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   Table of Contents - Current issue
Coverpage
March-April 2017
Volume 8 | Issue 2
Page Nos. 79-165

Online since Thursday, March 16, 2017

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REVIEW ARTICLE  

Arthropathy in dermatology: A comprehensive review Highly accessed article p. 79
Soumya Jagadeesan, Padmanabha Shenoy
DOI:10.4103/idoj.IDOJ_25_17  
Dermatology and rheumatology are two specialties that deal with significant overlap. In this context, it is important that the dermatologists acquaint themselves with conditions presenting with arthropathy. As the first step, it is essential to know whether the origin of musculoskeletal symptom is articular or extra-articular; inflammatory or noninflammatory; acute or chronic; oligo- or poly-articular. This will help in narrowing down the differential diagnoses as well as in better correlation with the cutaneous symptoms. In this review, we discuss the skin and articular manifestations of common inflammatory and noninflammatory arthropathies including rheumatoid arthritis, spondyloarthropathies, connective tissue disorders, vasculitis, crystal arthropathies, infective arthritis, arthritis associated with degenerative, endocrine and metabolic conditions, etc. We have also added a section on the common cutaneous features associated with the treatment of rheumatologic diseases. A basic understanding of the joint pathologies and associated skin changes will help a long way in the better management of these conditions.
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ORIGINAL ARTICLES Top

Autologous serum and plasma skin tests in chronic spontaneous urticaria: A reappraisal p. 94
Muthu Sendhil Kumaran, Sonia Mangal, Tarun Narang, Davinder Parsad
DOI:10.4103/2229-5178.202266  
Aim: The objective of this study was to assess autologous serum skin test (ASST) vs autologous plasma skin test (APST) response in chronic spontaneous urticaria (CSU) patients and study the significance of intensity of positive responses in relation to clinicoepidemiological parameters. Materials and Methods: One hundred CSU patients and 100 age and sex-matched controls were recruited. The demographic and clinical features were recorded in all patients and routine investigations were performed. ASST and APST tests were performed as per the standard guidelines. Results: The mean duration of illness was 4.85 ± 5.07 years, 90% patients were APST (+), 68% ASST (+), and 22 patients were only APST (+). Positive predictive value (PPV) of ASST and APST was 90.7% and 95.7%, respectively. A significant inverse association was seen between thyroid status and serum IgE levels with APST and ASST positivity. Conclusion: APST appears to have better PPV and high intensity of positive response on autologous tests, and correlates with ANA positivity and angioedema.
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Clinicoepidemiological and mycological study of tinea capitis in the pediatric population of Kashmir valley: A study from a tertiary care centre p. 100
Yasmeen J Bhat, Sumaya Zeerak, Farhat Kanth, Atiya Yaseen, Iffat Hassan, Rubina Hakak
DOI:10.4103/2229-5178.202279  
Background: Tinea capitis is a superficial fungal infection that predominantly affects the pediatric population. The etiological factors vary from region to region, and the exact incidence remains obscure. The clinicoepidemiological and mycological aspects of this dermatophytosis were studied in a tertiary care centre in Kashmir valley. Aim: To determine the clinicoepidemiological aspects and mycological findings of dermatophytes involved in tinea capitis cases in Kashmir valley. Materials and Methods: Wood's lamp examination, KOH examination, and fungal culture were performed in one hundred fifty clinically diagnosed cases of tinea capitis with patients' age upto 14 years over a period of 6 months. The epidemiological factors associated with the disease were also evaluated.Results: Tinea capitis was predominant in the 3–6 and 6–9 years age groups with a male preponderance. Grey patch tinea capitis was the most common variant. KOH positivity was 76%, and Trichophyton tonsurans was the most common fungal isolate. Conclusion: Tinea capitis is a very common fungal infection in our setting. Early detection and diagnosis is mandatory to prevent its spread in the community as well as the development of scarring alopecia in the affected individual.
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Cutaneous manifestations of polycystic ovary syndrome: A cross-sectional clinical study p. 104
Mohammad Abid Keen, Iffat Hassan Shah, Gousia Sheikh
DOI:10.4103/2229-5178.202275  
Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, affecting 5–10% of reproductive-aged women. The dermatologic manifestations of hyperandrogenism, chiefly hirsutism, acne vulgaris, androgenic alopecia, and acanthosis nigricans, are among the cardinal manifestations of PCOS. Aim: To study the incidence and prevalence of various cutaneous manifestations in patients with PCOS and to correlate these skin manifestations with hormonal changes. Settings and Design: This study was conducted at a dermatology centre over a period of 1 year from November 2012 to 2013. Materials and Methods: The present study included 100 women diagnosed to have PCOS. Hormonal analysis as well as radiological assessment was done in all the cases. Cutaneous manifestations were ascertained and inferences were drawn. Statistical Analysis: Statistical analysis was carried out by the Chi-square test and independent samples t-test. Statistical significance was determined at a level of P < 0.05. Results: In our study, the prevalence of hirsutism, acne, female pattern hair loss, acanthosis nigricans, seborrhea, striae and acrochordons was 78%, 48%, 31%, 30%, 29%, 13%, and 9%, respectively. Conclusion: Dermatologic manifestations of PCOS play a significant role in making the diagnosis and constitute a substantial portion of the symptoms experienced by women with this syndrome.
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Assembling a hand-held trichotillometer and determination of epilation force in normal individuals p. 111
Kumaresan Muthuvel, Srinivas Chakravati, Sasidaharan Nair
DOI:10.4103/2229-5178.202286  
Aim: To assemble a simple, inexpensive hand-held trichotillometer and to determine the epilation force (EF) required to pluck the anagen hair and telogen hair from four regions of the scalp in healthy volunteers. Materials and Methods: A simple hand-held trichotillometer was assembled by modifying a laboratory spring balance, and the instrument was calibrated after attachments. EF was measured in 30 healthy individuals on four regions of the scalp. Results: A total of 30 volunteers were included in the study, among them 15 were males and 15 were females. A total of 1200 hairs were examined. The mean EF in our study was 70.15 grams (g). The mean EF required to pluck the anagen hair was 86.61 g and telogen hair was 53.69 g. Conclusion: The assembled- hand held trichotillometer is a simple and reliable device. Tricotillometer is a useful device to measure the EF in various physiological and pathological conditions and may have diagnostic, prognostic, and therapeutic value in various hair diseases.
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BRIEF REPORTS Top

