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   2014| January-February  | Volume 80 | Issue 1  
    Online since January 20, 2014

 
 
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REVIEW ARTICLE
Platelet-rich plasma in dermatology: Boon or a bane?
Arshdeep , M Sendhil Kumaran
January-February 2014, 80(1):5-14
DOI:10.4103/0378-6323.125467  
There has been a recent spurt in application of platelet-rich plasma (PRP) in dermatology and aesthetic medicine. However, the details regarding use of PRP in various dermatological indications ranging from hair restoration to chronic ulcers are dispersed in literature, herein we have tried to focus all under one heading. Overall, PRP seems to be a promising therapeutic modality but the level of evidence as of now, from the available published data is low. This review will also stimulate readers to carry out well designed, larger population based trials, so as to validate its use in dermatology practice.
  3 56,520 3,959
CASE REPORTS
IgG/IgA pemphigus reactive with desmoglein 1 with additional undetermined reactivity with epidermal basement membrane zone
Amrinder J Kanwar, Keshavamurthy Vinay, Uma N Saikia, Hiroshi Koga, Kwesi Teye, Daisuke Tsuruta, Takashi Hashimoto
January-February 2014, 80(1):46-50
DOI:10.4103/0378-6323.125499  
IgG/IgA pemphigus is an extremely rare subset of pemphigus, showing anti-keratinocyte cell surface antibodies of both IgG and IgA classes. Herein, we describe a unique case of IgG/IgA pemphigus with clinical features of edematous erythema and peripheral vesiculopustules. Histopathology showed the presence of subcorneal pustules and acantholytic blisters in the mid-epidermis with neutrophilic infiltration and eosinophilic spongiosis. Direct immunofluorescence of perilesional skin showed both IgG and IgA deposits to keratinocyte cell surfaces and unusual granular deposits of IgG, IgM, and C3 along basement membrane zone. On enzyme linked immunosorbent assay , the auto-antibodies were found to be reactive to desmoglein 1 antigen. Various clinical, histopathological, and immunological findings in our case overlapped with the features of IgA pemphigus, pemphigus herpetiformis, and pemphigus foliaceus. These findings indicate that IgG/IgA pemphigus may be a transitional form between IgA pemphigus and pemphigus herpetiformis, and thus provides insight into the pathogenicity of this rare disorder.
  2 2,686 141
LETTERS TO THE EDITOR
Imatinib mesylate-induced severe lichenoid rash
Arshdeep , Dipankar De, Pankaj Malhotra, Uma Nahar Saikia
January-February 2014, 80(1):93-95
DOI:10.4103/0378-6323.125505  
  2 2,058 122
ORIGINAL ARTICLES
Randomized controlled study to evaluate the effectiveness of dexamethasone oral minipulse therapy versus oral minocycline in patients with active vitiligo vulgaris
Akhilendra Singh, Amrinder Jit Kanwar, Davinder Parsad, Rahul Mahajan
January-February 2014, 80(1):29-35
DOI:10.4103/0378-6323.125479  
Background: Oral minocycline has been recently shown to halt disease progression in active vitiligo. Aims: The present study was planned to compare the efficacy and tolerability of oral minocycline with oral mini pulse (OMP) corticosteroids in active vitiligo. Methods: A total of 50 patients with actively spreading vitiligo were randomized to receive either minocycline 100 mg/day (Group I - 25 patients) or OMP 2.5 mg dexamethasone on 2 consecutive days in a week (Group II - 25 patients) for 6 months. These were followed-up at every 2 weeks interval. Mean vitiligo disease activity score (VIDA) and mean Vitiligo Area Scoring Index (VASI) were assessed in all patients in addition to the photographic comparison before and after treatment. Results: Both groups showed a significant decrease in VIDA from 4.0 to 1.64 ± 0.86 (P < 0.001) in Group I and from 4.0 to 1.68 ± 0.69 (P < 0.001) in Group II. However, the difference between the mean VIDA scores in the two groups was not statistically significant (P = 0.60) at the end of treatment period. The mean VASI declined from 1.71 ± 1.45 to 1.52 ± 1.43 Group I (P = 0.06) and from 1.39 ± 1.31 to 1.17 ± 1.34 in Group II (P = 0.05). The difference between VASI in Group I and II was not significant at the end of 24 weeks of treatment (P = 0.11). Conclusion: Both dexamethasone OMP and oral minocycline are effective drugs for managing the arrest of disease activity in vitiligo.
