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  Citation statistics : Table of Contents
   2016| July-August  | Volume 7 | Issue 4  
    Online since July 5, 2016

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Microneedling: Advances and widening horizons
Aashim Singh, Savita Yadav
July-August 2016, 7(4):244-254
DOI:10.4103/2229-5178.185468  PMID:27559496
Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique. It was initially introduced for skin rejuvenation, however, now it is being used for a very wide range of indications including acne scar, acne, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more. Moreover, during the last 10 years, many new innovations have been made to the initial instrument, which was used for microneedling. This technique can be combined with other surgical techniques to provide better results. In particular, it is a very safe technique for dark skin types, where risk of postinflammatory pigmentation is very high with other techniques that damage the epidermis. In this review article, we are updating on the different instruments now available for this procedure, and its efficacy when performed alone or in combination with other techniques for various indications.
  57 39,094 4,155
Vitamin E in dermatology
Mohammad Abid Keen, Iffat Hassan
July-August 2016, 7(4):311-314
DOI:10.4103/2229-5178.185494  PMID:27559512
Vitamin E is an important fat-soluble antioxidant and has been in use for more than 50 years in dermatology. It is an important ingredient in many cosmetic products. It protects the skin from various deleterious effects due to solar radiation by acting as a free-radical scavenger. Experimental studies suggest that vitamin E has antitumorigenic and photoprotective properties. There is a paucity of controlled clinical studies providing a rationale for well-defined dosages and clinical indications of vitamin E usage in dermatological practice. The aim of this article is to review the cosmetic as well as clinical implications of vitamin E in dermatology.
  36 18,619 2,809
Clinico-microbiological study of dermatophytosis in a tertiary-care hospital in North Karnataka
Tonita M Noronha, Raghavendra S Tophakhane, Shobha Nadiger
July-August 2016, 7(4):264-271
DOI:10.4103/2229-5178.185488  PMID:27559499
Context: The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age. Aims: The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations. Settings and Design: This was a hospital-based observational study. Materials and Methods: One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail) and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Statistical Analysis Used: Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis. Results: Out of 150 patients studied, majority belonged to the age group of 21–30 years (22.7%). Male-to-female ratio was 1.63:1. Tinea corporis (24.7%) was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%). Conclusions: The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka.
  18 5,683 726
A study of postherpetic pruritus
Asit Mittal, Ankita Srivastava, Manisha Balai, Ashok Kumar Khare
July-August 2016, 7(4):343-344
DOI:10.4103/2229-5178.185479  PMID:27559527
  4 1,528 184
Misuse of topical corticosteroids on the face: A cross-sectional study among dermatology outpatients
Abhijeet Kumar Jha, Rajesh Sinha, Smita Prasad
July-August 2016, 7(4):259-263
DOI:10.4103/2229-5178.185492  PMID:27559498
Background: Topical corticosteroids (TC) are being misused widely on the face without a prescription from the dermatologist. Aim: To evaluate the misuse of TC-containing preparations on the face and the adverse effects due to its application. Materials and Methods: A questionnaire-based analysis was done among patients attending the dermatology outpatient department of a tertiary care hospital between March 2014 and March 2015. Patients with various facial dermatoses were asked about their current use of topical preparations and on further followup questioning, those who revealed the use of TCs (25g or more) continuously or intermittently for a minimum duration of four weeks were included in the study and observed for local adverse effects. Results: A total of 410 patients were observed, 306 were females (74.6%) and 104 were males (25.3%). One hundred and seventy-eight patients (43.4%) used topical steroids alone, 124 (30.2%) used creams containing TC, hydroquinone, and tretinoin, 108 (26.3%) used creams containing a combination of TC, antibiotic, and/or antifungal. One hundred and seventy-six patients (42.9%) bought TC or TC containing creams over the counter on their own, without the prescription of a dermatologist, 35 (8.5%) were recommended TC by a beautician (beauty parlors), 82 (20%) by their friends, family members, or neighbors, 75 (18.2%) by a non-dermatologist practitioner, and 42 (10.2%) by a dermatologist. Limitations: The sample size was small. Conclusion: Dispensing of TCs must be regulated in India; they should only be issued against a doctor's prescription.
  4 6,730 563
Dyskeratosis congenita presenting with dysphagia
Kalpana Gupta, Swati Tripathi, Nidheesh Agarwal, Anurag Bareth
July-August 2016, 7(4):275-277
DOI:10.4103/2229-5178.185461  PMID:27559501
Dyskeratosiscongenita (DKC) is a genetically heterogeneous disease of defective telomere maintenance that may demonstrate different patterns of inheritance. It is characterized by thetriad of dystrophy of the nails, leukokeratosis of the oral mucosa, and extensive net-like pigmentation of the skin. We report a case ofDKC who presented with a chief complaint of dysphagia.
