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   2012| January-April  | Volume 3 | Issue 1  
    Online since March 3, 2012

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Mantoux test and its interpretation
Surajit Nayak, Basanti Acharjya
January-April 2012, 3(1):2-6
DOI:10.4103/2229-5178.93479  PMID:23130251
The tuberculin skin test is one of the few investigations dating from the 19 th century that are still widely used as an important test for diagnosing tuberculosis. Though very commonly used by physicians worldwide its interpretation always remains difficult and controversial. Various factors like age, immunological status coexisting illness etc influence its outcome, so also its interpretation. Utmost care is required while interpreting the result and giving an opinion. This article has been written with the purpose of elucidating the performance and interpretation of the standard tuberculin test.
  71,747 4,619 63
Finasteride and sexual side effects
Venkataram Mysore
January-April 2012, 3(1):62-65
DOI:10.4103/2229-5178.93496  PMID:23130269
Finasteride, a 5-alpha reductase inhibitor, widely used in the medical management of male pattern hairloss, has been reported to cause sexual side effects. This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.
  29,475 1,678 20
Clinicoepidemiological study of pigmented purpuric dermatoses
Lata Sharma, S Gupta
January-April 2012, 3(1):17-20
DOI:10.4103/2229-5178.93486  PMID:23130254
Background: Pigmented purpuric dermatoses (PPD) are a group of vascular disorders with varied manifestations which cause concern and are resistant to treatment. The literature is still lacking in clinicoepidemiological studies. Aim: To study the epidemiology, etiological, host and environmental factors, clinical manifestations, its variations, and the type prevalent in this part of the world. Materials and Methods: All cases of PPD were selected for the study from Skin and Venereal Disease, Out Patient Department between January 2008 and June 2009. Their history, examination, hematological investigations, and, in a few, histopathology findings were also recorded and data obtained were evaluated statistically. Results: There were 100 cases of PPD of total 55 323 patients (0.18%). There were 79 males and 21 females between 11 and 66 years. They were working as police men, security guards, barber, chemist, teachers, students, farmers, businessmen, and housewives. In a majority, there was a history of prolonged standing in day-to-day work. Purpuric, brownish pigmented, lichenoid or atrophic lesions were seen depending upon the type of PPD on lower parts of one or both lower limbs. Blood investigations were normal. Schamberg's disease was seen in ninety five, Lichen aureus in three, lichenoid dermatosis and Majocchi's disease in one case each. Discussion: Three clinical types of PPD were diagnosed which may represent different features of the same disease. Cell-mediated immunity, immune complexes, capillary fragility, gravitational forces, venous hypertension, focal infection, clothing, contact allergy to dyes, and drug intake have been incriminating factors in the past. Patient's occupation and environmental factors may also be considered contributory in precipitating the disease. Conclusions: The study revealed the problem of PPD in this geographical area, its magnitude, clinical presentation, the type prevalent, and possible aggravating factors to be kept in mind while managing the disease.
  23,381 979 9
Pyoderma gangrenosum: An update
Ramesh M Bhat
January-April 2012, 3(1):7-13
DOI:10.4103/2229-5178.93482  PMID:23130252
Pyoderma gangrenosum (PG) is an uncommon, distinctive cutaneous ulceration which is usually idiopathic, but may be associated with many systemic disorders. The etipathogenesis of of PG is still not well understood. Clinically it is classified into ulcerative, pustular, bullous and vegetative types. A few atypical and rare variants have also been described. The diagnosis mainly depends on the recognition of evolving clinical features as investigations only assist in the diagnosis. In view of this a few criteria have been proposed for the diagnosis of PG. the treatment mainly consists of corticosteroids and immunosuppressive agents. A few new agents have also been tried in the management.
  22,134 2,226 23
Implantation dermoid of the palm: An unusual presentation
Sanjay Saraf
January-April 2012, 3(1):37-39
DOI:10.4103/2229-5178.93499  PMID:23130260
An unusual case of palmar implantation dermoid causing paresthesia in the fingers is reported. The tumor was successfully excised with relief of the symptoms. The report discusses important points regarding management of such tumors.
