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2006| September-October | Volume 72 | Issue 5
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ORIGINAL ARTICLE
Efficacy of 3% diclofenac gel for the treatment of actinic keratoses: A randomized, double-blind, placebo controlled study
Iraji Fariba, Asilian Ali, Siadat Amir Hossein, Safavai Atefeh, Seyed Afshin Atarzadeh Behbahan
September-October 2006, 72(5):346-349
DOI
:10.4103/0378-6323.27749
PMID
:17050927
Background:
Actinic keratoses (AKs) are premalignant skin lesions caused by excessive sun exposure.
Aims:
To explore the therapeutic efficacy of 3% diclofenac in 2.5% hyaluronan gel in the topical treatment of AK.
Methods:
Sixty-four lesions in 20 patients were evaluated. They were randomized to receive either the active treatment, 3% diclofenac in 2.5% hyaluronan gel or placebo, which consisted of the inactive gel vehicle, hyaluronan for a period of three months. The collected data were analyzed by using Student t- tests.
Results:
There was a reduction in the lesion size in 64.7% of diclofenac-treated lesions and 34.3% of control lesions during the three-month course of treatment. Only 9.3% of the lesions in the diclofenac group were completely cleared during three months of treatment. During the treatment, no significant side-effect was observed in both groups.
Conclusion:
Considering the malignant potential of actinic keratoses and the importance of clearing them to prevent their transformation to squamous cell carcinoma, the efficacy of diclofenac gel seen in our study seems to be low. This treatment may be useful for patients who do not tolerate other, more effective kinds of treatment for actinic keratoses.
[ABSTRACT]
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LETTER TO EDITOR
Oral fixed drug eruption due to fluconazole
Aneet Mahendra, Sanjeev Gupta, Sunita Gupta, Shaveta Sood, Parveen Kumar
September-October 2006, 72(5):391-391
DOI
:10.4103/0378-6323.27767
PMID
:17050944
[FULL TEXT]
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[PubMed]
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5,882
217
CASE REPORTS
Undiagnosed purpura: A case of autoerythrocyte sensitization syndrome associated with dermatitis artefacta and pseudo-ainhum
MPS Sawhney, Gulhima Arora, Sandeep Arora, Jyoti Prakash
September-October 2006, 72(5):379-381
DOI
:10.4103/0378-6323.27759
PMID
:17050937
A 23-year-old young woman presented with recurrent episodes of painful bruising along with linear erosions on the accessible areas of the body of nine years duration with a pseudo-ainhum of her left nipple for the past three months. Her case history included repeated visits to various physicians at different centers and an extensive investigative profile. A diagnosis of autoerythrocyte sensitization was made on the basis of the clinical history, dermatological examination complemented by a positive autoerythrocyte sensitization test, psychiatric evaluation and absence of any organic cause for her ailment. She was placed on psychiatric management and has remained symptom-free after six months follow-up. The case is reported for its rarity, as well as for the association of autoerythrocyte sensitization syndrome with frank dermatitis artefacta and pseudo-ainhum, which to the best of our knowledge has not yet been reported in the literature.
[ABSTRACT]
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LETTER TO EDITOR
Reversible hyperpigmentation as the first manifestation of dietary vitamin B
12
deficiency
Neeraj Srivastava, Satish Chand, Manish Bansal, Kanchan Srivastava, Sanjay Singh
September-October 2006, 72(5):389-390
DOI
:10.4103/0378-6323.27766
PMID
:17050943
[FULL TEXT]
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[CITATIONS]
[PubMed]
7
22,313
401
ORIGINAL ARTICLE
Western blot profile in HIV infection
T Sudha, V Lakshmi, VD Teja
September-October 2006, 72(5):357-360
DOI
:10.4103/0378-6323.27752
PMID
:17050930
Background:
Although the overall sensitivity and specificity of the western blot (WB) test for detection of antibodies to various viral proteins is high, there has been a substantial difference in the timing of the appearance of antibody bands and their intensities during different stages of HIV infection.
Aims:
Mapping different band patterns of Western blot results and correlating them with stages of HIV infection.
Methods:
We performed a retrospective study with 1,467 HIV-1 infected cases confirmed by WB test between January 2002 to July 2005, with the objective of mapping different band patterns of western blot results and determining whether the presence or absence of certain bands was associated with any specific stage of HIV infection. For the interpretation of the WB results in this study, the guidelines recommended by NACO, India were followed.