Spectrum of lip lesions in a tertiary care hospital: An epidemiological study of 3009 Indian patients p. 115
Shivani Bansal, Sana Shaikh, Rajiv S Desai, Islam Ahmad, Pavan Puri, Pooja Prasad, Pankaj Shirsat, Dipali Gundre
DOI:10.4103/2229-5178.202280  
Aim: Large-scale population-based screening studies have identified lip lesions to be the most common oral mucosal lesions; however, few studies have been carried out to estimate the prevalence of lip lesions exclusively. The aim of present study is to highlight the diversity of lip lesions and determine their prevalence in an unbiased Indian population. Materials and Methods: Lip lesions were selected from 3009 patients who visited the department over a period of 3 years (January 2012 to December 2014). Age, sex, location of lip lesions, a detailed family and medical history, along with the history of any associated habit was recorded. Biopsy was carried out in necessary cases to reach a final diagnosis. The pathologies of the lip were classified based on the etiology. Results: Among 3009 patients, 495 (16.5%) had lip lesions ranging from 4 years to 85 years with a mean age of 39.7 years. There were 309 (62.4%) males and 185 (31.9%) females. Lower lip was the most affected region (54.1%) followed by the corner of the mouth (30.9%) and upper lip (11.7%). In 3.2% of the cases, both the lips were involved. Of the 495 lip lesions, the most common were Potentially Malignant Disorders (PMDs) (37.4%), herpes labialis (33.7%), mucocele (6.7%), angular cheilitis (6.1%), and allergic and immunologic lesions (5.7%). Conclusion: Lip lesions may act as an indicator for the presence of an underlying systemic disease. PMDs and infections were the most common lip lesions in the present study.
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Over-the-counter and prescription medications for acne: A cross-sectional survey in a sample of university students in Saudi Arabia p. 120
Mohja D Alshehri, Abdulsalam T Almutairi, Asma M Alomran, Batool A Alrashed, Feroze Kaliyadan
DOI:10.4103/2229-5178.202273  
Introduction and Background: Acne is a very common dermatological condition found among the adolescent population in Saudi Arabia. Many patients with acne try various forms of self-medication, over the counter medicines (OTC), and prescription medicines for the same. Materials and Methods: This was a cross-sectional study among university students in the Kingdom of Saudi Arabia (KSA). A validated questionnaire was distributed to a convenience sample of university students to evaluate their knowledge and attitudes towards OTC (mainly) as well as prescription medicine for acne. Chi-square and multiple logistic regression tests were used for comparisons between groups. Results: Four hundred and twenty valid, completed questionnaires were obtained. A total of 220 (52.4%) used some type of OTC medications at least once, where as 108 (25.7%) used prescription medicines and 92 (21.9%) used both. The most common OTC medications used were cleansers by 250 participants (41.9%). Among prescription medicines, the most common were topical and oral antibiotics (11.4%). Bivariate and multivariate analysis showed that females are statistically more likely to use OTC medicines compared to males (Odds ratio: 1.7). Conclusion: The use of self-medications and OTC medications is common among university students in KSA. The most common OTC medicine used for acne was cleanser.
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CASE REPORTS Top

