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   2012| September-December  | Volume 3 | Issue 3  
    Online since September 29, 2012

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Eponymous signs in dermatology
Bhushan Madke, Chitra Nayak
September-December 2012, 3(3):159-165
DOI:10.4103/2229-5178.101810  PMID:23189246
Clinical signs reflect the sheer and close observatory quality of an astute physician. Many new dermatological signs both in clinical and diagnostic aspects of various dermatoses are being reported and no single book on dermatology literature gives a comprehensive list of these "signs" and postgraduate students in dermatology finds it difficult to have access to the description, as most of these resident doctor do not have access to the said journal articles. "Signs" commonly found in dermatologic literature with a brief discussion and explanation is reviewed in this paper.
  72,628 11,583 6
Lichen scrofulosorum: A diagnosis overlooked
Priyanka Singhal, Pankil H Patel, Yogesh S Marfatia
September-December 2012, 3(3):190-192
DOI:10.4103/2229-5178.101817  PMID:23189252
Lichen scrofulosorum, also known as "tuberculosis cutis lichenoides," is a rare tuberculid that presents as a lichenoid eruption of minute papules in children and adolescents with tuberculosis. The lesions are usually asymptomatic, closely grouped, skin-colored to reddish-brown papules, often perifollicular, and are mainly found on the abdomen, chest, back, and proximal parts of the limbs. The eruption is usually associated with a strongly positive tuberculin reaction. Diagnosis of these lesions can be difficult, as they resemble many other dermatological conditions that are often primarily considered. We report a case of lichen scrofulosorum in an adult male without any focus of tuberculosis. He responded promptly to antitubercular therapy with complete clearance of lesions in one month.
  16,067 672 2
Learning from eponyms: Jose Verocay and Verocay bodies, Antoni A and B areas, Nils Antoni and Schwannomas
Rajiv Joshi
September-December 2012, 3(3):215-219
DOI:10.4103/2229-5178.101826  PMID:23189261
Schwannomas are benign peripheral nerve sheath neoplasms composed almost entirely of Schwann cells and are diagnosed histopathologically by the presence of singular architectural patterns called Antoni A and Antoni B areas. These were described first in 1920 by the Swedish neurologist Nils Antoni. The Antoni A tissue is highly cellular and made up of palisades of Schwann cell nuclei, a pattern first described in 1910 by the Uruguayan neuro-pathologist Jose Verocay and are known as Verocay bodies. This article describes the structure and appearance of Verocay bodies and Antoni A and B areas with a brief biographical introduction of the men who described these patterns.
  9,957 717 10
Psychosocial aspects of Hansen's disease (leprosy)
Gurvinder Pal Singh
September-December 2012, 3(3):166-170
DOI:10.4103/2229-5178.101811  PMID:23189247
In general, the prevalence of psychiatric disorders among people with Hansen's disease has greatly increased to date. However, inadequate psychiatric care of people with Hansen's disease is an area of increasing concern. Many studies have been conducted in India and abroad to find out the prevalence of comorbid psychiatric disorders in patients suffering from Hansen's disease. Although efforts have been made by the government and international organizations to solve the medical problems among this group of patients, this disease still carries a number of psychosocial issues. The social stigma connected to these patients makes this disease completely different from others. Even nowadays people affected by Hansen's disease have to leave their village and are socially isolated. Depression is the most common psychiatric disorder found in these patients. Early detection and treatment of psychiatric disorders among Hansen's disease patients is a powerful psychotherapeutic measure. Integrated healthcare strategy will be beneficial to these patients. A comprehensive MEDLINE search and review of relevant literature was carried out and the data extracted and studied with particular reference to psychosocial issues in Hansen's disease. The focus of this research work is related to psychiatric and social aspects vis-à-vis stigma in these patients with Hansen's disease.
  6,182 2,266 10
Extensive morphea profunda with autoantibodies and benign tumors: A rare case report
Leelavathy Budamakuntla, Dipali Malvankar
September-December 2012, 3(3):208-210
DOI:10.4103/2229-5178.101823  PMID:23189258
The term deep morphea describes a variant of morphea (localised scleroderma) in which inflammation and sclerosis are found in the deep dermis, panniculus, fascia or superficial muscle. It is sometimes associated with autoantibodies. We report the case of a 49 year-old male who had morphea profunda (radiologically and histopathologically confirmed) affecting mainly the left side of the body with face, trunk and limb involvement, along with autoantibody production and associated neurofibromas and lipomas.
