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   2012| March-April  | Volume 78 | Issue 2  
    Online since March 9, 2012

 
 
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ORIGINAL ARTICLES
A comparative study on efficacy of high and low fluence Q-switched Nd:YAG laser and glycolic acid peel in melasma
Hemanta Kumar Kar, Lipy Gupta, Amrita Chauhan
March-April 2012, 78(2):165-171
DOI:10.4103/0378-6323.93633  PMID:22421647
Background: Melasma is acquired symmetric hypermelanosis characterized by light-to-deep brown pigmentation over cheeks, forehead, upper lip, and nose. Treatment of this condition is difficult and associated with high recurrence rates. With the advent of newer therapies, there is interest in the use of glycolic acid peels and Q-switched Nd:YAG laser (QSNYL) in high and low fluence for this disorder. Aims: To compare the therapeutic efficacy of low fluence QSNYL, high fluence QSNYL, and glycolic acid peel in melasma in three study groups of 25 patients each. Methods: Seventy-five Indian patients diagnosed as melasma were included. These patients were randomly divided in three groups (Group A = 25 patients of melasma treated with low-fluence QSNYL at weekly intervals, Group B = 25 patients of melasma treated with glycolic acid peel at 2 weeks intervals, Group C = 25 patients of melasma treated with high-fluence QSNYL at 2 weeks intervals). Study period and follow-up period was of 12 weeks each. Out of the 75 patients included, 21 patients in Group A, 19 patients in Group B, and 20 patients in Group C completed the study. Response to treatment was assessed using melasma area and severity index score. Results: Significant improvement was recorded in all the three groups. The improvement was statistically highly significant in Group A as compared to Group C (P<0.005), significant in Group A as compared to Group B (P<0.05), and also in Group B when compared to Group C (P<0.05). Low-fluence QSNYL was associated with least side effects. Conclusions: This study shows the efficacy of low-fluence QSNYL and glycolic acid peel in melasma. These could be an effective treatment options compared to conventional methods for the treatment of melasma.
  13 9,831 428
NET CASE
Spectrum of purpura fulminans: Report of three classical prototypes and review of management strategies
Ankur Talwar, Sharath Kumar, MG Gopal, AS Nandini
March-April 2012, 78(2):228-228
DOI:10.4103/0378-6323.93655  PMID:22421668
Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin that is rapidly progressive and is accompanied by vascular collapse and disseminated intravascular coagulation. It usually occurs in children, but this syndrome has also been noted in adults. The three forms of this disease are classified by the triggering mechanisms. We describe three classical cases of purpura fulminans of the three classical prototypes treated at our center and their varied clinical outcomes. We also describe a case of acute infectious purpura fulminans secondary to systemic leptospirosis which to our best knowledge is the first reported case in world literature. The various treatment options for purpura fulminans have also been reviewed.
  11 13,811 498
REVIEW ARTICLES
Oatmeal in dermatology: A brief review
Nader Pazyar, Reza Yaghoobi, Afshin Kazerouni, Amir Feily
March-April 2012, 78(2):142-145
DOI:10.4103/0378-6323.93629  PMID:22421643
The purpose of this review is to gather and summarize in vitro, in vivo, and clinical trials on oatmeal preparations and their uses in dermatology. Literature searches have been carried out to collect in vivo and in vitro studies as well as clinical trials on this subject. The results suggest that oatmeal possesses antioxidant and anti-inflammatory properties and its administration is effective on a variety of dermatologic inflammatory diseases such as pruritus, atopic dermatitis, acneiform eruptions, and viral infections. Additionally, oatmeal plays a role in cosmetics preparations and skin protection against ultraviolet rays. Although some promising results citing the use of oatmeal to treat numerous dermatologic conditions have been found, the complete efficacy of oatmeal has not been sufficiently explored. This paper proposes accurate and useful information concerning the use of oatmeal in clinical practice to dermatologists.
