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Indian Journal of Dermatology
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   2012| May-June  | Volume 57 | Issue 3  
    Online since May 16, 2012

 
 
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CASE REPORTS
Disseminated cutaneous histoplasmosis in an immunocompetent adult
Manoj Harnalikar, Vidya Kharkar, Uday Khopkar
May-June 2012, 57(3):206-209
DOI:10.4103/0019-5154.96194  PMID:22707773
Histoplasmosis, a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii is endemic to many parts of the world. The clinical manifestations range from acute or chronic pulmonary infection to a progressive disseminated disease. After initial exposure to the fungus, the infection is self-limited and restricted to the lungs in 99% of healthy individuals. The remaining 1%, however, progress to either disseminated or chronic disease involving the lungs, liver, spleen, lymph nodes, bone marrow or rarely, the skin and mucous membranes. Mucocutaneous histoplasmosis is frequently reported in patients with acquired immune deficiency syndrome (AIDS), but it is rare in immunocompetent hosts. A 60-year-old male presented with asymptomatic swelling of the hard palate and crusted papules and nodules over the extremities, face and trunk. Clinically, the diagnoses of cutaneous cryptococcosis versus histoplasmosis was considered in this patient. A chest X-ray revealed hilar lymphadenopathy. Enzyme-linked immunosorbent assay (ELISA) for human immunodeficiency virus (HIV) was nonreactive. Skin biopsy revealed multiple tiny intracellular round yeast forms with a halo in the mid-dermis. Culture of the skin biopsy in Sabouraud's dextrose agar showed colonies of Histoplasma capsulatum. Despite an investigation including no evidence of underlying immunosuppression was found, he was started on IV amphotericin-B (0.5 mg/kg/day). However, the patient succumbed to his disease 2 days after presentation. We report a rare case of disseminated cutaneous histoplasmosis in an immunocompetent individual.
  4 5,020 178
ORIGINAL ARTICLES
Drug eruptions: An 8-year study including 106 inpatients at a dermatology clinic in Turkey
Fatma Akpinar, Emine Dervis
May-June 2012, 57(3):194-198
DOI:10.4103/0019-5154.96191  PMID:22707770
Background: Few clinical studies are found in the literature about patients hospitalized with a diagnosis of cutaneous drug eruption. Aims: To determine the clinical types of drug eruptions and their causative agents in a hospital-based population. Materials and Methods: This retrospective study was performed in the Dermatology Department of Haseki General Hospital. Through 1751 patients hospitalized in this department between 2002 and 2009, inpatients diagnosed as drug eruption were evaluated according to WHO causality definitions. 106 patients composed of probable and possible cases of cutaneous drug eruptions were included in this study. Results: Seventy one females and 35 males were evolved. Mean age was 44.03±15.14. Duration between drug intake and onset of reaction varied from 5 minutes to 3 months. The most common clinical type was urticaria and/or angioedema in 48.1% of the patients, followed by maculopapular rash in 13.2%, and drug rash with eosinophilia and systemic symptoms in 8.5%. Drugs most frequently associated with cutaneous drug eruptions were antimicrobial agents in 40.5% of the patients, followed by antipyretic/anti-inflammatory analgesics in 31.1%, and antiepileptics in 11.3%. Conclusion: Urticaria and/or angioedema and maculopapular rash comprised majority of the drug eruptions. Rare reactions such as acute generalized exanthematous pustulosis, sweet syndrome, oral ulceration were also found. Antimicrobial agents and antipyretic/anti-inflammatory analgesics were the most commonly implicated drugs. Infrequently reported adverse reactions to myorelaxant agents, newer cephalosporins and fluoroquinolones were also detected. We suppose that studies on drug eruptions should continue, because the pattern of consumption of drugs is changing in every country at different periods and many new drugs are introduced on the market continuously.
  3 4,529 144
REVIEW ARTICLE
Nanotechnology in medicine and relevance to dermatology: Present concepts
KH Basavaraj
May-June 2012, 57(3):169-174
DOI:10.4103/0019-5154.96186  PMID:22707765
Nanotechnology and nanomedicine are complementary disciplines aimed at the betterment of human life. Nanotechnology is an emerging branch of science for designing tools and devices of size 1-100 nm, with unique functions at the cellular, atomic and molecular levels. The concept of using nanotechnology in medical research and clinical practice is known as nanomedicine. Today, nanotechnology and nanoscience approaches to particle design and formulations are beginning to expand the market for many drugs and forming the basis for a highly profitable niche within the industry, but some predicted benefits are hyped. Under many conditions, dermal penetration of nanoparticles may be limited for consumer products such as sunscreens, although additional studies are needed on potential photooxidation products, experimental methods and the effect of skin condition on penetration. Today, zinc oxide and titanium dioxide nanoparticles (20-30 nm) are widely used in several topical skin care products such as sunscreens. Thus, in the present scenario, nanotechnology is spreading its wings to address the key problems in the field of medicine. The benefits of nanoparticles have been shown in several scientific fields, but very little is known about their potential to penetrate the skin. Hence, this review discusses in detail the applications of nanotechnology in medicine with more emphasis on the dermatologic aspects.
