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   2019| March-April  | Volume 85 | Issue 2  
    Online since February 8, 2019

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Painful tumors of the skin – from ENGLAND to LEND AN EGG to BLEND TAN EGG
M Ramesh Bhat, Anusha Ann George, Jyothi Jayaraman
March-April 2019, 85(2):231-234
DOI:10.4103/ijdvl.IJDVL_1165_16  PMID:30289111
  6,865 614 -
Crusted nipple and areola: A new aetiology of secondary hyperkeratosis of the nipple and areola
Dhaifallah A Alenizi
March-April 2019, 85(2):169-170
DOI:10.4103/ijdvl.IJDVL_399_17  PMID:29491192
Hyperkeratosis of the nipple and areola is a rare condition first described by Tauber in 1923. Less than 100 cases have been reported in the literature. Hyperkeratosis of the nipple and areola presents as hyperkeratotic, hyperpigmented plaques on the nipple and areola. It is more common in females. An 18-year-old female patient presented with hyperkeratotic, plaque-like, hard crusts on both nipples and areolas. The examining physician could successfully remove this crust using his finger. The crust had accumulated as a result of the patient's reluctance to touch or clean the breast area due to psychological issues. A crusted nipple and areola may occur as a secondary condition due to a patient's reluctance to touch or clean their breasts.
  4,332 280 -
Risk factors for chronic and chronic-relapsing tinea corporis, tinea cruris and tinea faciei: Results of a case–control study
Sanjay Singh, Priyanka Verma, Usha Chandra, Narendra Kumar Tiwary
March-April 2019, 85(2):197-200
DOI:10.4103/ijdvl.IJDVL_807_17  PMID:30719987
  3,995 266 -
Ultrasound assessment of enthesis thickness in psoriasis and psoriatic arthritis: A cross-sectional study
Dario Graceffa, Claudio Bonifati, Viviana Lora, Pier Luigi Saraceni, Catia De Felice, Maria Sole Chimenti, Roberto Perricone, Aldo Morrone
March-April 2019, 85(2):175-181
DOI:10.4103/ijdvl.IJDVL_205_17  PMID:29547136
Background: The inflammatory involvement of the enthesis in the course of psoriasis is accompanied by structural abnormalities detectable by ultrasound. The most common of these abnormalities is the thickening of the tendon at the insertion site. Aims: The aim of the present study was to compare the thickness of entheses of patients with psoriatic arthritis, only skin psoriasis, and healthy controls. Methods: A cross-sectional study was conducted in a cohort of patients affected with either only skin psoriasis or psoriatic arthritis as well as in a control group. Eight entheses sites were scanned by ultrasound bilaterally. The following entheseal characteristics were collected and recorded in a predefined database: entheseal thickness, bone erosions, enthesis calcifications (enthesophytes), presence of blood flow, and presence of bursitis. All the detected entheseal changes were scored, and the data was statistically analyzed. Results: The major differences in enthesis thickness between only skin psoriasis and psoriatic arthritis patients were found at the following sites: (i) olecranon tuberosity, (ii) superior pole of the patella, and (iii) medial epicondyle of femur. The thickness of the medial collateral ligament at the site of the femoral origin was increased in psoriatic arthritis, but not in both only skin psoriasis and healthy controls. The score obtained by adding the thickness of all the 8 examined entheses for each patient showed significant differences among the three groups (psoriatic arthritis: 81.3; only skin psoriasis 74.4; Controls: 67.6; P < 0.0001). Interestingly, we found that in psoriatic arthritis patients, the highest enthesis thickening was seen in entheses affected by bone erosions. Limitations: The small sample of patients studied is a limiting factor in this study. Conclusions: Our data demonstrated that the ultrasound measurement of the enthesis thickness enables a distinction between patients with psoriatic arthritis from those with only skin psoriasis. It is a useful method to improve diagnostic accuracy, especially in patients without clear clinical signs of enthesitis.
