Browsing by Author "Palit, Aparna"
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Item Acute skin failure: concept, causes, consequences and care.(2005-11-06) Inamadar, Arun C; Palit, AparnaAcute skin failure is a state of total dysfunction of the skin resulting from different dermatological conditions. It constitutes a dermatological emergency and requires a multi-disciplinary, intensive care approach. Its effective management is possible only when the underlying pathomechanism of each event is clear to the treating clinician. The concept of skin failure is new to non-dermatologist clinicians and sketchy among many dermatologists. Here the pathomechanism of skin failure has been analyzed and a guideline for monitoring has been provided. There is a need for intensive care units for patients with acute skin failure.Item Anticoagulants in dermatology.(2016-11) Adya, Keshavmurthy A; Inamadar, Arun C; Palit, AparnaAnticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non‑thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others. Further, the use of anticoagulants for any indication is associated with various adverse effects with dermatologic manifestations including specific reactions such as warfarin‑induced skin necrosis, heparin‑induced thrombocytopenia and anticoagulant‑associated cholesterol embolization syndrome.Item Bullous impetigo mimicking epidermolysis bullosa(Scientific Scholar, 2022-12) Dash, Siddhartha; Palit, Aparna; Behera, BiswanathItem Chancroid: an update.(2002-01-28) Inamadar, Arun C; Palit, AparnaChancroid, an important sexually transmissible genital ulcer disease of the developing world, has gained new importance with the onset of HIV era. Though common, it poses diagnostic problem because of the difficulties in demonstrating Haemophilus ducreyi itself or indirect evidence of its presence. In the present discussion, various aspects of this challenging disease along with recent aspects of its pathogenesis, diagnosis and treatment have been focussed.Item Childhood vitiligo.(2012-01) Palit, Aparna; Inamadar, Arun CChildhood vitiligo is often encountered in dermatological practice. When present in infancy or early childhood, various nevoid and hereditary disorders are to be differentiated. In many cases, familial aggregation of the disease is seen and other autoimmune disorders may be associated. Segmental presentation is more common, and limited body surface area involvement is usual in this age group. Children with vitiligo often suffer from anxiety and depression because of their unusual appearance. Management of vitiligo in children is difficult as therapeutic options are restricted when compared to that in adult patients. Selection of treatment should be careful in these patients with the aim to achieve best results with minimal side effects as well as relieving patients' and parents' anxiety.Item Circumferential skin folds in a child: a case of Michelin tire baby syndrome.(2007-01-23) Palit, Aparna; Inamadar, Arun CA six-month-old girl who presented with dermatitis was found to have multiple, symmetric, deep, gyrate skin folds involving her trunk and similar circumferential lesions on her extremities since birth. She had a characteristic round face with hypertelorism, depressed nasal bridge, thin, down-turned vermillion border of upper lip and short neck. Skin biopsy demonstrated increased smooth muscle fibers in the deeper dermis. A diagnosis of Michelin tire baby syndrome was made. Clinical features, histopathology, differential diagnosis and prognosis of this rare disorder have been discussed.Item Clinicodermoscopic and immunopathological profile of non-infectious non-eczematous inflammatory tattoo reactions: A retrospective study from a tertiary care centre of East India(Scientific Scholar, 2023-08) Sethy, Madhusmita; Behera, Biswanath; Dash, Siddhartha; Palit, Aparna; Nayak, Ashish Kumar; Ayyanar, PavithraIntroduction: Tattoo-associated complications are on the rise due to the popularity of decorative tattoos in recent years. The exact pathogeneses of various tattoo reaction patterns are still unclear, and their dermoscopic details are sparsely reported. Aim: We aimed to retrospectively study the clinical, dermoscopic and immunopathological details of patients with non-infectious, non-eczematous inflammatory tattoo reaction patterns in a tertiary care centre of East India. Method: The clinical, dermoscopic and pathological details of all the patients who had non-infectious, non-eczematous inflammatory tattoo