  8 22,900 732
CASE REPORTS
Efficacy of topical photodynamic therapy for keratoacanthomas: A case-series of four patients
Maria M Farias, Ariel Hasson, Cristian Navarrete, Claudia Nicklas, Isidora Garcia-Huidobro, Sergio Gonzalez
March-April 2012, 78(2):172-174
DOI:10.4103/0378-6323.93634  PMID:22421648
Topical photodynamic therapy (PDT) is an excellent treatment option for various non-melanoma skin cancers and precancerous lesions, including actinic keratosis, Bowen's disease, and basal cell carcinoma. The clinical use of PDT includes a broad range of neoplastic, inflammatory, and infectious skin diseases. There is also anecdotal evidence suggesting the efficacy of PDT for the treatment of keratoacanthomas (KA). We report a case-series of four patients with solitary KA confirmed by histology, treated with topical PDT with methylaminolevulinic acid (MAL) cream. After three sessions of PDT, the lesions completely disappeared. There was no evidence of recurrence and excellent cosmetic outcome was achieved after three years of follow-up. Topical photodynamic therapy with MAL can be a therapeutic alternative for KA with good clinical and cosmetic outcomes.
  6 4,362 178
LETTERS TO THE EDITOR
Are Q-switched lasers for Nevus of Ota really effective in pigmented skin?
Kabir Sardana, Shikha Chugh, Vijay Garg
March-April 2012, 78(2):187-189
DOI:10.4103/0378-6323.93639  PMID:22421653
  4 6,285 237
ORIGINAL ARTICLES
Hand eczema: Correlation of morphologic patterns, atopy, contact sensitization and disease severity
Sanjeev Handa, Inderjit Kaur, Tarun Gupta, Rashmi Jindal
March-April 2012, 78(2):153-158
DOI:10.4103/0378-6323.93631  PMID:22421645
Background: Hand eczema is a common distressing condition aggravated by a number of endogenous and exogenous factors. Various morphological forms of hand eczema have been described, but categorization into one of them is not always possible. Aims: To study the morphological patterns of hand eczema, relationship of atopy with hand eczema, and the implications of contact sensitization with respect to severity and diagnosis of hand eczema. Methods: Hundred consecutive patients of hand eczema attending the contact dermatitis clinic of the institute were recruited over a two year period from 2004-05. Objective assessment was done using hand eczema severity index (HECSI) and all the patients were patch tested using Indian standard series. Results: Unspecified type of hand eczema with no definite morphologic picture was seen in 62% followed by pompholyx in 14%. Hand eczema severity was not found to be statistically associated with age, sex, and atopic status of the patient. Positive patch test to one or more allergen was present in 65% of patients. The most common allergens were potassium dichromate (25%), fragrance mix (16%), nickel sulphate (14%), and PPD (13%). There was no significant correlation between patch test positivity and hand eczema severity or atopic status of the patient. Among the morphological patterns pompholyx was strongly associated with an atopic status (P=0.004). Conclusions: Hand eczema was seen twice more commonly in men. Atopic and non-atopic patients of hand eczema had no difference in the severity of disease. Contact sensitivity to different allergens did not correlate with increased eczema severity.
