthyosiform MF usually features a relatively favorable course, diffuse alopecia and the renal involvement in this case might indicate aggressive disease and poor prognosis.
  5,603 83 -
ORIGINAL ARTICLES
Clinical and bacteriological profile and outcome of sepsis in dermatology ward in tertiary care center in New Delhi
DP Asati, VK Sharma, S Khandpur, GC Khilnani, A Kapil
March-April 2011, 77(2):141-147
DOI:10.4103/0378-6323.77452  PMID:21393942
Background: There is paucity of data regarding the clinical and bacteriological profile of sepsis in dermatology in-patients. Aims: To study the frequency, etiology, and outcome of sepsis dermatology in-patients. Methods: The study was conducted in a 30-bedded dermatology ward of a tertiary care center. Sepsis was defined by presence of ≥2 SIRS (systemic inflammatory response syndrome) criteria along with evidence of infection (clinically obvious/culture proven infection of skin or internal organs). Patients were also assessed for known (common) risk factors of sepsis. In suspected sepsis patients, at least two samples of blood cultures by venepuncture were taken. Pus, skin swab, urine, and sputum samples were also collected for culture as needed with avoidance of contamination. Results: Among 860 admitted patients studied from November 2004 to July 2006, 103 (12%) fulfilled SIRS criteria. Of these, 63 had nonsepsis causes of SIRS positivity, while 40 (4.65%) had sepsis. Majority of the sepsis patient had vesicobullous diseases (42.5%), erythroderma (25%), toxic epidermal necrolysis (TEN) (22.5%). Severe sepsis developed in 17 (42.5%) patients, while 15 (37.5%) died. Methicillin-resistant Staphylococcus aureus (MRSA) was the commonest organism isolated (99; 25.9%) in all culture specimens followed by Acinetobacter spp. (52; 13.6%), Pseudomonas spp. (40; 10.5%), Methicillin-sensitive S. aureus (MSSA: 33; 8.7%), and Klebsiella spp. (22; 5.8%). Various risk factors affecting mortality and sensitivity patterns for various isolates were also analyzed. Conclusion: Sepsis occurred in 40 (4.65%) inpatients in dermatology ward. The frequency of sepsis was highest in TEN (90%), followed by drug-induced maculopapular rash (20.0%), erythroderma (17.5%), and vesicobullous diseases (8.5%). MRSA, acinetobacter, pseudomonas, MSSA, and Klebsiella were important etiological agents involved in sepsis in dermatology in-patients.
  5,383 262 -
CASE REPORTS
Vulvar ulcer as a presentation of systemic langerhans cell histiocytosis
Nina A Madnani, Kaleem J Khan
March-April 2011, 77(2):177-179
DOI:10.4103/0378-6323.77458  PMID:21393948
We report a 38-year-old housewife with systemic Langerhans cell histiocytosis (LCH) presenting as a chronic vulvar and peri-anal ulcer. She had systemic involvement in the form of diabetes insipidus and bone "hot-spots". She responded favorably to etoposide, 6-mercaptopurine, and systemic steroids, and has been in remission since 10 years. Chronic vulvar ulcers not responding to routine therapy should not be neglected and need to be biopsied repeatedly to come to a specific diagnosis. The vulvar ulcer in our case provided a vital clue to a systemic LCH, with a successful outcome.