  3,482 259 -
A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities
Rashmi Sarkar, Vijay Kumar Garg, Annie Jain, Divya Agarwal, Anupama Wagle, Frederic Flament, Michèle Verschoore
March-April 2019, 85(2):160-168
DOI:10.4103/ijdvl.IJDVL_932_17  PMID:30381582
Background: Regular exposure to ultraviolet rays is high in India, where most Indians present Fitzpatrick skin phototypes IV and V. Aims: To evaluate the efficacy and compare the effectiveness of two sunscreen products on Indian skin types IV and V with pigmentation irregularities. Methods: A randomized, uncontrolled and investigator-blinded, single-center study enrolled adult men and women (18–45 years) with Fitzpatrick skin phototypes IV (28° < individual typological angle <10°) and V (10° < individual typological angle < −30°) with pigmentary abnormalities seen on the face in adults (actinic lentigines and postinflammatory hyperpigmentation), who did not use sunscreens. Participants were randomized (1:1) to either of the two marketed sunscreen products, Product A (sun protection factor 50 PA+++) or Product B (sun protection factor 19 PA+++), applied twice daily before sun exposure for ≥2 h. Primary objectives aimed at assessing possible improvement in hyperpigmented spots and overall skin appearance after 12 weeks of use. Evaluation of skin radiance and skin color was done by means of L'Oréal color chart and colorimetric measurements (Chromameter®). Results: Among the 230 enrolled participants, 216 (93.91%) completed the study. The clinical assessment of the density of pigmented spots and skin radiance showed significant (P < 0.001) improvement in both groups during all visits. The qualitative (participant perception) and quantitative (Chromameter®) data indicated improvement in pigmentation from Week 0 to Week 12. Both products were well-tolerated. Limitations: The study was conducted over a rather short period of time (12 weeks) at a single location. Conclusions: This is the first study conducted on Indian skin phototypes IV and V under real-life conditions. It demonstrated the effect of regular sunscreen usage in the prevention of certain signs of skin photoaging such as increased pigmentation or pigmentary abnormalities, thus providing support and assistance to clinicians in suggesting the use of efficient sun-screening products to patients.
  3,005 297 -
Subclinical atherosclerosis and cardiovascular markers in patients with lichen planus: A case–control study
Soheila Nasiri, Afsaneh Sadeghzadeh-Bazargan, Reza Mahmoud Robati, Hamid Reza Haghighatkhah, Shima Younespour
March-April 2019, 85(2):138-144
DOI:10.4103/ijdvl.IJDVL_1080_16  PMID:30632483
Background: Lichen planus is an idiopathic and chronic inflammatory disease that affects the skin and the mucous membranes, and has been associated with an increased risk for cardiovascular diseases. Hyperhomocysteinemia has been regarded as a risk factor for atherosclerosis and cardiovascular diseases. Increased plasma fibrinogen levels are also associated with increased risk of myocardial infarction. Objective: The main aim of this study is the evaluation of common carotid artery mean intima media wall thickness, serum fibrinogen and homocysteine levels in patients with lichen planus. Methods: Forty-three patients with lichen planus and 43 age, gender and body mass index (BMI) matched healthy controls (from general population without the disease) were included in this study. Results: Compared to the healthy controls, patients had statistically significant greater mean intima media wall thickness of the common carotid artery. Moreover, a positive correlation was observed between lichen planus and increased serum homocysteine and c-reactive protein levels. Limitations: The main limitation of this study is the small sample size due to the time limitation and financial constraints. Conclusion: Early diagnosis of atherosclerosis in patients with lichen planus might afford better prophylaxis, including weight control and/or lipid profile monitoring. Measurement of the mean intima media wall thickness of the common carotid artery by duplex high-resolution B-mode ultrasound scanning could be beneficial as a valuable method for early diagnosis of atherosclerosis in lichen planus.
