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2016| March-April | Volume 61 | Issue 2
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March 1, 2016
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IJD® MODULE ON BIOSTATISTICS AND RESEARCH METHODOLOGY FOR THE DERMATOLOGIST - MODULE EDITOR: SAUMYA PANDA
Methodology series module 2: Case-control studies
Maninder Singh Setia
March-April 2016, 61(2):146-151
DOI
:10.4103/0019-5154.177773
PMID
:27057012
Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias.
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DERMATOSURGERY ROUND
Fractional CO
2
laser versus intense pulsed light in treating striae distensae
Moustafa Adam El Taieb, Ahmed Khair Ibrahim
March-April 2016, 61(2):174-180
DOI
:10.4103/0019-5154.177774
PMID
:27057017
Context:
Striae distensae are linear atrophic dermal scars covered with flat atrophic epidermis. They may cause disfigurement, especially in females. Many factors may cause striae distensae such as steroids, obesity, and pregnancy. Although there is no standard treatment for striae; many topical applications, peeling, and light and laser systems have been tried. Aims: To evaluate and compare the efficacy of fractional CO
2
laser with intense pulse light in treating striae distensae.
Subjects and Methods:
Forty patients with striae distensae were recruited. Twenty of them were treated by fractional CO
2
laser and 20 were treated with intense pulse light. Length and width of the largest striae were measured pre- and post-treatment. Patient satisfaction was also evaluated and graded. Patients were photographed after each treatment session and photos were examined by a blinded physician who had no knowledge about the cases. Results: Both groups showed significant improvement after treatments (
P
< 0.05). Patients treated with fractional CO
2
laser showed significant improvement after the fifth session compared with those treated with ten sessions of intense pulsed light (
P
< 0.05) in all parameters except in the length of striae (
P
> 0.05).
Conclusions:
The current study has provided supportive evidence to the effectiveness of both fractional CO
2
laser and intense pulse light as treatments for striae distensae. Fractional CO
2
laser was found to be more effective in the treatment of striae distensae compared with intense pulse light.
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ORIGINAL ARTICLES
Assessment of life quality index among patients with acne vulgaris in a suburban population
Neirita Hazarika, Radha K Rajaprabha
March-April 2016, 61(2):163-168
DOI
:10.4103/0019-5154.177758
PMID
:27057015
Background and Aims:
Acne vulgaris affects about 85% of adolescents, often extending into adulthood. Psychosocial impact of acne on health-related quality of life (QoL) has been identified, but it remains under-evaluated, especially in Indian patients. This study was aimed to assess the impact of acne and its sequelae on the QoL.
Materials and Methods:
This was a hospital-based, prospective, cross-sectional study done between June and November 2014 on 114 consenting patients above 15 years of age with acne vulgaris. Acne vulgaris and its sequelae were graded, and QoL was assessed by using Dermatology Life Quality Index (DLQI) questionnaire.
Results:
Most cases (64%) were between 15 and 20 years. Females (57%) outnumbered males. Facial lesions (61.4%) and grade II acne were most common. Mean DLQI score was 7.22. DLQI scores were statistically influenced by the age of the patient, duration and grade of acne, acne scar, and postacne hyperpigmentation.
Conclusion:
This study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.
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E-IJD® - ORIGINAL ARTICLE
Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up?
Bahareh Abtahi-Naeini, Farahnaz Fatemi Naeini, Ali Saffaei, Shadi Behfar, Mohsen Pourazizi, Majid Mirmohammadkhani, Najmeh-Sadat Bolandnazar
March-April 2016, 61(2):234-234
DOI
:10.4103/0019-5154.177789
PMID
:27057039
Background:
Primary axillary hyperhidrosis (PAH) is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution.
Objective and Aim:
The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR) as an alternative permanent treatment for PAH with long-term follow-up. Materials and Methods: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group), and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS) at baseline and the end of the study, as well as during the 1 year follow-up phase.
Results:
HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation) of HDSS in the group being treated with radiofrequency was 2.50 (±0.88) after 1 year follow-up, and that of the control group was 3.38 (±0.49;
P
< 0.001). Follow-up results show that there were 10 patients (41.6%) with no relapse and 11 patients (45.9%) with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI) (
P
= 0.03).
Conclusion:
Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs.
Clinical Trial Registration:
IRCT2013111915455N1.
Level of Evidences:
Level II-1.
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ORIGINAL ARTICLES
Risk of Parkinson's disease among patients with psoriasis: A systematic review and meta-analysis
Patompong Ungprasert, Narat Srivali, Wonngarm Kittanamongkolchai
March-April 2016, 61(2):152-157
DOI
:10.4103/0019-5154.177771
PMID
:27057013
Background:
Patients with psoriasis might be at a higher risk of developing Parkinson's disease (PD) as a result of the detrimental effect of chronic inflammation on the neuronal tissue. This meta-analysis aimed to investigate this risk by comprehensively reviewing all available data.
Methods:
We conducted a systematic review and meta-analysis of cohort and case–control studies that reported relative risk, hazard ratio, odds ratio, or standardized incidence ratio comparing the risk of PD in patients with psoriasis versus subjects without psoriasis. Pooled risk ratio and 95% confidence interval (CI) were calculated using random-effect, generic inverse variance methods of DerSimonian and Laird.