  4 7,623 586
NET LETTERS
Hidradenitis suppurativa involving the preauricular region : An unusual location
Shalu Jain, Kabir Sardana, Vijay K Garg, Surabhi Sinha
March-April 2012, 78(2):229-229
DOI:10.4103/0378-6323.93660  PMID:22421673
  3 5,958 165
ORIGINAL ARTICLES
The safety and efficacy of a combined diode laser and bipolar radiofrequency compared with combined infrared light and bipolar radiofrequency for skin rejuvenation
Yeon Jin Choi, Jung Yeon Lee, Ji Young Ahn, Myeung Nam Kim, Mi Youn Park
March-April 2012, 78(2):146-152
DOI:10.4103/0378-6323.93630  PMID:22421644
Background: As the demand for noninvasive procedures for skin rejuvenation is increasing, combined diode laser and radiofrequency and combined infrared and radiofrequency devices have recently emerged. Aim: To compare Polaris WRA TM , a combination device of diode light and RF, and ReFirme ST TM , a combination device of infrared and bipolar RF, in terms of safety and efficacy on skin rejuvenation. Methods: Fourteen Korean volunteers of skin type II-IV, with facial laxity and periorbital rhytids, received three treatments at 3-week intervals with combined diode laser and bipolar radiofrequency (laser fluence 30 J/cm 2 , RF fluence 90 J/cm 3 ) on the right half of their faces and combined infrared light and bipolar radiofrequency (RF fluence 120 J/cm 3 ) on the left half of their faces. Clinical photos of front and bilateral sides of the subjects' faces were taken at baseline and at 6, 9, 12 weeks after the treatment initiation. The investigators' and the subjects' global assessments were performed. Results: There is no statistically significant difference in the overall outcome between Polaris WRA TM and Refirme ST TM based on pre- and post-treatment objective measurements. Polaris WRA TM was more effective than Refirme ST TM at reducing wrinkles when therapeutic results of the two appliances were compared based on the patient satisfaction measurements. After the treatment with both instruments, histological increase in the production and rearrangement of collagen fibers at the dermal layer was observed. The density of the collagen fibers was more increased with the Polaris WRA TM -treated facial area than that of Refirme ST TM . Treatment was generally well tolerated, and there was no serious complication. Conclusion: In this study, both the lasers appeared to be safe, and effective methods for treating skin laxity and facial wrinkles. Combined diode laser and radiofrequency was more effective than combined infrared and radiofrequency at reducing wrinkles and pores when the therapeutic results of both the appliances were compared.
  3 6,576 240
REVIEW ARTICLES
Morphea: Evidence-based recommendations for treatment
Nicole M Fett
March-April 2012, 78(2):135-141
DOI:10.4103/0378-6323.93628  PMID:22421642
Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.
  3 20,729 964
FOCUS
Eberconazole - Pharmacological and clinical review
Latha Subramanya Moodahadu-Bangera, Jacintha Martis, Rajan Mittal, Binny Krishnankutty, Naveen Kumar, Shantala Bellary, Sunoj Varughese, Parinitha K Rao
March-April 2012, 78(2):217-222
DOI:10.4103/0378-6323.93651  PMID:22421664
  2 12,164 973
LETTERS TO THE EDITOR
Rhabdomyolysis associated with roxithromycin hypersensitivity syndrome
Qingtao Kong, Hong Sang, Min Zhang, Meihua Zeng, WX Hu, DQ Deng, XL Wang, F Liu, GF Wang
March-April 2012, 78(2):197-199
DOI:10.4103/0378-6323.93645  PMID:22421658
  2 2,686 144
Is cholinergic urticaria a seasonal disorder in some patients?
M Ramam, Pooja Pahwa
March-April 2012, 78(2):190-191
DOI:10.4103/0378-6323.93641  PMID:22421654
  2 6,627 177
NET CASE
Bardet-Biedl syndrome: A rare case report from North India
Sumir Kumar, Bharat B Mahajan, Jyotisterna Mittal
March-April 2012, 78(2):228-228
DOI:10.4103/0378-6323.93656  PMID:22421669
The Bardet-Biedl syndrome (BBS) is a rare ciliopathic human autosomal-recessive disorder, affecting multiple organ systems. Less than 15 cases have been reported from India. The authors present a classical case of BBS presenting to dermatology outpatient with hypogonadism and features such as marked central obesity, retinal dystrophy, polydactyly, structural renal abnormalities and mental retardation, along with a brief review of the literature. This case exemplifies the need for multidisciplinary management in such cases.
