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  Citation statistics : Table of Contents
   2005| November-December  | Volume 71 | Issue 6  
 
 
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ORIGINAL ARTICLE
Efficacy of low dose intravenous immunoglobulins in children with toxic epidermal necrolysis: An open uncontrolled study
Kanu Mangla, Swati Rastogi, Puneet Goyal, Rekha B Solanki, Ranjan C Rawal
November-December 2005, 71(6):398-400
DOI:10.4103/0378-6323.18943  PMID:16394480
Background: High dose intravenous immunoglobulins (IVIG) have emerged as a promising new therapy for treating the rare but potentially fatal drug reaction toxic epidermal necrolysis (TEN). Experimental in vitro studies support the view that IVIG can block the fas-fas ligand mediated apoptosis in TEN. Methods: Ten pediatric patients of TEN were treated with IVIG (0.05 - 0.1 gm/kg/day) along with antibiotics and supportive care. Results: Patients with 67% of mean body surface area of involvement showed an average of 2.1 days for arrest of progression of lesions and 8.1 days for complete reepithelization. There was no mortality. Conclusions: Low dose IVIG appears to be a safe and effective treatment for TEN in children. Randomized trials are needed to further evaluate the efficacy of IVIG and compare it with other therapeutic modalities.
  35 9,619 340
REVIEW ARTICLES
Nail changes and disorders among the elderly
Gurcharan Singh, Nayeem Sadath Haneef, Uday A
November-December 2005, 71(6):386-392
DOI:10.4103/0378-6323.18941  PMID:16394478
Nail disorders are frequent among the geriatric population. This is due in part to the impaired circulation and in particular, susceptibility of the senile nail to fungal infections, faulty biomechanics, neoplasms, concurrent dermatological or systemic diseases, and related treatments. With aging, the rate of growth, color, contour, surface, thickness, chemical composition and histology of the nail unit change. Age associated disorders include brittle nails, trachyonychia, onychauxis, pachyonychia, onychogryphosis, onychophosis, onychoclavus, onychocryptosis, onycholysis, infections, infestations, splinter hemorrhages, subungual hematoma, subungual exostosis and malignancies. Awareness of the symptoms, signs and treatment options for these changes and disorders will enable us to assess and manage the conditions involving the nails of this large and growing segment of the population in a better way.
  33 74,491 1,576
ORIGINAL ARTICLE
A study of autologous melanocyte transfer in treatment of stable vitiligo
Vishvabhavan Pandya, Kirti S Parmar, Bela J Shah, FE Bilimoria
November-December 2005, 71(6):393-397
DOI:10.4103/0378-6323.18942  PMID:16394479
Background: Replenishing melanocytes selectively in vitiliginous macules by autologous melanocytes is a promising treatment. With expertise in culturing melanocytes, it has now become possible to treat larger recipient areas with smaller skin samples. Aim: To study the extent of repigmentation after autologous melanocyte transplantation in patients with stable vitiligo. Methods: The melanocytes were harvested as an autologous melanocyte rich cell suspension from a donor split thickness graft. Melanocyte culture was performed in selected cases where the melanocyte cell count was insufficient to meet the requirement of the recipient area. These cells were then transplanted to the recipient area that had been superficially dermabraded. Results: An excellent response was seen in 52.17% cases with the autologous melanocyte rich cell suspension (AMRCS) technique and in 50% with the melanocyte culture (MC) technique. Conclusion: Autologous melanocyte transplantation can be an effective form of surgical treatment in stable but recalcitrant lesions of vitiligo.