  5,422 84 3
LETTERS TO THE EDITOR
Primary cutaneous diffuse large B cell lymphoma, leg type
Atul Dongre, Sumit Kar, Swati Gondse, Nitin Gangane, Bhupendra Kumar Mehra
March-April 2011, 77(2):212-214
DOI:10.4103/0378-6323.77473  PMID:21393962
  5,402 104 -
NET CASES
Unresponsive cutaneous leishmaniasis and HIV co-infection: Report of three cases
Prasoon Soni, Neha Prasad, Kanika Khandelwal, Bhikam C Ghiya, Rajesh D Mehta, Ram A Bumb, Poonam Salotra
March-April 2011, 77(2):251-251
DOI:10.4103/0378-6323.77484  PMID:21393971
Cutaneous leishmaniasis (CL) is a vector borne disease caused by various species of Leishmania parasite. CL is endemic in the Thar desert of Rajasthan state and Himachal Pradesh in India. Immune suppression caused by human immunodeficiency virus (HIV) infection is associated with atypical clinical presentation of CL which responds poorly to the standard treatment and causes frequent relapses. We are reporting three cases of localized and disseminated CL due to Leishmania tropica which failed to respond to conventional intralesional/intramuscular sodium stibogluconate (SSG) injections. Initially, we did not think of HIV infection because CL is endemic in this region. When patients did not respond to SSG injections, we performed enzyme-linked immunosorbent assay (ELISA) tests for HIV and they turned out to be HIV positive. Our report showed that CL is emerging as an opportunistic infection associated with HIV/AIDS and may be the first manifestation in HIV positive patients in an endemic area.
  5,251 95 1
NET LETTERS
Acantholytic dyskeratotic epidermal nevus
Cheng-Han Lee, Cheng-Hsiang Hsiao, Hsien-Ching Chiu, Tsen-Fang Tsai
March-April 2011, 77(2):253-253
DOI:10.4103/0378-6323.77494  PMID:21393978
  5,236 87 -
NET CASES
Palmar cutaneous metastasis from carcinoma cervix
TP Elamurugan, Ajit Agrawal, R Dinesh, R Aravind, Dipankar Naskar, Vikram Kate, Rani Reddy, Sujindra Elamurugan, Siddaraju , Debdatta Basu, Parthasarathy
March-April 2011, 77(2):252-252
DOI:10.4103/0378-6323.77486  PMID:21393976
Carcinoma of the uterine cervix is the most common gynecological malignancy in developing countries. However, its cutaneous metastasis is a rare entity. The reported incidence of cutaneous metastasis ranges from 0.1 to 2%. Frequent sites of cutaneous metastasis in decreasing order are: abdominal wall, vulva and anterior chest wall. To the best of our knowledge, only three cases of cutaneous metastasis to the upper extremity have been reported in the world. We report a case of a 74-year-old postmenopausal lady diagnosed to have carcinoma cervix (stage IIIB) who presented with cutaneous metastasis to palm and thigh, 10 months after radical radiotherapy. At presentation, the primary disease had resolved completely. She had a small nodular growth in the left palm and left thigh. Fine needle aspirate cytology and core needle biopsy from both the nodular lesions were positive for squamous cell carcinoma.
  5,105 74 1
LETTERS TO THE EDITOR
Prevalence of metabolic syndrome in patients with psoriasis
Safiye Kutlu, Tugba Rezan Ekmekci, Sema Ucak, Adem Koslu, Yuksel Altuntas
March-April 2011, 77(2):193-194
DOI:10.4103/0378-6323.77464  PMID:21393953
  4,758 284 4
NET LETTERS
Mycobacterium leprae in ocular tissues: Histopathological findings in experimental leprosy
Adriana V Cardozo, Patrícia Deps, João M.A.P Antunes, F Belone Andréa de, Patrícia S Rosa
March-April 2011, 77(2):252-253