  2 56,465 286
NET LETTERS
Patient-physician relationship in patients with psoriasis
Cataldo Patruno, Fabio Ayala, Matteo Megna, Maddalena Napolitano, Nicola Balato
March-April 2012, 78(2):228-228
DOI:10.4103/0378-6323.93657  PMID:22421670
  2 2,483 158
Fusarial onychomycosis among gardeners: A report of two cases
Shaveta Jandial, Geeta Sumbali
March-April 2012, 78(2):229-229
DOI:10.4103/0378-6323.93658  PMID:22421671
  2 4,166 172
ORIGINAL ARTICLES
Ultrathin split-thickness skin grafting followed by narrowband UVB therapy for stable vitiligo: An effective and cosmetically satisfying treatment option
Imran Majid, Saher Imran
March-April 2012, 78(2):159-164
DOI:10.4103/0378-6323.93632  PMID:22421646
Background: Different surgical techniques in the form of tissue or cellular grafting procedures are used alone or in combination with narrowband UVB (NBUVB) to treat stable vitiligo resistant to medical treatment. Aim: To evaluate the cosmetic results obtained with ultrathin split-thickness skin grafts followed by NBUVB therapy in resistant, stable vitiligo. Methods: Forty patients of stable vitiligo were treated with ultrathin split-thickness grafting and the patients were then put on NBUVB therapy. The results obtained were analyzed by the extent of repigmentation achieved as well as the final cosmetic outcome at the recipient as well as donor sites. Results: The first evidence of repigmentation was seen in the second week after starting NBUVB. On objective assessment, more than 90% repigmentation was seen in 83% of patients and the overall cosmetic results at the recipient site were graded as good to excellent in 90% patients at the end of NBUVB treatment. Perigraft halo of depigmentation was seen in six patients (15%) on the recipient site. Hypertrophic scarring was observed in two patients at the donor site. Conclusions: Ultrathin split-thickness skin grafting, when combined with NBUVB therapy, leads to better cosmetic outcome with faster onset of repigmentation in resistant stable vitiligo.
  2 9,453 375
CASE REPORTS
Familial atrophia maculosa varioliformis cutis: First case report from the Indian subcontinent with pedigree analysis
Tarang Goyal, Anupam Varshney, SK Bakshi
March-April 2012, 78(2):182-185
DOI:10.4103/0378-6323.93637  PMID:22421651
Familial atrophia maculosa varioliformis cutis is a very rare disorder with less than 28 cases being reported in the literature worldwide and remains a mystery both as far as genetics and the virtue of its pathogenesis is concerned. We present a case of mother and son, both having this disorder with presentations unique in terms of sites involved and try to draw a five generations pedigree chart for the same. We further support its inheritance pattern as autosomal dominant. Also, we propose oral isotretinoin as an effective treatment modality for the same.
  1 8,628 207
LETTERS TO THE EDITOR
Hyperhidrosis of face and scalp: Repeated successful treatment with botulinum toxin type A
Peter Komericki, Navid Ardjomand
March-April 2012, 78(2):201-202
DOI:10.4103/0378-6323.93647  PMID:22421660
  1 7,202 203
NET LETTERS
An unusual case of multiple erythematous nodules with ulcerative lesion
Abhijeet Kumar Jha, Sambeet Kumar Mallik, Satyaki Ganguly, Kranti Chandan Jaykar
March-April 2012, 78(2):229-229
DOI:10.4103/0378-6323.93659  PMID:22421672
  1 3,300 169
Delleman syndrome: Report of a case in an adolescent boy
Mabel J Nocito, Paula C Luna, María L Contardi, Miguel A Mazzini
March-April 2012, 78(2):229-229