Results:
Three retrospective studies and one case–control study met our eligibility criteria and were included in this meta-analysis. The pooled risk ratio of PD in patients with psoriasis versus participants without psoriasis was 1.38 (95% CI, 1.15–1.66). The statistical heterogeneity was low with an
I
2
of 35%.
Conclusions:
Our meta-analysis demonstrated a statistically significant increased risk of PD among patients with psoriasis.
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CASE REPORTS
Loeffler's syndrome following cutaneous larva migrans: An uncommon sequel
Indrashis Podder, Somodyuti Chandra, Ramesh Chandra Gharami
March-April 2016, 61(2):190-192
DOI
:10.4103/0019-5154.177753
PMID
:27057020
Cutaneous larva migrans (CLM) is characterized by the formation of distinctive, tortuous, and serpentine skin lesions occurring as a result of epidermal burrowing by certain helminthic larvae. Although this condition is usually uneventful, rarely it may result in patchy pulmonary infiltration with peripheral eosinophilia, also called Loeffler's syndrome. This association is fairly uncommon and is thus being reported.
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CORRESPONDENCES
Isoscartopic response: Another facet of the immunocompromised cutaneous district
Stefano Caccavale, Maddalena La Montagna, Tobia Caccavale
March-April 2016, 61(2):219-220
DOI
:10.4103/0019-5154.177770
PMID
:27057029
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IJD® MODULE ON BIOSTATISTICS AND RESEARCH METHODOLOGY FOR THE DERMATOLOGIST - MODULE EDITOR: SAUMYA PANDA
Biostatistics series module 2: Overview of hypothesis testing
Avijit Hazra, Nithya Gogtay
March-April 2016, 61(2):137-145
DOI
:10.4103/0019-5154.177775
PMID
:27057011
Hypothesis testing (or statistical inference) is one of the major applications of biostatistics. Much of medical research begins with a research question that can be framed as a hypothesis. Inferential statistics begins with a null hypothesis that reflects the conservative position of no change or no difference in comparison to baseline or between groups. Usually, the researcher has reason to believe that there is some effect or some difference which is the alternative hypothesis. The researcher therefore proceeds to study samples and measure outcomes in the hope of generating evidence strong enough for the statistician to be able to reject the null hypothesis. The concept of the
P
value is almost universally used in hypothesis testing. It denotes the probability of obtaining by chance a result at least as extreme as that observed, even when the null hypothesis is true and no real difference exists. Usually, if
P
is < 0.05 the null hypothesis is rejected and sample results are deemed statistically significant. With the increasing availability of computers and access to specialized statistical software, the drudgery involved in statistical calculations is now a thing of the past, once the learning curve of the software has been traversed. The life sciences researcher is therefore free to devote oneself to optimally designing the study, carefully selecting the hypothesis tests to be applied, and taking care in conducting the study well. Unfortunately, selecting the right test seems difficult initially. Thinking of the research hypothesis as addressing one of five generic research questions helps in selection of the right hypothesis test. In addition, it is important to be clear about the nature of the variables (e.g., numerical vs. categorical; parametric vs. nonparametric) and the number of groups or data sets being compared (e.g., two or more than two) at a time. The same research question may be explored by more than one type of hypothesis test. While this may be of utility in highlighting different aspects of the problem, merely reapplying different tests to the same issue in the hope of finding a
P
< 0.05 is a wrong use of statistics. Finally, it is becoming the norm that an estimate of the size of any effect, expressed with its 95% confidence interval, is required for meaningful interpretation of results. A large study is likely to have a small (and therefore “statistically significant”)
P
value, but a “real” estimate of the effect would be provided by the 95% confidence interval. If the intervals overlap between two interventions, then the difference between them is not so clear-cut even if
P
< 0.05. The two approaches are now considered complementary to one another.
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CORRESPONDENCES
Low prevalence of anti-cyclic citrullinated peptide antibodies in japanese patients with pustulotic arthro-osteitis
Takenobu Ohashi, Tomoko Hiraiwa, Toshiyuki Yamamoto
March-April 2016, 61(2):221-222
DOI
:10.4103/0019-5154.177769
PMID
:27057031
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E–IJD® - CASE REPORTS
Levetiracetam induced drug reaction with eosinophilia and systemic symptom syndrome
Waseem Raja Dar, Najeebullah Sofi, Muzamil Latief, Imtiyaz Ahmad Dar, Basharat Ahmad Kasana
March-April 2016, 61(2):235-235
DOI
:10.4103/0019-5154.177777
PMID
:27057042
Drug reaction with eosinophilia and systemic symptom syndrome (DRESS) is a hypersensitivity drug reaction, most frequently associated with antiepileptic drugs, characterized by skin rash, fever, pharyngitis, lymphadenopathy, and visceral organ involvement, typically presenting within 8 weeks of initiation of therapy. Management involves prompt withdrawal of the offending drug and use of systemic corticosteroids. We here present a rare case of DRESS secondary to levetiracetam. Only few case reports of DRESS secondary to levetiracetam have been published so far.