  2,919 253 -
Basidiobolomycosis mistaken for cutaneous tuberculosis
Gnana Kireeti Gummadi, B Sathish Pai, U K Sudhir Nayak, PY Prakash, Kanthilatha Pai
March-April 2019, 85(2):236-236
DOI:10.4103/ijdvl.IJDVL_16_17  PMID:29536980
  2,800 154 -
Recurrent pyogenic granuloma over nevus flammeus
Sharma Shruti, Fouzia Siraj, Vasanthi Ramesh, V Ramesh
March-April 2019, 85(2):236-236
DOI:10.4103/ijdvl.IJDVL_80_17  PMID:29547139
  2,748 144 -
Psoriasis increases the risk of concurrent inflammatory bowel disease: A population-based nationwide study in Korea
Jin Yong Lee, Sungchan Kang, Jung Min Bae, Seong Jin Jo, Seong-Joon Koh, Hyun-Sun Park
March-April 2019, 85(2):145-152
DOI:10.4103/ijdvl.IJDVL_875_17  PMID:30058564
Background: The epidemiology of the association between psoriasis and inflammatory bowel disease is poorly defined and remains controversial. Aim: To evaluate the prevalence of inflammatory bowel disease in patients with psoriasis compared with the general population. Methods: We searched the nationwide health claims database between 2011 and 2015 and evaluated the prevalence of inflammatory bowel disease, including Crohn's disease and ulcerative colitis. Results: Prevalence of inflammatory bowel disease, Crohn's disease and ulcerative colitis in patients with psoriasis vs the general population in 2011 were 0.16, 0.05 and 0.12% vs 0.08, 0.03 and 0.06%, respectively, which increased significantly with time between 2011 and 2015. Patients with psoriasis consistently revealed higher standardized prevalence (age and sex adjusted) of inflammatory bowel disease, Crohn's disease and ulcerative colitis compared with the general population. Subgroup analysis revealed the highest risk of prevalent inflammatory bowel disease in patients younger than 19 years (crude odds ratio 5.33, 95% confidence interval 3.74–7.59). Severe psoriasis demonstrated higher odds of inflammatory bowel disease (odds ratio 2.96, 95% confidence interval 2.54–3.45) than mild psoriasis (odds ratio 1.68, 95% confidence interval 1.51–1.88). Limitations: Limited data for doing adjustment and cross-sectional study design. Conclusions: Psoriasis patients revealed higher risk of inflammatory bowel disease. In particular, young patients and those with severe psoriasis may require closer monitoring and comprehensive management.
  2,553 152 -
Predictors of serological cure after treatment in patients with early syphilis: A retrospective observational study in Thailand
Charussri Leeyaphan, Preawphan Punyaratabandhu, Sukhum Jiamton, Natchaya Junsuwan, Pornchai Chirachanakul, Pattriya Chanyachailert, Viboon Omcharoen
March-April 2019, 85(2):235-235
DOI:10.4103/ijdvl.IJDVL_810_17  PMID:30719988
Background: Some patients with early syphilis who receive appropriate treatment do not reach a serological cure and have a persistent titer which does not meet the criteria for treatment failure (serofast state). Aims: This retrospective study aimed to determine the prevalence of serological cure and the serofast state as well as the factors associated with serological cure after treatment of patients with early syphilis. Methods: A serological cure was defined as occurring when there was a ≥4-fold decrease in nontreponemal titer, whereas patients with a ≥4-fold increase were considered as having either a treatment failure or reinfection. Nontreponemal titers that neither increased nor decreased ≥4-fold after treatment were considered to be in a serofast state. Seroreversion was defined as occurring when there was a negative test within 12 months of treatment. Results: There were 179 patients with a mean age of 31.9 years; 174 (97.2%) were men, and 125 (70%) were HIV patients. Of the total, 174 (98%; 95% confidence interval 94.82–99.42%) patients achieved a serological cure, whereas five were in a serofast state 12 months after treatment. Those five serofast patients were all HIV-positive men, of which 4 (80%) had secondary-stage syphilis, a CD4 count ≤200 cells/μl and a titer <1:8. In a bivariate analysis, a serological cure was associated with a baseline Venereal Disease Research Laboratory >1:16 titers (P = 0.018), and a CD4 cell count >200 cells/μl in 6 months preceding treatment (P = 0.016). The median time to a serological cure was 96 days. Only 22 (12.3%) of the patients achieved seroreversion at 12 months after treatment. Limitations: A retrospective medical record review is likely to have a selection bias, and in our study, 196 (52%) patients were excluded due to missing information. Conclusions: Most patients with early syphilis who achieved a serological cure at 12 months after treatment had high baseline Venereal Disease Research Laboratory titers and CD4 cell counts. However, only 22 (12.3%) had a negative Venereal Disease Research Laboratory titer after 1 year of treatment.