  3 2,368 258
A rare case of multiple keratoacanthomas treated with oral acitretin and intralesional methotrexate
Sweta Hasmukh Rambhia, Kinjal Deepak Rambhia, Amit Gulati
July-August 2016, 7(4):321-323
DOI:10.4103/2229-5178.185480  PMID:27559516
  3 2,122 144
Aquagenic syringeal acrokeratoderma
Amit Kumar Dhawan, Kavita Bisherwal, Vijay Gandhi, Prachi Kawthekar, Preeti Diwaker
July-August 2016, 7(4):327-329
DOI:10.4103/2229-5178.185490  PMID:27559519
  3 1,676 242
Pachyonychia congenita with late onset (PC tarda)
A Sravanthi, P Srivalli, K. V. T. Gopal, T Narayana Rao
July-August 2016, 7(4):278-280
DOI:10.4103/2229-5178.185463  PMID:27559502
Pachyonychia congenita is a rare type of ectodermal dysplasia further classified into 4 types. Cutaneous manifestations seen in most of the cases of Pachyonychia congenita include palmoplantar keratoderma, follicular hyperkeratosis, wedge shaped nails, oral leukokeratosis and woolly hair. A 25-year-old male presented to us with thickened nails and scanty scalp hair. On examination, we noticed hyperkeratotic plaques over both the soles, palmoplantar hyperhidrosis and yellowish discoloration, wedging with subungual hyperkeratosis of all the nails. Follicular hyperkeratotic papules and steatocystoma multiplex were also observed over the scalp and face. The patient had history of natal teeth and on dental examination, lower central incisors were absent. All cutaneous changes in our case had manifested first in the 2nd decade except for natal teeth. All the above features suggested the diagnosis of pachyonychia congenita with late onset (PC tarda), which is an infrequently reported rare variant.
  2 2,037 204
Erythema elevatum diutinum in association with IgA monoclonal gammopathy: A rare case report
Guru Prasad Patnala, Anila P Sunandini, Rama Rayavarapu, Padmasri Somala Yandapalli
July-August 2016, 7(4):300-303
DOI:10.4103/2229-5178.185472  PMID:27559509
Erythema elevatum diutinum (EED) is a rare form of vasculitis characterized clinically by red-violet brown papules, plaques, and nodules mainly involving the extensor surfaces; histologically by leukocytoclastic vasculitis in early lesions, and fibrosis and cholesterolosis in late lesions. EED has been associated with many systemic disorders including infections, autoimmune disorders, and both benign and malignant hematological disorders. As it is a rare form of vasculitis and only 250 cases reported till date, we report a case of EED in association with IgA monoclonal gammopathy with partial response to dapsone treatment.
  2 2,139 285
Seronegative necrolytic acral erythema: A report of two cases and literature review
Vishalakshi S Pandit, Arun C Inamadar, Aparna Palit
July-August 2016, 7(4):304-307
DOI:10.4103/2229-5178.185464  PMID:27559510
Necrolytic acral erythema (NAE) is a newly described entity, seen in patients infected with hepatitis C virus. It is characterized by its distinguishing acral distribution, psoriasiform skin eruption and histological features. Its etiopathogenesis is not fully understood though hypo amino academia, hyperglucagonemia and zinc deficiency are considered as probable causes. In 1996, El Darouti and Abu el Ela first described this entity in seven Egyptian patients with hepatitis C virus (HCV). Since then, several small studies and cases have been reported around the world. Nevertheless, it may occur independently without HCV association as a few cases have been reported recently. We report two seronegative cases of NAE, which responded dramatically with oral zinc therapy. This suggests that NAE could be an isolated clinical subset.
  2 3,741 305
Clinical and dermatoscopic features of porokeratosis palmaris et plantaris
Satish Udare, Karishma Hemmady
July-August 2016, 7(4):290-292
DOI:10.4103/2229-5178.185483  PMID:27559506
A dermatoscope is an important tool in a dermatologist's armamentarium as it can eliminate the need for a biopsy in a wide array of conditions. Porokeratosis was described by Mibelli and Respighi in 1893, as a disorder of keratinization which on the basis of distribution patterns was described as five clinical variants that portrayed a coronoid lamella on histopathology. We describe a case of asymptomatic, long-standing palmar and plantar pits, which on dermatoscopy showed features suggestive of porokeratosis, which was later reconfirmed by histopathologic sections. This report depicts diagnostic features of porokeratosis and obviates the need for invasive procedures for its diagnosis.