  16 23,250 889
Chronic actinic dermatitis - A study of clinical features
Vijay K Somani
November-December 2005, 71(6):409-413
DOI:10.4103/0378-6323.18946  PMID:16394483
Background: Chronic actinic dermatitis (CAD), one of the immune mediated photo-dermatoses, comprises a spectrum of conditions including persistent light reactivity, photosensitive eczema and actinic reticuloid. Diagnostic criteria were laid down about 20 years back, but clinical features are the mainstay in diagnosis. In addition to extreme sensitivity to UVB, UVA and/or visible light, about three quarters of patients exhibit contact sensitivity to several allergens, which may contribute to the etiopathogenesis of CAD. This study was undertaken to examine the clinical features of CAD in India and to evaluate the relevance of patch testing and photo-aggravation testing in the diagnosis of CAD. Methods: The clinical data of nine patients with CAD were analyzed. Histopathology, patch testing and photo-aggravation testing were also performed. Results: All the patients were males. The average age of onset was 57 years. The first episode was usually noticed in the beginning of summer. Later the disease gradually tended to be perennial, without any seasonal variations. The areas affected were mainly the photo-exposed areas in all patients, and the back in three patients. Erythroderma was the presenting feature in two patients. The palms and soles were involved in five patients. Patch testing was positive in seven of nine patients. Conclusions: The diagnosis of CAD mainly depended upon the history and clinical features. The incidence of erythroderma and palmoplantar eczema was high in our series. Occupation seems to play a role in the etiopathogenesis of CAD.
  15 15,526 614
REVIEW ARTICLES
Acute skin failure: Concept, causes, consequences and care
Arun C Inamadar, Aparna Palit
November-December 2005, 71(6):379-385
DOI:10.4103/0378-6323.18007  PMID:16394477
Acute skin failure is a state of total dysfunction of the skin resulting from different dermatological conditions. It constitutes a dermatological emergency and requires a multi-disciplinary, intensive care approach. Its effective management is possible only when the underlying pathomechanism of each event is clear to the treating clinician. The concept of skin failure is new to non-dermatologist clinicians and sketchy among many dermatologists. Here the pathomechanism of skin failure has been analyzed and a guideline for monitoring has been provided. There is a need for intensive care units for patients with acute skin failure.
  14 66,331 4,642
CASE REPORTS
Linear scleroderma following Blaschko's lines
Amiya Kumar Mukhopadhyay
November-December 2005, 71(6):421-422
DOI:10.4103/0378-6323.18949  PMID:16394486
Blaschko's lines form a pattern, which many diseases are found to follow, but linear scleroderma following Blaschko's lines is a controversial entity rarely reported in the literature. A 24-year-old man presented with multiple linear, atrophic, hyperpigmented lesions punctuated by areas of depigmentations on the left half of the trunk distributed on the anterior, lateral and posterior aspects. The lesions were distributed in a typical S-shaped line. Antinuclear antibody and antihistone antibody tests were negative. Histopathological examination of the skin from the affected area showed features suggestive of scleroderma. Here, we present a case of linear scleroderma following Blaschko's lines in a male patient - an entity reported only three times so far.
  9 7,755 212
Extramammary Paget's disease
Santanu Banerjee, Manas Chatterjee, Kailash Chand
November-December 2005, 71(6):417-420
DOI:10.4103/0378-6323.18948  PMID:16394485
Two patients with extramammary Paget's disease are being reported. The first case was a 60-year-old male who presented with gradually progressive pruritic ulcerated lesion over perianal region not responding to various topical medications. Dermatological examination revealed a large erythematous sharply marginated scaly plaque in the perianal region extending into the anal canal, covered with grayish crusts and shallow erosions. Skin biopsy from the lesion was suggestive of Paget's disesase. The second patient, a 60-year-old male, with a three year long history, presented with similar lesions and findings. Skin biopsy in this case was also consistent with Paget's disease. These two cases of extramammary Paget's disease involving the perianal region are being reported because of their rarity and also to stress the fact that a high degree of suspicion is needed for the diagnosis of this uncommon disease entity.
  7 8,984 224
Waardenburg syndrome type 2 in an african patient
S GH Otman, NI Abdelhamid
November-December 2005, 71(6):426-427
DOI:10.4103/0378-6323.18951  PMID:16394488
A thirty six year-old African man, born in the Southern part of Libya, presented with congenital deafness and white forelock, variable-sized hypopigmented, depigmented patches and hyperpigmented islands within the areas of hypomelanosis affecting the upper parts of the trunk, both arms and forearms. The nasal root was hypertrophied, but there was a lack of lateral displacement of medial canthi. We report this case of Waardenburg syndrome type 2 (WS 2). As no treatment is available for patients with WS 2, prompt diagnosis and referral to a hearing specialist are crucial for the normal development of patients affected with this condition.
