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   2011| September-October  | Volume 77 | Issue 5  
    Online since August 20, 2011

 
 
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ORIGINAL ARTICLES
Topical permethrin and oral ivermectin in the management of scabies: A prospective, randomized, double blind, controlled study
Reena Sharma, Archana Singal
September-October 2011, 77(5):581-586
DOI:10.4103/0378-6323.84063  PMID:21860157
Background: Scabies is a highly contagious and intensely pruritic parasitic infestation. It is a re-emerging infection in the new millennium especially with HIV pandemic and a significant health problem in developing countries. Various treatment modalities have been used since time immemorial but the search for an ideal scabicide is ongoing. Aims: In this study, we compared the therapeutic efficacy of single application of topical 5% permethrin with oral ivermectin (200 μg/kg/dose) in a single-dose and a two-dose regimen in patients with scabies. Methods: 120 clinically diagnosed cases of scabies (>5 years of age and/or >15 kg) were randomized into three treatment groups A, B, C of 40 patients each; receiving either topical 5% permethrin (group A) or oral ivermectin (200 μg/kg/dose) in a single dose (group B) or double dose regimen (group C) repeated at 2 weeks interval. Patients were followed up at 1, 2, and 4 weeks interval. At each visit, cure rate (>50% improvement in lesion count and pruritus and negative microscopy) was assessed and compared. Results: Cure rate in three treatment groups at the end of 4 weeks was 94.7% (A), 90% (B), 89.7%(C), and thus all three treatment modalities were equally efficacious. However, at 1 week follow up, group A patients reported better improvement in both lesion count and pruritus. Conclusions: Both permethrin and ivermectin in both single and two dose regimen are equally efficacious and well tolerated in scabies. However, permethrin has a rapid onset of action.
  12 14,035 447
1064 nm Q switched Nd: YAG laser treatment of nevus of Ota: An Indian open label prospective study of 50 patients
Hemanta Kumar Kar, Lipy Gupta
September-October 2011, 77(5):565-570
DOI:10.4103/0378-6323.84057  PMID:21860154
Background: Nevus of Ota is very common in Asians. Estimated male to female ratio is 1:4.8. Patients seek treatment early in life due to psychological trauma and cosmetic disfigurement. The creation of high power, short pulse Q switched lasers has recently provided tools for considerable therapeutic advances in the treatment of dermal pigmented lesions. Aims: To determine the efficacy and side-effect profile of Q switched Nd:YAG Laser (QSNYL) in fifty Indian patients. Methods: Fifty patients of nevus of Ota underwent multiple treatments (average 5 sessions) at monthly intervals carried out over a period of 2 years with QSNYL (Med-lite C6). Of the 50 patients, 2 were males; and the rest were females. Skin types treated included phototype IV and V. The response after subsequent treatments was documented through serial photographs that were taken before and after every treatment session. Response to the treatment was graded based on quartile grading scale. Results: Near total improvement was seen in 8%, marked improvement in 22%, moderate improvement in 38% and 32% patients reported less than 25% clearing of the lesion. All patients reported some improvement. Transient postinflammatory hyperpigmentation was observed in 4 (8%) patients, which cleared with use of sunscreens and bleaching agents within 2 months. No textural change or scarring was observed in any patient. Conclusions: QSNYL is an easy-to-perform and effective treatment in cases of nevus of Ota in Indian patients with few side effects.