DOI:10.4103/0378-6323.93662  PMID:22421675
  1 4,362 165
Linear IgA bullous dermatosis induced by ampicillin/sulbactam
Fabiola Schafer, Ximena Echeverria, Sergio Gonzalez
March-April 2012, 78(2):230-230
DOI:10.4103/0378-6323.93663  PMID:22421676
  1 3,042 156
A rare cause of oral papillomatous lesions: Cowden syndrome
Didem Didar Balci, M Murat Çelik, Ebru Çelik, Mehmet Demir, Mehmet Yaldiz
March-April 2012, 78(2):230-230
DOI:10.4103/0378-6323.93666  PMID:22421679
  1 9,323 163
NET QUIZ
Reddish-brown plaque on the left buttock
Reza Yaghoobi, Maryam Aliabdi, Amir Feily, Nastaran Ranjbari, Sadegh Shahriari
March-April 2012, 78(2):231-231
DOI:10.4103/0378-6323.93667  PMID:22421680
  1 3,368 222
RESIDENT’S PAGE
Named cells in dermatology
Fiona F Sequeira, Suneil Gandhi, Usha Kini, Ishwar Bhat
March-April 2012, 78(2):207-216
DOI:10.4103/0378-6323.93650  PMID:22421663
  1 9,936 1,328
BOOK REVIEW
Textbook of Laser and Light Dermatology in the Asian Skin
Maya Vedamurthy
March-April 2012, 78(2):232-232
  - 2,061 182
CASE REPORTS
Drug-induced hypersensitivity syndrome with human herpesvirus-6 reactivation
Najeeba Riyaz, S Sarita, G Arunkumar, S Sabeena, Neeraj Manikoth, CP Sivakumar
March-April 2012, 78(2):175-177
DOI:10.4103/0378-6323.93635  PMID:22421649
A 45-year-old man, on carbamazepine for the past 3 months, was referred as a case of atypical measles. On examination, he had high-grade fever, generalized itchy rash, cough, vomiting and jaundice. A provisional diagnosis of drug hypersensitivity syndrome to carbamazepine was made with a differential diagnosis of viral exanthema with systemic complications. Laboratory investigations revealed leukocytosis with eosnophilia and elevated liver enzymes. Real-time multiplex polymerase chain reaction (PCR) on throat swab and blood was suggestive of human herpesvirus-6 (HHV-6). Measles was ruled out by PCR and serology. The diagnosis of drug-induced hypersensitivity syndrome (DIHS) was confirmed, which could explain all the features manifested by the patient. HHV-6 infects almost all humans by age 2 years. It infects and replicates in CD4 T lymphocytes and establishes latency in human peripheral blood monocytes or macrophages and early bone marrow progenitors. In DIHS, allergic reaction to the causative drug stimulates T cells, which leads to reactivation of the herpesvirus genome. DIHS is treated by withdrawal of the culprit drug and administration of systemic steroids. Our patient responded well to steroids and HHV-6 was negative on repeat real-time multiplex PCR at the end of treatment.
  - 11,364 235
A family of Bart-Pumphrey syndrome
Müzeyyen Gönül, Ülker Gül, Pelin Hizli, Ömer Hizli
March-April 2012, 78(2):178-181
DOI:10.4103/0378-6323.93636  PMID:22421650
Bart-Pumphrey syndrome (BPS) is an autosomal-dominant disorder characterized by hearing loss, leukonychia, knuckle pads and palmoplantar keratoderma. Two mutations in the extracellular domain of GBJ2 are resposible for this syndrome. To date, less than 10 case reports or clinical series about BPS have been published in the literature. Hearing loss and knuckle pads are the more commonly seen findings of this syndrome. Three generations and six family members with variable findings of knuckle pads, leukonychia, hearing loss and palmoplantar hyperkeratosis were presented in this report. We want to emphasize that dermatogists must be alert during the evaluation of these findings because some findings of this disorder may be vague or absent.