Lyme disease: A case report with typical and atypical lesions Highly accessed article p. 124
Anuj Sharma, Sandesh Guleria, Reena Sharma, Anita Sharma
DOI:10.4103/2229-5178.202271  
Lyme disease is a multisystem infectious disease caused by the spirochete “Borrelia burgdorferi,” which is transmitted by “Ixodes” tick, with skin being the most common and earliest organ to be affected. Diagnosis of erythema chronicum migrans (ECM), which is the characteristic lesion of early disease, may help in early treatment and prevention of complications. Here, we are reporting a case of Lyme disease in a 10-year-old young boy from a non-endemic zone of Himachal Pradesh, who presented with typical as well as atypical ECM lesions. The clinical diagnosis was confirmed serologically, and the child was treated successfully with doxycycline.
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Arteriovenous malformation underlying a plexiform neurofibroma: An unusual presentation p. 128
Zaheer Abbas, Sepideh Khani, Javad Zare
DOI:10.4103/2229-5178.202272  
Vascular abnormalities associated with neurofibromatosis type 1 are well described in the literature, however, arteriovenous malformation is a very rare finding in neurofibromatosis type 1. We report the case of an 11-year-old girl who presented with a soft mass on the right flank. Provisional diagnosis of plexiform neurofibroma was made on the basis of clinical and histological observations. Because the lesion was warm on palpation, imaging studies were performed to evaluate further and arteriovenous malformation was detected underlying the plexiform neurofibroma. This report emphasizes the importance of careful examination and proper investigations of the plexiform neurofibroma prior to treatment strategies to avoid future complications. The rarity of plexiform neurofibroma in association with arteriovenous malformation at the same site was also highlighted in this report.
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Linear and whorled nevoid hypermelanosis with depigmentation p. 131
Preema Sinha, Manas Chatterjee, Kamlesh K Singh, Aradhana Sood
DOI:10.4103/2229-5178.202274  
Linear and whorled nevoid hypermelanosis (LWNH) is a rare disorder of pigmentation characterized by hyperpigmented macules in a linear or whorled streaky configuration. Lesions are distributed mainly on the trunk and extremities, sparing the palms, soles, and mucosae. Depigmentation occurring in the pre-existing whorls has not been reported till date. Herein, we report one such rare case of familial LWNH with depigmentation.
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LETTERS TO THE EDITOR Top

