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  Citation statistics : Table of Contents
   2006| May-June  | Volume 72 | Issue 3  
 
 
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ORIGINAL ARTICLE
No association between seropositivity for Hepatitis C virus and lichen planus: A case control study
Arup Das, Jayasri Das, Gautam Majumdar, Nandita Bhattacharya, Dhruba Kumar Neogi, Bibhuti Saha
May-June 2006, 72(3):198-200
DOI:10.4103/0378-6323.25778  PMID:16766832
Background: The epidemiological association of lichen planus (LP) with hepatitis C virus (HCV) infection has been recorded from some countries and HCV RNA3 has been isolated from lesional skin in patients with LP and chronic HCV infection. The observed geographical differences regarding HCV infection and LP could be immuno-genetically related. Aim: To determine whether HCV has a causal relationship with LP. Methods: Histopathologically proved cases of LP were subjected to antibody to HCV test by the Third Generation Enzyme Immunoassay Kit for the detection of antibody to HCV (Anti-HCV) in human serum or plasma. They were routinely screened in the virology department by the reagent kit, HIVASE 1 + 2, adopting the "direct sandwich principle" for the assay to detect antibodies to HIV-1 and/or HIV-2. There were 150 age and sex matched controls (not suffering from LP) and HIV-I and II negative, and negative for HCV. Results: Of the 104 patients studied only 2 patients (1.92%) of generalized LP with disease duration of more than 3 months were found to be positive for antibodies to HCV. This was not a significant finding and no statistical methods, e.g. Chi square test etc. could be applied. Conclusion: Hepatitis C virus is not significant to the causation of LP in India.
  18 5,998 275
BRIEF REPORT
Langerhans cell histiocytosis of skin: A clinicopathologic analysis of five cases
Rajpal Singh Punia, Maneesh Bagai, Harsh Mohan, GP Thami
May-June 2006, 72(3):211-214
DOI:10.4103/0378-6323.25782  PMID:16766836
Background and Aims: Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of histiocytes characterized by a proliferation of abnormal and clonal Langerhans cells. We retrospectively studied clinicopathologic features of this disorder in five cases. Methods: Clinical and histopathological findings of five cases of cutaneous LCH were reviewed based on the hospital records. Results: The age of patients ranged from 28 days to 5 years and M: F ratio was 1:1.5. Clinically, the diagnoses suggested were histiocytosis, varicella, transient neonatal pustular melanosis, keloid, sarcoidosis, seborrheic keratosis and LCH. The most common type of skin lesion was a generalized papular lesion. Histologically, all cases showed aggregates of large mononuclear histiocytes (Langerhans cells) with reniform, irregular, cleaved nuclei and abundant eosinophilic cytoplasm. There was multi-systemic involvement in two patients and single-system involvement in three patients. Conclusion: Cutaneous lesions may be the sole presenting feature of LCH. Diagnosis is based on demonstration of S-100 positive histiocytes.
  15 12,468 456
ORIGINAL ARTICLE
Study of desmoglein 1 and 3 antibody levels in relation to disease severity in Indian patients with pemphigus
Bhushan Kumar, Sunil Arora, Muthu Sendhil Kumaran, Rajesh Jain, Sunil Dogra
May-June 2006, 72(3):203-206
DOI:10.4103/0378-6323.25780  PMID:16766834
Objectives : To conduct a cross-sectional study to compare Dsg1 and Dsg3 antibody levels independently with severity of disease activity in pemphigus vulgaris (PV) and pemphigus foliaceus (PF). Methods : Blood samples from 44 patients with pemphigus (PV-38, PF-6) were analyzed using ELISA. The severity of skin and mucosal disease was graded using a score from 0 to 3. Results: A statistically significant correlation between increase in Dsg 3 antibody titres with severity of oral involvement and Dsg 1 titres with severity of skin involvement was found in both PV and PF patients ( p <0.01). However, we were unable to demonstrate a relationship between increased titres of Dsg1 and Dsg 3 antibodies with oral and skin involvement respectively. Conclusion : This study suggests that the severity of skin and oral disease in pemphigus is determined by the quantities of Dsg1 and Dsg3 antibodies respectively.