DOI:10.4103/0378-6323.77490  PMID:21393973
  4,737 97 1
LETTERS TO THE EDITOR
Degos disease-like presentation in systemic lupus erythematosus
Najeeba Riyaz, Rahima Saleem, Roshni Shafeeq
March-April 2011, 77(2):219-221
DOI:10.4103/0378-6323.77477  PMID:21393965
  4,537 97 -
IMAGES IN CLINICAL PRACTICE
REM syndrome
Vikram K Mahajan, Saurabh Sharma, Nand Lal Sharma
March-April 2011, 77(2):188-189
DOI:10.4103/0378-6323.77461  PMID:21393951
  4,493 134 1
QUIZ
Keratotic papules on the margins of palms
Nina A Madnani, Kaleem J Khan
March-April 2011, 77(2):249-250
DOI:10.4103/0378-6323.77482  PMID:21393970
  4,359 142 -
LETTERS TO THE EDITOR
Reactive perforating collagenosis with a giant lesion at the site of healed herpes zoster
Ashok Krishnarao Ghorpade
March-April 2011, 77(2):202-203
DOI:10.4103/0378-6323.77468  PMID:21393957
  4,240 74 2
Pacinian neurofibroma: A rare neurogenic tumor
Amiya Kumar Nath, Dependra Kumar Timshina, Devinder Mohan Thappa, Debdatta Basu
March-April 2011, 77(2):204-205
DOI:10.4103/0378-6323.77469  PMID:21393958
  4,195 93 1
Acute graft versus host disease
Mahesh K Kumawat, Sujay Khandpur
March-April 2011, 77(2):217-219
DOI:10.4103/0378-6323.77476  PMID:21393964
  4,066 117 -
NET QUIZ
Asymptomatic cerebriform papules and nodules over left buttock
Gutte Rameshwar, Siddhi Chikhalkar, Sunanda Mahajan, Vidya Kharkar, Uday Khopkar
March-April 2011, 77(2):254-254
DOI:10.4103/0378-6323.77497  PMID:21393981
  4,030 114 -
LETTERS TO THE EDITOR
Exfoliative dermatitis with leukemia cutis in a patient with chronic myeloid leukemia: A rare association
Anju Raj, Reena Rai, Bharath Rangarajan
March-April 2011, 77(2):208-210
DOI:10.4103/0378-6323.77471  PMID:21393960
  3,771 74 2
Knowledge and attitude of auto-rickshaw drivers about HIV/AIDS and other sexually transmitted diseases
SS Chaudhary, MM Nagargoje, SS Kubde, AK Bhardwaj, R Singh
March-April 2011, 77(2):197-199
DOI:10.4103/0378-6323.77466  PMID:21393955
  3,748 96 -
Patch test results from a contact dermatitis clinic in North India
Sanjeev Handa, Rashmi Jindal
March-April 2011, 77(2):194-196
DOI:10.4103/0378-6323.77465  PMID:21393954
  3,421 205 -
NET LETTERS
Primary cutaneous CD30+ lymphoproliferative disorder in an atopic dermatitis patient on cyclosporine therapy
S Nakamura, K Takeda, Y Hashimoto, T Mizumoto, A Ishida-Yamamoto, H Iizuka
March-April 2011, 77(2):253-253
DOI:10.4103/0378-6323.77496  PMID:21393977
  3,269 86 -
Squamous cell carcinoma arising from radiation-treated lupus vulgaris scar
Magdalena Kiedrowicz, Andrzej Królicki, Bielecka-Grzela Stanislawa, Romuald Maleszka
March-April 2011, 77(2):253-253
DOI:10.4103/0378-6323.77493  PMID:21393979
  3,236 70 -
LETTERS TO THE EDITOR
Dexamethasone pulse therapy: Evidence for no benefit in pemphigus
Marcel F Jonkman
March-April 2011, 77(2):190-191
DOI:10.4103/0378-6323.77462  PMID:21393952
  3,089 183 2
CURRENT BEST EVIDENCE
Current best evidence in dermatology literature
Rishu Sarangal, Dipankar De
March-April 2011, 77(2):255-259
  2,922 131 -
NET LETTERS
Measuring knowledge about HIV among youth: A survey for Vadodara district
PV Kotecha, Sangita Patel, Bharti Makwana, Mansi Diwanji
March-April 2011, 77(2):252-252
DOI:10.4103/0378-6323.77489  PMID:21393974
  2,724 81 1
LETTERS TO THE EDITOR
Authors' reply
JS Pasricha, Poonam
March-April 2011, 77(2):191-192
  1,997 82 -
Online since 15th March '04
Published by Wolters Kluwer - Medknow