  2 6,584 522
CASE REPORTS
Sturge-Weber syndrome in association with Klippel-Trenaunay syndrome and phakomatosis pigmentovascularis type IIb
Rajesh Kumar Mandal, Sudip Kumar Ghosh, Sankha Koley, Asit Chandra Roy
January-February 2014, 80(1):51-53
DOI:10.4103/0378-6323.125507  
Phakomatosis pigmentovascularis (PPV) is a rare combination of pigmentary and vascular components with or without systemic involvement. We report here a rare association of Sturge-Weber syndrome, Klippel-Trenaunay syndrome, and PPV type IIb in a 15-year-old boy who had right upper limb monoparesis along with a history of recurrent convulsions.
  1 4,498 165
LETTERS TO THE EDITOR
Long-term prognosis of pemphigus in central Kerala, India: A retrospective cohort study
Kidangazhiathmana Ajithkumar
January-February 2014, 80(1):64-65
DOI:10.4103/0378-6323.125529  
  1 2,131 97
Fixed drug eruption due to modafinil
Sidharth Sonthalia, Rahul Arora, Rashmi Sarkar, Amit Dhawan, Ankur Srivastava
January-February 2014, 80(1):90-92
DOI:10.4103/0378-6323.125497  
  1 3,595 82
Psoriasiform reactions during treatment with abatacept
Elena Conde-Montero, Ofelia Baniandrés-Rodríguez, María Dolores Mendoza-Cembranos, Celia Horcajada-Reales, Ricardo Suárez-Fernández
January-February 2014, 80(1):92-93
DOI:10.4103/0378-6323.125502  
  1 2,076 64
Squamous cell carcinoma presenting as a giant cutaneous horn of the lower lip
Mirjana Popadić
January-February 2014, 80(1):74-76
DOI:10.4103/0378-6323.125469  
  1 1,128 13
NET CASE
Thrombophlebitis of the lateral chest wall (Mondor's disease)
D Crisan, R Badea, Maria Crisan
January-February 2014, 80(1):96-96
DOI:10.4103/0378-6323.125512  
Mondor's disease is a rare condition, which involves the thrombophlebitis of the superficial veins of the breast and anterior chest wall. A 37-year-old woman presented with sudden onset of local pain and edema on her right chest wall, accompanied by a longitudinal retraction of the skin during arm abduction in the area. Clinical, histological and ultrasonographic findings confirmed Mondor's disease and the treatment was symptomatic, using pain relievers and warm compresses. The symptomatology remitted within 2 weeks of therapy. Mondor's disease is a rare condition where ultrasound complements the clinical evaluation and allows the characterization of certain abnormalities, which correlated with functional biochemical data and other procedures may substitute the need of biopsy.
  1 10,603 79
ORIGINAL ARTICLES
The efficacy of azithromycin in pityriasis rosea: A randomized, double-blind, placebo-controlled trial
Deepika Pandhi, Archana Singal, Prashant Verma, Reena Sharma
January-February 2014, 80(1):36-40
DOI:10.4103/0378-6323.125484  
Background: Macrolides are prescribed in the treatment of pityriasis rosea despite conflicting results of the limited number of studies evaluating their role in its treatment. Aim: A randomized double-blind placebo-controlled trial was conducted to evaluate the effect of azithromycin on the clinical course of pityriasis rosea. Methods: Seventy patients of pityriasis rosea were given either azithromycin (n = 35) or placebo (n = 35) and were followed-up at 2, 4 and 6 weeks. Pruritus was assessed in both groups using the visual analogue scale (VAS) . Change in the pityriasis rosea severity score (PRSS) and in the VAS were recorded as outcome measures and were compared statistically. Results: The decrease in PRSS from baseline through 2, 4 and 6 weeks within both treatment (P < 0.001) and placebo (P < 0.001) arms was found to be statistically significant; however, this change was not significantly different in the two groups (P = 0.179). Similarly, the decrease in VAS was found to be statistically significant within both groups (P < 0.001); however, the change was comparable between the two groups (P < 0.937). Analysis by Fisher's exact test did not find a significant difference between the two groups for PRSS and VAS. Conclusion: Azithromycin is not effective in pityriasis rosea and the use of macrolides for this disease should not be encouraged in clinical practice.