  7,774 339 -
Pemphigus vegetans: An unusual presentation
Ashish Dhamija, Paschal D'souza, Ashok Meherda, Raj K Kothiwala
September-December 2012, 3(3):193-195
DOI:10.4103/2229-5178.101818  PMID:23189253
Pemphigus vegetans is a rare variant of pemphigus vulgaris that is characterized by vegetating lesions primarily in the flexures. We report a 45-year-old male patient with an unusual presentation of the disease. A careful analysis of the clinical and laboratory findings enabled us to reach a diagnosis and successfully treat the patient.
  7,071 610 2
Median canaliform dystrophy of Heller
Bhushan Madke, Reshma Gadkari, Chitra Nayak
September-December 2012, 3(3):224-225
DOI:10.4103/2229-5178.101832  PMID:23189265
  6,800 417 1
Study on epidemiology of cutaneous amyloidosis in northern India and effectiveness of dimethylsulphoxide in cutaneous amyloidosis
Arvind Krishna, Bhola Nath, GG Dhir, Ranjeeta Kumari, Virendra Budhiraja, Kalpana Singh
September-December 2012, 3(3):182-186
DOI:10.4103/2229-5178.101814  PMID:23189250
Context: Amyloidosis, which is characterized by the extracellular deposition of a proteinaceous substance, is usually associated with considerable tissue dysfunction. However, the etiology of the disease remains uncertain and the treatment disappointing. Aim: 1. To know the epidemiology of cutaneous amyloidosis 2. To evaluate the effect of dimethylsulphoxide on cutaneous amyloidosis. Settings and Design: Data was collected from patients attending the Outpatient Department (OPD) over a period of one year. Material and Methods: Patients were screened on the basis of signs and symptoms and then confirmed histologically. A total of 62 patients who were suspected to be suffering from amyloidosis on the basis of clinical signs and symptoms and 38 patients who were further confirmed histopathologically underwent the treatment. Statistical Analysis Used: Chi-square test was used for testing the significance of proportions. Results: 63.15 percent of the patients had macular amyloidosis and the interscapular area was the most common area involved (52.63%). Pruritus, pigmentation, and papules responded excellently to dimethylsulphoxide after one month of treatment. Conclusions: Cutaneous amyloidosis is a disease found in middle-aged persons, with a female preponderance, and dimethylsulphoxide seems to be an effective therapy.
  4,767 521 3
Nevus lipomatosus cutaneous superficialis: An unusual presentation
Ashish Dhamija, Ashok Meherda, Paschal D'Souza, Ram S Meena
September-December 2012, 3(3):196-198
DOI:10.4103/2229-5178.101819  PMID:23189254
Nevus lipomatosus cutaneous superficialis (NLCS) is an uncommon benign hamartomatous condition characterized by the presence of mature ectopic adiopocytes in the dermis. It was first reported by Hoffman and Zurhelle in 1921. Clinically they areit is classified into two forms. The classical form is characterized by groups of multiple, non-tender, soft, pedunculated, cerebriform, yellowish or skin-colored papules, nodules, or plaques. The other form of NLCS clinically manifests as a solitary dome-shaped or sessile papule. The classical NLCS is mostly reported to involve the pelvic or gluteal region. We report here a case of adult-onset classical NLCS on perianal area because of its rarity and unusual location. In addition, our patient also had some rare features of NLCS, such as recurrent in nature, presence of foul-smelling discharge, and comedo-like plugs on the lesions.