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BASIC RESEARCH
Serum homocysteine and total antioxidant status in vitiligo: A case control study in indian population
Shikha Gupta, Paschal D’souza, Tapan Kumar Dhali, Sarika Arora
March-April 2016, 61(2):131-136
DOI
:10.4103/0019-5154.177764
PMID
:27057010
Background:
Oxidative stress is considered as an initial pathogenic event in melanocyte destruction. These free radicals are scavenged by antioxidants, whose sum of activity in serum is measured by total antioxidant status (TAS). In addition, homocysteine (Hcy) may mediate melanocyte destruction via increased oxidative damage. However, previous studies investigating these parameters in vitiligo provide equivocal results.
Aims:
To study and compare serum Hcy and TAS levels in vitiligo patients with controls and also to correlate these parameters with the various disease characteristics. The present study further looked into any correlation between serum Hcy and TAS in vitiligo.
Materials and Methods:
A case control study was conducted on 82 vitiligo patients and 83 controls aged 18–45 years after excluding factors which could potentially alter serum Hcy or TAS levels. Disease characteristics were studied and blood samples were obtained for measuring serum Hcy and TAS levels.
Results:
TAS levels were lower in vitiligo patients than controls (1.79 ± 0.51 vs. 2.16 ± 0.63 mmol/L;
P
< 0.001) and had a negative correlation with disease activity (
r
= −0.410,
P
< 0.001). However, serum Hcy levels were comparable between vitiligo patients (18.68 ± 9.90 μmol/L) and controls (20.21 ± 13.39 μmol/L) (
P
= 0.406). No significant correlation was found between serum Hcy and serum TAS levels.
Conclusions:
Serum TAS may be further investigated to establish its role as biomarker for vitiligo since its levels also correlate with disease activity. However, serum Hcy may not be a reliable marker in Indian population probably because of differences in dietary habits.
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CASE REPORTS
Varied presentations of cutaneous rhinosporidiosis: A report of three cases
Thurakkal Salim, Fibin Komu
March-April 2016, 61(2):209-212
DOI
:10.4103/0019-5154.177750
PMID
:27057026
Rhinosporidiosis is a chronic granulomatous disorder of infective etiology and it frequently affects the nasal cavity and nasopharynx. Involvement of skin in rhinosporidiosis is unusual and it may manifest itself in a diverse manner mimicking several common dermatological conditions. Three cases of cutaneous rhinosporidiosis with different presentations are reported here to highlight the manifold nature of the condition. Cutaneous rhinosporidiosis can mimic several common cutaneous disorders.
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ORIGINAL ARTICLES
Risk of herpes zoster and family history: A Meta-analysis of case–control studies
Yi Chun Lai, Yik Weng Yew
March-April 2016, 61(2):157-162
DOI
:10.4103/0019-5154.177748
PMID
:27057014
Background:
Herpes zoster (HZ) results from the reactivation of latent varicella zoster virus (VZV) residing in dorsal root and cranial nerve ganglia. Advanced age and dysfunctional cell-mediated immune responses are well-established risk factors for VZV reactivation. There have been recent interests in whether there is an increased risk of the disease associated with a positive family history.
Aims and Objectives:
We aimed to conduct a meta-analysis to evaluate the association between HZ infection and family history. In addition, we investigated the dose-response relationship between HZ infection and the number of relatives with a history of HZ.
Materials and Methods:
Observational studies were searched from MEDLINE, EMBASE, and Cochrane Central Register from inception to April 15, 2015. The Meta-analysis of Observational Studies in Epidemiology guidelines were followed in conducting this study. To estimate the pooled odds ratio, random-effects model of DerSimonian and Laird was used. Heterogeneity between studies was assessed using the
I
2
statistic. A dose-response meta-analysis with studies that reported appropriate data were done using the generalized least squares for trend method.
Results:
Five studies, yielding a total of 4169 subjects, were identified for meta-analysis. Cases with HZ were 3.03 (95% confidence interval [CI]: 1.86–4.94,
P
< 0.001) and 3.27 (95% CI: 1.75–6.10,
P
< 0.001) times more likely to report the first-degree relatives and total relatives with a history of HZ, respectively. A significant positive dose-response relationship between the risk of HZ infection and the number of relatives with a history of HZ was also demonstrated (
P
< 0.001).
Conclusions:
This meta-analysis demonstrated that family history is a significant risk factor for HZ infection. This risk has a dose-response relationship with the number of relatives with a history of HZ.
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CASE REPORTS
Pachyonychia congenita Type 1: Case report and review of the literature
Praveen Kumar Rathore, Varun Khullar, Anupam Das
March-April 2016, 61(2):196-199
DOI
:10.4103/0019-5154.177761
PMID
:27057022
The case of an 8-year-old boy is hereby reported, who presented with nail dystrophy, subungual hyperkeratosis, oral leukokeratosis, and numerous follicular papules all over the body. The features were consistent with a diagnosis of pachyonychia congenita type 1. The case is being reported for its rarity. We also discuss in a nutshell, the literature till date.