  15,178 420 3
Annular, erythematous skin lesions in a neonate
Aparna Palit, Arun C Inamadar
January-April 2012, 3(1):45-47
DOI:10.4103/2229-5178.93504  PMID:23130263
A 7-day-old premature female infant presented with rapidly progressive, erythematous, annular skin lesions from the 5 th day of life. She was diagnosed provisionally as a case of neonatal lupus erythematosus and was investigated accordingly. Histopathological examination of the skin biopsy specimen revealed presence of hyphae of dermatophytes in the stratum corneum, and the diagnosis was changed to tinea corporis. Differential diagnosis of the annular erythema of infancy has been discussed and the importance of scraping a scaly lesion for KOH preparation in the diagnostic work-up of such a patient has been highlighted.
  7,326 615 8
Cutaneous polyarteritis nodosa: A rare isolated cutaneous vasculitis
Praveen Kumar A Subbanna, Negi Vir Singh, Rathinam P Swaminathan
January-April 2012, 3(1):21-24
DOI:10.4103/2229-5178.93488  PMID:23130255
Cutaneous polyarteritis nodosa (CPAN) is a rare form of cutaneous vasculitis that involves small and medium sized arteries of the dermis and subcutaneous tissue without systemic involvement. It presents with tender subcutaneous nodules, digital gangrene, livedo reticularis and subcutaneous ulcerations. The diagnosis is by skin biopsy and characteristic pathologic feature is a leukocytoclastic vasculitis in the small to medium-sized arterioles of the dermis. We report a rare case of benign cutaneous PAN in a 14-year-old girl who presented with history of fever, subcutaneous nodules with cutaneous ulcer and digital gangrene. The skin biopsy showed leukocytoclastic vasculitis with fibrinoid necrosis in the dermal vessels. She received treatment with steroids and lesions resolved completely over a period of month.
  6,769 645 9
SkIndia Quiz 5 - Shiny, waxy papules on face and extremities in a female with dyspnea
M Ranga Swaroop, Kuchangi C Nischal, Uday Khopkar
January-April 2012, 3(1):78-79
DOI:10.4103/2229-5178.86117  PMID:23130277
  6,796 326 -
Co-occurrence of intraoral hemangioma and port wine stain: A rare case
Prasanna Kumar Rao, Vishal Bejai, Sanath Rao, Shishir Ram Shetty
January-April 2012, 3(1):28-30
DOI:10.4103/2229-5178.93493  PMID:23130257
Hemangiomas are neoplastic proliferations of endothelial cells, characterized by a period of growth after birth, and eventual spontaneous involution. The course can be uneventful with spontaneous resolution; or it may be marked by complications such as infection, bleeding, ulceration, visual defects and feeding difficulties. Apart from these, rare life-threatening complications such as congestive heart failure and consumption coagulopathy may also be seen. Although hemangiomas commonly occur in the head and neck region, intraoral occurrence is relatively rare. A port wine stain is defined as a macular telangiectatic patch which is present at birth and remains throughout life. They may be localized or extensive, affecting a whole limb. This article reports a rare case of co-occurrence of port wine stain with intraoral hemangioma.
  5,648 510 2
Cutis laxa with pulmonary artery stenosis
Krina B Patel, Ruchin Patel
January-April 2012, 3(1):70-71
DOI:10.4103/2229-5178.93487  PMID:23130272
  5,504 273 -
Keratitis-Ichthyosis-Deafness syndrome: A rare congenital disorder
Vinay Shanker, Mudita Gupta, Aditi Prashar
January-April 2012, 3(1):48-50
DOI:10.4103/2229-5178.93505  PMID:23130264
Keratitis-Icthyosis-Deafness syndrome is a rare congenital disorder characterized by keratitis, ichthyosis, and deafness. We report a 13 year old female child who presented with diffuse alopecia of the scalp and body. There was erythrokeratoderma of face and discrete hyperkeratotic hyperpigmented papulo plaque lesions on the body. Patient also had reticulate hyperkeratosis of palms and soles. There was history of recurrent episodes of folliculitis over the scalp and body. There was no evidence of any malignancy. Eye involvement in the form of bilateral vascularising keratitis was present. There was bilateral mixed hearing loss.
  5,163 482 6
Lipoid proteinosis in a six-year-old child
Surajit Nayak, Basanti Acharjya
January-April 2012, 3(1):25-27
DOI:10.4103/2229-5178.93490  PMID:23130256
Lipoid proteinosis (LiP) (OMIM 247100) is a rare autosomal recessive disease caused by loss of function mutations in the extracellular matrix protein 1 gene, ECM1, on chromosome 1q21. Clinically characterized by hoarseness in early infancy, followed by waxy papules and plaques on the face and body along with pox-like and acneiform scars. We report here a 6-year-old female child with LiP, who presented to our OPD for recurrent vesicullobullous lesions and beaded lesions over eyelid margins.