  3 7,559 433
BASIC RESEARCH
Morphometry and epidermal fas expression of unexposed aged versus young skin
Nagwa H Abd El-Aal, Faten A Abd El-Wadood, Nayera H Moftah, Mohamed S El-Hakeem, Abdalla Y El-Shaal, Neven B Hassan
May-June 2012, 57(3):181-186
DOI:10.4103/0019-5154.96188  PMID:22707767
Background: Identifying the molecular mechanisms of intrinsic aging is critical in developing modalities for reversal of cutaneous aging. Objective: The objective was to evaluate the expression of epidermal Fas, epidermal thickness, collagen, and elastic fibers degeneration in unexposed skin of aged individuals compared with young ones. Materials and Methods: Skin biopsies were taken from normal skin of the back of 22 old subjects (age range: 48-75 years) and 15 young subjects (age range: 18-28 years). Skin sections were stained with hematoxylin and eosin, Masson trichrome, orcein. Epidermal thickness was measured with image analyzer and scoring was done for collagen and elastic fiber degeneration. Fas immunostaining was done. Quantitative and qualitative data were compared statistically between the old and young subjects. Results: A statistically significant decreased epidermal thickness was found in old compared with young skin (P<0.05). A statistically significant number of patients showed decreased epidermal thickness, density, and fragmentation of both collagen and elastic fibers in old compared with young skin (P<0.001). Epidermal Fas expression was detected in 19 of 22 old subjects (86.4%) compared with 2 of 15 young subjects (13.3%) (P<0.001). There was no statistically significant correlation between age of old subjects and each of epidermal thickness, collagen, and elastic fiber degeneration. Conclusion: The decreased epidermal thickness and morphological alteration of collagen and elastic fibers are not correlated with aging and Fas-mediated apoptosis could be involved in thinning of the epidermis in unexposed aged skin.
  2 5,788 42
Expression of apoptosis regulatory markers in the skin of advanced hepatitis-C virus liver patients
Moetaz El-Domyati, Mahmoud Abo-Elenin, Wael Hosam El-Din, Hossam Abdel-Wahab, Hamza Abdel-Raouf, Tarek El-Amawy, Manal Barakat, Mahmoud Hamdy
May-June 2012, 57(3):187-193
DOI:10.4103/0019-5154.96189  PMID:22707768
Background: Hepatitis-C virus (HCV) infection is considered a major worldwide public health problem with a global prevalence. Maintenance of skin homeostasis requires a delicate balance between proliferation, differentiation, and apoptosis. Meanwhile, it is unclear if there is an altered keratinocyte proliferation/apoptosis balance in advanced liver disease with HCV infection. Aim: This work aimed to evaluate the epidermal thickness and changes in the expression of apoptosis regulatory markers as well as apoptotic index in skin samples of advanced HCV liver patients compared to normal controls. Materials and Methods: Twenty biopsies were taken from apparently normal skin of advanced HCV liver disease patients, as well as five healthy control subjects. These specimens were used for histometric epidermal measurement, immunohistochemical staining of apoptosis regulatory proteins (Bax, Fas, p53, Caspase-3, Bcl-2, Bcl-xL) as well as the TUNEL technique for detection of apoptotic cells. Results: The mean epidermal thickness was significantly lower than the control group (P=0.000). There were significant overexpression of pro-apoptotic markers (Bax, Fas, P53, and Caspase-3) in patients (P=0.03, 0.03, 0.003, 0.003 respectively), with increased apoptotic index in HCV liver patients (P=0.002) when compared to normal controls. On the other hand, no statistically significant difference were encountered in the expression of antiapoptotic markers (Bcl-2, Bcl-xL) in HCV patients when compared to normal controls (P=0.5, 0.9, respectively). Conclusion: These findings suggest that an alteration in the proliferation/apoptosis balance is present in the skin of HCV liver patients.