  2 2,058 234
Dermatology in India and Indian dermatology: A Medico-Historical perspective
Amiya K Mukhopadhyay
July-August 2016, 7(4):235-243
DOI:10.4103/2229-5178.185460  PMID:27559495
  2 4,798 414
Reactive eccrine syringofibroadenoma in hyperkeratotic eczema
Chirag A Desai, Uday Khopkar
July-August 2016, 7(4):325-327
DOI:10.4103/2229-5178.185476  PMID:27559518
  2 1,776 179
Pyoderma gangrenosum associated with mantle cell lymphoma
Tanmay Padhi, Swetalina Pradhan, Krupasindhu Pradhan, Suresh K Kumar
July-August 2016, 7(4):332-334
DOI:10.4103/2229-5178.185467  PMID:27559522
  2 1,105 236
Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia
Felix B Yap, Sze T Kiung, Jeffrey B Yap
July-August 2016, 7(4):255-258
DOI:10.4103/2229-5178.185495  PMID:27559497
Background: There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life. Materials and Methods: This cross-sectional study was conducted in Hansen's Clinic, Hospital Kuala Lumpur between January 2010 and December 2013 among patients with multibacillary leprosy using the Dermatology Life Quality Index (DLQI). Results: A total of 153 patients participated with 31.4% suffering from ENL. The mean age at presentation was 40.5 ± 16.49 years. The mean DLQI was 7.1 ± 3.72. Patients with ENL were younger (mean age 36.5 vs. 42.4, P = 0.026), had higher mean bacteriologic index (4.3 vs. 3.8, P = 0.004), had physical deformities (47.9% vs. 31.4%, P = 0.049), and had higher mean DLQI score (9.1 vs. 6.2, P < 0.001). All the DLQI domains were higher in patients suffering from ENL except the treatment domain. Symptoms and feeling was the domain with the largest effect followed by daily activities and leisure. Personal relationship had the lowest effect. Conclusion: Quality of life impairment in patients with leprosy in Malaysia is moderate, with larger effect among patients with ENL. The impairment in ENL is comparable to itchy skin conditions such as urticarial and is worse than chronic skin disease such as psoriasis. Thus, it is essential that management of leprosy incorporate quality of life issues.
  2 2,436 382
Fibroepithelioma of Pinkus in continuity with nodular basal cell carcinoma: A rare presentation
Atul M Dongre, Uday S Khopkar, Yogesh N Kalyanpad, Prachi V Gole
July-August 2016, 7(4):285-287
DOI:10.4103/2229-5178.185477  PMID:27559504
Fibroepithelioma of Pinkus and nodular basal cell carcinoma (BCC) are different morphological variants of BCC. It is very rare to see both the variants together in a single lesion. Here we report a case of a 56-year-old female who presented with a nodule on the trunk, which on biopsy showed features of both nodular BCC and fibroepithelioma of Pinkus.
  1 2,058 178
Cutaneous tuberculosis with a difference: Documenting transfollicular elimination of granulomas
Chirag A Desai, Uday Khopkar
July-August 2016, 7(4):297-299
DOI:10.4103/2229-5178.185473  PMID:27559508
A patient presented with a an asymptomatic brown to erythematous, scaly indurated solitary plaque on his elbow. The lesion was diagnosed as lupus vulgaris on the basis of clinical features and biopsy findings. The histopathology further revealed a granuloma within the follicular infundibulum, which was possibly being expelled out. The phenomenon of transepidermal elimination has been described previously in many conditions, including cutaneous tuberculosis; however, transfollicular elimination of the granuloma has not been reported. We report this unusual phenomenon as a possible mode of elimination of the granuloma.
