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  Citation statistics : Table of Contents
   2016| January-February  | Volume 7 | Issue 1  
    Online since January 18, 2016

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Ecthyma gangrenosum in the periorbital region in a previously healthy immunocompetent woman without bacteremia
Somenath Sarkar, Arnab Kumar Patra, Madhumita Mondal
January-February 2016, 7(1):36-39
DOI:10.4103/2229-5178.174326  PMID:26955586
Ecthyma gangrenosum (EG) is a cutaneous lesion classically associated with potentially fatal Pseudomonas septicemia in immunocompromised patients. Other bacterial and fungal pathogens have also been implicated. Although EG typically occurs in immunocompromised or neutropenic patients, it may occasionally affect a previously healthy person. The cutaneous findings are characteristic with small indurated papulovesicles progressing rapidly to necrotic ulcers with surrounding erythema and a central black Eschar. While lesions can occur at any site, most are commonly found over the buttocks, perineum, limbs, and axillae. We describe a case of EG in periorbital region in a previously healthy woman who responded to appropriate antibiotic treatment for Pseudomonas. It is very important to establish the diagnosis early so that appropriate systemic antibiotic therapy can be initiated to reduce morbidity and potential mortality.
  8 2,038 243
Photopatch and UV-irradiated patch testing in photosensitive dermatitis
Reena Rai, Maria Thomas
January-February 2016, 7(1):12-16
DOI:10.4103/2229-5178.174319  PMID:26955581
Background: The photopatch test is used to detect photoallergic reactions to various antigens such as sunscreens and drugs. Photosensitive dermatitis can be caused due to antigens like parthenium, fragrances, rubbers and metals. The photopatch test does not contain these antigens. Therefore, the Indian Standard Series (ISS) along with the Standard photopatch series from Chemotechnique Diagnostics, Sweden was used to detect light induced antigens. Aim: To detect light induced antigens in patients with photosensitive dermatitis. Methods: This study was done in a descriptive, observer blinded manner. Photopatch test and ISS were applied in duplicate on the patient's back by the standard method. After 24 hours, readings were recorded according to ICDRG criteria. One side was closed and other side irradiated with 14 J/cm2 of UVA and a second set of readings were recorded after 48 hrs. Result: The highest positivity was obtained with parthenium, with 18 out of 35 (51%) patients showing a positive patch test reaction with both photoallergic contact dermatitis and photoaggravation. Four patients (11%) showed positive patch test reaction suggestive of contact dermatitis to potassium dichromate and fragrance mix. Six patients had contact dermatitis to numerous antigens such as nickel, cobalt, chinoform and para-phenylenediamine. None of these patients showed photoaggravation on patch testing. Conclusion: Parthenium was found to cause photoallergy, contact dermatitis with photoaggravation and contact allergy. Hence, photopatch test and UV irradiated patch test can be an important tool to detect light induced antigens in patients with photosensitive dermatitis.
  5 8,618 652
Position statement for the use of omalizumab in the management of chronic spontaneous urticaria in Indian patients
Kiran Godse, Murlidhar Rajagopalan, Mukesh Girdhar, Sanjiv Kandhari, Bela Shah, Prashant N Chhajed, Sushil Tahiliani, DS Krupa Shankar, Vijay Somani, Vijay Zawar
January-February 2016, 7(1):6-11
DOI:10.4103/2229-5178.174314  PMID:26955580
Chronic spontaneous urticaria (CSU) affects 1% of the world population and also their quality of life, and 50% of these patients are refractory to H1-antihistamines. Omalizumab is a humanized monoclonal anti-IgE antibody that binds with free IgE antibodies and reduces the circulating levels of free IgE. This reduction in free IgE prevents mast-cell degranulation. The EAACI/GA2LEN/EDF/WAO guidelines recommend omalizumab as the third-line of therapy as an add-on to antihistamines. The recommended dose of omalizumab is 300 mg, 4 weekly in the management of CSU refractory to standard of care with H1-antihistamines in adults and adolescents ≥12 years of age. In some patients, a dose of 150 mg may be acceptable. Omalizumab has a good safety profile. However, due to the biologic nature of the drug, all patients administered omalizumab must be observed for 2 h after administration for anaphylactoid reactions. There have been no studies on the effect of impaired renal or hepatic function on the pharmacokinetics of omalizumab. While no particular dose adjustment is recommended, omalizumab should be administered with caution in these patients.