  2,512 100 -
An observational study on glabellar wrinkle patterns in Indians
Amala Kamat, Trisha Quadros
March-April 2019, 85(2):182-189
DOI:10.4103/ijdvl.IJDVL_211_17  PMID:29620040
Background: Botulinum A exotoxin is an established treatment for glabellar frown lines, crow's feet, and horizontal furrows of the forehead. The glabella is probably the most common site for botulinum toxin treatment in Asians. Five glabellar contraction patterns have been classified in earlier studies based on eyebrow approximation, depression, and elevation. Unfortunately, this was found to be confusing by many practitioners. Indians, as all Asians, have smaller muscles compared to the European population, and there is no consensus on the optimal dosage per injection site or concentration of toxin to be used. Aims: (a) Identification and classification of glabellar wrinkle patterns in Indians. (b) Optimization of the minimal effective dose of toxin per site. Materials and Methods: Retrospective photographic analysis of 200 patients who received botulinum toxin for the first time to treat glabellar wrinkles was conducted. The wrinkle patterns were identified and classified by the authors based on the prevalence of perpendicular and transverse glabellar lines, nasal, and forehead wrinkles. Results: Six patterns were identified: (1) 11 (2) U (3) Pi (4) X (5) W (6) I. The relevant muscles were identified and doses optimized for those sites. Limitations: The doses mentioned in this study are not universal for all patients and toxin units would have to be altered and individualized according to the bulk of the facial muscles and individual needs. Conclusion: The investigators classification, injection patterns, and dosage may provide valuable guidance to facial esthetic treatment.
  2,303 266 -
Linking of psoriasis with osteopenia and osteoporosis: A cross-sectional study
Antonio Martinez-Lopez, Gonzalo Blasco-Morente, Maria Sierra Giron-Prieto, Miguel Angel Arrabal-Polo, Maria Luque-Valenzuela, Juan de Dios Luna-Del Castillo, Jesus Tercedor-Sanchez, Salvador Arias-Santiago
March-April 2019, 85(2):153-159
DOI:10.4103/ijdvl.IJDVL_831_17  PMID:30226478
Background/Purpose: Psoriasis is a multisystem disease which has been related to vitamin-D deficiency through chronic inflammation. This psoriasis-related inflammatory state and vitamin-D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis. Methods: A total of 185 subjects were studied; 58 psoriatic patients who had not been under systemic or biological treatment were included. Age, gender, body mass index, phosphocalcic metabolic parameters and hip and lumbar (L4) bone mineral density data were collected. These variables were compared with those collected in 61 healthy controls and 67 patients with osteopenia/osteoporosis. Results: Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients. Limitations: The main limitations are those of cross-sectional studies, such as a lack of follow up period, and a male predominance in the psoriatic group, which is corrected employing a multivariate analysis with an adjusted model for confounding factors. Conclusions: Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density.
  2,365 151 -
Syringocystadenoma papilliferum with coexisting hydrocystoma
Uma Keyal, Anil Kumar Bhatta, Yeqiang Liu
March-April 2019, 85(2):236-236
DOI:10.4103/ijdvl.IJDVL_592_17  PMID:29536975
  2,380 126 -
Medical device regulation in India: What dermatologists need to know
Sandeep Lahiry, Rajasree Sinha, Suparna Chatterjee
March-April 2019, 85(2):133-137
DOI:10.4103/ijdvl.IJDVL_326_18  PMID:30688215
  2,190 190 -
Primary mucinous carcinoma of skin with a trichoadenomatous component: A rare case report
Athota Kavitha, Chennamsetty Kavya, Kovi Sneha, Chennamsetty Teja
March-April 2019, 85(2):171-174
DOI:10.4103/ijdvl.IJDVL_217_17  PMID:29620041
Primary mucinous carcinoma of the skin is a rare subtype of eccrine sweat gland tumors. Differentiating it from metastatic adenocarcinomas is important in the management of this condition. We report the case of a 55-year-old female presenting with a painless nodule, which was subsequently diagnosed as primary mucinous carcinoma of skin with a trichoadenomatous component. The possibility of a metastatic adenocarcinoma was ruled out by performing ultrasound abdomen, total body computed tomography, mammogram and colonoscopy.
