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   2014| May-June  | Volume 80 | Issue 3  
    Online since May 12, 2014

 
 
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LETTERS TO THE EDITOR
Localized bullous pemphigoid occurring on surgical scars: An instance of immunocompromised district
Adone Baroni, Vincenzo Piccolo, Teresa Russo, Marco Adriano Chessa
May-June 2014, 80(3):255-255
DOI:10.4103/0378-6323.132256  PMID:24823406
  1 1,256 92
Psoriasis and metabolic syndrome: A case control study
Neema Muhammed Ali, Maria Kuruvila, Bhaskaran Unnikrishnan
May-June 2014, 80(3):255-257
DOI:10.4103/0378-6323.132257  PMID:24823407
  1 2,712 264
Deep morphea in a child after pneumococcal vaccination
Elena del Alcazar Viladomiu, Anna Tuneu Valls, Begoña Aseguinolatza Zabaleta, Ane Jaka Moreno, Nerea Ormaechea Pérez
May-June 2014, 80(3):259-260
DOI:10.4103/0378-6323.132259  PMID:24823409
  1 2,301 89
Cryoglobulin and antineutrophil cytoplasmic antibody positive cutaneous vasculitis due to propylthiouracil
Zeynep Meltem Akkurt, Derya Uçmak, Gurbet Acar, Selvihan Beysel, Gül Türkcü, Haydar Uçak, Sedat Akdeniz
May-June 2014, 80(3):262-264
DOI:10.4103/0378-6323.132261  PMID:24823411
  1 1,854 81
Rosacea fulminans
Hong Yi Koh, See Ket Ng, Wee Ping Tan
May-June 2014, 80(3):272-274
DOI:10.4103/0378-6323.132267  PMID:24823417
  1 8,100 147
ORIGINAL ARTICLES
Drug reaction with eosinophilia and systemic symptoms: Observations from a tertiary care institution
Sarita Sasidharanpillai, Najeeba Riyaz, Uma Rajan, Manikoth P Binitha, Anza Khader, Olasseri K Reena Mariyath, Rajiv John, Jayasree Puravoor
May-June 2014, 80(3):221-228
DOI:10.4103/0378-6323.132249  PMID:24823399
Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction which can mimic a viral infection, an autoimmune disease or a neoplastic disease. Aims: To study the clinical and epidemiological aspects of DRESS and to identify the precipitating drugs. Methods: All patients admitted to the dermatology ward of our tertiary care hospital from 1 st October 2010 to 30 th September 2013 with probable or definite DRESS as per the RegiSCAR scoring system were included in this prospective study. The clinical manifestations observed in the study population were studied and the common offending drugs were identified. Results: During the 3 year study period, 26 patients fulfilled criteria for probable or definite DRESS. In more than 50% of cases, the culprit drug was phenytoin. Most common symptoms observed were fever, rash and facial edema. Liver was the most common internal organ affected. Most of the patients responded to withdrawal of the drug and administration of steroids for 3-6 weeks. One patient with dapsone-induced DRESS died. Conclusions: Intense facial erythema and edema and an elevated eosinophil count were not found to be bad prognostic factors. In most instances the flare ups during the course of the disease could be managed with a slower tapering of steroids. More prospective studies on DRESS are required to assess the prognostic factors and to formulate better diagnostic criteria.
  1 4,765 380
Methicillin-resistant Staphylococcus aureus colonization and disease severity in atopic dermatitis: A cross-sectional study from South India
Soumya Jagadeesan, George Kurien, Manjula Velikkakathu Divakaran, Sadeep Melethil Sadanandan, K Sobhanakumari, A Sarin
May-June 2014, 80(3):229-234
DOI:10.4103/0378-6323.132250  PMID:24823400
Background: Colonization by methicillin-resistant Staphylococcus aureus (MRSA) in atopic dermatitis is little studied but has therapeutic implications. It may have a role in disease severity given the additional virulence factors associated. Aims: Our aims were to record the proportion of patients with MRSA colonization in atopic dermatitis and to ascertain if any association exists between MRSA colonization and disease severity. Methods: An observational cross-sectional study involving children aged≤12 years with atopic dermatitis attending the outpatient department of Government Medical College, Kottayam was conducted. Socio-demographic data, exacerbating factors and risk factors for hospital care-associated MRSA were documented. Extent of atopic dermatitis was recorded using a standardized scale (Eczema Area Severity Index, EASI). Skin swabs were taken from anterior nares and the worst affected atopic dermatitis sites for culture and sensitivity. Results: Of the 119 subjects recruited during the study period (November 2009-April 2011), Staphylococcus aureus was isolated from 110 (92.4%) patients and MRSA from 30 (25.21%) patients. A total of 18 patients with MRSA had risk factors for healthcare associated-MRSA. The patients whose cultures grew MRSA were found to have significantly higher EASI score when compared to those patients colonized with methicillin sensitive Staphylococcus aureus (P < 0.01). Presence of Staphylococcus aureus, early age of onset, presence of food allergies, seasonal exacerbation and inadequate breastfeeding did not seem to influence disease severity. Conclusions: There is a high degree of prevalence of MRSA (25.2%) in atopic dermatitis and presence of MRSA is associated with increased disease severity. Further studies are needed to validate these findings.