  5 6,878 928
Dowling–Degos disease with reticulate acropigmentation of Kitamura: Extended spectrum of a single entity
Shyam Govind Rathoriya, Sumit S. L Soni, Dinesh Asati
January-February 2016, 7(1):32-35
DOI:10.4103/2229-5178.174307  PMID:26955585
Dowling–Degos disease (DDD) and reticulate acropigmentation of Kitamura (RAK) are rare genodermatoses inherited as an autosomal dominant trait with variable penetrance. They are considered to be part of a spectrum of reticulate pigmentary dermatoses, characterized by the presence of hyperpigmented macules coalescing in a reticular fashion. The authors describe a 28-year-old male patient having hyperpigmented macules on the axillae, neck and face, reticulate acropigmentation of dorsum of the hands, forearms and feet, palmar pitting, and comedo-like lesions over back. The patient showed the unique clinical as well as histopathological overlap of both the rare diseases (DDD and RAK), substantiating the hypothesis that they represent two different features of a single entity with variable phenotypic expression.
  4 5,032 372
Cutaneous collagenous vasculopathy: A rare case report
Kinjal Deepak Rambhia, Snehal D Hadawale, Uday S Khopkar
January-February 2016, 7(1):40-42
DOI:10.4103/2229-5178.174327  PMID:26955587
Cutaneous collagenous vasculopathy (CCV) is a distinct, rare, and underdiagnosed condition. We report a case of CCV in a 50-year-old woman presenting as asymptomatic, erythematous to hyperpigmented nonblanchable macules over both the lower extremities. The clinical differential diagnosis of the lesions was pigmented purpuric dermatoses (Schamberg's purpura) and cutaneous small vessel vasculitis. Histology of the lesions revealed dilated superficial dermal vessels with abundant pink hyaline material in the vessel wall, which stained with periodic acid Schiff stain. The patient was diagnosed as CCV. This condition remains largely underdiagnosed and is commonly mistaken for pigmented purpuric dermatosis or generalized essential telangiectasia. Emphasis on the differentiation of CCV from its clinical and histological mimicks is made.
  4 3,653 300
Purpura fulminans secondary to rickettsial infections: A case series
Saloni Katoch, Ravindra Kallappa, Murugesh B Shamanur, Sneha Gandhi
January-February 2016, 7(1):24-28
DOI:10.4103/2229-5178.174324  PMID:26955583
Purpura fulminans (PF) is a descriptive term used to describe a heterogeneous group of disorders characterized by rapidly progressive purpuric lesions that may develop into extensive areas of skin necrosis, and peripheral gangrene. This rare disorder is associated with laboratory evidence of consumptive coagulopathy and is often fatal. PF is usually associated with many infections, most notably with meningococcal, staphylococcal, and streptococcal infections. However, there are very few reports of this entity with spotted fever and scrub typhus from India. Rickettsial infections are an underdiagnosed group of diseases presenting as acute febrile illness, with high mortality in untreated cases. Of the available tests, Weil–Felix is a handy and economical tool for early diagnosis of this fatal disease especially in resource poor settings. We present four infants with PF secondary to rickettsial fever diagnosed by the Weil–Felix test.
  4 3,691 358
Hansen's disease in association with immune reconstitution inflammatory syndrome
Anju George, Suja Vidyadharan
January-February 2016, 7(1):29-31
DOI:10.4103/2229-5178.174305  PMID:26955584
Immune reconstitution inflammatory syndrome is characterized by a paradoxical worsening of an existing infection or disease process, soon after initiation of highly active antiretroviral therapy. The first case of leprosy presenting as immune reconstitution inflammatory syndrome was published in 2003. Here we report a case of Hansen's disease borderline tuberculoid presenting with type 1 lepra reaction 5 months after initiation of highly active antiretroviral therapy.