  - 3,819 96
EDITORIAL
Update on cutaneous lupus erythematosus
Laxmisha Chandrashekar
March-April 2012, 78(2):129-132
DOI:10.4103/0378-6323.93626  PMID:22421640
  - 8,021 863
ERRATUM
Erratum

March-April 2012, 78(2):227-227
PMID:22421667
  - 1,458 131
HISTORY
The eminent Indian leprosy researcher - Dr. C. K. Job
Ramaswamy Premkumar
March-April 2012, 78(2):223-224
DOI:10.4103/0378-6323.93652  PMID:22421665
  - 2,664 202
IMAGES IN CLINICAL PRACTICE
A case of subungual exostosis
Hakan Turan, Mustafa Uslu, Havva Erdem
March-April 2012, 78(2):186-186
DOI:10.4103/0378-6323.93638  PMID:22421652
  - 3,427 184
LETTERS TO THE EDITOR
Prevalence of autoantibodies in patients with pemphigus
Asma El Beldi, Ines Zaraa, Mélika B Ahmed, Amel B Osman, Mourad Mokni, Hechmi Louzir
March-April 2012, 78(2):192-193
DOI:10.4103/0378-6323.93642  PMID:22421655
  - 2,183 164
A case of granular cell tumor with an interesting clinical course
Ozkan Kanat, Halil Ozguc, Ulviye Yalcinkaya, Erdem Cubukcu
March-April 2012, 78(2):193-195
DOI:10.4103/0378-6323.93643  PMID:22421656
  - 3,303 147
Genital squamous cell carcinoma presenting with multicentric ulcers: An unusual manifestation of skin malignancy
Pelin Üstüner, Nursel Dilek, Hasan Güçer
March-April 2012, 78(2):195-197
DOI:10.4103/0378-6323.93644  PMID:22421657
  - 7,531 50
A rare case of multiple genital and perianal melanoacanthomas
Tonita M Noronha, Banavasi S Girisha, Hosapatna L Kishanprasad, Michelle S Fernandes
March-April 2012, 78(2):202-204
DOI:10.4103/0378-6323.93648  PMID:22421661
  - 5,559 162
Multiple subcutaneous angiomyxolipomas associated with olecranon bursa cyst: A rare presentation of a rare entity
Mani Anand, Sanjay D Deshmukh, Harveen K Gulati, Prashant R Yadav
March-April 2012, 78(2):204-206
DOI:10.4103/0378-6323.93649  PMID:22421662
  - 3,422 145
A case of herpes gestationis: Follow-up study of autoantibodies using enzyme-linked immunosorbent assay and immunoblotting
Shunpei Fukuda, Norito Ishii, Takahiro Hamada, Bungo Ohyama, Naoya Momosaki, Tadashi Karashima, Takekuni Nakama, Daisuke Tsuruta, Takashi Hashimoto
March-April 2012, 78(2):199-201
DOI:10.4103/0378-6323.93646  PMID:22421659
  - 2,849 156
Authors' reply
Hemanta Kumar Kar, Lipy Gupta
March-April 2012, 78(2):189-190
DOI:10.4103/0378-6323.93640  
  - 1,718 144
NET LETTERS
Pulmonary and cutaneous sarcoidosis in a treated case of renal tuberculosis
Lalit K Gupta, SK Luhadia, AK Khare, Anubhav Garg, Asit Mittal, CM Kuldeep
March-April 2012, 78(2):229-229
DOI:10.4103/0378-6323.93661  PMID:22421674
  - 2,430 156
Plasma cell vulvitis: A vulvar itching dilemma
Aygen Çelik, Berna Haliloglu, Yonca Tanriöver, Erdin Ilter, Tonguç Gündüz, Ipek Ulu, Ahmet Midi, Ümit Özekici
March-April 2012, 78(2):230-230
DOI:10.4103/0378-6323.93664  PMID:22421677
  - 21,321 75
Cutaneous combined desmoplastic melanoma
Chih-Tsung Hung, Bai-Yao Wu
March-April 2012, 78(2):230-230
DOI:10.4103/0378-6323.93665  PMID:22421678
  - 2,802 131
OBITUARIES
Obituary: Tribute to Dr. R. Ganapati - Mahaguru of Leprosy Workers
VV Dongre
March-April 2012, 78(2):233-234
  - 1,785 153
Obituary: Dr. (Mrs.) Inderjeet Kaur
AJ Kanwar
March-April 2012, 78(2):235-236
  - 2,390 162
QUIZ
Lobulated mass on the back of the scalp
Sudip Kumar Ghosh, Debabrata Bandyopadhyay, Loknath Ghoshal, Sharmila Sarkar
March-April 2012, 78(2):225-227
DOI:10.4103/0378-6323.93653  PMID:22421666
  - 3,876 241
VIEW POINT
Skin health in Bangladesh: An overview
Pritish Barua
March-April 2012, 78(2):133-134
DOI:10.4103/0378-6323.93627  PMID:22421641
  - 3,688 202
Online since 15th March '04
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