  11 11,157 249
LETTERS TO THE EDITOR
Psoriasiform skin eruption associated with sorafenib therapy
Marcos A González-López, M Carmen González-Vela, Sonsoles Yáñez, Héctor Fernández-Llaca, J Fernando Val-Bernal
September-October 2011, 77(5):614-615
DOI:10.4103/0378-6323.84089  PMID:21860169
  4 2,698 47
ORIGINAL ARTICLES
Skin tags, leptin, metabolic syndrome and change of the life style
Omar S El Safoury, Rania M Abdel Hay, Marwa M Fawzy, Dina Kadry, Iman M Amin, Ola M Abu Zeid, Laila A Rashed
September-October 2011, 77(5):577-581
DOI:10.4103/0378-6323.84061  PMID:21860156
Background: Skin tags (STs), are papillomas commonly found in the neck and in the axillae of middle-aged and elderly people. Metabolic syndrome (MS) is a complex of interrelated risk factors for cardiovascular disease and diabetes. Epidemiologic studies of different ethnic populations have indicated that hyperleptinaemia and leptin resistance are strongly associated with MS. Aim: To study the possible relation of skin tags and leptin levels to MS guided by the International Diabetes Federation (IDF) diagnostic criteria. Methods: This study included 80 participants, 40 ST patients and 40 apparently healthy controls. Age, sex, waist circumference (WC), body mass index (BMI), smoking status, fasting glucose level, insulin level and insulin resistance were estimated as well as cholesterol, triglycerides, HDL, criteria of MS, and leptin levels. Results: The univariate analysis showed that WC, BMI, fasting glucose, insulin levels, insulin resistance, cholesterol, triglycerides, HDL, and leptin levels were significantly higher in ST patients compared to controls (P < 0.001). The multivariate analysis between MS components and ST showed that only high triglyceride levels (OR 1.205/95% CI 1.044-1.391/P = 0.011) and low HDL levels (OR 0.554/95% CI 0.384-0.800/P = 0.002) were significantly associated with ST. Multivariate linear regression analysis of the predictors of high plasma leptin levels, showed that high triglyceride levels (OR 0.287/95% CI 0.410-3.56/P = 0.014), and low HDL levels (OR -0.404/95% CI -8.7 to -2.08/P = 0.002) were significant predictors. Conclusion: The results of this study suggested that the presence of both ST and hyperleptinaemia in patients with STs may be associated with high levels of triglycerides and low levels of HDL and this could suggest that changing the life style of patients with ST may have a beneficial role.
  4 6,823 219
CASE REPORTS
Progressive symmetric erythrokeratoderma: Report of a Chinese family
Hong-Bo Yan, Jing Zhang, Wen Liang, Hang-Yang Zhang, Jing-Yu Liu
September-October 2011, 77(5):597-600
DOI:10.4103/0378-6323.84070  PMID:21860161
A large pedigree of progressive symmetric erythrokeratoderma is reported. The proband was a 22-year-old male with generalized asymptomatic lesions characterized by symmetrical well-demarcated erythematous hyperkeratotic plaques mainly distributed on the extremities. The proband's parents were also affected, and they were first cousins. Thus, a case of familial progressive symmetric erythrokeratoderma is described.
  3 7,107 118
Langerhans cell histiocytosis: An uncommon presentation, successfully treated by thalidomide
Mohammad Shahidi-Dadras, Mohammad Saeedi, Safoura Shakoei, Azin Ayatollahi
September-October 2011, 77(5):587-590
DOI:10.4103/0378-6323.84064  PMID:21860158
Langerhans cell histiocytosis (LCH) is a rare disease and generally affects children under 15 years of age. Adult onset form and cutaneous features at presentation are uncommon. There are some options for treatment of the skin lesions of LCH such as topical and intralesional corticosteroid, nitrogen mustard, etc., which are not completely curative. Herein, we report a case of perianal LCH in a 20-year-old man with one-year history of recalcitrant well-demarcated, erythematous, and ulcerated plaque surrounding the anal orifice, with pain and difficulty in defecation that was successfully treated with thalidomide.
  3 6,774 180
NET CASES
Localized bullous pemphigoid at urostomy site
Ana Batalla, Gonzalo Peón, Carlos De la Torre
September-October 2011, 77(5):625-625
DOI:10.4103/0378-6323.84067  PMID:21860176
Localized bullous pemphigoid occurs in less than one-third of the cases of bullous pemphigoid and it usually appears on the shins. Localized bullous pemphigoid around a stoma site is very uncommon, with few reports in the literature. We report a case of localized bullous pemphigoid at urostomy site and we review its main characteristics. We highlight the importance of considering bullous pemphigoid in chronic bullous lesions on peristomal skin.