Multiple basal cell carcinomas in a patient of oculocutaneous albinism p. 134
Debasmita Behera, Tapaswini Tripathy, Bikash R Kar
DOI:10.4103/2229-5178.202262  
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Dermographic urticaria induced by long-pulsed diode laser-assisted epilation: Rare etiology of a common eruption p. 136
Aanchal Panth, Saurabh Singh, Neena Khanna
DOI:10.4103/2229-5178.202284  
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Sarcomatoid carcinoma of the hard palate: An unusual cause of palatal ulcer p. 137
Sweta Subhadarshani, Savita Yadav, Ashok Singh, Anurag Chahal
DOI:10.4103/2229-5178.202268  
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A sporadic case of ichthyosis hystrix: Curth and Macklin type p. 139
Pragya A Nair, Rochit Singhal, Shailee Gandhi, Nilofar Diwan
DOI:10.4103/2229-5178.202264  
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Acanthoma fissuratum: Lest we forget p. 141
Nikhil S Deshpande, Arijit Sen, Biju Vasudevan, Shekhar Neema
DOI:10.4103/2229-5178.202267  
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Nevoid hypertrichosis in a pre-adolescent girl p. 143
Deepashree Daulatabad, Chander Grover, Nadeem Tanveer
DOI:10.4103/2229-5178.202285  
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Extensive giant tuberous xanthomas in a 12-year-old boy p. 145
Rita V Vora, RahulKrishna S Kota, Nishit K Surti, Rochit R Singhal
DOI:10.4103/2229-5178.202265  
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Minoxidil-induced hypertrichosis in a child with alopecia areata p. 147
Ajay Kumar Rai
DOI:10.4103/2229-5178.202269  
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Laugier–Hunziker syndrome in a young female p. 148
Bidweshwar Verma, Akhilesh Behra, Abdul K. M. Ajmal, Sumit Sen
DOI:10.4103/2229-5178.202282  
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Nevoid psoriasis coexisting with verrucous epidermal nevus p. 150
Vaishali Masatkar, Lalit K Gupta, Sharad Mehta, Ashok K Khare, Asit Mittal
DOI:10.4103/2229-5178.202263  
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SKINDIA QUIZ Top

SkIndia Quiz 34: Asymptomatic swelling over an old forehead scar p. 153
Pravesh Yadav, Preksha Singh, Ram Chander
DOI:10.4103/2229-5178.198809  
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SkIndia quiz 35: A girl with multiple papules p. 155
Siddhi Gaurish Sinai Khandeparkar, Maithili M Kulkarni, Sanjay Deshmukh, Yuvraj E More
DOI:10.4103/2229-5178.198810  
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SkIndia quiz 36: A phantasmagoric lesion: A face for thought p. 157
Sunil K Gupta, Anisha Sethi
DOI:10.4103/2229-5178.202283  
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THROUGH THE LENS Top

Plexiform neurofibroma overlying giant café-au-lait macule p. 159
Sanjiv V Choudhary, Anuja A Dhope, Ruchi Singh, Pravin Tidke
DOI:10.4103/2229-5178.202270  
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Case of unilateral temporal triangular alopecia p. 161
Sujit J. S. Shanshanwal, Garima Adwani, Ameet L Dandale, Rachita S Dhurat
DOI:10.4103/2229-5178.202276  
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THROUGH THE DERMOSCOPE Top

A dermoscopic diagnosis and activity evaluation of frontal fibrosing alopecia in an indian lady p. 162
Sidharth Sonthalia, Abhijeet K Jha, Pankaj K Tiwary
DOI:10.4103/idoj.IDOJ_307_16  
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OBITUARY Top

Prof. K. Siddappa p. 164
Arun C Inamadar
DOI:10.4103/idoj.IDOJ_65_17  
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