  2 3,325 46
CASE REPORTS
Erythema multiforme following application of hair dye
Sankha Koley, Jyotirindranath Sarkar, Sanjiv Choudhary, Suparna Dhara, Manoj Choudhury
May-June 2012, 57(3):230-232
DOI:10.4103/0019-5154.96209  PMID:22707781
Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction with varying degrees of blistering and ulceration. Common causes of EM are herpes simplex virus infection, mycoplasma infection, drug hypersensitivity, vaccination and drug-virus interaction. EM induced by contact dermatitis is rare. Paraphenylene diamine, a common ingredient in many hair dyes, is well known to produce allergic contact dermatitis. We report a 35-year-old lady presenting with EM following severe contact dermatitis to hair dye. So far as we know, this is the first report from India describing EM following contact dermatitis.
  2 4,490 103
Terminal 4q deletion syndrome
CM Kuldeep, AK Khare, Anubhav Garg, Asit Mittal, Lalit Gupta
May-June 2012, 57(3):222-224
DOI:10.4103/0019-5154.96203  PMID:22707778
Terminal deletion of the long arm of chromosome 4, (4q) is a rare event. It is characterized by spectral phenotypic manifestations, depending upon the site and quantity of chromatin lost. The chromosomal loss which span 4 (q31-q35) segment often manifests as craniofacial anomalies, mental retardation with ocular, cardiac, genitourinary defects and pelvic/limb dysmorphism. These abnormalities are usually unilateral. We report a female child (46, XX), aged 11 months, born to nonconsanguineous parents, bearing chromosomal deletion of 4 (q31.2-35.2) segment, which has manifested as craniofacial hypoplasia of left side of face, ipsilateral ptosis, erythroderma and bilateral thumb anomalies.
  2 4,939 49
SHORT COMMUNICATION
Role of nasal carriage of Staphylococcus aureus in chronic urticaria
Ashimav Deb Sharma
May-June 2012, 57(3):233-236
DOI:10.4103/0019-5154.96211  PMID:22707782
Aim: To evaluate the role of nasal carriage of Staphylococcus aureus in patients suffering from chronic urticaria. Method: All total 82 patients were included for this study. Study group comprised 57 patients with chronic urticaria and the control group comprised 25 healthy volunteers. Nasal swab specimens were taken from all the 82 patients for bacterial culture and antimicrobial sensitivity. Patients with chronic urticaria who had positive growth for S. aureus were treated with sensitive antimicrobial agent. Nasal swab specimens were taken again from all the patients who received antimicrobial therapy to ensure complete eradication of S. aureus. All patients were followed up for a period of 6 weeks after the treatment. Urticarial activity was measured with the help of urticarial activity score. Results: S. aureus was detected in swab specimens from the nasal cavity in 32 patients in the study group and 7 patients in the control group. In the study group, after the antimicrobial treatment, 9 patients (28.12%) had complete recovery from urticaria during the follow-up period; 4 patients (12.5%) showed partial recovery from urticaria while the remaining patients (59.37%) continued to suffer from urticaria. Conclusion: This study showed that nasal carriage of S. aureus can act as an etiological factor in chronic urticaria.
  2 2,538 102
BASIC RESEARCH
Response of T-cell subpopulations to superantigen and recall antigen stimulation in systemic sclerosis
Sajad Ahmad Dar, Sambit Nath Bhattacharya, Shukla Das, Vishnampettai Ganapathysubramanian Ramachandran, Basu Dev Banerjee, Prateek Arora
May-June 2012, 57(3):175-180
DOI:10.4103/0019-5154.96187  PMID:22707766
Background: There is great disagreement regarding which effector T-cells are responsible for the pathogenesis of systemic sclerosis. Further, the possible role of superantigens in modulating the T-cell phenotype responsible for the immunopathogenesis of this disease and the response of these patients to common recall antigens have not been adequately determined. Aims: To investigate the T-cell subsets and activation markers in peripheral blood mononuclear cells of systemic sclerosis patients before and after stimulation with different bacterial superantigens and common recall antigens to better understand the immunopathogenesis of this disease. Materials and Methods: T-cells (CD3 + ) from 20 systemic sclerosis patients and 17 age-matched healthy controls were studied using flow cytometry for the expression of CD4, CD8, CD45RA, and CD45RO at baseline and upon stimulation with different superantigens and recall antigens. Patients were also tested for skin delayed hypersensitivity to common recall antigens. Results: The proportions of CD45RA + (naive) and CD45RO + (memory) CD4 + T-cells were found to be significantly higher in patients than in controls upon stimulation with bacterial superantigens. However, T-cells from these patients responded weakly to recall antigen stimulation, indicating a loss of specific memory cells. This was further supported by the skin delayed hypersensitivity test in which 16 patients were found to be anergic. Conclusions: Our findings suggest that both naïve (CD45RA + ) and memory (CD45RO + ) CD4 + superantigen-reactive T-cells are effector T-cells that may modulate the pathogenic autoantibody response in systemic sclerosis. Accumulation of these cells in these patients may result in increased risk of relapses and resistance to therapy.
