Indian Journal of Dermatology
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   2008| October-December  | Volume 53 | Issue 4  
    Online since December 31, 2008

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Aloe vera: A short review
Amar Surjushe, Resham Vasani, DG Saple
October-December 2008, 53(4):163-166
DOI:10.4103/0019-5154.44785  PMID:19882025
Aloe vera is a natural product that is now a day frequently used in the field of cosmetology. Though there are various indications for its use, controlled trials are needed to determine its real efficacy. The aloe vera plant, its properties, mechanism of action and clinical uses are briefly reviewed in this article.
  44,048 1,627 46
Deflazacort versus other glucocorticoids: A comparison
Surajit Nayak, Basanti Acharjya
October-December 2008, 53(4):167-170
DOI:10.4103/0019-5154.44786  PMID:19882026
Steroids form an important component of dermatological therapy and are used since very long time for different conditions in different forms. Though very few molecules are used since very long time, the side effect associated with this group of drugs are almost always there. Recently a new molecule deflazacort has been introduced into Indian market, is a glucocorticoid and a derivative of old molecule prednisolone. Though claimed to be having less side effect, very few studies have been done in Indian prospective. This review will highlight the very basics of this drug and its advantages and disadvantages.
  38,450 1,530 18
Pityriasis versicolor: A clinicomycological and epidemiological study from a tertiary care hospital
Sudip Kumar Ghosh, Sunil Kumar Dey, Indranil Saha, Jayasree Nath Barbhuiya, Arghyaprasun Ghosh, Aloke Kumar Roy
October-December 2008, 53(4):182-185
DOI:10.4103/0019-5154.44791  PMID:19882030
Background: Pityriasis versicolor is a mild, chronic, usually asymptomatic superficial fungal infection of the stratum corneum, caused by Malassezia yeasts. The purpose of the present study is to assess the clinical profile of a group of patients with pityriasis versicolor and to find out the epidemiological characteristics in this part of India as well as any association, if any, with other diseases. Materials and Methods: For this purpose, 110 consecutive patients of pityriasis versicolor were evaluated clinically and diagnosis was confirmed mycologically at a tertiary care hospital in Kolkata. All data were recorded in a predesigned, pretested semi-structured schedule. The total duration of study period was 12 months. Results: Majority of the patients were young adults. Most of the patients were asymptomatic. There is prominent seasonal variation of the patients with a peak in August and September months. Most of the lesions were hypopigmented scaly macules and were KOH positive. Most commonly involved sites were chest, face and back. Seborrheic dermatitis sometimes coexisted with pityriasis versicolor and a number of patients also had diabetes mellitus and immunosuppressive conditions. Conclusions: Overall, the clinicomycological and epidemiological profile of pityriasis versicolor infection as observed in a tertiary care setting in eastern India does not differ significantly from those observed by previous workers elsewhere.
  6,581 568 8
An unusual location of basal cell carcinoma: The clitoris and the vulva
Comert Asuman, Akin Ozlem, Tumerdem Burcak, Peker Onder
October-December 2008, 53(4):192-194
DOI:10.4103/0019-5154.44795  PMID:19882033
Vulvar basal cell carcinoma (BCC) is rare, accounting for less than 5% of all vulvar neoplasms and less than 1% of all BCCs. Vulvar BCCs are usually diagnosed late because they are often asymptomatic and tend to grow at slow rates. They may be invasive and destructive if neglected or improperly treated. Nevertheless, they have a very low propensity for metastatic spread, but frequently recur after simple excision. We report a 78 year-old woman presenting with the complaint of painful vulvar ulceration and vaginal bleeding. The physical examination revealed a 3 2 cm indurated nodulo-ulcerative lesion involving the clitoris, both labia minora and left labium majus. The histopathology was consistent with the "solid type BCC" that invaded the subcutaneous tissue without lymph node metastasis. The patient underwent wide local excision with clitoral amputation and remained disease free at post-surgical follow-up after 18 months.