  15 9,556 395
CASE REPORTS
Nasal extranodal NK/T-cell lymphoma presenting as a perforating palatal ulcer: A diagnostic challenge
Vidula Patel, Sunanda Mahajan, Vidya Kharkar, Uday Khopkar
May-June 2006, 72(3):218-221
DOI:10.4103/0378-6323.25784  PMID:16766838
A 40-year-old man presented with chronic nasal stuffiness and bloodstained discharge of 3 years' duration, along with a non-healing palatal ulcer since 2 months. Examination revealed a perforation in the midline on the hard palate and a superficial ulcer on the soft palate. Histopathology and immunohistochemistry suggested a diagnosis of extranodal nasal/nasal-type T-cell lymphoma. The patient was started on multiagent chemotherapy in the form of cyclophosphamide, doxorubicin, vincristine and prednisolone but succumbed after two cycles. Only one case of nasal T cell lymphoma presenting as nasal septal perforation, oronasal fistula and a concomitant palatal ulcer has been described. We report this case of a perforating palatal ulcer as a rare presentation of nasal lymphoma.
  11 10,419 378
Amoebiasis cutis in HIV positive patient
RA Bumb, RD Mehta
May-June 2006, 72(3):224-226
DOI:10.4103/0378-6323.25786  PMID:16766840
Protozoan infections of the skin, particularly cutaneous amoebiasis, are rare in HIV-positive patients. We report a case of amoebiasis cutis in an HIV-positive truck driver with a history of frequent unprotected sexual exposures. He presented with multiple painful ulcers and sinuses with purulent discharge, necrotic slough and scarring in the perianal and gluteal region for the last 2 years. He was positive for HIV-1 and -2. Cutaneous biopsy revealed numerous Entamoeba histolytica in the trophozoite form, in addition to an inflammatory infiltrate and necrotic debris. He responded well to oral metronidazole and chloroquine. Amoebiasis cutis should be considered in the differential diagnosis of perianal ulcers, particularly in HIV-positive patients.
  7 7,501 239
ORIGINAL ARTICLE
Evaluation of leprosy patients with 1 to 5 skin lesions with relevance to their grouping into paucibacillary or multibacillary disease
P Narasimha Rao, DVS Pratap, AV Ramana Reddy, Suneetha Sujai
May-June 2006, 72(3):207-210
DOI:10.4103/0378-6323.25781  PMID:16766835
Background: Patients with 1 to 5 skin lesions are arbitrarily categorized as belonging to the paucibacillary (PB) group for treatment purposes. With the decreasing prevalence of leprosy in India and modifications in leprosy program, the relevance of this grouping needs further study. Aims: To study a group of leprosy patients with 1 to 5 skin lesions and compare the clinical parameters with histopathological findings and bacteriological status of the skin and nerve to evaluate the relevance of this grouping. Methods: Seventy seven patients of leprosy with 1 to 5 skin lesions were included in the study. The number of skin lesions was recorded. Slit skin smears (SSS) and skin biopsies were taken in all patients and nerve biopsy was performed in 19 of them. The biopsies were evaluated for the type of pathology and AFB status. Results: In these 77 patients (single skin lesions, 42; two lesions, 18; three lesions, 10; four lesions, 5; and five lesions, 2 patients) the clinical classification was indeterminate leprosy (IL) in 4, tuberculoid leprosy (TT) in 4 patients and borderline tuberculoid leprosy (BT) in 69 patients. Skin smears were positive only in 1 patient. The histological diagnoses in the skin were IL in 13, TT in 3, BT in 48 and borderline lepromatous (BL) in 4 patients. Acid-fast bacilli (AFB) were found in 14 out of 77 skin biopsies. Of the 19 nerve biopsies, 17 showed histological features of BT leprosy; of these, 12 demonstrated AFB on Fite staining. The bacillary index of granuloma (BIG) ranged from 1+ to 2+. The clinico-histopathogical correlation was 63% in the BT group, with 4 patients of this group showing features of BL on histopathology. When the presence of AFB was assessed, the percentage of positivity was 1.3% in SSS, 18% in skin biopsies and 63% in nerve biopsies. Conclusion: Our results point to the non-homogeneous nature of this group of leprosy patients with 1 to 5 skin lesions, with varied bacteriological and histopathological features. The significance of MB type findings on histopathology in patients grouped as PB leprosy should be resolved so that these patients may be given the drug therapy and the duration of therapy they warrant.