  1 3,188 68
CASE REPORTS
Adult T-cell leukemia/lymphoma: A retroviral malady
Anza Khader, Mohamed Shaan, Saritha Sasidharanpillai, Jaheersha Pakran, Uma Rajan
May-June 2012, 57(3):219-221
DOI:10.4103/0019-5154.96201  PMID:22707777
Adult T-cell leukemia/lymphoma (ATLL) is an aggressive leukemia/lymphoma of mature T-lymphocytes caused by human T-cell lymphotropic virus type 1 (HTLV-1). At a tertiary healthcare center in South India, a 58-year-old female presented with multiple erythematous, crusted, and umbilicated papules over the body along with cervical lymphadenopathy. The skin biopsy was consistent with cutaneous T-cell lymphoma. Although she responded initially to chemotherapy, the disease relapsed after 3 months, and she developed disseminated infiltrated skin lesions, generalized lymphadenopathy, and leukemia. Due to the unusual clinical findings we did HTLV-1 Enzyme-linked immunosorbent assay (ELISA), which turned out to be positive in high titers. Her mother had died at an early age from a hematological malignancy and her daughter was also found to be seropositive. To the best of our knowledge, this is the first case to be reported from India of the chronic type of ATLL associated with mother-to-child transmission of HTLV-1 in two generations. This case also emphasizes that the chronic type of ATLL can occur in nonendemic areas like India and should be suspected in nonresponding cases of mycosis fungoides. It should be kept in mind that the chronic type often presents without hypercalcemia or the characteristic 'flower cells' in the peripheral smear.
  1 4,455 53
Punctate vascular papules on the tongue and scrotum
Pooja Pahwa, Dilip Meena, Nadeem Tanveer, Vinod K Sharma, Gomathy Sethuraman
May-June 2012, 57(3):228-229
DOI:10.4103/0019-5154.96207  PMID:22707780
We report a 60-year-old man who presented with a 2-year history of painless red raised lesions involving the tongue and scrotum. Histopathology was suggestive of angiokeratoma. Oral angiokeratomas are most commonly found as a component of the generalized systemic disorder in Fabry's disease or fucosidosis. Our patient had isolated mucosal angiokeratomas which is very rare.
  1 4,033 81
CORRESPONDENCES
Bowen's disease treated with imiquimod and cryotherapy
Krina B Patel
May-June 2012, 57(3):239-241
DOI:10.4103/0019-5154.96217  PMID:22707785
  1 2,909 56
Malaria presenting as urticaria
Kiran V Godse, Vijay Zawar
May-June 2012, 57(3):237-238
DOI:10.4103/0019-5154.96213  PMID:22707783
  1 1,845 72
ORIGINAL ARTICLES
Causative drugs and clinical outcome in Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and SJS-TEN overlap in children
Gomathy Sethuraman, Vinod K Sharma, Pooja Pahwa, Pooja Khetan
May-June 2012, 57(3):199-200
DOI:10.4103/0019-5154.96192  PMID:22707771
Background : Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the most severe adverse drug reactions in children. Objectives : The objective was to study the causative drugs and outcome in children with SJS, SJS-TEN overlap, and TEN. Materials and Methods : Retrospective analysis of all the in-patient records of children below 18 years of age with the diagnosis of SJS, SJS-TEN overlap, and TEN was carried out. Results and Conclusions : Twenty children were identified, eight patients each were diagnosed as SJS and TEN and four as SJS-TEN overlap. Multiple drugs were implicated in 15 cases while single drug was responsible in 5 cases. Antibiotics (40.7%) were implicated as the commonest cause followed by NSAIDS (25.9%) and anticonvulsants (7.4%). Seventeen patients recovered completely and three patients died.