  5,128 351 2
Giant lupus vulgaris: A rare presentation
S Sacchidanand, S Sharavana, M Mallikarjun, HV Nataraja
January-April 2012, 3(1):34-36
DOI:10.4103/2229-5178.93498  PMID:23130259
Cutaneous tuberculosis continues to be an important public health problem even with the availability of highly effective anti-tuberculous drugs. It constitutes 0.1% of all cases of extrapulmonary tuberculosis. Lupus vulgaris is the most common form of cutaneous tuberculosis that occurs in previously sensitized individuals with a moderate degree of immunity against tubercle bacilli. The different types of lupus vulgaris include plaque, ulcerative, vegetative, papular and nodular, and tumor forms. A 40-year-old man presented with large multiple plaques over right upper limb, right side of chest and back, and right lower limb for the past 30 years. Histopathology showed numerous noncaseating granulomas with Langhan's type of giant cells. The Mantoux test showed strong positivity and there was excellent response to anti-tuberculous treatment. This case is being reported because of its extreme chronicity of 30 years duration, unusually large size and multiplicity of lesions.
  5,004 439 3
Generalized papular granuloma annulare
Manish Bansal, Shyam Sunder Pandey, Kajal Manchanda
January-April 2012, 3(1):74-76
DOI:10.4103/2229-5178.93492  PMID:23130275
  4,773 413 2
'Venetian blinds' artifact in dermatohistopathology
Rajiv Joshi
January-April 2012, 3(1):59-61
DOI:10.4103/2229-5178.93497  PMID:23130268
The 'Venetian blinds' artifact is an uncommon tissue cutting artifact that leads to the formation of parallel series of strips of tissue separated from one another by narrow clear spaces. It has been attributed to either hardening of the tissue in the paraffin block or defective assembly of the microtome knife. This artifact occurs in both inflammatory and neoplastic conditions in which there are nodular collections of cells and may reflect vibration-induced disintegration of fragile cellular aggregates that lack dermal stromal support. At scanning magnification, it serves to draw the histopathologist's eye to the site of pathology.
  4,651 382 2
Histoid leprosy with penile shaft lesions
Feroze Kaliyadan, Andezthu D Dharmaratnam, Malayil J Cyriac
January-April 2012, 3(1):68-70
DOI:10.4103/2229-5178.93485  PMID:23130271
  4,300 261 1
Herpes zoster duplex bilateralis in an immunocompetent host
Pratik Gahalaut, Sandhya Chauhan
January-April 2012, 3(1):31-33
DOI:10.4103/2229-5178.93495  PMID:23130258
Varicella zoster virus causes both chicken pox and herpes zoster. The phenomenon of herpes zoster occurring concurrently in two non-contiguous dermatomes involving different halves of the body is termed herpes zoster duplex bilateralis (HZDB). Few cases, reported in the literature, were seen in either an immunosuppressed host or in the older age group. Here we present a case of HZDB in an immunocompetent host, probably the first in India.
  3,778 372 3
Cutaneous angiomyolipoma
Anand S Ammanagi, Vijay D Dombale, Vishwanath V Shindholimath
January-April 2012, 3(1):40-41
DOI:10.4103/2229-5178.93501  PMID:23130261
We report a case of cutaneous angiomyolipoma (AML) found on the anterior abdominal wall of a 3-year-old female child. Histologic examination showed a well-circumscribed nodule in the dermis composed of an intimate mixture of convoluted thick-walled blood vessels, smooth muscle, and mature fat. This lesion differs from renal AML in terms of a lack of association with tuberous sclerosis, circumscription, absence of epithelioid cells, and male predominance. We concluded that the unique features of this lesion distinguish it from other lesions such as angiomyoma, angiolipoma, myolipoma, haemangioma, and other mixed mesenchymal tumors. This case report suggests that the features considered diagnostic of AML can occur in extrarenal sites and, therefore, this diagnosis cannot be excluded on the basis of site alone.