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Cerebriform cutaneous lesions in pemphigus vegetans
Meryl Sonia Rebello, Bhat M Ramesh, D Sukumar, Geethu F Alapatt
March-April 2016, 61(2):206-208
DOI
:10.4103/0019-5154.177760
PMID
:27057025
Pemphigus vegetans is an autoimmune bullous disorder characterized by vegetating lesions commonly over the flexures. A 42-year-old female patient came with pemphigus vegetans presenting with interesting cerebriform morphology of the cutaneous lesions over the flexures. Cerebriform tongue, a morphology with typical pattern of sulci and gyri over dorsum of the tongue is a well-known sign seen in pemphigus vegetans. Interestingly, we noticed the typical sulci and gyri pattern in the skin lesions of pemphigus vegetans over the flexures of the body. This clinical sign can be used as a clue in the diagnosis of pemphigus vegetans. Morphology and physical characteristics are important for the diagnosis of the disease. Clinical signs always give a clue to the probable or possible diagnosis in most of the dermatological conditions.
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CORRESPONDENCES
Infantile digital fibromatosis: A rare case report
Sudarshan P Gaurkar, Mangesh P Nikam, Sheetal S Paithankar, Shishir P Mirgunde
March-April 2016, 61(2):222-224
DOI
:10.4103/0019-5154.177751
PMID
:27057032
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E-IJD® - CORRESPONDENCE
Alopecia areata and vitiligo as a Long-term sequelae of drug reaction with eosinophilia and systemic symptoms syndrome
Mehdi Iskandarli, Gunseli Ozturk
March-April 2016, 61(2):238-238
DOI
:10.4103/0019-5154.177781
PMID
:27057057
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Cutaneous leukocytoclastic vasculitis associated with erlotinib
Takahiro Sawada, Mitsuhiro Suehiro, Osamu Hiranuma
March-April 2016, 61(2):238-238
DOI
:10.4103/0019-5154.177793
PMID
:27057058
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E–IJD® - CASE REPORTS
Piezogenic pedal papules with mitral valve prolapse
Cihan Altin, Ulku Askin, Esin Gezmis, Haldun Muderrisoglu
March-April 2016, 61(2):234-234
DOI
:10.4103/0019-5154.177803
PMID
:27057041
Piezogenic pedal papules (PPP) are herniations of subcutaneous adipose tissue into the dermis. PPP are skin-colored to yellowish papules and nodules on lateral surfaces of feet that typically become apparent when the patient stands flat on his/her feet. Some connective tissue diseases and syndromes have been reported in association with PPP. Mitral valve prolapse (MVP) is a myxomatous degeneration of the mitral valve, characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. MVP may be isolated or part of a heritable connective tissue disorder. PPP, which is generally considered as an isolated lesion, might be also a predictor of some cardiac diseases associated with connective tissue abnormalities such as MVP. A detailed systemic investigation including cardiac examination should be done in patients with PPP. Since in the literature, there are no case reports of association of PPP with MVP, we report these cases.
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Superficial basal cell carcinoma on the face is a diagnostic challenge
Joydeep Singha, Naval Patel
March-April 2016, 61(2):236-236
DOI
:10.4103/0019-5154.177802
PMID
:27057051
Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The incidence of BCC is rising. The nodular, superficial spreading, and infiltrating variants are the three most commonly encountered types of BCC in descending order of prevalence. Superficial spreading basal cell carcinoma (SSBCC) accounts for 15-26% of all cases of BCC. It usually occurs on the trunk and upper extremities, but may be seen on the face. Surgical excision is the most commonly used treatment for BCC. Topical chemotherapy agents such as imiquimod or 5-fluorouracil (5-FU) may be various alternatives or adjuvants in the treatment of SSBCC. characteristically shows areas of uninvolved skin between tumor nests.
[7]
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INVESTIGATIVE DERMATOLOGY
Urinary biopyrrins: A new marker of oxidative stress in psoriasis
Ola Ahmed Bakry, Sally El Hefnawy, Alaa Hassan Mariee, Yara El Gendy
March-April 2016, 61(2):169-173
DOI
:10.4103/0019-5154.177756
PMID
:27057016
Background:
Psoriasis is a common chronic, relapsing, immune-mediated disease involving skin and joints of genetically predisposed individuals. Oxidative stress has been found to play many important roles in cellular damage and loss of function in a number of tissues and organs and is believed to contribute to the pathogenesis of a variety of diseases. Urinary biopyrrin levels have gained attention as an indicator of oxidative stress.
Aim and Objective:
To measure urinary biopyrrins excretion as a marker of oxidative stress in psoriasis.
Patients and Methods:
This case–control study was carried out on 85 subjects; 55 cases with chronic plaque psoriasis and 30 age, gender and body mass index-matched normal subjects as a control group. Urinary biopyrrin levels were measured using enzyme immunoassay.
Results:
There was a highly significant difference between cases and controls regarding urinary biopyrrins level (
P
< 0.001). There was significant positive correlation between biopyrrins level and both the age of cases (
r
= 0.28,
P
= 0.01) and psoriasis area and severity index score (
r
= 0.99,
P
< 0.001).