  1 4,755 194
Mucocutaneous and demographic features of systemic sclerosis: A profile of 46 patients from Eastern India
Sudip Kumar Ghosh, Debabrata Bandyopadhyay, Indranil Saha, Jayanta Kumar Barua
May-June 2012, 57(3):201-205
DOI:10.4103/0019-5154.96193  PMID:22707772
Background: Systemic sclerosis (SSc) is a multisystem connective tissue disorder of uncertain etiology. The clinical picture is frequently dominated by prominent cutaneous manifestations that have diagnostic and prognostic significance. The objective of the present study was to find out the demographic profile and the relative frequencies and characteristics of different mucocutaneous features of SSc in a group of patients from eastern India. In addition, we sought to compare the frequency and pattern of the findings in the limited versus the diffuse variety of the disease. Materials and Methods:This was a cross-sectional, clinical observational study. Consecutive patients of SSc attending the dermatology O.P.D. of a tertiary care hospital of eastern India over 3 years were enrolled to the present study. Results:A total of 46 patients (41 females and 5 males; mean age 29.6±12.3 years) of SSc were evaluated. Among mucocutaneous manifestations Raynaud's phenomenon was present in 39 (84.8%) patients. Other cutaneous features included dyspigmentation (40, 86.9%), sclerodactyly (38, 82.6%), inability to open the mouth (38,82.6%), mat-like telangiectasia (11,23.1%), fingertip ulceration and scarring (29,63%), cutaneous calcinosis (1,2.2%), digital gangrene in (2,4.3%), generalized pruritus (4,8.7%), cutaneous small vessel vasculitis (2,4.3%), chronic urticaria (2,4.3%), flexion contractures of the fingers (13,28.3%), and amputation of the digits (3,6.5%). Mucosal changes were observed in 10 (21.7%) patients and nail changes were seen in 13 (28.2%) patients. Diffuse cutaneous SSc was noted in 27 (58.7%) patients and limited cutaneous SSc was seen in the remainder. Thirty-six (78.2%) patients tested positive for ANA. Conclusion: The present study provides a snapshot of the spectrum of the demographic and mucocutaneous manifestations of SSc in the eastern Indian population. We have not observed any statistically significant differences between dcSSc and lcSSc in terms of mucocutaneous manifestations in the studied population.
  1 6,161 193
CASE REPORTS
Pseudoxanthoma elasticum with periumbilical perforation in a Nullipara
Parimalam Kumar, Athilakshmi Sivasubramanian, Sampath Vadivel, Manoharan Krishnaswamy
May-June 2012, 57(3):210-212
DOI:10.4103/0019-5154.96195  PMID:22707774
Pseudoxanthoma elasticum (PXE) is an inherited multisystem disorder that primarily affects the skin and is characterized by progressive calcification and degeneration of the elastic fibers. PXE has recently been found to be caused by mutations in the ATP-binding cassette transporter C6 (ABCC6) or the multidrug resistance-associated protein 6 (MRP6) genes. Perforating PXE is a rare presentation that is usually seen in the periumbilical area in obese multiparous black women; it has distinct clinical and histopathological features and there may or may not be systemic manifestations. We report an unusual case of PXE in a nulliparous woman, with perforation in the periumbilical area and without any systemic involvement.
  - 3,414 70
Psoriasis herpeticum due to Varicella zoster virus: A Kaposi's varicelliform eruption in erythrodermic psoriasis
Geeta Garg, Gurvinder P Thami
May-June 2012, 57(3):213-214
DOI:10.4103/0019-5154.96197  PMID:22707775
Kaposi's varicelliform eruption (KVE) or eczema herpeticum is characterized by disseminated papulovesicular eruption caused by a number of viruses like Herpes simplex virus I and II, Coxsackie virus, and Vaccinia and Small pox viruses in patients with pre-existing skin disease. The occurrence of KVE with psoriasis has been reported recently as a new entity psoriasis herpeticum. The rare causation of psoriasis herpeticum due to Varicella zoster virus in a patient with underlying psoriasis is being reported for the first time.