  6,275 163 7
Malignant melanoma - cutaneous metastases
L Padmavathy, L Lakshmana Rao, N Ethirajan, B Krishna Swamy
October-December 2008, 53(4):212-214
DOI:10.4103/0019-5154.44803  PMID:19882041
Melanoma composed of melanocytes may arise in the skin or other tissues harboring melanocytes, such muco-cutaneous junctions, mucosa including the conjunctiva, iris, choroids and substantia nigra. Metastases to the skin and subcutaneous tissues from a malignant melanoma are less common. A case of multiple painless nodules on the body that revealed metastatic deposits of melanoma on histopathological examination is being reported.
  5,584 171 -
Giant cutaneous horn
M Kumaresan, Pramod Kumar, Manohar Varadharaj Pai
October-December 2008, 53(4):199-200
DOI:10.4103/0019-5154.44800  PMID:19882036
A 53-year-old male presented with a giant cutaneous horn over the left leg. Cutaneous horn was excised and primary closure of the defect was done under spinal anesthesia. Histopathology showed underlying seborrheic keratosis. Cutaneous horn has been noticed on top of many clinical conditions of diverse etiology, such as actinic keratoses, wart, molluscum contagiosum, seborrheic keratoses, keratoacanthoma, basal cell and squamous cell carcinoma. We report a patient with giant cutaneous horn on the leg successfully treated by excision and wound closure.
  4,496 172 3
Evaluation of clinicomycological aspects of onychomycosis
Ravinder Kaur, Bineeta Kashyap, Rati Makkar
October-December 2008, 53(4):174-178
DOI:10.4103/0019-5154.44788  PMID:19882028
Background: Incidence of onychomycosis has increased tremendously in recent times. Relatively little work has been done on this problem in our country. Research in past has been concentrated mainly on superficial mycoses of the skin. Aim: It is a well-established fact that geographical distribution of the fungi may change from time to time; hence, this study was planned to analyze clinical, epidemiological, and mycological features of onychomycosis. Materials and Methods: Sixty patients clinically suspected and microscopically proven to have onychomycosis were taken up for the study. Nail samples, collected by scraping in 30 patients and by using a dental drill in the rest, were examined microscopically and cultured for fungus. Results and Conclusions: Forty-five fungal isolates were obtained from 60 patients. Trichophyton rubrum was the commonest fungus isolated (46.67%). Trichophyton mentagrophytes and Candida albicans accounted for 20% and 15.56% isolates, respectively. Two cases showed mixed growth of Trichophyton rubrum and Aspergillus niger in one and Trichophyton rubrum and Aspergillus fumigatus in the other. Isolation rate was higher by drilling compared to scraping, the rates being 83.33% and 66.67%, respectively. Superficial mycotic infections were present in 27 patients (45%).
  4,052 376 8
Chemotherapy induced nail changes
Aashima Gupta, Ankit Parakh, Anand Prakash Dubey
October-December 2008, 53(4):204-205
DOI:10.4103/0019-5154.44804  PMID:19882038
Anticancer chemotherapy is associated with a variety of nail changes. We present two children who developed different nail changes, while receiving almost similar antineoplastic drugs.
  4,198 201 3
A cross section of skin diseases in rural Allahabad
Sanjiv Grover, Rakesh K Ranyal, Mehar K Bedi
October-December 2008, 53(4):179-181
DOI:10.4103/0019-5154.44789  PMID:19882029
Background: The pattern of skin diseases varies form one country to another and across different parts within the same country. A two-day multispecialty medical camp was held among the local population at the district of Kausambi, Allahabad, UP, in October 2005. A cross section of pattern of skin diseases observed at the camp is reported and compared with similar studies in literature. Materials and Methods: All cases attending the medical camp were included in the study. All those with dermatological complaints were examined in detail, brief relevant history was elicited and clinical diagnosis was made. Results: Skin diseases comprised 7.86% of all those who attended the camp. The 11-20 year age group was the most common age group involved with 164 (31.4%) cases. Infective disorders were found in 59.1% and noninfective disorders in 40.9% of all the skin cases. Among the infective disorders, fungal infections were most common (54.52%), and among the noninfective dermatoses, eczemas were most common (39.2%) cutaneous disorders. Conclusion: Our study brought out a higher prevalence of infective dermatoses and a relatively higher, but statistically insignificant, prevalence of fungal infections, scabies and eczemas, thereby reflecting minor regional variance in our study group.