  1 4,261 330
RESIDENT’S PAGE
Informed consent in dermatology: What's known and what's new?
Balakrishnan Nirmal, Sarvajnamurthy A Sacchidanand
January-February 2014, 80(1):58-61
DOI:10.4103/0378-6323.125520  
  1 3,154 494
CASE REPORTS
Trichorhinophalangeal syndrome type I - Clinical, microscopic, and molecular features
Jiehyun Jeon, Joo Ha Kim, Chil Hwan Oh
January-February 2014, 80(1):54-57
DOI:10.4103/0378-6323.125515  
Trichorhinophalangeal syndrome type I (TRPS I) is an autosomal dominant malformation syndrome characterized by a triad of hair alteration, craniofacial and skeletal abnormalities. TRPS1 gene was first identified in 2000 and mapped on chromosome 8q23.3. A 39-year-old female patient with short stature (149 cm) visited for fine sparse and slow-growing hair with receded medio-occipital hairline of roughly triangular shape since infancy. A typical pear-shaped nose and elongated philtrum were noticeable. In addition, she reported deviation of middle phalanges, bilateral coxa varus in both hips and brachydactyly on bilateral fourth digits. Mutation analysis identified a transition of cytosine to thymine at position 1630 (exon 4), which results in amino acid change R544X and a premature stop of translation. There is no established treatment. But through careful evaluation of suspicious cases to identify potential mutation carriers, the patient can receive information about the disease and genetic counseling.
  - 3,772 98
EDITORIALS
Under construction
M Ramam
January-February 2014, 80(1):4-4
DOI:10.4103/0378-6323.125466  
  - 1,462 142
Looking forward and looking backward - Making impact with impact factor
Devinder Mohan Thappa
January-February 2014, 80(1):1-3
DOI:10.4103/0378-6323.125465  
  - 1,982 162
IMAGES IN CLINICAL PRACTICE
A t(r)icky mole behind the ear
KT Ashique
January-February 2014, 80(1):44-45
DOI:10.4103/0378-6323.125494  
  - 3,072 155
LETTERS TO THE EDITOR
Contact allergens in Kashmiri population: Results from a 6-year patch testing experience in 550 patients
Imran Majid
January-February 2014, 80(1):62-64
DOI:10.4103/0378-6323.125522  
  - 1,275 108
Fatal newborn varicella despite varicella zoster immunoglobulin prophylaxis
Poonam Marwah, Ashish Marwah
January-February 2014, 80(1):65-67
DOI:10.4103/0378-6323.125535  
  - 4,849 112
A case of ultraviolet B-induced linear IgA bullous dermatosis
Yu Gong, Xin Ling Bi, Ying Wang, Jun Gu
January-February 2014, 80(1):67-68
DOI:10.4103/0378-6323.125537  
  - 1,359 70
Spontaneous partial repigmentation of halo nevi around congenital melanocytic nevus and vitiligo in a 13-year-old boy
MJ Concha-Garzón, A Hernández-Martín, C Faura-Berruga, P Dávila-Seijo, A Torrelo
January-February 2014, 80(1):69-70
DOI:10.4103/0378-6323.125539  
  - 2,131 71
Pigmentation resembling cross-section of a mitochondrion
U. K. Sudhir Nayak, Handattu Sripathi
January-February 2014, 80(1):70-71
DOI:10.4103/0378-6323.125542  
  - 1,410 94
Happle-Tinschert syndrome: Report of a newly delineated entity
Nayeem Sadath Haneef, S Ramachandra, Arun Kumar Metta, B Sushmalatha, Sravani Sandhya Bellam, Nimmy Ohatkar
January-February 2014, 80(1):71-73
DOI:10.4103/0378-6323.125468  
  - 2,766 101
Scrofuloderma associated with tuberculosis verrucosa cutis
Angoori Gnaneshwar Rao
January-February 2014, 80(1):76-78
DOI:10.4103/0378-6323.125471  
  - 2,363 116
Malassezia associated hyperkeratosis of the nipple in young females: Report of three cases
Conghui Li, Yuping Ran, Takashi Sugita, Enshi Zhang, Zhen Xie, Ludan Cao
January-February 2014, 80(1):78-80
DOI:10.4103/0378-6323.125475  
  - 6,431 86
Bullous pemphigoid presenting as a malar rash
Rochelle L Castillo, Claudine Yap Silva, Ma Lorna F Frez