  1 3,397 236
BOOK REVIEW
Text book of Pediatric Dermatology
Vibhu Mendiratta
May-June 2014, 80(3):280-280
  - 1,260 137
CASE REPORTS
Insight into evolution of a giant congenital nevomelanocytic nevus over 14 years
BD Sathyanarayana, HB Basavaraj, KC Nischal, MR Swaroop, MS Lavanya, Sarda Okram
May-June 2014, 80(3):243-246
DOI:10.4103/0378-6323.132252  PMID:24823402
Giant congenital nevomelanocytic nevus (GCNN) is a rare variant of congenital melanocytic nevus measuring >20 cm in size that often has a garment-like distribution. Regular follow up is recommended because of a risk of melanoma transformation of 4.6%. We report a 14-year-old boy with gradual regression of giant congenital melanocytic nevus over the left upper limb, chest, back and axilla, whom we have followed-up since birth. At birth, a hyperpigmented jet-black patch without hair was present over the left side of torso and upper limb including palms and nails. Follow up at the ages of 1, 5, 11 and 14 years showed progressive spontaneous regression of the nevus resulting in shiny atrophic skin, diffuse hypopigmentation, lentigo-like macules, nodules and arthrogryphosis of affected areas. Histopathology of the lesions on follow-up revealed absence of pigmented nevus cells in the regressing areas and thickened sclerotic collagen bundles.
  - 2,525 178
Ulcerative penile Leishmaniasis in a child
Yavuz Yesilova, Enver Turan, Hacer Altun Sürücü, Sezen Kocarslan, Osman Tanrikulu, Naime Eroglu
May-June 2014, 80(3):247-249
DOI:10.4103/0378-6323.132253  PMID:24823403
Penile ulcers may be caused by several different agents. Rarely, cutaneous leishmaniasis may also be accompanied by penile ulcers. We report a five-year-old boy with who had an ulcer on the glans penis. Smears from the ulcer demonstrated amastigotes, biopsy showed histopathological features of leishmaniasis and Leishmania was grown in culture. Treatment with meglumine antimoniate injections led to improvement.
  - 2,249 109
Atypical cutaneous features in adult onset Still's disease
Zeynep Meltem Akkurt, Mehtap Bozkurt, Derya Uçmak, Gül Türkcü, Haydar Uçak
May-June 2014, 80(3):250-253
DOI:10.4103/0378-6323.132254  PMID:24823404
Adult onset Still's disease is a rare but potentially serious disease. We present five cases of adult-onset Still's disease seen by us over a period of one year. The patients were all females and 28-39 years of age. Symptoms had been present for 2-6 weeks in three patients. The other two had been on a few years' follow-up for rheumatoid arthritis before the onset of rashes and fever. The patients had persistent erythematous maculopapular eruptions on face, body and extremities, with moderate to severe pruritus and/or a burning sensation that decreased their quality of life. The typical evanescent rash was not observed. High ferritin values were detected in all the patients and total serum IgE was increased in two. All the patients were started on oral prednisolone (0.5-1.0 mg/kg/day), and methotrexate (10-15 mg/week) had to be added in three patients. One patient was started on tocilizumab due to recalcitrant disease and one was lost to follow-up. Further investigation and classification of the various atypical cutaneous findings in adult-onset Still's disease is necessary.