  6 5,420 146
Multicentric squamous cell carcinoma over lesions of porokeratosis palmaris et plantaris disseminata and giant porokeratosis
Sujata Sengupta, Jayanta Kumar Das, Asok Gangopadhyay
November-December 2005, 71(6):414-416
DOI:10.4103/0378-6323.18947  PMID:16394484
Porokeratosis is a specific disorder of keratinization that has five clinical types and shows a characteristic 'cornoid lamella' on histopathology. Malignant degeneration has been described in all forms of porokeratosis. To the best of our knowledge, this is the first Indian report of multicentric squamous cell carcinoma complicating porokeratosis.
  5 5,688 150
FOCUS
Sebumeter
Sushil Y Pande, Rachita Misri
November-December 2005, 71(6):444-446
DOI:10.4103/0378-6323.18959  PMID:16394496
  5 8,728 380
CASE REPORTS
Ewing's sarcoma with cutaneous metastasis - a rare entity: Report of three cases
G Biswas, A Khadwal, P Kulkarni, A Bakshi, C Nair, P Kurkure, M Muckaden, P Parikh
November-December 2005, 71(6):423-425
DOI:10.4103/0378-6323.18950  PMID:16394487
Ewing's sarcoma (ES) is a small round cell tumor, usually arising from flat bones and diaphyseal region of long bones. It is commonly found in the first two decades of life. It is curable when diagnosed in the localized stage and requires multimodality treatment. ES is a chemosensitive tumor. It metastasizes commonly to lung, pleura and other bones. Less common sites of metastasis are lymph nodes, CNS and liver. Skin metastasis is extremely uncommon. It occurs in up to 9% of all patients with cancer. Growth pattern of cutaneous metastasis is unpredictable and may not reflect that of primary tumor. We hereby report three cases of Ewing's sarcoma that developed skin metastasis.
  4 9,140 149
LETTER TO EDITOR
Keratoacanthoma of the conjunctiva complicating xeroderma pigmentosum
RK Chowdhury, T Padhi, GS Das
November-December 2005, 71(6):430-431
DOI:10.4103/0378-6323.18954  PMID:16394491
  4 5,212 108
Chronic mucocutaneous candidiasis in a child
Sathish Kumar T, Julius Xavier Scott, Renu George
November-December 2005, 71(6):432-433
DOI:10.4103/0378-6323.18955  PMID:16394492
  4 6,924 231
ORIGINAL ARTICLE
A comparative evaluation of skin and nerve histopathology in single skin lesion leprosy
Raghunatha R Reddy, Gurcharan Singh, S Sacchidanand, Rajendra Okade, Shivakumar V, Uday A, Nayeem Sadath Haneef
November-December 2005, 71(6):401-405
DOI:10.4103/0378-6323.18944  PMID:16394481
Background: In spite of leprosy being a disease of nerves, ROM therapy for single skin lesion leprosy was based on clinical trials without much evidence-based studies of nerve pathology. The present study was undertaken to compare the histology of skin and nerve in single skin lesion leprosy, and to assess the scientific rationale and justification of single dose ROM therapy. Methods: Twenty-seven untreated patients with single skin lesion without significantly thickened peripheral nerves were selected. Skin and nearby pure cutaneous nerve biopsies were studied under both H&E and Fite's stain. Results: All the skin biopsies were negative for AFB and clinico-pathological correlation was positive in 51.85% of skin biopsy specimens. Histopathological diagnosis of leprosy was evident in 55.5% of clinically normal looking nerves, with AFB positivity in 29.6% of nerve biopsy specimens. Correlation between clinical diagnosis and nerve histopathology was poor (26%). Conclusions: Single skin lesion without thickened peripheral nerves as criteria for single dose ROM therapy is not logical, since the histological diagnosis of leprosy in normal looking nerves with presence of AFB is revealed in this study. Pure cutaneous nerve biopsy is a simple outpatient procedure, without complications. This study emphasizes the need to consider nerve pathology as an important tool for further therapeutic recommendations, than just clinical trials and skin pathology alone. Though single dose ROM therapy has been withdrawn recently, the principle holds good for any future therapeutic recommendations.