Conclusion:
Urinary biopyrrins are increased in patients with psoriasis, and the level is correlated with disease severity. Further large-scale studies involving different ages and different clinical varieties of the disease are needed to expand and validate current findings. The clinical usefulness of antioxidants in psoriasis treatment needs to be evaluated in future research. Furthermore, the value of biopyrrins as biomarkers for monitoring response to therapy needs to be evaluated.
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CASE REPORTS
Primary cutaneous plasmacytosis: Masquerading as hidradenitis suppurativa
Tarang Goyal, Anupam Varshney, Vijay Zawar, Veena Sharma
March-April 2016, 61(2):213-215
DOI
:10.4103/0019-5154.177768
PMID
:27057027
Isolated cutaneous plasmacytosis (CP) is a rare entity with few cases reported in world literature. CP masquerading as hidradenitis suppurativa like presentation is a unique case with some features differentiating it clinically from it which were further confirmed by histopathology and immunostaining. Our case showed hyperplasia of mature plasma cells and polyclonal hypergammaglobulinemia, immunostaining for CD138 positivity and kappa: lambda ratio more than 3:1. Extensive clinical and laboratory investigations failed to reveal any underlying pathology, presence of any underlying disease accompanying the hypergammaglobulinemia and/or plasma cell proliferation.
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Primary systemic amyloidosis with unusual dermatological manifestations: A rare case report
Kapil Vyas, Manjaree Morgaonkar, Savera Gupta, Suresh Kumar Jain
March-April 2016, 61(2):216-218
DOI
:10.4103/0019-5154.177767
PMID
:27057028
Amyloidosis is a group of heterogeneous diseases characterized by pathological deposition of proteinaceous substance extracellularly in various tissues. The clinical presentation depends on the site of amyloid deposition, with predominant involvement of mesenchymal elements and cutaneous findings in 30–40% of patients in case of primary systemic amyloidosis. We present a case of idiopathic primary systemic amyloidosis presenting with an unusual finding of nodulo-ulcerative lesion over tongue along with multiple skin-colored nodules, mimicking squamous cell carcinoma of tongue with secondary cutaneous metastasis, as well as lacking the classical presentation of purpura, macroglossia, waxy papules, and plaques.
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CORRESPONDENCES
Giant congenital melanocytic nevus with occipital encephalocele: A very rare association
Surajit Gorai, Mahimanjan Saha, Joly Seth
March-April 2016, 61(2):224-226
DOI
:10.4103/0019-5154.177757
PMID
:27057033
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Late-onset segmental angioma serpiginosum
Sushil S Savant, Anupam Das, Piyush Kumar, Shahid Hassan
March-April 2016, 61(2):226-227
DOI
:10.4103/0019-5154.177752
PMID
:27057034
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2
3,326
61
E-IJD® - CORRESPONDENCE
Acrokeratosis verruciformis of hopf clinically mimicking epidermodysplasia verruciformis
Nilofar G Diwan, Nidhi B Jivani, Pragya Ashok Nair
March-April 2016, 61(2):237-237
DOI
:10.4103/0019-5154.177783
PMID
:27057054
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2
4,318
74
Co-localization of linear lichen planus pigmentosus and milia in a child
Sidharth Sonthalia, Anupam Das, Sonal Sharma
March-April 2016, 61(2):237-237
DOI
:10.4103/0019-5154.177790
PMID
:27057056
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4,349
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Throwing light onto the core of a halo nevus: A new finding
Ashwini Babu, M Ramesh Bhat, Sukumar Dandeli, Neema M Ali
March-April 2016, 61(2):238-238
DOI
:10.4103/0019-5154.177801
PMID
:27057061
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5,678
82
Pustular psoriasis occurring on the striae distensae: Isotopic phenomenon/koebner's phenomenon
Pradeep Balasubramanian, CR Srinivas
March-April 2016, 61(2):239-239
DOI
:10.4103/0019-5154.177792
PMID
:27057062
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2
3,132
63
Hurler's disease with multiple atypical mongolian spots
Sidharth Sonthalia, Rashmi Khurana
March-April 2016, 61(2):239-239
DOI
:10.4103/0019-5154.177795
PMID
:27057063
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2
4,577
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E-IJD®- RESIDENTS PAGE
Nose: Applied aspects in dermatology
Dammaningala Venkataramaiah Lakshmi, Kanathur Shilpa, Holavanahally Veerabhadrappa Nataraja, Kallapa Gorur Divya
March-April 2016, 61(2):234-234
DOI
:10.4103/0019-5154.177782
PMID
:27057038
Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents.
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12,242
471
E–IJD® - CASE REPORTS
Atypical cutaneous sporotrichosis in an immunocompetent adult: Response to potassium iodide
Nikita Gandhi, Ram Chander, Arpita Jain, Sarita Sanke, Taru Garg
March-April 2016, 61(2):236-236
DOI
:10.4103/0019-5154.177776
PMID
:27057047
Cutaneous sporotrichosis, also known as “Rose Gardener's disease,” caused by dimorphic fungus
Sporothrix schenkii
, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of
Sporothrix
. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.