  7 7,676 448
CASE REPORTS
Poland syndrome (anomaly) with congenital hemangioma: A new association
Najeeba Riyaz, A Riyaz
May-June 2006, 72(3):222-223
DOI:10.4103/0378-6323.25785  PMID:16766839
Unilateral defect of pectoral muscle and ipsilateral syndactyly constitute Poland syndrome. Absence or hypoplasia of the breast and nipple, axillary hair loss and dermatoglyphic abnormalities have also been reported in this syndrome. The primary defect could be in the development of the proximal subclavian artery with early deficit of blood flow to the distal limb and the pectoral region, resulting in partial loss of tissue in those regions. However, the association of congenital hemangioma with Poland sequence has not been observed so far. Such an association is being reported here in a 1-year-old infant, second-born of nonconsanguineous parents, who also had polydactyly instead of the documented syndactyly.
  6 7,715 188
EDITORIAL
Antiaging therapies
Maya Vedamurthy
May-June 2006, 72(3):183-186
DOI:10.4103/0378-6323.25776  PMID:16766830
  5 22,569 1,402
RESIDENTíS PAGE
Skin scraping and a potassium hydroxide mount
Sachin M Kurade, Sangeeta A Amladi, Autar K Miskeen
May-June 2006, 72(3):238-241
DOI:10.4103/0378-6323.25794  PMID:16766846
  4 40,255 1,384
CASE REPORTS
CD-3 positive extranodal T-cell lymphoma of nasal type with skin involvement
Raghunatha R Reddy, Gurcharan Singh, KJ Prathima, ML Harendra Kumar
May-June 2006, 72(3):215-217
DOI:10.4103/0378-6323.25783  PMID:16766837
A 40-year-old previously healthy lady presented with nasal obstruction and localized plaques over the right arm. She developed complete nasal obstruction due to a mass in the right nasal cavity and skin lesions that ulcerated to present as ecthyma gangrenosum like lesions. Patient's condition deteriorated fast and she developed icterus with fatal outcome within 4 weeks of developing skin lesions. Nasal and skin biopsy revealed angiocentric T-cell lymphoma, which on immuno-phenotyping revealed CD-3 positive; and CD-20, CD-30, ALK and EMA negativity. She was seronegative for HIV. Final diagnosis of CD-3 positive extranodal T-cell lymphoma of nasal type was made. Extranodal T-cell lymphomas are very aggressive NHLs with poor prognosis. Prognosis depends on histology, stage of the disease and sites of involvement. NK/T cell lymphoma of nasal type is common with EBV association. Skin involvement is rare and is also an indicator of poor prognosis.
  3 6,247 155
REVIEW ARTICLES
Evolution of venereology in India
Devinder Mohan Thappa
May-June 2006, 72(3):187-196
DOI:10.4103/0378-6323.25777  PMID:16766831
  3 10,004 507
CASE REPORTS
Macular degeneration in a case of Reiter's disease
MPS Sawhney, JKS Parihar
May-June 2006, 72(3):227-230
DOI:10.4103/0378-6323.25787  PMID:16766841
Posterior uveitis is not a documented feature of Reiter's disease. We describe here a patient of Reiter's disease, who after a bout of dysentery in January 2002 developed macular edema of the right eye with visual acuity of 6/36. In December 2002, she was found to have phlyctenular conjunctivitis. In June 2004, when she reported with scaly plaques over both palms, repeat ophthalmological examination revealed macular degeneration of the right eye. The simultaneous occurrence of Reiter's disease and macular degeneration in this patient may be fortuitous but the immunological basis of both diseases suggests a possible association.