  3 4,476 70
CASE REPORTS
White piedra of scalp hair by Trichosporon inkin
Vishalakshi Viswanath, Dimple Kriplani, Autar Kishen Miskeen, Bharti Patel, Raghunandan Govind Torsekar
September-October 2011, 77(5):591-593
DOI:10.4103/0378-6323.84065  PMID:21860159
White piedra is a rare fungal infection of hair and is reported to be all the more rare on scalp. Trichosporon inkin is usually associated with white piedra of pubic hair. We report a case of white piedra of scalp hair caused by T. inkin. This is the first case reported from India and the fifth case reported worldwide. A 50-year-old Muslim female presented with white knots over scalp hair. Diagnosis of Trichosporon was made by examining KOH mounts of epilated hair and Lactophenol Cotton Blue preparations of the growth in culture. Automated mini-API test (for biochemical profiles) and Electronmicroscopy studies (for cell wall structures) helped in identification of the species. Mini-API test was also positive for Cryptococcus curvatus which could be due to similarity in biochemical and physiological properties of the two species. Absence of C. curvatus on culture further supports this view. Topical antifungal therapy resulted in clinical clearance within 2 months. Higher incidence of scalp white piedra is observed in Muslim females; contributing factor being the custom of using a veil, leading to higher humidity and limited sunlight exposure.
  2 13,178 118
Multiple isolated cutaneous plexiform schwannomas
Enas A. S. Attia, Marwa Yassin, Mohamed A Lasheen, Samar Abdalla Salem, Naziha H Khafagy
September-October 2011, 77(5):594-596
DOI:10.4103/0378-6323.84068  PMID:21860160
Plexiform schwannoma is a rare neurogenic tumor, arising from skin and subcutaneous tissue. The presence of multiple schwannomas suggests a possible association with neurofibromatosis type 2 (NF2). A 50-year old male patient presented with multiple papulo-nodular cutaneous lesions on both arms and forearms. Histopathological examination revealed a dermal multinodular pattern of well-circumscribed masses of closely packed cells, with peripheral myxoid tissue, well-encapsulated in a thin collagenous capsule. S-100 immunohistochemical staining was diffusely and strongly positive. Neuron-specific enolase was positive, confirming a neural tissue tumor. An audiogram and Magnetic Resonance Imaging (MRI) of cerebro-pontine angle showed no detected abnormality, excluding acoustic neuroma. Thus, we present a case of multiple bilateral isolated cutaneous plexiform schwannomas, not associated with NF2. Multiple plexiform schwannomas is a very rare entity, distinct from neurofibromatosis (NF), and being confined to the dermis is even more rarely reported.
  2 5,302 89
LETTERS TO THE EDITOR
Contact depigmentation following irritant contact dermatitis to chloroxylenol (dettol)
Ghanshyam K Verma, Vikram K Mahajan, Vinay Shanker, Geeta Ram Tegta, Nidhi Jindal, Samridhi Minhas
September-October 2011, 77(5):612-614
DOI:10.4103/0378-6323.84086  PMID:21860168
  2 6,590 113
NET CASES
Trichophyton rubrum onychomycosis in an 8-week-old infant
Vinod K Khurana, Rakesh K Gupta, Leela Pant, Sanjay Jain, Kapil Chandra, Yukti Sharma
September-October 2011, 77(5):625-625
DOI:10.4103/0378-6323.84069  PMID:21860175
An 8-week-old infant presented with 7 weeks history of nail involvement and discoloration. Lesions started over the middle fingernail of right hand at 1 week of age, spreading over to other nails within 2 weeks. Only two nails of the feet were spared. On KOH examination, fungal hyphae were seen and culture showed growth of Trichophyton rubrum. The purpose is to report the earliest case of onychomycosis having multiple nail involvement of fingers and toes (18 nails).
  2 5,935 112
NET LETTERS
Palmoplantar involvement in psoriasis: A clinical study
Sujay Khandpur, Vijay Singhal, Vinod K Sharma
September-October 2011, 77(5):625-625
DOI:10.4103/0378-6323.84071  PMID:21860174
  2 4,311 234
Dermatosis neglecta unmasking recurrence of carcinoma nasopharynx
Thirthar Palanivelu Vetrichevvel, Venkatswami Sandhya, Subramanyam Shobana, Sankarasubramanian Anandan
September-October 2011, 77(5):627-627
DOI:10.4103/0378-6323.84087  PMID:21860183
  2 2,781 77
VIEW POINT
Is leprosy 'Elimination' a conceptual illusion?