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RESIDENTS PAGE
Approach to infantile hemangiomas
Anil Abraham, Anupa Mary Job, Gillian Roga
March-April 2016, 61(2):181-186
DOI
:10.4103/0019-5154.177755
PMID
:27057018
Infantile hemangiomas are a group of vascular tumors and are considered to be one of the most common tumors in infancy. Ambiguity still prevails over its origin, etiopathogenesis, and optimal management.
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523
CASE REPORTS
Interchanging autoimmunity - lupus mastitis coexisting with systemic polyarteritis nodosa
Mary Vineetha, Seena Palakkal, K Sobhanakumari, MI Celine
March-April 2016, 61(2):200-202
DOI
:10.4103/0019-5154.177759
PMID
:27057023
Lupus mastitis is an uncommon presentation of lupus erythematosus profundus (LE profundus), characterized by inflammation of the subcutaneous fat. LE profundus occurring as initial manifestation of LE is rare. We report a case where the patient presented with lupus mastitis and years later, she developed disseminated discoid LE (DLE) and polyarteritis nodosa (PAN). PAN and DLE are connective tissue diseases with different etiologies, clinical, immunological, and histopathological features. One connective tissue disease evolving into another is rare, and the reasons remain unexplained. This woman had histopathologically proven DLE and lupus mastitis with a negative antinuclear antibody profile. She satisfied the American College of Rheumatology criteria for PAN.
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5,124
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E-IJD® - CORRESPONDENCE
Rare benign cystic lesions on face: Apocrine hidrocystoma
Ajay Govindrao Ovhal, Shruthi Vasanthkumar Deshkulakarani, Rahul Suryakantrao Abhange, Shivaji Dadarao Birare
March-April 2016, 61(2):237-237
DOI
:10.4103/0019-5154.177778
PMID
:27057052
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Lower-leg cellulitis-like manifestations of erythema nodosum induced by
Chlamydophila pneumoniae
infection
Takahiro Sawada, Mitsuhiro Suehiro, Kiho Takaya
March-April 2016, 61(2):237-237
DOI
:10.4103/0019-5154.177786
PMID
:27057055
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E-IJD®- RESIDENTS PAGE
Clothing-related eponyms and signs
Valencia Long
March-April 2016, 61(2):234-234
DOI
:10.4103/0019-5154.177799
PMID
:27057040
The world of dermatology is pieced together by clinical conditions unique in their colors, morphology, and configuration. Dermatological signs and terms are influenced by etymology, language, and history. Eponyms also make dermatology a fascinating but linguistically challenging subject. This article reviews dermatological conditions described in relation to fashion, and what we wear in everyday life from top to toe, demonstrating that dermatology can be inspired even in the most common things.
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413
E–IJD® - CASE REPORTS
Solitary angiokeratoma presenting as cutaneous horn over the prepuce: A rare appearance
Manoj Kumar Agarwala, Sramana Mukhopadhyay, M Raja Sekhar, Aswathy Menon, CV Dincy Peter
March-April 2016, 61(2):236-236
DOI
:10.4103/0019-5154.177779
PMID
:27057048
We present a case of a 47-year-old man with 4 months history of conical growth on the prepuce with a progressive increase in size. The patient had been treated for seminoma a decade ago. Histopathology of the growth showed features of angiokeratoma. It is unusual for angiokeratoma to masquerade as a cutaneous horn.
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Lamotrigine-induced hypersensitivity syndrome with histologic features of cd30+ lymphoma
Farid Stephan, Roger Haber, Elio Kechichian, Francois Kamar
March-April 2016, 61(2):235-235
DOI
:10.4103/0019-5154.177784
PMID
:27057043
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome or drug-induced hypersensitivity syndrome (DIHS) is a severe adverse drug reaction. It can present with clinical, paraclinical, and histological findings mimicking skin and/or systemic lymphomas. We report the first case of a lamotrigine-induced DRESS with histologic features of a cutaneous CD30+ lymphoma. The patient responded well to a tapering course of oral steroids. This case highlights the atypical presentation of a lamotrigine-induced DRESS/DIHS in the presence of a cutaneous and a lymph node CD30 + lymphocytic infiltrate mimicking systemic lymphoma. Pathologists and clinicians must be aware of this “lymphomatous” presentation of drug reactions.
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Acute generalized exanthematous pustulosis induced by fexofenadine
Tanvi Gupta, Vijay K Garg, Rashmi Sarkar, Anjali Madan
March-April 2016, 61(2):235-235
DOI
:10.4103/0019-5154.177787
PMID
:27057044
Acute generalized exanthematous pustulosis (AGEP) is a skin eruption, frequently drug induced and characterized by the acute development of multiple sterile minute pustules on an erythematous base. There is no case of fexofenadine-induced AGEP in literature (PubMed search). A 40-year-old female presented to us with fever and sudden onset development of multiple discrete to coalescent 1–2 mm nonfollicular pustules on an erythematous base present mainly on her trunk and upper extremities for past 2 days. She had a history of use of fexofenadine 180 mg OD for rhinitis for 2 days. Gram's stain showed no organism and pus culture showed no growth. Histopathological examination revealed subcorneal pustules with epidermal spongiosis. Scattered neutrophils and eosinophils were noted in the dermis. During this period, she took fexofenadine 180 mg unknowingly once following which she developed similar episode within 24–48 h. After withdrawal of the drug, the lesions subsided with scaling in 8–10 days. To the best of our knowledge, this is the first reported case of AGEP induced by fexofenadine. Recognition of such a rare entity is important given the frequent usage of fexofenadine for allergic disorders.