Results:
Reactivity with all the bands was the most commonly observed WB pattern, occurring in 92.91% (1363/1467) of cases, whereas the other 7.09% showed uncommon band patterns. Of all individual bands, p31 band was the most frequently missing one, absent in 7.09% cases. On classifying the WB reactive cases by the WHO clinical staging system, 38.45% (564/1467) were in Stage 1, 47.99% (704/1467) in stages 2 and 3 and 13.56% in stage 4. Correlation of CD4 cell counts with the various uncommon band patterns showed that only 5.56% (4/72) had counts in the 200-500 cells/µl range, whereas 45.83% and 48.61% had counts of <200 and >500 cells/µl respectively.
Conclusion:
Interpretation of the WB band pattern in combination with clinical features may be occasionally useful in predicting the stage of HIV infection.
[ABSTRACT]
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368
CASE REPORTS
Cerebrotendinous xanthomatosis: Need for early diagnosis
K Muhammed, G Nandakumar, S Saritha
September-October 2006, 72(5):364-366
DOI
:10.4103/0378-6323.27754
PMID
:17050932
Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestanol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects and premature death from arteriosclerosis. The primary biochemical defect is deficiency of hepatic mitochondrial enzyme sterol-27-hydroxylase which catalyses the hydroxylation of cholestanol (5-alpha dehydro derivative of cholesterol) and this deficiency decreases bile acid synthesis. Substantial elevation of serum cholestanol and urinary bile alcohols with low to normal plasma cholesterol concentration establishes the diagnosis. Cerebrotendinous xanthomatosis is exceptionally rare in the Indian population. We are reporting a woman with this rare disorder, who was on antiepileptic and antipsychotic drugs for a prolonged period and whose original condition went undiagnosed. She presented with xanthomas on the Achilles tendons and the upper end of tibia. She was mentally subnormal and her serum cholestanol level was raised. Her younger sister too was severely affected by this disorder. Early treatment with chenodeoxycholic acid is known to prevent disease progression.
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5,806
215
Eyelid involvement in disseminated chronic cutaneous lupus erythematosus
D Pandhi, A Singal, J Rohtagi
September-October 2006, 72(5):370-372
DOI
:10.4103/0378-6323.27756
PMID
:17050934
Eye involvement in chronic cutaneous lupus erythematosus (CCLE) has been reported infrequently. We describe two cases of disseminated CCLE, a 50-year-old woman and a 45-year-old man, with eyelid involvement and disease duration of 4 and 20 years respectively. The first patient showed an excellent response to chloroquine while there was lack of response in the second patient.
[ABSTRACT]
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8,165
204
QUIZ
Verrucous growth on leg
L Mohanty, P Mohanty, T Padhi, S Samantray
September-October 2006, 72(5):399-400
DOI
:10.4103/0378-6323.27770
PMID
:17050950
[FULL TEXT]
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[PubMed]
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7,619
186
LETTER TO EDITOR
Apocrine chromhidrosis localized to the areola in an Indian female treated with topical capsaicin
Vijay Gandhi, Amit Vij, SN Bhattacharya
September-October 2006, 72(5):382-383
DOI
:10.4103/0378-6323.27760
PMID
:17050938
[FULL TEXT]
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129
CASE REPORTS
Superficial basal cell carcinoma on face treated with 5% imiquimod cream
Amit Kumar Malhotra, Arika Bansal, Asit R Mridha, Binod K Khaitan, Kaushal K Verma
September-October 2006, 72(5):373-375
DOI
:10.4103/0378-6323.27757
PMID
:17050935
Imiquimod, an immune response modifier, is known to possess both anti-viral and anti-tumor effect. We report our experience of treating a large superficial spreading basal cell carcinoma with 5% imiquimod cream. A 65-year-old male had an asymptomatic, hyperpigmented, slowly progressive, indurated, 3 x 4 cm plaque on the left cheek for two months. Biopsy from the lesion showed features of basal cell carcinoma. The patient was treated with imiquimod 5% cream, topically three times a week for six months with complete resolution of the lesion and without any side-effects. There was no clinical or histological recurrence after three months of stopping the treatment.
[ABSTRACT]
[FULL TEXT]
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[CITATIONS]
[PubMed]
3
8,454
228
Leg ulcers due to hyperhomocysteinemia
DS Krupa Shankar, Syed Akhib
September-October 2006, 72(5):367-369
DOI
:10.4103/0378-6323.27755
PMID
:17050933
Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.