  2 5,894 148
FOCUS
Phototrichogram
Rachita Dhurat
May-June 2006, 72(3):242-244
DOI:10.4103/0378-6323.25795  PMID:16766847
  2 8,198 620
LETTER TO EDITOR
Pseudo-tattoo dermatitis
Vandana Mehta Rai, SD Shenoi
May-June 2006, 72(3):232-234
DOI:10.4103/0378-6323.25790  PMID:16766843
  2 5,219 160
Parthenium dermatitis treated with azathioprine weekly pulse doses
CR Srinivas
May-June 2006, 72(3):234-234
DOI:10.4103/0378-6323.25791  PMID:16766844
  2 4,125 147
Blog your clinical photos
Bell Raj Eapen
May-June 2006, 72(3):231-231
DOI:10.4103/0378-6323.25788  PMID:16766842
  1 4,501 98
NET CASE
Amelanotic malignant melanoma with multiple secondaries
Manas Chatterjee
May-June 2006, 72(3):252-252
DOI:10.4103/0378-6323.25799  PMID:16766852
A 37-year-old female presented with a fungating cauliflower-like growth over the right inguinal region with fracture of the right distal femur. Clinical examination revealed an asthenic individual and showed a large fungating protuberant mass over right inguinal region and right knee. Investigations revealed pancytopenia, massive splenomegaly with right iliac lymphadenopathy on ultrasonography of abdomen and a soft tissue mass over upper end of femur and fracture of distal femur on radiological examination. CT scan showed multiple deposits in the lungs with splenomegaly and lymphadenopathy. Fine needle aspiration cytology showed poorly cohesive cellular aspirate with spindle and round cell population with no pigment. Biopsy showed replacement of the dermis by coalescent nests of malignant melanocytes. S-100 antigen was found to be positive. The patient was diagnosed as a case of amelanotic malignant melanoma in Stage III disease and treated with general measures, stabilization of the fracture site followed by oncological management.
  1 5,870 129
ORIGINAL ARTICLE
Achieving asepsis of banana leaves for the management of toxic epidermal necrolysis
CR Srinivas, V Shanmuga Sundaram, B Appala Raju, S Karthick Prabhu, M Thirumurthy, AC Bhaskar
May-June 2006, 72(3):201-202
DOI:10.4103/0378-6323.25779  PMID:16766833
Background: Banana leaf is used in many centers in India during the care of patients with toxic epidermal necrolysis (TEN) and other extensive blistering disorders. Sepsis is an important cause of death in TEN patients and use of banana leaf may be a source of such infection. Aims: We conducted this study to detect the bacterial flora of the banana leaf and to examine various methods of rendering the leaf aseptic. Methods: Five pieces of banana leaf, 2 x 2 cm in size, were cultured separately in blood agar as follows: One piece was heated over a flame and one was soaked in boiling water and one was autoclaved. Methylated spirit was applied over one piece and ignited. One piece was placed on the media, 'as is.' The Petri dishes were incubated examined after 48 h. Results: All the pieces except the autoclaved specimen of the leaf grew coagulase-negative staphylococci (CONS) when aseptic precautions were not maintained and aerobic spore bearers when all aseptic measures were subsequently instituted during the procedure. Conclusion: We recommend measures to prevent possible transmission of bacterial infection by the leaf. Autoclaved and aseptically handled banana leaves may be used to reduce chance of infection in the treatment of TEN.
  1 7,858 272
QUIZ
Zosteriform lesion over abdomen
S Chidambara Murthy
May-June 2006, 72(3):245-246
DOI:10.4103/0378-6323.25796  PMID:16766848
  1 5,258 123
LETTER TO EDITOR
Response by author
Maged N Kamel Boulos
May-June 2006, 72(3):231-232
DOI:10.4103/0378-6323.25789  
  - 5,556 84
Response by authors
Kaushal K Verma, Arika Bansal, G Sethuraman
May-June 2006, 72(3):235-235
DOI:10.4103/0378-6323.25792  
  - 2,744 82
A clinico-epidemiological study of allergens in patients with dermatitis
VP Sudhashree, BG Parasuramalu, MS Rajanna
May-June 2006, 72(3):235-237
DOI:10.4103/0378-6323.25793  PMID:16766845
  - 3,740 153
NET LETTER
Segmental motor paralysis of the right upper limb in herpes zoster
Karjigi Siddalingappa, K Lokanatha
May-June 2006, 72(3):252-252
DOI:10.4103/0378-6323.25800  PMID:16766851
  - 6,575 107
NET QUIZ
Linear cord-like lesion on the chest wall
Mary Muthachen
May-June 2006, 72(3):252-252
DOI:10.4103/0378-6323.25801  PMID:16766850
  - 5,979 76
OBITUARY
Obituary
Rohit V Hede
May-June 2006, 72(3):250-250
  - 2,776 76
QUIZ
Numerous yellow-brown papules over the trunk
Evren Sarifakioglu, Canan Gorpelioglu, Reyhan Bayrak
May-June 2006, 72(3):247-248
DOI:10.4103/0378-6323.25797  PMID:16766849
  - 4,777 129
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