  4,531 324 5
Immunohistochemical detection of P53 and Mdm2 in vitiligo
Ola A Bakry, Mostafa A Hammam, Moshira M Abdel Wahed
September-December 2012, 3(3):171-176
DOI:10.4103/2229-5178.101812  PMID:23189248
Background: Vitiligo is a common depigmented skin disorder that is caused by selective destruction of melanocytes. It is generally accepted that the main function of melanin resides in the protection of skin cells against the deleterious effect of ultraviolet rays (UVRs). Association of vitiligo and skin cancer has been a subject of controversy. Occurrence of skin cancer in long-lasting vitiligo is rare despite multiple evidences of DNA damage in vitiliginous skin. Aim: To detect the expression of P53 and Mdm2 proteins in both depigmented and normally pigmented skin of vitiligo patients and to compare it to control subjects suffering from nonmelanoma skin cancer (NMSC). Materials and Methods: Thirty-four patients with vitiligo and 30 age and sex-matched patients with nodulo-ulcerative basal cell carcinoma (BCC) as a control group were selected. Both patients and control subjects had outdoor occupations. Skin biopsies were taken from each case and control subjects. Histopathological examination of Hematoxylin and eosin-stained sections was done. Expression of P53 and Mdm2 proteins were examined immunohistochemically. Results: Both P53 and Mdm2 were strongly expressed in depigmented as well as normally pigmented skin of vitiligo patients. This expression involved the epidermis, skin adnexa and blood vessels with significant differences between cases and controls. Conclusions: The overexpression of P53 and Mdm2 proteins in both normally pigmented and depigmented skin of patients with vitiligo could contribute to the decreased occurrence of actinic damage and NMSC in these patients.
  3,249 1,229 2
Wells syndrome
Manish Bansal, Tulika Rai, Shyam S Pandey
September-December 2012, 3(3):187-189
DOI:10.4103/2229-5178.101815  PMID:23189251
Wells syndrome or eosinophilic cellulitis is characterized clinically by an acute dermatitis resembling cellulitis and histopathologically by dermal eosinophilic infiltration. Various morphological presentations have been described. We report a 32-year-old female with recurrent, erythematous plaques on left forearm of 8 months duration, associated with mild itching that resolved leaving mild hyperpigmentation.
  3,578 475 3
Spinosad: An effective and safe pediculicide
Suruchi Aditya, Aditya Rattan
September-December 2012, 3(3):213-214
DOI:10.4103/2229-5178.101825  PMID:23189260
Although head lice are not a major health hazard, they have been a source of irritation and disgust for thousands of years. Despite the use of over-the-counter (OTC) treatments, it has high prevalence, and epidemics occur regularly. Permethrin 1% is currently recommended as a drug of choice, but many areas have shown resistance to this insecticide. A 0.9% suspension of spinosad, a naturally occurring pest control product, has recently been approved by the USFDA for treatment of pediculosis capitis. It acts by enhancing the action of nicotinic acetylcholine, resulting in paralysis of the parasite. Clinical trials show that spinosad is more effective and safe than current drugs of treatment. Additionally, it does not require nit combing. Spinosad appears as a powerful recruit in the battle against head lice.
  3,311 500 -
Pemphigus vulgaris presenting as gingival involvement
Mukhatar Ahmed Javali, Heena Zainab
September-December 2012, 3(3):202-204
DOI:10.4103/2229-5178.101821  PMID:23189256
Pemphigus vulgaris (PV) is an autoimmune blistering disease affecting the mucous membrane and skin. Typically, oral lesions appear before skin lesions, and in a majority of the cases only oral lesions are present. The dentist may then be the first to recognize and diagnose this disease. It is unusual for PV to present over the gingiva as a primary site of involvement. Diagnosis is based on clinical presentation and confirmed by histopathological study. Early diagnosis and management can prevent the uneven life- threatening effects of this potentially chronic mucocutaneous disorder. The case serves to enhance our awareness of the gingiva as a site at which systemic disease can manifest itself.
  3,109 454 1
Eczematous skin lesion with nipple destruction
Arun C Inamadar
September-December 2012, 3(3):230-231
DOI:10.4103/2229-5178.101834  PMID:23189268
  3,130 311 -
Prevalence and relevance of secondary contact sensitizers in subjects with psoriasis
DS Krupashankar, Shakthi R Manivasagam
September-December 2012, 3(3):177-181
DOI:10.4103/2229-5178.101813  PMID:23189249
Background: Psoriasis may be complicated by contact dermatitis due to an impaired cutaneous barrier. Patch testing helps elucidate sensitizers if any. Aims: To determine the prevalence and relevance of secondary contact dermatitis in subjects with psoriasis. Materials and Methods: Patch testing with Indian Standard Series was done and readings interpreted after 48 and 96 hours. Results: Among 110 subjects 47 (42.7%) showed reactions to at least one antigen. Fifteen (13.6%) reacted to fragrance mix, 10 (9.1%) to nickel sulfate, seven (6.4%) to parthenium, and six (5.5%) to balsam of Peru. Palmoplantar psoriasis was the commonest type of psoriasis patch tested. Fragrance mix was the commonest antigen showing 100% current relevance as an aggravating factor of psoriasis. Cosmetics, beauty preparations, skin and healthcare products followed by topical medications were found to be the most common sources of the patch test positivity. Conclusions: Secondary contact dermatitis is common in patients with psoriasis. Patch testing is necessary to determine the triggering or aggravating antigens in these patients to avoid sensitizers and improve quality of life.