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3
6,506
208
LETTER TO EDITOR
Candidal intertrigo: Treatment with filter paper soaked in Castellani's paint
Shanmuga V Sundaram, CR Srinivas, M Thirumurthy
September-October 2006, 72(5):386-387
DOI
:10.4103/0378-6323.27763
PMID
:17050941
[FULL TEXT]
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[CITATIONS]
[PubMed]
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7,782
210
ORIGINAL ARTICLE
Indirect immunofluorescence to demonstrate lichen planus specific antigen (LPSA) in lichen planus
Raghavendra Rao, SD Shenoi
September-October 2006, 72(5):350-352
DOI
:10.4103/0378-6323.27750
PMID
:17050928
Background:
Current evidence suggests that lichen planus is an immunological disease. Cytotoxic CD8+ cells in the lesional epidermis recognize a unique antigen called lichen planus specific antigen. This antigen could be demonstrated by indirect immunofluorescence using the patient's serum and autologous lesional skin.
Aim:
To study indirect immunofluorescence pattern in lichen planus, among Indian patients.
Methods:
Twenty-five consecutive patients with the clinical diagnosis of lichen planus were enrolled in the study. Direct immunofluorescence was done in all patients. Indirect immunofluorescence using lesional skin as substrate was done in all 25 patients and five patients with other dermatoses.
Results:
A specific fluorescence pattern corresponding to the distribution of lichen planus specific antigen was observed in the stratum spinosum and granulosum in 22 (88%) patients. It was absent from other parts of the epidermis, dermis and in patients with other dermatoses.
Conclusion:
Indirect immunofluorescence is a useful adjuvant test in lichen planus, particularly in atypical cases.
[ABSTRACT]
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EDITORIAL
Treatment of actinic keratoses: Why, when and how?
Volker Steinkraus, Almut Boer
September-October 2006, 72(5):331-333
DOI
:10.4103/0378-6323.27747
PMID
:17050925
[FULL TEXT]
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[PubMed]
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13,661
284
ORIGINAL ARTICLE
Dressing spray enhances the adhesive strength of surgical dressing tapes
Evren Sarifakioglu, Nedim Sarifakioglu
September-October 2006, 72(5):353-356
DOI
:10.4103/0378-6323.27751
PMID
:17050929
Background:
The use of surgical adhesive tapes after minor surgical and dermatologic operations is widespread. Their use reduces the wound tension and separation and they ultimately improve the postoperative scar. The most commonly used wound adhesives to enhance the adhesiveness of the surgical tapes, are tincture of benzoin and mastisol.
Aim:
The purpose of the present study is to demonstrate the role of adhesive power of dressing spray with the adhesive tape application on the skin, which is widely used in clinics after the skin closure.
Methods:
Fifteen volunteers who were chosen among the medical personnel of the hospital comprised the study group. The skin of the flexor aspect of the 1/3 middle forearm of the subjects was used as the procedure region. The data is collected in the first, second and eighth days of the study. At the first stage of the study, an adhesive wound closure tape was applied to the skin without any compound of adhesives (group A). In the second and third stages, a thin coat of transparent film dressing spray (group B) and an adhesive compound of tincture of benzoin (group C) were applied to the skin before the adhesive tape placement, respectively. Different values of weights ranging between 50-900 gm were hanged by hooking into the center of the adhesive tape. The weights that caused complete separations of the tape from the skin after exactly 20 seconds were recorded in all groups. The data was analyzed by using Friedman test in order to calculate statistical significance between groups A, B and C.
Results:
The difference in adhesive power between control and groups B and C was found to be highly significant (
p
< 0.05). Compound tincture of benzoin was observed to have greatest adhesive strength. Transparent film dressing spray was not as efficient as tincture of benzoin, but when compared with the control group, it enhanced the tape adhesion by 2-fold.
Conclusion:
The results indicated that dressing spray tested has an additional adhesive power besides its well known features and that it can be used as an efficient alternative material among other adhesive compounds.
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7,686
169
REVIEW ARTICLES
Vasculitis: Approach to diagnosis and therapy
Aparna Palit, Arun C Inamadar
September-October 2006, 72(5):334-345
DOI
:10.4103/0378-6323.27748
PMID
:17050926
[FULL TEXT]
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24,185
2,344
BRIEF REPORT
Exploiting the igloo principle and greenhouse effect to regulate humidity and temperature
Karthick S Prabhu, CR Srinivas, Shashidharan Nair, Shanmuga V Sundaram, M Thirumurthy
September-October 2006, 72(5):361-363
DOI
:10.4103/0378-6323.27753
PMID
:17050931
Background:
Toxic epidermal necrolysis can be fatal and nursing care with careful monitoring of temperature and humidity can improve survival rate. We adapted the greenhouse and igloo principle using a common hood to monitor the temperature and humidity.