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Recurrent cutaneous eosinophilic vasculitis: A rare entity
Najeeba Riyaz, Sarita Sasidharanpillai, Cherukattil Hazeena, Karumathil P Aravindan, Chettithodi Sivasankaran Bindu, Krishnakumari Nair Silpa
March-April 2016, 61(2):235-235
DOI
:10.4103/0019-5154.177794
PMID
:27057046
Recurrent cutaneous necrotizing eosinophilic vasculitis is a rare entity described by Chen
et al
. It has a benign course without any systemic involvement. However, often long-term treatment with systemic steroids is required. The exact etiopathogenesis remains unknown. We report a female patient, who presented with recurrent pruritic purpuric papules and plaques affecting different body parts of long duration. Disease was well controlled with low dose systemic steroids, but invariably recurred on its withdrawal. Histology revealed the features of eosinophilic vasculitis. Subsequent detailed evaluation ruled out systemic involvement, underlying diseases, and any precipitating factors. Hence, a diagnosis of recurrent cutaneous eosinophilic vasculitis was made. Patient showed excellent response to prednisolone, and on tapering the drug, it was found that she needed a maintenance dose of 5 mg/day. We did not come across any previous reports of recurrent cutaneous eosinophilic vasculitis from India.
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EPIDEMIOLOGY ROUND
Pattern of dermatoses among nicobarese in a community health camp at Nancowry, Andaman and Nicobar Islands
Radhakrishnan Subramaniyan
March-April 2016, 61(2):187-189
DOI
:10.4103/0019-5154.177766
PMID
:27057019
Background:
The Andaman and Nicobar Islands are a group of islands to the east of the Indian mainland. The Nicobar district in its southern part includes the Nancowry group. Very little is known about the dermatoses in this remote region and hence, this study was carried out at a community medical camp held in Kamorta on November 12, 2014.
Aims:
To study the pattern of dermatoses in Nicobarese attending a community medical camp at Nancowry.
Subjects and Methods:
All Nicobarese, predominantly mongoloid, attending a multi-specialty community medical camp at Kamorta on November 12, 2014, were initially seen by a general practitioner. Persons with dermatologic complaints or the presence of skin lesions were then seen by a single dermatologist.
Results:
A total of 375 patients were seen. Out of these, 113 cases (30.13%) had a skin disorder. Females comprised 50.44% and males 49.56% of the cases. The mean age was 21.28 years. The most common dermatoses were infections and infestations comprising 53 cases (46.9%) of which fungal infections were seen in 25 cases (22.12%), pyodermas in 12 cases (10.62%), scabies in 9 cases (7.96%), warts in 4 cases (3.54%), 1 case each of molluscum contagiosum, herpes zoster, and pediculosis capitis (0.88%) followed by eczema in 20 cases (17.70%), acne in 13 cases (11.5%), papular urticaria in 9 cases (7.96%), and psoriasis in 3 cases (2.65%). Miscellaneous dermatoses made up the rest of the 15 cases (13.27%).
Conclusion:
The pattern of dermatoses seen among the Nicobarese is quite similar with respect to the prevalence of infections in other regions of India, especially humid regions such as Assam, coastal Karnataka, and Kolkata and much higher than arid regions such as the deserts of Rajasthan.
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CASE REPORTS
Hemorrhagic skin nodules and plaques: A diagnostic clue to underlying primary plasma cell leukemia
Ranjan Gupta, Amiya Kumar Nath, Murugavel Subbian, Debdatta Basu, Abdoul Hamide, Mariette D’Souza
March-April 2016, 61(2):203-205
DOI
:10.4103/0019-5154.177762
PMID
:27057024
Plasma cell leukemia (PCL) is a rare lymphoproliferative disorder characterized by a malignant proliferation of plasma cells (PC) in blood and marrow. Cutaneous involvement is very rare in PCL. We present the case of a 45-year-old lady who presented with multiple hemorrhagic nodules and plaques in the skin. Her total leucocyte count was 2,00,200/cmm with 85% abnormal plasmacytoid cells in peripheral smear. Biopsy of the skin lesions revealed diffuse infiltration by plasma cells with 'choked' blood vessels. A diagnosis of plasma cell leukemia with cutaneous involvement was made. On the second day of admission, the patient expired probably because of intracranial bleed due to thrombocytopenia. Post-mortem bone marrow and liver biopsy also showed diffuse infiltration by plasma cells. Monoclonality of the cells was proven by demonstrating the production of only kappa light chains.