Binod K Patro, K Madhanraj, Amarjeet Singh
September-October 2011, 77(5):549-551
DOI:10.4103/0378-6323.84043  PMID:21860152
  2 5,609 404
FOCUS
Hereditary angioedema: An update
Pramod Kumar Nigam
September-October 2011, 77(5):621-624
DOI:10.4103/0378-6323.84093  PMID:21860172
  1 6,413 345
IMAGES IN CLINICAL PRACTICE
Giant porokeratosis
Tanumay Raychaudhury, Dincy Peter Christudas Valsamma
September-October 2011, 77(5):601-602
DOI:10.4103/0378-6323.84072  PMID:21860162
  1 3,153 152
LETTERS TO THE EDITOR
Pattern of skin diseases in Kumaun region of Uttarakhand
Saurabh Agarwal, Pallavi Sharma, Shalini Gupta, Amit Ojha
September-October 2011, 77(5):603-604
DOI:10.4103/0378-6323.84073  PMID:21860163
  1 4,422 121
Sister Mary Joseph's nodule derived from lung cancer
Fang Wang, Haihong Chen, Xingqi Zhang
September-October 2011, 77(5):609-611
DOI:10.4103/0378-6323.84082  PMID:21860166
  1 4,033 58
Isolated unilateral palisaded neutrophilic and granulomatous dermatitis
Rameshwar Gutte, Uday Khopkar
September-October 2011, 77(5):615-617
DOI:10.4103/0378-6323.84091  PMID:21860170
  1 4,126 83
NET LETTERS
Metastasizing squamous cell carcinoma arising from chronic discoid lupus erythematosus plaque of recent onset
Mandeep Dhingra, Mala Bhalla, Gurvinder Pal Thami, Preeti Mittal
September-October 2011, 77(5):626-626
DOI:10.4103/0378-6323.84078  PMID:21860179
  1 3,297 78
Cutaneous aspergilloma in an immunocompetent patient treated with itraconazole
Vinod K Sharma, Sah Gaurang Krishna, Chaitali Gupta, Mahesh Kumawat
September-October 2011, 77(5):626-626
DOI:10.4103/0378-6323.84080  PMID:21860178
  1 3,174 90
ORIGINAL ARTICLES
Late onset vitiligo and audiological abnormalities: Is there any association?
Nawaf Al-Mutairi, Khalid H Al-Sebeih
September-October 2011, 77(5):571-576
DOI:10.4103/0378-6323.84059  PMID:21860155
Background: There is scarce published data on late onset vitiligo. All the studies showing association of audiological abnormalities have been done on younger age group of patients. Aim: To study the clinical characteristics of the patients with late onset vitiligo. Also, to investigate the audiological abnormalities seen in these patients and compare them with age and sex matched healthy volunteers. Methods: One hundred and ninety-seven consecutive patients developing vitiligo after the age of 40 were studied. These patients were examined for the audiological abnormalities, and compared with those seen in age and sex matched healthy volunteers. Results: Vitiligo started between 40 and 50 years of age in 68.02% of our patients. Vitiligo vulgaris was the commonest clinical pattern, and most patients reported onset of their vitiligo on the upper extremities. Fifty four had diabetes mellitus, 19 patients had autoimmune thyroid diseases, and 32 showed hypoacusis on audiometric examination. Eighteen controls (age and sex matched healthy volunteers) also showed hypoacusis. The difference in frequency was not significant (22.37% vs 18%, χ2 - test, P > 0.05). The sensorineural type of audiologic impairment was more commonly seen both in patients as well as in controls. Conclusion: Late onset vitiligo was not found to have statistically significant association with audiological abnormalities in this study.