  3 1,880 285
Treatment of refractory ulcerative necrobiosis lipoidica diabeticorum with oral thalidomide
Swapnil D Shah, Girish V Kale
January-February 2016, 7(1):43-45
DOI:10.4103/2229-5178.174328  PMID:26951036
Ulcerative necrobiosis lipoidica (NL) in diabetic patients is a rare, painful condition. It is a difficult-to-treat condition, impairing quality of life of patients. Although various drugs have been tried, none of them is consistently effective. Biologics in the form of TNF-alpha inhibitors show promising results in the treatment. But because of their high cost we chose thalidomide, which also has TNF-alpha inhibiting properties to successfully treat a long-standing case of ulcerative NL, which was refractory to various treatment modalities.
  3 3,414 254
Subcutaneous emphysema mimicking angioedema
Amit Kumar Dhawan, Archana Singal, Kavita Bisherwal, Deepika Pandhi
January-February 2016, 7(1):55-56
DOI:10.4103/2229-5178.174304  PMID:26955588
  2 1,081 184
Lymphangioma circumscriptum of the male genitalia
Ganesh Avhad, Hemangi Jerajani
January-February 2016, 7(1):68-69
DOI:10.4103/2229-5178.174311  PMID:26955596
  2 1,173 201
Familial dyskeratotic comedones: A rare entity
Raghu Ram Maddala, Ashok Ghorpade, Mercy Polavarpu, Satish A Adulkar, Manbendra Das
January-February 2016, 7(1):46-48
DOI:10.4103/2229-5178.174308  PMID:26953840
Familial dyskeratotic comedones is an inherited disorder with distinctive clinical features and a disease course that is refractory to treatment. It is clinically characterized by numerous, discrete, disseminate, hyperkeratotic papules and comedones. On histopathology, it shows crater-like invaginations filled with keratinous material and evidence of dyskeratosis. We report here one family from central India with this rare disorder.
  1 4,101 320
Cutaneous lupus erythematosus of elbows: A distinct entity?
Nidhi Singh, Laxmisha Chandrashekar, Nava Kumar, Rakhee Kar, Mary Theresa Sylvia, Devinder Mohan Thappa
January-February 2016, 7(1):20-23
DOI:10.4103/2229-5178.174306  PMID:26952182
The elbow is not recognized as common site for cutaneous lupus erythematosus (CLE) lesions. Twelve cases of CLE over the elbows were evaluated for systemic involvement and Cutaneous Lupus Disease Area and Severity Index activity and damage scores and Systemic Lupus Erythematosus Disease Activity Index scoring was done. Histopathological examination of the affected skin was performed in doubtful cases. Most of the patients were women (10, 83.3%) with mean age of 28.75 years. Three patients had only elbow lesions and the remaining nine patients had CLE lesions at sites other than the elbows, of which five had elbow lesions preceding skin lesions elsewhere over the body and three patients were not aware of whether elbow lesions preceded or succeeded CLE lesions at other sites, and one patient had noticed malar rash 9 months prior to elbow lesions. All the patients antinuclear antibody positivity, systemic involvement, and fulfilled criteria for systemic lupus erythematosus. This peculiar localization of CLE to the elbows may be associated with a greater risk of systemic involvement and may be an predictor of flare of LE.
  1 1,948 281
Scholarships, grants, and training opportunities for dermatology residents in India by Indian Association of Dermatologists, Venereologists and Leprologists
Venkataram Mysore
January-February 2016, 7(1):3-5
DOI:10.4103/2229-5178.174321  PMID:26955579
  1 5,551 413
Tufted angioma
Kinjal D Rambhia, Uday S Khopkar
January-February 2016, 7(1):62-63
DOI:10.4103/2229-5178.174313  PMID:26955593
  1 1,249 242
Two cases of systemic mantle cell lymphoma involving the skin
Viktoryia Kazlouskaya, Amy Spizuoco, Jacqueline M Junkins-Hopkins
January-February 2016, 7(1):49-52
DOI:10.4103/2229-5178.174317  PMID:26951614
Mantle cell lymphoma (MCL) is a form of non-Hodgkin lymphoma that rarely affects skin. Cutaneous involvement is non-specific but usually indicates widespread disease. Herein we present two cases of MCL with secondary skin involvement. One case presented as an acneiform eruption on the face and had aberrant expression of bcl-2 and bcl-6 with weak CD5 expression. The second presented with multiple tumors on the abdomen and thighs. In both cases expression of Cyclin-D1 by the tumor cells was seen. Both patients died shortly after the diagnosis was established.