January-February 2014, 80(1):80-82
DOI:10.4103/0378-6323.125482  
  - 2,055 90
Revisiting cutaneous metastasis from carcinoma gall bladder
Wesley M Jose, Pavan Kumar Boyella, Indu R Nair, Malini Eapen, Pavithran Keechilat
January-February 2014, 80(1):82-85
DOI:10.4103/0378-6323.125486  
  - 1,363 75
Familial reactive perforating collagenosis in three siblings
Rajat Kandhari, Vikas Sharma, V Ramesh, Avninder Singh
January-February 2014, 80(1):86-87
DOI:10.4103/0378-6323.125488  
  - 2,192 89
A case of Frey's syndrome
Duriye Deniz Demirseren, Gülşen Akoglu, Selma Emre, Ahmet Metin
January-February 2014, 80(1):88-89
DOI:10.4103/0378-6323.125492  
  - 1,443 97
Late onset localized steatocystoma multiplex of the vulva
Jin Park, Su-Ran Hwang, Dae-Woo Kim, Joo-Ik Kim, Seok-Kweon Yun
January-February 2014, 80(1):89-90
DOI:10.4103/0378-6323.125495  
  - 5,559 83
NET LETTERS
Facial variant of eruptive vellus hair cyst
Premanshu Bhushan, Avninder Singh
January-February 2014, 80(1):96-96
DOI:10.4103/0378-6323.125513  
  - 2,381 83
Nicolau syndrome involving whole ipsilateral limb induced by intramuscular administration of gentamycin
Dai Hyun Kim, Hyo Hyun Ahn, Young Chul Kye, Jae Eun Choi
January-February 2014, 80(1):96-96
DOI:10.4103/0378-6323.125516  
  - 2,025 101
Giant porokeratosis of Mibelli with squamous cell carcinoma
Amir Hooshang Ehsani, Safoura Shakoei, Maryam Ranjbar
January-February 2014, 80(1):96-96
DOI:10.4103/0378-6323.125519  
  - 1,653 85
Hair casts
Satyaki Ganguly, Sheela Kuruvila
January-February 2014, 80(1):97-97
DOI:10.4103/0378-6323.125523  
  - 3,724 146
Lupus vulgaris in a child: A complication of ear piercing
Piyush Kumar, Avijit Mondal, Niharika Ranjan Lal, Ramesh Chandra Gharami
January-February 2014, 80(1):97-97
DOI:10.4103/0378-6323.125526  
  - 2,710 106
ORIGINAL ARTICLES
Prevalence and clinical patterns of psoriatic arthritis in Indian patients with psoriasis
Ramesh Kumar, Aman Sharma, Sunil Dogra
January-February 2014, 80(1):15-23
DOI:10.4103/0378-6323.125472  
Background: The prevalence and clinical patterns of psoriatic arthritis (PsA) varies in different parts of the world and there is little clinical and epidemiological data from the Indian subcontinent. Aims: Our study was designed to evaluate the prevalence and clinical patterns of PsA in Indian patients. Methods: This was a non-interventional, cross-sectional study, in which 1149 consecutive psoriasis patients seen over 1 year were screened for PsA according to classification of psoriatic arthritis (CASPAR) criteria. Demographic and disease parameters were recorded including Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), and number of swollen and tender joints. Results: Among 1149 patients with psoriasis, 100 (8.7%) patients had PsA, of which 83% were newly diagnosed. The most common pattern was symmetrical polyarthritis (58%), followed by spondyloarthropathy 49%, asymmetric oligoarthritis (21%), isolated spondyloarthropathy (5%), predominant distal interphalangeal arthritis (3%), and arthritis mutilans (1%). Enthesitis and dactylitis were present in 67% and 26% of cases, respectively. The mean number of swollen and tender joints were 3.63 ± 3.59 (range, 0-22) and 7.76 ± 6.03 (range, 1-26), respectively. Nail changes were present in 87% of the cases. The median PASI and NAPSI of the subjects with PsA was 3.6 and 20, respectively. There was no significant correlation of number of swollen/tender joints with PASI or NAPSI. Conclusion: There is a relatively low prevalence of PsA among Indian psoriasis patients presenting to dermatologists. No correlation was found between the severity of skin and nail involvement and articular disease.