  2,165 195 -
Bead retention test in koilonychia
T Muhammed Razmi, Dipankar De
March-April 2019, 85(2):229-230
DOI:10.4103/ijdvl.IJDVL_350_18  PMID:30719990
  2,078 90 -
Bilateral agminated skin-colored papules and nodules on the dorsum of the hands
Adane Ayele, Georgios Kravvas, Richard B Weller, Asok Biswas
March-April 2019, 85(2):192-194
DOI:10.4103/ijdvl.IJDVL_160_17  PMID:30117462
  1,861 124 -
Pentazocine induced skin ulcers: An 'easy to miss' diagnosis
Rajsmita Bhattacharjee, Rahul Mahajan
March-April 2019, 85(2):224-225
DOI:10.4103/ijdvl.IJDVL_659_17  PMID:29667614
  1,721 218 -
Serum galectin-9 levels in atopic dermatitis, psoriasis and allergic contact dermatitis: A cross-sectional study
Eman Nofal, Fatma Eldesoky, Ahmad Nofal, Ahmed Abdelshafy, Amal Zedan
March-April 2019, 85(2):195-196
DOI:10.4103/ijdvl.IJDVL_252_18  PMID:30719989
  1,756 48 -
Onychomatricoma: Clinical, dermoscopy and ultrasound findings
Denise Gamé, Ane Jaka, Carlos Ferrándiz
March-April 2019, 85(2):190-191
DOI:10.4103/ijdvl.IJDVL_621_17  PMID:30058567
  1,579 118 -
Varenicline-induced symmetrical drug-related intertriginous and flexural exanthema
Chun-Yu Cheng, Chuang-Wei Wang, Fang-Ying Wang, Wen-Hung Chung
March-April 2019, 85(2):209-211
DOI:10.4103/ijdvl.IJDVL_768_17  PMID:30719986
  1,625 49 -
Dermatofibrosarcoma protuberans: Two rare variants
Sarina Jain, Shuken Dashore, Bharat Singhania, Uday S Khopkar, Bhushan Darkase
March-April 2019, 85(2):204-208
DOI:10.4103/ijdvl.IJDVL_923_17  PMID:30719992
  1,577 64 -
Acquired acrodermatitis enteropathica secondary to sleeve gastrectomy
Birgül Özkesici Kurt, Ceren Memiş İrican, Betül Ünal, Mehmet A Çiftçioğlu, Soner Uzun
March-April 2019, 85(2):220-223
DOI:10.4103/ijdvl.IJDVL_337_18  PMID:30688216
  1,554 42 -
Dome-shaped nodules and scaly, verruciform plaques on the legs and feet
Carmen María Alcántara-Reifs, Rafael Salido-Vallejo, Gloria María Garnacho-Saucedo, Antonio Vélez García-Nieto
March-April 2019, 85(2):226-228
DOI:10.4103/ijdvl.IJDVL_255_17  PMID:29620042
  1,371 181 -
Primary cutaneous marginal zone B-cell lymphoma of vulva in a pregnant woman
Jiaoqing Tang, Jihui Chen, Hongjie Liu, Lin Wang
March-April 2019, 85(2):211-214
DOI:10.4103/ijdvl.IJDVL_295_18  PMID:30665994
  1,450 36 -
Pigmented nipple-like nodule on the neck
Sabha Mushtaq, Saurabh Singh, Sudeep Khera, Anand Bardia
March-April 2019, 85(2):235-235
DOI:10.4103/ijdvl.IJDVL_345_18  PMID:30719993
  1,339 72 -
The histopathological and dermoscopic correlation of primary cutaneous mucinous carcinoma
Chun-Yu Cheng, Yau-Li Huang, Tseng-Tong Kuo, Sindy Hu
March-April 2019, 85(2):215-220
DOI:10.4103/ijdvl.IJDVL_286_18  PMID:30719985
  1,284 35 -
A rare case of metastatic skin tumors originating from the sarcomatous component of lung carcinosarcoma
Yuka Takashima, Reine Moriuchi, Takahisa Shirato, Satoko Shimizu
March-April 2019, 85(2):201-203
DOI:10.4103/ijdvl.IJDVL_626_17  PMID:30719994
  1,238 31 -
IJDVL International Awards 2018

March-April 2019, 85(2):237-237
  672 57 -
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