  - 3,379 140
EDITORIAL
Emphasizing basic science research in medical training for evidence-based practice
Nicholas R Blickenstaff, Garrett C Coman, Howard I Maibach
May-June 2014, 80(3):199-200
DOI:10.4103/0378-6323.132245  PMID:24823395
  - 1,613 220
IMAGES IN CLINICAL PRACTICE
Mudi-chood
KT Ashique
May-June 2014, 80(3):254-254
DOI:10.4103/0378-6323.132255  PMID:24823405
  - 3,128 246
LETTERS TO THE EDITOR
Lichen planus of the uterine cervix: A rare manifestation of mucocutaneous lichen planus
Behrooz Barikbin, Safoura Shakoei, Maryam Ranjbar
May-June 2014, 80(3):264-265
DOI:10.4103/0378-6323.132262  PMID:24823412
  - 2,959 80
Miliary pulmonary tuberculosis with tuberculosis verrucosa cutis
Saka VinodKumar, S Mathanraj, Narhari Narendra Kumar, Jagannathan Venugopal, Debadutta Basu
May-June 2014, 80(3):266-267
DOI:10.4103/0378-6323.132263  PMID:24823413
  - 1,586 95
Accidental high-dose methotrexate toxicity due to an electronic prescribing error
Ercan Çaliskan, Mustafa Tunca, Gürol Açikgöz, Ercan Arca, Ahmet Akar
May-June 2014, 80(3):268-269
DOI:10.4103/0378-6323.132264  PMID:24823414
  - 1,789 125
Tick bite
Cui-Cui Liu, Lilla Landeck, Min Zheng
May-June 2014, 80(3):269-270
DOI:10.4103/0378-6323.132265  PMID:24823415
  - 1,612 99
Lipedematous scalp
CV Dincy Peter, Anne Jennifer, Tanumay Raychaudhury, Laxmisha Chandrashekhar, Sophia Merilyn, Sadashiv Gowda, Gowda Shyam
May-June 2014, 80(3):270-272
DOI:10.4103/0378-6323.132266  PMID:24823416
  - 6,598 121
Gram-negative diplococci in vaginal smear mistaken for child sexual abuse
Seema Sood, Rachna Verma, Anjan Mukherjee, Neeraj Mahajan, Bimal K Das, Arti Kapil, Somesh Gupta, Vinod K Sharma
May-June 2014, 80(3):260-262
DOI:10.4103/0378-6323.132260  PMID:24823410
  - 4,200 100
'Swiss cheese' appearance of dilated follicular infundibula in trichotillomania
Rajiv Joshi
May-June 2014, 80(3):257-258
DOI:10.4103/0378-6323.132258  PMID:24823408
  - 2,644 118
NET LETTER
Cutaneous manifestations of obesity among dermatology patients in a tertiary care center
Ramnathpur Achar Divyashree, Kikkeri Narayanashetty Naveen, Varadraj V Pai, Sharathchandra Bhimrao Athanikar, Gaurang Gupta
May-June 2014, 80(3):278-278
DOI:10.4103/0378-6323.132270  PMID:24823419
  - 3,256 272
A study of candidiasis in HIV reactive patients in a tertiary care hospital, Mysore - South India
Umamaheshwari Shivaswamy, Sumana Mahadevaiah Neelambike
May-June 2014, 80(3):278-278
DOI:10.4103/0378-6323.132271  PMID:24823420
  - 1,106 109
A case of atypical scleromyxedema without gammopathy treated with cyclosporine
Gürol Açikgöz, Ibrahim Özmen, Sikar Hüseynov, Mehmet Gamsizkan, Ercan Çaliskan, Ercan Arca, Erol Koç
May-June 2014, 80(3):278-278
DOI:10.4103/0378-6323.132272  PMID:24823421
  - 1,069 60
A painful subungual lesion with a surprising diagnosis: Molluscum contagiosum
Yeliz Karakoca Basaran, Enver Turan, Baris Keklik, Emine Zeynep Tarini
May-June 2014, 80(3):278-278
DOI:10.4103/0378-6323.132273  PMID:24823422
  - 2,164 104
Sporotrichoid cutaneous tuberculosis
TS Nagesh, A Akhilesh
May-June 2014, 80(3):279-279
DOI:10.4103/0378-6323.132274  PMID:24823423
  - 1,898 104
Bullous lichen planus
Rajesh Verma, Biju Vasudevan, Prateek Kinra, P Vijendran, Ambresh Badad, Vikram Singh
May-June 2014, 80(3):279-279
DOI:10.4103/0378-6323.132275  PMID:24823424
  - 7,270 213
Epidermoid cyst of the glans penis
Shankar Prasad Hazra, Rajkumar Singha Mahapatra, Debasis Chakraborty, Dilip Kumar Pal
May-June 2014, 80(3):279-279
DOI:10.4103/0378-6323.132277  PMID:24823425
  - 2,979 95
ORIGINAL ARTICLES
Comparison of dermatoses seen in community health camps and a tertiary care centre in Kashmir
Iffat Hassan, Parvaiz Anwar, Safoora Bilquis, Shahnaz Nabi, Farhaan Rasool, Iftikar Munshi
May-June 2014, 80(3):214-220
DOI:10.4103/0378-6323.132248  PMID:24823398