  1 1,589 205
Cellular dermatofibroma: A hyperkeratotic indurated plaque on the thigh
Amira Elbendary, John R Griffin, Dirk M Elston, Shyam B Verma
July-August 2016, 7(4):308-310
DOI:10.4103/2229-5178.185497  PMID:27559511
  1 2,458 413
Idiopathic hemihypertrophy with multiple fibroadenoma
Asha Nyati, Sarita Kalwaniya, Parul Agarwal
July-August 2016, 7(4):316-317
DOI:10.4103/2229-5178.185481  PMID:27559513
  1 6,354 233
Comparative assessment of the efficacy of topical ketoconazole and topical luliconazole in cases of pityriasis versicolor at a tertiary care hospital in eastern India: A prospective, open, randomized controlled trial
Somenath Sarkar, Dipayan Sengupta, Sukumar Basak, Shabab Ahmed Damji, Devesh Kumar Shukla, Deep Anurag
July-August 2016, 7(4):335-336
DOI:10.4103/2229-5178.185471  PMID:27559523
  1 7,902 504
Huriez syndrome with superadded dermatophyte infection
Trupti Surana, Bela Padhiar, Umesh Karia, Purna Pandya
July-August 2016, 7(4):288-289
DOI:10.4103/2229-5178.185466  PMID:27559505
Palmoplantarkeratodermas (PPKs) are a heterogeneous group of hereditary and acquired disorders with underlying gene defects, and characterized by hyperkeratosis of palms and soles with or without other ectodermal and systemic abnormalities. Huriez syndrome is a rare autosomal dominant transgradient type of PPK with high frequency of squamous cell carcinoma in the affected skin. We hereby describe a case of a very rare autosomal dominant PPK in a 40-year-old male patient presenting since birth with PPK extending onto the dorsal aspects of hands and feet with peeling of the skin. The complaints were associated with sclerodactyly, hyperhidrosis, and nail abnormalities. Also superadded dermatophyte infection was observed involving abdomen. No history of loss of any digit. No mucosal, dental, or any systemic involvement was present. No sign of malignancy was noted. Baseline investigations, including ultrasonography of abdomen were normal. Histological findings were nonspecific with only orthohyperkeratosis and acanthosis. Diagnosis was mainly done on clinical grounds. The patient is better with oral retinoids and topical emollients and keratolytics along with antifungal treatment for dermatophyte infection. He is under follow up.
  - 1,634 186
Macrodystrophia lipomatosa: Review of clinico-radio-histopathological features
Banashree Majumdar, Atul Jain, Debashis Sen, Sanchaita Bala, Pranshu Mishra, Sumit Sen, Projna Biswyas, Akhilesh Behra
July-August 2016, 7(4):293-296
DOI:10.4103/2229-5178.185465  PMID:27559507
We report clinical, radiological, and pathological features of three cases of macrodystrophia lipomatosa, which is characterized by progressive proliferation of all mesenchymal elements, with a disproportionate increase in fibroadipose tissue. The peculiarity in our report is the involvement of contralateral hand and feet in our 1st case in contrast to usual presentations of this rare condition, which is often unilateral. In our 2nd case, the lateral aspect of foot was involved as against the usual finding of involvement of medial aspect in lower limbs, also another surprising finding in this case is increase in the size of lesion after puberty. Coming to our 3rd case, enlargement of almost whole of an upper extremity with profound involvement of middle, ring and little finger along with total sparing of the thumb is in itself an extremely rare occurrence as in upper limb, mainly the lateral aspect of hand and related digits bear the burnt and more over involvement of whole limb is itself an unique phenomenon.
  - 2,104 203
Cutaneous metastases from signet cell carcinoma of the gut: A report of two cases
Anu Anna George, Dincy Peter, Deepti Masih, Meera Thomas, Susanne Pulimood
July-August 2016, 7(4):281-284
DOI:10.4103/2229-5178.185462  PMID:27559503
Cutaneous metastasis from visceral tumors is a rare entity with a reported incidence between 0.3% and 9.8%. These usually occur late in the course of the disease; the average time interval between the diagnosis of malignancy and presentation of cutaneous metastases has been reported to be 33 months. In rare instances (in about 0.8%–1.3% of patients), cutaneous metastases may be a pointer to an underlying undiagnosed malignancy. We report two patients presenting to us with soft, nodular, cutaneous lesions, which was the manifestation of metastatic signet cell carcinoma arising from the gut. We report these cases owing to their rarity.
  - 2,077 193
Cystic acantholytic dyskeratosis of the vulva: An unusual presentation of a follicular adnexal neoplasm
Kara Melissa Tiangco Torres, Jacqueline M Junkins-Hopkins
July-August 2016, 7(4):272-274
DOI:10.4103/2229-5178.185482  PMID:27559500
Acantholytic dyskeratosis (AD) is a histologic pattern seen in Darier's disease or dyskeratosis follicularis, warty dyskeratoma, and transient AD. This pattern is characterized by suprabasilar clefting, acantholysis, and formation of corps ronds and grains. We present a case of AD that is unique based on its genital location and cystic architecture. A 53-year-old woman presented with an otherwise asymptomatic cyst on her left vulva of uncertain duration. On microscopic examination, there were fragments of cystic epithelium with areas of hypergranulosis, acantholysis, corps ronds, and corps grains formation. These features are felt by the authors to be a unique presentation of a follicular adnexal neoplasm.