  - 7,623 614
Pruritic porokeratotic peno-scrotal plaques: Porokeratosis or porokeratotic epidermal reaction pattern? A report of 10 cases
Rajiv Joshi, Sudhanshu G Mehta
January-February 2014, 80(1):24-28
DOI:10.4103/0378-6323.125474  
Background: Porokeratosis restricted to the genital region is rare with few cases described in the literature. Cases of porokeratosis restricted to the genital region are similar to plaque type of porokeratosis of Mibelli seen elsewhere on the body. We encountered 10 young males with pruritic plaques restricted to the peno-scrotal region, which clinically were not diagnosed as porokeratosis, but on biopsy revealed multiple cornoid lamellae, some of which were seen to arise from eccrine and follicular structures. Aims: The aim of this study is to study lesions restricted to the peno-scrotal region in males, which on biopsy showed cornoid lamellae suggestive of porokeratosis. Methods: Retrospective analysis of available data of patients who were rendered a histological diagnosis of genital porokeratosis. The database consisted of biopsies received in private consultation by the first author in the period January 2000 to March 2013. Results: Ten young men, 8 in their third decade, presented with pruritic plaques restricted to the peno-scrotal region of variable duration. The lesions were well-demarcated on the penis, but ill-defined with a rough granular surface on the scrotum. None of patients were diagnosed clinically as porokeratosis. The lesions were poorly responsive to topical steroid/antifungal treatment, but two patients showed partial improvement with oral isotretinoin. Biopsy in nine patients revealed multiple cornoid lamellae involving epidermis (6) and adnexal structures (3). One patient had a single cornoid lamella. Conclusion: The clinical and histological presentation of these patients is different from typical genital porokeratosis described in the literature and we postulate that these patients have an unusual porokeratotic reaction pattern of the epidermis with multiple cornoid lamellae.
  - 2,925 118
Removal of corns by punch incision: A retrospective analysis of 15 patients
Şule Güngör, Nilgün Bahçetepe, İlteriş Topal
January-February 2014, 80(1):41-43
DOI:10.4103/0378-6323.125491  
Background: Hard corns are firm, small, dome-shaped papules with translucent central cores, which occur on the palmoplantar region of toes and hands due to repeated trauma. Medical management of hard corns is difficult and sometimes requires surgical excision. Punch incision is a technique which is performed using a circular blade or trephine attached to a pencil-like handle. Aim: We hypothesized that it might serve as an alternative method to surgical excision in the treatment of recalcitrant corns and performed the technique to treat 17 corns in 15 patients. The present study aimed to review these 15 patients retrospectively and evaluate the effectiveness of punch incision. Method: A total of 15 patients with recalcitrant corns were treated using punch incision between April 2011 and December 2012 and were evaluated by photographs and patient satisfaction questionnaires. Results: Out of the 17 corns, 3 corns persisted after punch incision and the patients were referred to the orthopedic clinic for further treatment; 2 of the 17 corns partially responded and required additional topical treatment; and 12 of the 17 corns responded completely to punch incision. Conclusion: Punch incision is a simple and effective technique for the treatment of small corns on the palms and soles.
  - 5,036 242
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