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Heritage Article

Indian Journal Of Dermatology

Vol 42 No 4
October - December 1997

ABSTRACTS


A Study of 7 cases of Depressed Facial Scars corrected by Subcision

Subrata Malakar, Sandipan Dhar

Seven (7) cases of depressed facial scars which included depressed distensile acne scars, depressed bound down scars of acne excluding deep ice pick scars, and scars of varicella constituted the study group. The scars were treated with a new method named subcuticular undermining. A tri-bevelled hypodermic needle was inserted through a puncture in the skin surface and its sharp edges were manouevered under the scar. The depression was lifted by the releasing action of the needle maneuevere and from connective tissue that forms in course of normal wound healing. Approximately 50% to 80% improvement of all the scars were noticed. Patient's compliance was highly satisfactory. Subcision is an appropriate option in depressed scars of black skin (Type IV-TypeVI) where dermabrasion and mediumdepth and deep chemical peeling are contraindicated.

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Successful Split Thickness Skin Graft in Stable Vitiligo not Responding to Autologous Sking Grafts

Subrata Malakar

Surgical replacements of stable vitiligo with pigmented skin is an effective alternative for patients. But none of them is fully dependable as they induce satisfactory repigmentation with some drawbacks. One such is the occasional depigmentation of the minigrafts.

Split thickness skin grafting (STSG) has been tried in cases not responding to autologous miniature punch grafts. A series of 7 patients with 10 localised, stable, refractory and minigraft-failure patches was treated institutionally by dermabrasion and STSG and followed up for 16 months. The graft take was 100% in 7 patches and 90% in the remaining 3 and 100% repigmentation was achieved in 4 cases, 95% in 2 cases and 90% in 1. Time taken for satisfactory colour match varied 4.5 to 8.5 months. Complications were minor and did not affect the results. Stable and refractory patches of vitiligo, not responding to autologous miniature punch grafts, can be treated by STSG with good to excellent repigmentation.

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Punch Grafting in Chronic Stable Vitiligo : A Preliminary Report

C S Sirka, D M Thappa, K Agrawal

Eleven patients of stable vitiligo (7 segmental, 2 focal, 2 contact depigmentation) having localized lesions were treated with autologous punch skin graft. The cosmetic improvement at 5th month was good in 3, fair in 7 and poor in 1. However, at 7th month the improvement was excellent in 4, good in 6 and poor in 1. Complications in the form of variegated colour - 9 patients, cobblestoning - 8 patients, depigmentation - 1 patient and graft loss in 1 patient were noted in this study. The role of adjuvant thereapy (topical steroid and topical psoralen) is highlighted.

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Multiple Piloleiomyomas - A Report of 4 cases

Rajeev Sharma, A K Bajaj

Piloleiomyomas are uncommonly reported tumours in Indian literature. The classical tenderness often helps in diagnosis. Multiple lesions are usually seen in familial cases. Our cases had multiple lesions but were non-familial. Response to nifedipine was encouraging.

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An Eight Year Study on the Prevalence and Pattern of Syphilis

Sheba Harry, Ganesh S Pai

A retrospective data analysis of syphilitic patients attending the Skin and Venereol Diseases Department in a Government Hospital in Mangalore city, was studied for 8 years (1989-96). Out of the total number of patients attending the hospital in the eight years, syphilitic patients constituted 0.0385%. Even though the number of syphilitic patients attending the department has declined over 8 years, the prevalence of syphilitic patients does not show a satisfactory decrease.

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Epidemiology of Genital Ulcers and Prevalence of Seropositivity for Syphilis

B R Hazra, P P Banerjee, Niladri Biswas and P K Dutta

The study assesses the prevalence of seropositivity for syphilis amongst cases presenting with genital ulcer to STD Clinic, Medical College, Calcutta during July 1994 to January 1995, and their epidemiological characteristics.

Of the 157 cases studied, 142 (90.9%) were males and 15 (9.1%) were females. Prevalence of seropositivity for syphilis was in 22.93% cases of genital ulcers. In the age distribution of males, 9% were below 21 years, 33.8% between 21-25 years and 23.9% between 26-30 years. In females, the highest proportion (33.3%) was in the age range 16-20 years. While all the female patients were Hindus, 87.3% of males were Hindus and 12.7% were Muslims. Large majority (70%) of the cases were literate. Amongst male patients, unskilled labourers constituted the highest proportion (35.2%), and majority in females (53.3%) were prostitutes. While majority (55.4%) came from low income group, 28% were from middle income group and 16.6% from high income group. 90.1% of males were unmarried single against 87.9% in females. The type of family for both male and female patients was overwhelmingly nuclear (86.6% to 87.3%) and 2.8% of the males and 13.3% of the females were orphans. Amongst the seropositive patients, primary syphilis was present in 71.4% males and 62.5% females and the figures for secondary syphilis were 28.6% in males and 30.6% in females. 42% males and 26.7% females had knowledge about source of infection. While 85.9% males got infection from prostitutes, 66.7% females got it from clients. In females, 20% had been infected by friends and neighbours and 13.3% by casual contact.

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Cutaneous Rhinosporidiosis

Alok Shrivastava, Dharitri Bhat, Sanjay Parate and S K Bobhate

Rhinosporidiosis, an infection caused by Rhinosporidium Seeberi, predominantly causes lesions in nose followed by conjunctiva. Rarely the other mucocutaneous junctions are involved. Cutaneous rhinosporidiosis is infrequent and is associated with adjacent mucocutaneous disease. We present a case of cutaneous rhinosporidiosis which was not associated with disease elsewhere in the body and is very rare.