  4 8,467 408
Relevance of patch testing in patients with nummular dermatitis
DS Krupa Shankar, Shristi Shrestha
November-December 2005, 71(6):406-408
DOI:10.4103/0378-6323.18945  PMID:16394482
Background: A chronic dermatosis like nummular dermatitis may be complicated by contact dermatitis due to an impaired cutaneous barrier. This study is aimed at evaluating secondary contact dermatitis in patients with nummular dermatitis. Methods: Patch testing with the Indian Standard Series was performed in 50 of 78 patients with a clinical diagnosis of nummular eczema. Significant reactions were graded as per ICDRG criteria. Results: Significant reactions were noted in 23 of 50 tested patients. The most frequent sensitizers were colophony, nitrofurazone, neomycin sulfate and nickel sulfate (7.14% each) Reactions to antigens in topical medications, cosmetics and toiletries constituted 64.28% of all the reactions. Conclusions: Patients with nummular dermatitis are at significant risk of developing secondary allergic contact dermatitis, which contributes to the severity and chronicity of their dermatitis. Patch testing has the potential to improve the quality of life in these patients. Hence, patients with chronic recalcitrant nummular dermatitis must be patch tested.
  4 11,870 419
LETTER TO EDITOR
Drug rash due to levamisole
Ramji Gupta, Sarthak Gupta
November-December 2005, 71(6):428-429
DOI:10.4103/0378-6323.18952  PMID:16394489
  2 5,815 100
Scleroderma and dermographism in a case of carcinoma ovary
R Vottery, G Biswas, C Deshmukh, S Gupta, R Nair, P Parikh
November-December 2005, 71(6):429-430
DOI:10.4103/0378-6323.18953  PMID:16394490
  2 6,286 116
RESIDENTíS PAGE
Journal Club: screen, select, probe & evaluate
GR Kanthraj, CR Srinivas
November-December 2005, 71(6):435-440
DOI:10.4103/0378-6323.18957  PMID:16394494
Postgraduate dermatology training programs like seminars, panel discussions, and case presentations help residents to acquire knowledge. Journal club (JC) exercises help residents to update themselves with the current literature. What article a resident should choose and how a resident should evaluate and analyze an article or critically appraise a topic are issues that are most relevant for the success of a JC. Little guidance is available in the biomedical literature on how to deal with such issues. The objective of this article is to provide guidance to neophytes on dealing with JC exercises in a way that helps them in learning the critical appraisal skills. A review of the literature and of the author's experience in JC exercises will be presented. Knowing the methodology of rapid screening of articles along with the art of evaluating them, coupled with a sound knowledge of epidemiology and bio-statistics, helps a resident to select appropriate articles and discard poorly conceived or designed topics that may not generate interest in JC attendees. Hence, such an approach helps the resident in acquiring new knowledge in the shortest time. Choosing the right topic and then applying the newly obtained information to clinical practice, participants succeed in making the JC a valuable learning experience. Further, such well-formatted JCs help residents to improve the quality of health care delivered to patients.
  2 9,919 541
BOOK REVIEW
Sexually transmitted infections
KK Raja Babu
November-December 2005, 71(6):452-453
  - 4,753 112
GET SET FOR NET
Full text access to journals on the net
Vinay Gopalani
November-December 2005, 71(6):441-443
DOI:10.4103/0378-6323.18958  
  - 7,705 215
LETTER TO EDITOR
Whither "world without leprosy"?
R Ganapati, VV Pai
November-December 2005, 71(6):434-434
DOI:10.4103/0378-6323.18956  PMID:16394493
  - 4,149 96
OBITUARY
Prof. Dr. B. V. Satyanarayana (30-1-1927 - 15-8-2005)
G Raghurama Rao
November-December 2005, 71(6):454-454
  - 6,657 69
QUIZ
Acral papular eruption
Balkrishna Nikam, Sangeeta Amladi, Ganesh Bingewar, Chitra Nayak, SL Wadhwa
November-December 2005, 71(6):447-448
DOI:10.4103/0378-6323.18960  PMID:16394497
  - 7,934 189
Multiple painful nodules
Vandana Mehta Rai, C Balachandran, Ranjini Kudva
November-December 2005, 71(6):449-451
DOI:10.4103/0378-6323.18961  PMID:16394498
  - 7,298 205
Online since 15th March '04
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