  2,511 416 3
SkIndia Quiz 7 - Giant erythematous plaque on the arm of an elderly woman
KT Ashique
September-December 2012, 3(3):228-229
DOI:10.4103/2229-5178.96771  PMID:23189267
  2,610 305 -
Subcorneal pustular dermatosis masquerading as dermatophytosis
Jayakar Thomas, K Parimalam
September-December 2012, 3(3):220-221
DOI:10.4103/2229-5178.101827  PMID:23189262
  2,271 275 1
Childhood actinic keratosis in an albino transforming into squamous cell carcinoma
Shubhangi V Agale, Grace F D'Costa, Bhavana M Bharambe, Varsha Bhatia
September-December 2012, 3(3):199-201
DOI:10.4103/2229-5178.101820  PMID:23189255
Actinic keratosis is a scaly, cutaneous lesion that is often seen in elderly patients. It is almost never seen in children and young adults. It develops on areas such as the face, ears and dorsa of the hands with chronic sun exposure. Actinic keratosis is a premalignant lesion, since histological changes in the epidermis may progress to squamous cell carcinoma if left untreated. There are roughly 70,000 people with albinism in India. These patients are prone to develop actinic keratosis which may undergo spontaneous remission or develop into invasive squamous cell carcinoma, basal cell carcinoma and malignant melanoma.We present an unusual case of a 35 year old albino who developed actinic keratosis at the age 15 years which progressed to squamous cell carcinoma.
  1,993 293 -
Seborreic keratosis with Bowenoid transformation
A Shankar, Shaista Choudhary, YA Manjunatha
September-December 2012, 3(3):225-227
DOI:10.4103/2229-5178.101833  PMID:23189266
  1,939 298 -
Immune reconstitution inflammatory syndrome: A therapeutic paradox
Joan Felicita Samson, V Suja, K Abdul Samad, S Sankar, GK Libu
September-December 2012, 3(3):205-207
DOI:10.4103/2229-5178.101822  PMID:23189257
A 41-year-old HIV positive woman was started on highly active antiretroviral therapy when her CD 4 count was 54/cu mm. Three weeks later, she developed erythematous to skin-colored plaques over the face. Investigations revealed a moderate eosinophilia, raised ESR, elevated 24-hour urinary calcium and hyperglobulinemia. Skin biopsy of the facial plaque revealed prominent epithelioid cell granulomas in the dermis. Reticulin stain showed reticulin fibers within the granulomas. Five months later, all the facial lesions regressed with continuation of HAART, with no specific treatment for facial plaques. Repeat CD 4 count was 104/cu mm. A diagnosis of cutaneous sarcoidosis occurring as a part of immune reconstitution inflammatory syndrome was made. Although systemic sarcoidosis has been reported, the occurrence of cutaneous sarcoidosis as part of immune reconstitution inflammatory syndrome has not been elucidated conclusively.
  1,826 338 -
Dermatology and social networking sites
Bhushan Madke
September-December 2012, 3(3):211-212
DOI:10.4103/2229-5178.101824  PMID:23189259
  1,742 316 4
Towards quality improvement: Training and supportive supervision in STI control programme, Himachal Pradesh
Sunite A Ganju, Nand Lal Sharma, Anil Kanga
September-December 2012, 3(3):221-222
DOI:10.4103/2229-5178.101828  PMID:23189263
  1,580 223 1
Systemic sclerosis presenting as lobular panniculitis
VG Binesh, Jijith Krishnan, Neelakandhan Asokan, Kidangazhiathmana Ajithkumar
September-December 2012, 3(3):222-224
DOI:10.4103/2229-5178.101830  PMID:23189264
  1,472 274 -

September-December 2012, 3(3):232-233
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