  4,099 278 3
Study of role of streptococcal throat infection in pityriasis rosea
Madhuri Parija, Devinder Mohan Thappa
October-December 2008, 53(4):171-173
DOI:10.4103/0019-5154.44787  PMID:19882027
Background: Pityriasis rosea is a common, acute exanthem of uncertain etiology. The exact cause of pityriasis rosea is not known but various hypotheses have been postulated incriminating infective agents such as viruses, bacteria, spirochete and noninfective etiologies such as atopy and autoimmune causes have also been investigated. Aim: We undertook a study to investigate the role of Streptococcus haemolyticus in the causation of pityriasis rosea and study the levels of C-reactive protein (CRP) and ASLO titer in patients with pityriasis rosea. Materials and Methods: The study included 20 patients with pityriasis rosea attending the outpatient dermatology department at JIPMER hospital during the period from June to December 2004. Corresponding number of age- and sex-matched controls were chosen from amongst healthy individuals and patients attending skin OPD with dermatological disorders other than pityriasis rosea. Results: On analyzing the data collected from 20 cases of pityriasis rosea, the average age was found to be 15.3 years and ranged from 5 years to 30 years. The male to female ratio was found to be 1.5:1. The average duration of illness was 14.5 days (median) and 29.3 days (mean). CRP was negative in all the cases as well as the controls. ASLO titer was found to be raised in 2 (10%) cases, while it remained below the critical value in all the controls. On comparing the cases and controls, the raised ASLO titer in the cases was found to be not statistically significant (p = 0.147). From the throat swab culture, Streptococcus haemolyticus was isolated from only one case and none of the controls. This finding was not statistically significant (p = 0.310). Conclusion: As per the findings of the present study, we arrived at conclusion that there is no association between streptococcus pharyngitis and pityriasis rosea.
  3,987 311 -
Unusual presentation of generalized macular amyloidosis in a young adult
Mohan H Kudur, B Sathish Pai, H Sripathi, Smitha Prabhu
October-December 2008, 53(4):201-203
DOI:10.4103/0019-5154.44802  PMID:19882037
Macular amyloidosis is a common problem seen dermatology out-patient department. Generalized macular amyloidosis presenting with a poikilodermatous appearance is rare. In our case, an 18-year-old male presented with generalized hypopigmented macules with a poikilodermatous appearance of 10-year duration. His developmental milestones were normal with negative family history of similar complaints. Histopathology of hyperpigmented lesions revealed hyperkeratosis and acanthosis of epidermis and hypopigmented lesion showing only hyperkeratosis. Both lesions were showing the deposition of amorphous, hazy material in the tips of papillary dermis with perivascular inflammatory infiltrate. Congo red staining of the amorphous material was positive for amyloid.
  4,121 174 1
Scleredema diabeticorum with unusual presentation and fatal outcome
Francisco J Ruiz Miyares, Renju Kuriakose, Dirk T Deleu, Naghi Abd El-Wahad, Hassan Al-Hail
October-December 2008, 53(4):217-219
DOI:10.4103/0019-5154.44798  PMID:19882043
We present a case of Scleredema Diabeticorum (SD) in a patient with diabetic neuropathy and restrictive respiratory disease with unusual skin lesion distribution. The onset of dermatologic symptoms heralded a progressive respiratory disease with constrictive component. Painful diabetic neuropathy was noteworthy and difficult to relieve. Predominantly, distribution of the skin lesions on the thighs makes the case exceptional. T2-weighted MRI showed abnormal hyperintensities along the muscles of the thighs in correspondence with the skin lesions. Gait and respiratory symptoms progressively worsened. After a transient remitting period, he developed sudden shortening of breath, arrested and expired at home.The atypical distribution of the skin lesions with further involvement of underlying muscles plus concomitant polyneuropathy and respiratory constrictive disease with sudden death is quite unusual and aggressive presentation of SD.