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Favre-Racouchot Syndrome with Dubreuilh's Elastoma

Gurvinder P Thami, Gursharan K Bedi, Amrinder J Kanwar, Ritu Jaswal

A case of Favre-Racouchot syndrome with Dubreuilh's elastoma is being reported. Cysts were treated with excision and photoprotection was advised.

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Bilateral Subcutaneous Fibroadenomata on the Arm : A Rare Entity with Embryological Curiosity

Usha Kini, M K Babu

We report a case of multiple bilateral fibroadenomata on the arm away from the milk line in 33 year old female who in addition presented with fibrocystic disease of the breast and secondary infertility. Possible origin of these cutaenous fibroadenomas have been hypothesized. This is the second report of its kind being reported in the English literature.

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Cutaneous Horn overlying Basal Cell Carcinoma

Sandipan Gupta, S R Sengupta and Koushik Lahiri

A man of 60 years presented with a cutaneous horn overlying a nodulo-ulcerative basal cell carcinoma for the last 2 years on the face below right eye. Reconstructive surgery was undertaken after complete removal of the lesion.

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Eruptive Keratoaconthomas in Hodgkin's Disease

K Pavithran

A 38 year old man developed eruptive keratoacanthomas along with early signs and symptoms of Hodgkin's disease. The simultaneous development of both diseases and their simultaneous disappearance following chemotherapy suggest that their association is more than a simple chance occurrence.

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Clozapine Induced Pityriasiform Eruption

M S Bhatia, Sandeep Choudhary, Sanjay Khanna and Pradeep Agrawal

Clozapine is a new atypical antipsychotic drug. Pityriasiform eruption induced by clozapine is described for the first time.

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Folliculitis Decalvans in Siblings

Mariette D'Souza, Joseph Thadeus and Chaganti Ratnakar

Folliculitis decalvans is a rare cause of cicatricial alopecia. Apart from a single report by Shitara and co-workers, familial occurrence of folliculitis decalvans has not been reported. Two families in each of which two siblings were affected with folliculitis decalvans are reported and the aetiologic aspects discussed.

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Voh Winkel's Syndrome with Unusual Features

Ravikumar BC, Balachandran C and Sabitha L

Voh winkel's syndrome is a rare disease. Here a case of Voh winkel's syndrome is described with associated icthyosis vulgaris like dermatoses, ectropion and nail changes.

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Fournier's Gangrene

SK Sayal, KM Rai, AK Malik and AS Bal

A 55 year old male presented with insidious onset of redness and swelling of the penis and scrotum which progressed to gangrene. He was diagnosed and managed as a case of Fournier's gangrene.

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Cutaneous Metaplastic Synovial Cyst

Mary Mathew, Ravikala V Rao, Lakshmi Rao, Kanthilatha Pai and T S Rao

A case of cutaneous metaplastic synovial cyst is reported here for it is rather a new and rare entity.

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Unilateral Molluscum Contagiosum

Kailash Kumar, P Bhargava, C M Kuldeep and Dinesh Mathur

Two cases of molluscum contagiosum lesions distributed unilaterally on the left side of the body are reported.

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Xanthoma Following Medical Termination of Pregnancy

Puneet Bhargava, C M Kuldeep, Kailash Kumar and N K Mathur

Case report of a 25 year old female who developed yellowish discolouration of palms and soles 2 days after MTP operation is described here.

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Segmental Neurofibromatosis

Devakar Yesudian, S G S Krishnan, M Jayaraman, V R Janaki and Patrick Yesudian

Segmental neurofibromatosis is a rare variant of neurofibromatosis in which the lesions are confined to one segment or dermatome of the body. They resemble classical neurofibromas in their morphology, histopathology and electron microscopy. However, systemic associations are usually absent. We report one such case with these classical features.

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Reactional Plasmacytosis in Plasma Cell Oriifical Mucositis in a Patient of Pulmonary Tuberculosis

Sumit Kumar Bose

Skin biopsy of a 50 year old Moroccan male patient with labial and oro-pharyngeal showed hyperplastic, with papillomatous eroded epithelium. Dense infiltrates of plasma cells were seen in the dermis, with perivascular prominence. Hypopharynx, epiglottis, adenoids, and tonsils showed the same type of infiltration. Immunofluorescence (IF) and peroxidase antiperoxidase (PAP) techniques demonstrated the presence of mostly an infiltrate of plasma cells showing lgA (30 - 40%), lgM (20-30%), lgG(10-20%) after staining with polyclonal antibodies along with T4 & T8 lymphocytes with monoclonal stainng. Electron microscopy showed absence of atypical plasma cells with abundant endoplasmic reticulum8 . Patient's symptoms of stomatitis, dysphonia and pharyngitis were temporarily relieved by systemic corticosteroids and Azothioprine. Mantoux test was positive with fair amount of plasma cells suggesting a reactive type of benign plasmocytosis.

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Kaposi's Sarcoma in a Young Female : Some Unusual observations

Ashok Kumar Sharma and Suhas Jajoo

A patient of Kaposi's sarcoma which followed a progressive course but without systemic involvement or signs of acquired immunodeficiency is reported. Some unusual features in clinical presentation were noted.

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