  - 2,237 204
Dermpath Quiz: Which alopecia does the patient have?
Silvija Pejkovska Gottesman, Khanh Thieu, Dennis Polley, Dirk Elston
January-February 2016, 7(1):53-54
DOI:10.4103/2229-5178.174318  PMID:26951617
  - 1,610 218
Greetings from the desk of Editor-in-Chief
Sunil Dogra
January-February 2016, 7(1):1-2
DOI:10.4103/2229-5178.174320  PMID:26955578
  - 1,758 216
Erratum: Lymphomatoid contact dermatitis associated with textile dye at an unusual location

January-February 2016, 7(1):70-70
DOI:10.4103/2229-5178.174340  PMID:26955597
  - 887 152
More angioedema from instant coffee, but not from caffeine
Toban Dvoretzky
January-February 2016, 7(1):60-60
DOI:10.4103/2229-5178.174310  PMID:26955591
  - 1,001 173
Tuberculosis verrucosa cutis with multifocal involvement
Rita V Vora, Nilofar G Diwan, Kirti J Rathod
January-February 2016, 7(1):60-62
DOI:10.4103/2229-5178.174325  PMID:26955592
  - 4,946 461
Loose anagen hair syndrome: Is there any association with atopic dermatitis?
Vivek Kumar Dey, Manasi Thawani
January-February 2016, 7(1):56-57
DOI:10.4103/2229-5178.174309  PMID:26955589
  - 1,669 202
Alopecia universalis in a patient with Sheehan's syndrome
Shivani Bansal, Naresh Kumar, Atul M Kochhar, Rajeev Ghai
January-February 2016, 7(1):58-59
DOI:10.4103/2229-5178.174322  PMID:26955590
  - 2,293 203
Reticulin immunostaining revisited
Kara Melissa T Torres, Viktoryia Kazlouskaya, Kruti Parikh, Dirk M Elston
January-February 2016, 7(1):17-19
DOI:10.4103/2229-5178.174312  PMID:26955582
Introduction: Reticulin staining has been suggested as an inexpensive tool in the differential diagnosis of melanoma versus benign nevi. In the present study, reticulin immunostaining patterns in malignant melanomas, benign intradermal nevi, and blue nevi were observed. The concordance in evaluation of the pattern between observers was also done. Materials and Methods: A retrospective search was performed in the computer database of the Ackerman Academy of Dermatopathology for “melanoma,” “melanocytic nevus,” and “blue nevus”. Fifty-six melanomas (30 of nodular subtype and 26 of superficial spreading subtype), 54 benign compound nevi, and 27 blue nevi were selected for the study. Patterns of reticulin staining in the dermis and the basement membrane in these melanocytic lesions were evaluated and the concordance between the two groups of authors was assessed. Statistical evaluation was performed with the Statistica® 10 program, Tulsa, OK. Concordance of the pattern evaluation was evaluated using Cohen's kappa coefficient. Results: Melanomas show a variable basement membrane pattern some of which show flat, thin and smooth pattern. Benign nevi almost never showed this flat pattern at the basement membrane zone. In the dermis, melanomas showed reticulin fibers surrounding groups of melanocytic cells while nevi predominantly had reticulin fibers around individual cells. There was greater agreement in evaluating the dermal component compared to the basement membrane pattern. Conclusion: The dermal reticulin staining pattern may be of some value in the diagnosis of melanocytic lesions, but poor concordance in evaluation of the basement membrane zone pattern limits its usefulness.
  - 1,559 229
SkIndia Quiz 22: Scalp Tumor
Leonor Neto Lopes, Luís Soares-Almeida, Paulo Filipe
January-February 2016, 7(1):64-65
DOI:10.4103/2229-5178.169808  PMID:26955594
  - 1,954 251
Adult-onset familial palmoplantar keratoderma: An uncommon presentation
Tarang Goyal, Anupam Varshney
January-February 2016, 7(1):66-66
DOI:10.4103/2229-5178.174316  PMID:26951632
  - 1,154 174
Painful wart in the ear?
Chintaginjala Aruna, Harshavardhan Kollabathula, Ramamurthy Damaraju Venkata, Senthil Kumar Alagappan
January-February 2016, 7(1):67-67
DOI:10.4103/2229-5178.174323  PMID:26955595
  - 1,366 172
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