Methods:
A small heater with a regulator was placed in a mini hood and temperature was recorded inside the uncovered hood and hood covered with green cloth and aluminium foil separately. The regular hood was placed over a volunteer and the temperature was measured inside the open hood and hood covered with green cloth and aluminium foil separately. The relative humidity was also monitored using Zeal mercury dry - wet bulb hygrometer.
Results:
Temperature increase was most marked in the foil-covered hood followed by cloth-covered hood, both with the heater and the volunteer. Similarly, in the volunteer study, the humidity was best maintained inside the aluminium foil-covered hood.
Conclusion:
We recommend the use of regular hood with suitable cover to monitor the humidity and temperature of patients with toxic epidermal necrolysis.
[ABSTRACT]
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6,239
108
CASE REPORTS
Primary cutaneous multifocal CD 30
+
anaplastic large cell lymphoma
LK Asha, Daisy Thomas, MP Binitha, G Nandakumar
September-October 2006, 72(5):376-378
DOI
:10.4103/0378-6323.27758
PMID
:17050936
A 45-year-old male presented with asymptomatic tumors all over the body. The tumors showed no signs of ulceration or regression. There were generalized, nontender, firm to hard enlarged lymph nodes without hepatosplenomegaly. Biopsy and immunophenotyping revealed CD 30+ anaplastic primary cutaneous large cell lymphoma. Primary cutaneous anaplastic large cell lymphoma is characterized by single or grouped reddish-brown tumor nodules, which frequently tend to ulcerate. Secondary involvement of lymph nodes is seen in only 25%. The lesions responded dramatically to chemotherapy, but recurred.
[ABSTRACT]
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[PubMed]
1
6,262
202
NET CASE REPORT
Lichen planus affecting eyelid alone: A rare entity
Shyam B Verma
September-October 2006, 72(5):398-398
DOI
:10.4103/0378-6323.27771
PMID
:17050949
Lichen planus of the eyelid alone is a rarely reported condition with just about 11 cases reported so far in the international literature. We report a case of lichen planus of single lower eyelid with characteristic histopathologic findings on eyelid biopsy. It is unusual to encounter a usually characteristic and often widespread entity like lichen planus occuring at only one site like an eyelid. Lichen planus of the eyelid should be included in the differential diagnosis of eyelid dermatitis.
[ABSTRACT]
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[PubMed]
1
6,411
144
NET LETTER
Linear psoriasis
Saroj Purohit, Sanjay Kanodia, SR Shukla, VN Saxena, RS Meena, Veena Saxena
September-October 2006, 72(5):398-398
DOI
:10.4103/0378-6323.27772
PMID
:17050948
[FULL TEXT]
[PDF]
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[PubMed]
1
5,187
203
FOCUS
Confocal laser microscope
Rachita Misri, Sushil Pande, Uday Khopkar
September-October 2006, 72(5):394-397
DOI
:10.4103/0378-6323.27769
PMID
:17050946
[FULL TEXT]
[PDF]
[PubMed]
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13,160
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LETTER TO EDITOR
Is it delayed pressure urticaria or dermographism?
Gajanan A Pise, Devinder Mohan Thappa
September-October 2006, 72(5):387-388
DOI
:10.4103/0378-6323.27764
PMID
:17050942
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[PubMed]
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5,143
189
Authors' reply
Kiran V Godse
September-October 2006, 72(5):388-389
[FULL TEXT]
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2,408
70
Acanthosis nigricans in an HIV seropositive: Is there a correlation?
YS Marfatia, Archana Sharma
September-October 2006, 72(5):383-384
DOI
:10.4103/0378-6323.27761
PMID
:17050939
[FULL TEXT]
[PDF]
[PubMed]
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4,814
126
Nevoid hyperkeratosis of nipple: Nevoid or hormonal?
Siddhi B Chikhalkar, Rachita Misri, Vidya Kharkar
September-October 2006, 72(5):384-386
DOI
:10.4103/0378-6323.27762
PMID
:17050940
[FULL TEXT]
[PDF]
[PubMed]
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5,599
167
NET QUIZ
Erythematous polycyclic patches
Najeeba Riyaz, A Riyaz
September-October 2006, 72(5):398-398
DOI
:10.4103/0378-6323.27773
PMID
:17050947
[FULL TEXT]
[PDF]
[PubMed]
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4,427
147
RESIDENT’S PAGE
Clue cell
Silonie Sachdeva
September-October 2006, 72(5):392-393
DOI
:10.4103/0378-6323.27768
PMID
:17050945
[FULL TEXT]
[PDF]
[PubMed]
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29,130
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