  3,736 118 2
Penile papulonecrotic tuberculid: Revisited
Amiya Kumar Nath, Sakthi Kandan Janakiraman, Abhijit Chougule, Devinder Mohan Thappa
October-December 2008, 53(4):220-221
DOI:10.4103/0019-5154.44790  PMID:19882044
  3,632 154 -
Efficacy of pulsed dye laser in cosmetically distressing facial dermatoses in skin types IV and V
Sujay Khandpur, Vinod K Sharma
October-December 2008, 53(4):186-189
DOI:10.4103/0019-5154.44792  PMID:19882031
Background: Pulsed dye laser (PDL) has revolutionized treatment of vascular dermatoses. It has been successfully employed to treat several non-vascular conditions in fair skinned individuals without producing significant pigmentary and textural complications. Aim: A preliminary study was undertaken to assess its efficacy in cosmetically distressing facial, vascular and non-vascular dermatoses in Indian patients with skin types IV and V. Materials and Methods: Nine patients of ages 7 to 55 years, with facial verruca plana (VP- 4 cases), angiofibromas (AF- 4 cases) and multiple pyogenic granulomas (PG- one case) were recruited. They had no systemic complaints. Laser parameters used were (spot size/fluence/wavelength/pulse duration):VP- 5mm/5.5-7.5J/585nm/0.45ms; AF-5mm/6-8.5J/585nm/0.45ms;PG- 5mm/7J/585 and 595nm alternately/1.5ms. Response was assessed clinically and photographically. Results and Conclusions: All VP lesions completely resolved after 2-4 sessions (mean 3.25 sessions), AF showed 50% regression in all cases after 2-3 sessions (mean 2.5 sessions) and ≥75% subsidence after 3-7 sessions (mean 5.5 sessions) and in PG, after 3 sessions, there was complete subsidence of small satellite lesions with moderate shrinkage of larger papules and complete resolution after 5 sessions. Complications included transient hyperpigmentation/hypopigmentation only. There was no recurrence during next 6 months. PDL offers significant cosmetic improvement in facial dermatoses in Indian patients.
  3,492 163 1
Cutaneous pancreatic metastasis: A case report and review of literature
HZ Abdel Hafez
October-December 2008, 53(4):206-209
DOI:10.4103/0019-5154.44806  PMID:19882039
Pancreatic cancer is one of the most dangerous human cancers and will continue to be a major unsolved health problem as we enter the 21 st century. This is the case despite advances in imaging technology and surgical management. Indeed, 80% to 90% of pancreatic cancers are diagnosed either at the locally advanced or metastatic stage. Cutaneous metastases originating from pancreatic cancer are relatively rare. The most common site of cutaneous metastasis is the umbilicus, and this is known as the Sister Joseph's nodule. Very few patients have been reported with cutaneous lesions disclosing a pancreatic carcinoma at sites other than the umbilical area. To the best of our knowledge, there have been no previous reports on cutaneous pancreatic metastasis in Egypt. This is a report on a patient with cutaneous pancreatic metastases at the neck and review of reported non-umbilical cutaneous metastases from pancreatic carcinoma in the literatures.