  - 2,197 197
Necrotizing fasciitis associated with systemic lupus erythematosus in a child
Mahmood Dhahir Al-Mendalawi
July-August 2016, 7(4):319-320
DOI:10.4103/2229-5178.185496  PMID:27626093
  - 978 164
Necrotizing fasciitis associated with systemic lupus erythematosus in a child
Sahana M Srinivas, Alkarani T Patil, Gowri Shankar, Keshavmurthy M Lakshmikantha, Munirathnam Govindraj
July-August 2016, 7(4):319-319
DOI:10.4103/2229-5178.185498  PMID:27559515
  - 655 133
Eyelid excoriation and erythema with nepafenac eye drop
Kumar Saurabh, Rupak Roy, Debmalya Das, Aneesha Lobo
July-August 2016, 7(4):324-325
DOI:10.4103/2229-5178.185478  PMID:27559517
  - 1,013 138
Giant bilateral Becker's nevus appearing as gladiator arm armor
Premanshu Bhushan, Sarvesh S Thatte
July-August 2016, 7(4):329-330
DOI:10.4103/2229-5178.185469  PMID:27559520
  - 1,973 204
Half and half blisters in pemphigus vulgaris: A diagnostic quandary
Shagufta Rather, Atiya Yaseen, Iffat Hassan
July-August 2016, 7(4):331-332
DOI:10.4103/2229-5178.185487  PMID:27559521
  - 1,606 236
Cerebrotendinous xanthomatosis
Mahalakshmi Muniaswamy, Madhu Rengasamy, Ramesh Aravamuthan, Manoharan Krishnasamy
July-August 2016, 7(4):336-338
DOI:10.4103/2229-5178.185484  PMID:27559524
  - 1,449 207
Acral lentiginous melanoma with multiple brain metastases in an Indian male
Kumar Parimalam, Jeyalakshmidevi Namasivayam, Subha Ramasamy, Suganthy Valavan
July-August 2016, 7(4):338-340
DOI:10.4103/2229-5178.185474  PMID:27559525
  - 2,006 164
Annular atrophic plaque over the arm
Amit Kumar Dhawan, Kavita Bisherwal, Chander Grover, Preeti Diwaker
July-August 2016, 7(4):340-342
DOI:10.4103/2229-5178.185486  PMID:27559526
  - 1,737 162
Extrafacial melasma over forearms
Bhushan Madke, Sumit Kar, Nidhi Yadav, Pooja Bonde
July-August 2016, 7(4):344-345
DOI:10.4103/2229-5178.185470  PMID:27559528
  - 3,495 286
Trigeminal trophic syndrome
Lalit Kumar Gupta, Ankita Srivastava, Ashok Kumar Khare, Asit Mittal, Sharad Mehta, Manisha Balai
July-August 2016, 7(4):346-347
DOI:10.4103/2229-5178.185485  PMID:27559529
  - 1,526 183
Lupus vulgaris in classical sporotrichoid pattern
Manjulata Dash, Swetalina Pradhan
July-August 2016, 7(4):317-318
DOI:10.4103/2229-5178.185491  PMID:27559514
  - 1,359 177
Dr. Balbir S. Bhogal (1950–2016)
Amrinder J Kanwar
July-August 2016, 7(4):357-358
  - 1,551 168
Sk India Quiz 26: Hypopigmented papules in a human immunodeficiency virus-positive patient
Lalit Kumar Gupta, Manisha Balai, Ashok Kumar Khare, Asit Mittal
July-August 2016, 7(4):348-349
DOI:10.4103/2229-5178.182402  PMID:27559530
  - 1,696 203
SkIndia Quiz 27: Rhinophyma and numerous facial papule and nodules in a 39-year-old woman
Vikram K Mahajan, Anju Lath Sharma, Pushpinder S Chauhan, Karaninder S Mehta, Saurabh Sharma
July-August 2016, 7(4):350-352
DOI:10.4103/2229-5178.182404  PMID:27559531
  - 1,436 169
Angoori Gnaneshwar Rao
July-August 2016, 7(4):353-355
DOI:10.4103/2229-5178.185489  PMID:27559532
  - 3,119 275
Black discoloration of palms
Feroze Kaliyadan, KT Ashique
July-August 2016, 7(4):356-356
DOI:10.4103/2229-5178.185493  PMID:27559533
  - 2,593 212
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