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The girl shedding glass pieces from her body parts: Unfolding the mystery behind dermatitis artefacta
Harpreet Singh, Adarsh Tripathi, Sujita Kumar Kar
March-April 2016, 61(2):193-195
DOI
:10.4103/0019-5154.177754
PMID
:27057021
Patients presenting with unusual symptoms are uncommon. Unusual symptoms often catch the attention of the public including the health professionals. Atypicality in the symptoms is usually seen in patients with factitious disorder. In patients with factitious disorder, there occurs conscious production of symptoms with an unconscious motive, irrespective of the fact whether they are ill or not. Self-inflicted injuries to skin often give rise to typical skin lesions known as dermatitis artefacta, which many a times simulate other dermatological conditions. Patients with factitious disorder often have a narrow line of demarcation from malingering. We present a case of an adolescent girl presenting with spontaneous extrusion of glass pieces from her body parts with focus on diagnostic dilemma and management.
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CONFERENCE REPORT
The 13
th
East Zonal Indian Association of Dermatology, Venereology and Leprology (IADVL) Conference, 19
th
Annual IADVL West Bengal Chapter Conference and the Indian Journal of Dermatology Diamond Jubilee Celebration, Kolkata, 2015: A Triple Educational Triumph
Robert A Schwartz
March-April 2016, 61(2):231-233
DOI
:10.4103/0019-5154.177749
PMID
:27057037
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CORRESPONDENCES
Pedal poppers: Soles to hold
Balkrishna Nikam, Harsimran Kaur, Varsha Jamale, Mohan Kale
March-April 2016, 61(2):227-228
DOI
:10.4103/0019-5154.177763
PMID
:27057035
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4,315
67
Verrucous plaque in pubic area: A social stigma dermatosis
Irma Margarita Perez-Rodriguez, Sonia Sofia Ocampo-Garza, Alejandro Quiroga-Garza, Jorge Ocampo-Candiani
March-April 2016, 61(2):229-230
DOI
:10.4103/0019-5154.177772
PMID
:27057036
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2,952
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Authors' Reply
Piyush Kumar, Sushil S Savant, Anupam Das, Shahid Hassan, Panchami Deb Barman
March-April 2016, 61(2):220-220
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E-IJD-®-CONFERENCE REPORT
41
st
Annual conference of the indian association of dermatology venereology and leprology (Punjab, Chandigarh, and Himachal Pradesh Chapter), government medical college Patiala, Punjab, India, October 2015
Robert A Schwartz, Davinder Parsad
March-April 2016, 61(2):239-239
DOI
:10.4103/0019-5154.177800
PMID
:27057065
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5,127
71
E-IJD® - CORRESPONDENCE
Late onset skin peeling syndrome
Smita Prasad, Rajesh Sinha, Abhijeet Kumar Jha
March-April 2016, 61(2):237-237
DOI
:10.4103/0019-5154.177780
PMID
:27057053
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4,717
67
Pyodermatitis-pyostomatitis vegetans with penile ulceration complicated by acute glomerulonephritis
Anza Khader, Betsy Ambooken, Kunnummal Muhammed, Manikoth P Binitha, Deepthi N Sureshan, Shyni P Manakkad
March-April 2016, 61(2):239-239
DOI
:10.4103/0019-5154.177797
PMID
:27057064
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3,488
51
Evidence of
Parthenium
sensitivity across all seasons in patients from middle and lower gangetic regions
Sujoy Khan, Nur Alam Mondal, Biswajit Ghosh
March-April 2016, 61(2):238-238
DOI
:10.4103/0019-5154.177796
PMID
:27057059
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2,876
102
Telangiectasia macularis eruptive perstans in an HIV-positive patient: true association or mere coincidence?
Rajesh Kumar Mandal, Anupam Das, Mousumi Roy Bandyopadhyay
March-April 2016, 61(2):238-238
DOI
:10.4103/0019-5154.177798
PMID
:27057060
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3,422
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Idiopathic thrombocytopenic purpura masquerading pediatric systemic lupus erythematosus
Mahmood Dhahir Al-Mendalawi
March-April 2016, 61(2):236-236
DOI
:10.4103/0019-5154.177785
PMID
:27057049
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3,050
54
Verrucous plaque on the sole of the foot: a case of missed diagnosis
Banavasi S Girisha, Tonita Mariola Noronha, Harish S Permi, KR Bhagwan, Sarpangala Radhika, Michelle S Fernandes
March-April 2016, 61(2):236-236
DOI
:10.4103/0019-5154.177788
PMID
:27057050
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3,674
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E–IJD® - CASE REPORTS
Radiation-induced vulvar angiokeratoma along with other late radiation toxicities after carcinoma cervix: A rare case report
Virendra Bhandari, Ayush Naik, KL Gupta, Mehlam Kausar
March-April 2016, 61(2):235-235
DOI
:10.4103/0019-5154.177791
PMID
:27057045
Angiokeratoma including vulvar angiokeratoma is a very rare complication of radiation. Exact incidence is still unknown, we report a case that developed radiation-induced angiokeratoma of skin in the vulvar region along with other late radiation sequelae in the form of bone fracture, new bone formation, bone marrow widening, muscle hypertrophy, and subcutaneous fibrosis, 18 years after radiotherapy to the pelvic region for the treatment of carcinoma cervix. All these late radiation sequel are rare to be seen in a single patient, and none of the case reports could be found in the world literature.
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© 2005 - Indian Journal of Dermatology | Published by Wolters Kluwer -
Medknow
Online since 25
th
November '05