  1 6,390 189
REVIEW ARTICLE
Facial melanoses: Indian perspective
Neena Khanna, Seemab Rasool
September-October 2011, 77(5):552-564
DOI:10.4103/0378-6323.84046  PMID:21860153
Facial melanoses (FM) are a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychological impact. Some of the well defined causes of FM include melasma, Riehl's melanosis, Lichen planus pigmentosus, erythema dyschromicum perstans (EDP), erythrosis, and poikiloderma of Civatte. But there is considerable overlap in features amongst the clinical entities. Etiology in most of the causes is unknown, but some factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens in Riehl's melanosis are implicated. Diagnosis is generally based on clinical features. The treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some form of active pigment reduction either with topical agents or physical modes of treatment. Topical agents include hydroquinone (HQ), which is the most commonly used agent, often in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid. Chemical peels are important modalities of physical therapy, other forms include lasers and dermabrasion.
  1 50,572 2,887
BOOK REVIEW
Skin diseases ("Dermatology") in India - History and Evolution: Amiya Kumar Mukhopadhyay
Devinder M Thappa
September-October 2011, 77(5):629-629
  - 3,830 168
EDITORIAL
Monitoring methotrexate hepatotoxicity in psoriasis
Priya Bishnoi, Rashmi Kumari, Devinder Mohan Thappa
September-October 2011, 77(5):545-548
DOI:10.4103/0378-6323.84014  PMID:21860151
  - 12,400 935
LETTERS TO THE EDITOR
Sudden irreversible worsening of myopia with isotretinoin treatment
Abir Saraswat
September-October 2011, 77(5):611-612
DOI:10.4103/0378-6323.84083  PMID:21860167
  - 4,633 101
Study of the density and distribution of Mycobacterium leprae in the epidermis and skin appendages in lepromatous patients
Mohamed A El-Khalawany, Amany A Abou-Bakr
September-October 2011, 77(5):604-607
DOI:10.4103/0378-6323.84076  PMID:21860164
  - 2,853 87
Extensive, adulthood inflammatory linear verrucous epidermal nevus associated with mucinous nevus
Jelica S Vukicevic, Danica J Milobratovic, Mirjana V Milinkovic, Zoran Bogdanovic
September-October 2011, 77(5):607-608
DOI:10.4103/0378-6323.84079  PMID:21860165
  - 4,060 94
Using a simple Jeweler's loupe as a dermoscopic instrument
Feroze Kaliyadan
September-October 2011, 77(5):617-620
DOI:10.4103/0378-6323.84092  PMID:21860171
  - 4,933 134
NET LETTERS
Psychiatric morbidity in psoriasis patients: A pilot study
Surender Kumar, Dilip Kachhawha, Ghanshyam Das Koolwal, Sanjay Gehlot, Ankit Awasthi
September-October 2011, 77(5):625-625
DOI:10.4103/0378-6323.84074  PMID:21860173
  - 3,252 169
Cutaneous changes associated with prolonged plaster of Paris immobilization
Joseph L Chongthu, Mahendra A Singh, Sanjib Waikhom, Mankima Khawlhring
September-October 2011, 77(5):626-626
DOI:10.4103/0378-6323.84075  PMID:21860181
  - 2,864 75
Microsporum canis tinea capitis in a centenarian patient
Efstathios Rallis, Elma Koumantaki-Mathioudaki, Helen Papadogeorgakis
September-October 2011, 77(5):626-626
DOI:10.4103/0378-6323.84077  PMID:21860180
  - 5,132 76
A myriad of paraneoplastic dermatoses
Smitha A Varghese, K Sobhanakumari, Celin M Issac, P Seena
September-October 2011, 77(5):626-626
DOI:10.4103/0378-6323.84081  PMID:21860177
  - 3,589 130
Multiple congenital vascular lesions in a child
Filipa Diamantino, VascoSerrão , João Alexandre, Juliana Bapstista
September-October 2011, 77(5):627-627
DOI:10.4103/0378-6323.84084  PMID:21860185
  - 2,904 70
Epidermoid cyst of penis
Sumitoj Singh, Tejinder Kaur
September-October 2011, 77(5):627-627
DOI:10.4103/0378-6323.84085  PMID:21860184
  - 18,837 107
NET QUIZ
Papulovesicular eruption located on the face and extremities in a child
Mutlu Çoban, Engin Kocabas, Peyker Temiz, Pelin Ertan, Aylin Türel Ermertcan
September-October 2011, 77(5):627-627
DOI:10.4103/0378-6323.84088  PMID:21860182
  - 3,260 151
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