  3,487 105 3
Infantile iatrogenic cushing's syndrome
Selahattin Katar, Sedat Akdeniz, M Nuri Ozbek, Ahmet Yaramis
October-December 2008, 53(4):190-191
DOI:10.4103/0019-5154.44793  PMID:19882032
High potency or/and extended use of topical corticosteroids, particularly in children, may cause suppression of the hypothalamopituitary-adrenal axis. However, iatrogenic Cushing's syndrome in infantile age group is very rare and only a few patients have been reported to date in the literature. Here, we report a case of iatrogenic Cushing's syndrome in a 6-month-old male child whose parents have admitted to the hospital for overweight and skin fragility.
  3,386 185 1
Generalized lichen nitidus in childhood
Vandana Mehta, C Balachandran
October-December 2008, 53(4):221-222
DOI:10.4103/0019-5154.44794  PMID:19882045
  3,054 184 3
Mucosal patch on anus: A rare sequel of sodomy
Sudip Das, Chinmoy Kar, Parag Prasun Giri
October-December 2008, 53(4):195-195
DOI:10.4103/0019-5154.44796  PMID:19882034
A case of mucosal patch on the perianal area of a 15-year-old boy with history of frequent sodomy is presented here.
  2,994 120 -
Scalp meningioma
Sunil K Singh, BK Ojha, A Chandra, M Rastogi, M Husain, N Husain
October-December 2008, 53(4):196-198
DOI:10.4103/0019-5154.44799  PMID:19882035
Primary extracranial meningiomas occur very rarely. We present a rare case of extracranial meningioma of the transitional variant which was excised satisfactorily. There was no suggestion of any connection to the intracranial compartment or cranial nerves. The underlying galea was uninvolved, suggesting the true extracranial nature of this tumour. This rare diagnosis should nonetheless be kept in the differential diagnosis of scalp tumors.
  2,795 138 -
Cardiac involvement in patients of systemic sclerosis
Qazi Masood Ahmad, Iffat Hassan Shah, Qazi Nauman, Farah Sameem, MA Kamili
October-December 2008, 53(4):215-216
DOI:10.4103/0019-5154.44801  PMID:19882042
Background: Systemic sclerosis is a multi-systemic autoimmune disorder. Cardiac involvement by the disease, although not included in the diagnostic criteria, may be seen either clinically, histologically or may be revealed by various investigative modalities. Purpose: To see the profile of cardiac involvement in patients of systemic sclerosis. Materials and Methods: Forty-seven patients of systemic sclerosis were included in the study. After taking a complete history and doing a detailed physical examination, the patients were submitted to electrocardiogram ECG (all leads), echocardiography and x-ray chest. Furst's organ indices scoring system for cardiac involvement was followed. Findings: Forty-seven patients of systemic sclerosis were included in the study. Five females gave a history of palpitations. A loud pulmonic heart sound was heard in 1. Arrhythmias were observed in 5 patients. Significantly, echocardiography revealed valvular involvement in 5 patients. Left ventricular hypertrophy was seen in 2 patients. Conclusions: In our patients, cardiac involvement was rare. In contrast to other studies, valvular involvement was a prominent feature. Limitations: Complete evaluation for arrhythmias with 24-h Holter monitor was not used
  2,641 124 1
Depigmentation along lymphatic channels following intralesional corticosteroid injection
Lakshmi Chembolli, Reena Rai, Chakravarty R Srinivas
October-December 2008, 53(4):210-211
DOI:10.4103/0019-5154.44805  PMID:19882040
A 39-year-old female with a pruritic verrucous plaque over dorsal aspect of great toe was treated with 4 intralesional corticosteroid injections each at an interval of 2 weeks. Three months later, she developed depigmentation at the injection site and in a network-like distribution radiating away from the site. The depigmentation corresponded to the lymphatic drainage channels of the great toe.
  2,488 123 -
Multiple calluses as occupational marks in slipper-strap makers
TP Vetrichevvel, R Sureshbabu, C Udayashankar, P Oudeacoumar
October-December 2008, 53(4):222-224
DOI:10.4103/0019-5154.44797  PMID:19882046
  2,244 99 -
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