Background: Various environmental, socio-economic and geographical factors influence the pattern of dermatoses in an area. Observations made at tertiary dermatology centres may not reflect the actual pattern of dermatoses at the community level. Aims: To evaluate the pattern of dermatoses at community level and compare it with that at a tertiary centre. Methods: Cases were registered through community visits in block Hazratbal in Kashmir valley, once a week over a calendar year. The pattern of dermatoses observed was compared with that seen at the tertiary centre over the same period. Results: A total of 1065 community cases, with 1105 dermatoses, were compared with 4358 patients with 4466 dermatoses seen at the tertiary centre. Non-infectious dermatoses in each group were more common than infectious dermatoses (34.08% infectious dermatoses versus 65.97% non-infectious in community cases and 29.42% infectious dermatoses versus 70.58% non-infectious in hospital patients). Infectious cases were seen significantly more in the community (34.08%) than at the tertiary centre (29.42%). Among the infectious diseases, fungal infection was the most common and in the non-infectious group, pigmentary disorders were the most common, followed by acne and eczema. Conclusion : Infectious dermatoses were found statistically significantly more in community cases as compared to hospital patients while the opposite was the case with non-infectious dermatoses. The study emphasizes the need for providing frequent dermatology services to the community at the primary healthcare level so that the burden of dermatoses, especially infectious, may be reduced. Also, wider studies should be conducted in different regions in order to assess the actual magnitude of dermatological illnesses in the community.
  - 1,672 173
A study of the clinico-histopathological features of erythematous tender nodules predominantly involving the extremities
K Maharaja, Sujay Khandpur, M Ramam, Manoj K Singh, Uma Kumar, Vinod K Sharma
May-June 2014, 80(3):235-242
DOI:10.4103/0378-6323.132251  PMID:24823401
Background: Erythematous tender nodules predominantly involving extremities are frequently encountered in dermatology and rheumatology practice. They are diagnosed based on distinct clinical and histopathological features. However, in clinical situations, considerable overlap is observed that poses a diagnostic challenge. We undertook a study on clinico-histological patterns of inflammatory nodules over extremities. Methods: After detailed history and examination, a preliminary clinical diagnosis was made in 43 cases, followed by skin biopsy from representative nodules. Histological diagnosis made was correlated with clinical features. Results: Of 43 cases, a single clinical diagnosis was made in 25 (58.5%) cases while in the remaining cases more than one diagnosis was considered. On correlating with the histopathological diagnosis, concordance was observed in 51% cases while the remaining showed either histological discordance with clinical diagnosis (14% cases) or were kept in the undecided category (35% cases). Conclusion: Considerable clinico-histological overlap was observed in inflammatory nodules over extremities. Histopathology alone was not helpful in differentiating one entity from another at all times since variable histo-pathological patterns were seen.
  - 4,816 362
PERSPECTIVE
Sales, status, prescriptions and regulatory problems with topical steroids in India
Shyam B Verma
May-June 2014, 80(3):201-203
DOI:10.4103/0378-6323.132246  PMID:24823396
  - 4,099 374
QUIZ
Tender indurated plaque with ulceration on the chin
Geeti Khullar, Dipankar De, Uma Nahar Saikia, Sanjeev Handa
May-June 2014, 80(3):275-277
DOI:10.4103/0378-6323.132268  PMID:24823418
  - 2,966 174
REVIEW ARTICLES
Severe combined immunodeficiency mouse-psoriatic human skin xenograft model: A modern tool connecting bench to bedside
Smriti Kundu-Raychaudhuri, Ananya Datta-Mitra, Christine J Abria, John Peters, Siba P Raychaudhuri
May-June 2014, 80(3):204-213
DOI:10.4103/0378-6323.132247  PMID:24823397
Psoriasis is a multifactorial chronic inflammatory disease. Research into the pathogenesis of this disease is hindered by the lack of a proper animal model. Over the past two decades, many scientists were involved in the development of animal models that nearly mirror the immunopathogenesis of psoriasis. One such model, which has opened doors to the study of molecular complexities of psoriasis as well as its treatment, is the severe combined immunodeficiency (SCID) mouse-human skin chimera model. This model not only mirrors the clinical and histopathological features of psoriasis but also help in the study of cell proliferation, angiogenesis, function of T cells, neurogenic inflammation and cytokines involved in inflammatory reactions. In this article, we have reviewed the prospects and the limitations of the SCID mouse model of psoriasis.
  - 3,923 198
Online since 15th March '04
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