  3,169 394 4
Endothelin-1 in systemic sclerosis
Mehrdad Aghaei, Farhad Gharibdost, Habib Zayeni, Maryam Akhlaghi, Sima Sedighi, Abduo Rahman Rostamian, Naser Aghdami, Mahdieh Shojaa
January-April 2012, 3(1):14-16
DOI:10.4103/2229-5178.93484  PMID:23130253
Introduction: Scleroderma is a systemic disorder with unknown etiology most notably characterized by skin thickening and organ damage. Endothelin-1 (ET-1) plays a role in skin fibrosis. The aim of this study was survey and comparison of ET-1 level in Systemic Sclerosis (SSc) patients with and without digital ulcer. Material and Methods: A cross-sectional analytical study conducted among the 95 patients with scleroderma in 2006 who were referred to the Rheumatology clinic in Shariati hospital of Tehran. The questionnaire was completed for every patient. Plasma level of endothelin-1 was also measured in all of them. The data was analyzed using SPSS software and statistical tests. Results: The result indicated, relationship among digital ulcers and digital pitting scars with plasma level of ET-1 were significant (P value < 0.05). We could not find any significant relationship between age and plasma level of ET-1. Conclusion: These data indicate plasma level of ET-1 in scleroderma patients with digital ulcer was higher than patients without digital ulcer. Thus, increase in plasma level of ET-1 could be effective in vascular damage, fibrosis, and skin thickness.
  2,994 444 5
Progressive symmetric erythrokeratodermia with delayed intellectual milestones and convulsions
Shyam B Verma, Wollina Uwe
January-April 2012, 3(1):54-56
DOI:10.4103/2229-5178.93502  PMID:23130266
Progressive symmetric erythrokeratoderma is an uncommon genodermatosis and is thought to arise due to mutations in the connexin gene, however, genetic heterogenicity has been described. Very few cases of neurological involvement have been described in this unusual entity. We report a case of progressive symmetric erythrokeratoderma, with convulsions and delayed intellectual milestones.
  2,795 340 2
Linear psoriasis: A rare presentation
Nidhi Singh, Naseem Noorunnisa
January-April 2012, 3(1):71-73
DOI:10.4103/2229-5178.93489  PMID:23130273
  2,759 359 -
Recurrence of zosteriform lesions on the contralateral dermatome: A diagnostic dilemma
Carounanidy Udayashankar, P Oudeacoumar, Amiya Kumar Nath
January-April 2012, 3(1):76-77
DOI:10.4103/2229-5178.93494  PMID:23130276
  2,757 279 1
Neurofibromatosis-1 with bilateral partial radial artery stenosis
Prabhakar M Sangolli
January-April 2012, 3(1):51-53
DOI:10.4103/2229-5178.93506  PMID:23130265
Not much attention is paid to vascular complications in neurofibromatosis-1 (NF-1) though they are well known to occur. A case of vascular NF-1 with bilateral partial radial artery stenosis resulting in digital gangrene involving fingers of both hands is being reported here. Various vascular abnormalities in NF-1 as complications resulting from them and their management is briefly highlighted.
  2,510 264 -
Transporting preloaded chambers for patch testing
Srinivas R Chakravarthi
January-April 2012, 3(1):57-58
DOI:10.4103/2229-5178.93500  PMID:23130267
  2,362 267 -
Recalcitrant generalized pustular eruption after diltiazem
Sridhar Jandhyala, V Manu
January-April 2012, 3(1):42-44
DOI:10.4103/2229-5178.93503  PMID:23130262
Generalized pustular eruptions may occasionally present challenges both for diagnosis and treatment. A 55-year-old male was hospitalized with fever and a severe generalized pustular eruption after recent intake of diltiazem. A careful interpretation of history, clinical course and investigation findings and an active treatment intervention proved the key to management of the case.
  2,302 242 -
Fire-breathing burn
Sanjay Saraf
January-April 2012, 3(1):73-74
DOI:10.4103/2229-5178.93491  PMID:23130274
  2,261 242 -
Aortoarteritis with systemic lupus erythematosus and secondary antiphopholipid syndrome
Nandini Chakrabarti, Chandan Chattopadhyay
January-April 2012, 3(1):66-68
DOI:10.4103/2229-5178.93483  PMID:23130270
  2,095 319 2
Angiolymphoid hyperplasia with eosinophilia
Vinitha V Panicker, Andezhathu D Dhramaratnam, Joel Kuruvilla
January-April 2012, 3(1):80-80
DOI:10.4103/2229-5178.93481  PMID:23130278
  1,909 322 2
Shyam Bhanu Verma
January-April 2012, 3(1):1-1
DOI:10.4103/2229-5178.93478  PMID:23130250
  1,731 316 -
Passing away of a hero: Dr. Ramaswami Ganapati
Terence J Ryan
January-April 2012, 3(1):81-81
  1,332 188 -
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