  - 4,553 83
Leukocytoclastic vasculitis: A window to systemic Churg Strauss syndrome
Sudhir V Medhekar, Resham J Vasani, Ratnakar R Kamath
May-June 2012, 57(3):215-218
DOI:10.4103/0019-5154.96198  PMID:22707776
A twenty year old male presented with purpuric lesions with chronic painful ulcers over the lower extremities and a recurrent pruritic rash on the trunk for 10 years. He was diagnosed as idiopathic leukocytoclastic vasculitis (LCV) after investigations failed to reveal a systemic association. He was treated with immunosuppressants at each visit with partial remission. In 2004, he was diagnosed with bronchial asthma and allergic rhinitis. In his recent admission, he showed necrotic ulcers on legs and extensive shiny, truncal micropapules. Examination revealed maxillary sinus tenderness and loss of sensation on the medial aspect of the left lower limb. Biopsy of ulcer and the micropapules showed the presence of extravascular eosinophils, while hematological investigations showed peripheral eosinophilia of 18%, raised serum Immunoglobulin E (IgE), Anti nuclear antibody (ANA) positivity and negative antineutrophil cytoplasmic antibody (ANCA). Radiography confirmed maxillary sinusitis, nerve conduction studies revealed mononeuritis of the anterior tibial nerve and pulmonary function tests (PFT) were normal. Clinical examination and investigations pointed towards the diagnosis of Churg-Strauss syndrome (CSS). This report highlights the development of full-blown CSS over a period of 12 years in a patient initially diagnosed as idiopathic LCV, emphasizing the need for regular follow-up of resistant and recurrent cases of LCV.
  - 3,662 55
Eccrine angiomatous hamartoma: A rare skin lesion with diverse histological features
Sumit Kar, Ajay Krishnan, Nitin Gangane
May-June 2012, 57(3):225-227
DOI:10.4103/0019-5154.96206  PMID:22707779
Eccrine angiomatous hamartoma (EAH) is an exceedingly rare benign tumor-like lesion prevalent in childhood which may produce pain and marked sweating. The histological features include proliferation of eccrine sweat glands and angiomatous capillary channels. We report an 8-year-old girl who had a single lesion on her left lower leg. Physical examination revealed a slightly elevated, 4×7 cm erythematous plaque on the lateral aspect of left leg. Sweating in the lesion was evoked by physical work or emotional stress. There was no pain or tenderness associated with the lesion. The patient had no history of trauma to the site. These lesions were clinically angiomatous, and we obtained the diagnosis by histopathological examination. Histopathological examination of the lesion showed increased numbers of eccrine glands, as well as dilated vascular channels in the deep dermis and subcutaneous tissue. These findings are consistent with EAH.
  - 3,089 63
CORRESPONDENCES
Beating palmoplantar psoriasis away
Paschal V D'Souza
May-June 2012, 57(3):241-242
DOI:10.4103/0019-5154.96219  PMID:22707786
  - 3,042 78
Current clinico-mycological trends of onychomycosis in Pune
Ram Tainwala, YK Sharma
May-June 2012, 57(3):242-243
DOI:10.4103/0019-5154.96220  PMID:22707787
  - 2,109 156
Cutaneous manifestations of sarcoidosis
Alka Dogra, Sukhjot Kaur
May-June 2012, 57(3):243-244
DOI:10.4103/0019-5154.96221  PMID:22707788
  - 2,608 108
Authors' reply
Raghunatha R Reddy, BM Shashi Kumar, MR Harish
May-June 2012, 57(3):244-245
PMID:22707789
  - 1,642 43
Gadolinium-bound contrast agents: No evidence-based data to support a relationship between structure and hypersensitivity reactions
Jean-Marc Idee, Sophie Gaillard, Claire Corot
May-June 2012, 57(3):245-245
DOI:10.4103/0019-5154.96223  PMID:22707790
  - 1,979 37
Author's Reply
Zhitong Zou
May-June 2012, 57(3):246-246
PMID:22707791
  - 1,380 29
A study on cutaneous manifestations of thyroid disease
Neerja Puri
May-June 2012, 57(3):247-248
DOI:10.4103/0019-5154.96227  PMID:22707792
  - 7,153 166
Pseudoainhum in psoriasis
Pradeep Kumar, Vijay Gandhi
May-June 2012, 57(3):238-239
DOI:10.4103/0019-5154.96215  PMID:22707784
  - 2,397 51
CORRIGENDA
Corrigenda

May-June 2012, 57(3):193-193
PMID:22707769
  - 1,115 34
EDITORIAL
IJD® becomes the official organ of the Asian Academy of Dermatology and Venereology
Koushik Lahiri
May-June 2012, 57(3):167-168
DOI:10.4103/0019-5154.96185  PMID:22707764
  - 3,511 66
PHOTO QUIZ
An unusually painful nodule
Rickson R Pereira, Chitra S Nayak, Afsha Topal, Rachita S Dhurat
May-June 2012, 57(3):249-250
DOI:10.4103/0019-5154.96229  PMID:22707793
  - 2,234 100
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