reactions were collected. In all the cases, immunohistochemistry was done for CD1a, CD3, CD4, CD8, FoxP3, CD20 and CD56. Results: A total of five patients of skin phototypes IV and V and six tattoo reactions were analysed. Five lesions had reactions at the site of a black tattoo, and one at the site of red tattoo. Clinically, the patients presented with erythematous or blue-grey flat-topped to verrucous papules and plaques. Dermoscopic features were dominated by a central white to pink-white structureless area, a peripheral grey-white to bluish-white structureless area, white scales, comedo-like opening with keratotic plugging, milia-like cysts and shiny white structures. Pathologically, except for one lesion that only showed a lichenoid reaction pattern in the red tattoo, all had a combination of reaction patterns. Immunohistochemistry showed increased epidermal and dermal Langerhans cells, predominantly CD8 positive T cells in the epidermis and dermis, sparse dermal B cells and CD4 positive T cells, reduced T regulatory cells and a complete absence of CD56 positive NK cells. Limitations: Small sample size was the limitation of the study. Conclusion: The clinical morphology and dermoscopy may not differentiate between various types of non-infectious non-eczematous inflammatory tattoo reactions. The immunological profile supports a delayed hypersensitivity reaction due to contact sensitisation to tattoo pigment, and CD8 positive T cells play a central role in executing various pathological reaction patterns, both in the epidermis and dermisItem Clinicopathological study of itchy folliculitis in HIV-infected patients.(2010-05) Annam, Vamseedhar; Yelikar, B R; Inamadar, Arun C; Palit, Aparna; Arathi, PBackground: Itchy folliculitis are pruritic, folliculo-papular lesions seen in human immunodeficiency virus (HIV)-infected patients. Previous studies have shown that it was impossible to clinically differentiate between eosinophilic folliculitis (EF) and infective folliculitis (IF). Also, attempts to suppress the intense itch of EF were ineffective. Aims: The present study is aimed at correlating clinical, histopathological and immunological features of itchy folliculitis in HIV patients along with their treatment. Methods: The present prospective study lasted for 36 months (September, 2005 to August, 2008) after informed consent, data on skin disorders, HIV status and CD4 count were obtained by physical examination, histopathological examination and laboratory methods. Results: Of 51 HIV-positive patients with itchy folliculitis, the predominant lesion was EF in 23 (45.1%) followed by bacterial folliculitis in 21 (41.2%), Pityrosporum folliculitis in five (9.8%) and Demodex folliculitis in two (3.9%) patients. The diagnosis was based on characteristic histopathological features and was also associated with microbiology confirmation wherever required. EF was associated with a lower mean CD4 count (180.58 ± 48.07 cells/mm 3 , P-value < 0.05), higher mean CD8 count (1675.42 ± 407.62 cells/mm3) and CD8/CD4 ratio of 9.27:1. There was significant reduction in lesions following specific treatment for the specific lesion identified. Conclusion: Clinically, it is impossible to differentiate itchy folliculitis and therefore it requires histopathological confirmation. Appropriate antimicrobial treatment for IF can be rapidly beneficial. The highly active antiretroviral therapy along with Isotretinoin therapy has shown marked reduction in the lesions of EF. Familiarity with these lesions may help in improving the quality of lives of the patients.Item Congenital asymptomatic papule on the lower eyelid(Indian Association of Dermatologists, Venereologists & Leprologists, 2018-09) Adya, Keshavmurthy A; Palit, Aparna; Inamadar, Arun CItem Current concepts in the management of bacterial skin infections in children.(2010-09) Palit, Aparna; Inamadar, Arun CBacterial skin infections in children vary widely clinically, starting from mild superficial folliculitis to deep necrotizing fasciitis. The causative organisms are mostly Staphylococcus aureus and Streptococcus, with occasional involvement of Gram-negative organisms. Treatment of even the milder forms of bacterial skin infections is of importance because of the long-term morbidity associated with them. However, because of global emergence of resistant strains of bacteria, treatment of these conditions is becoming increasingly difficult. The current antibacterial resistance patterns in organisms causing skin and soft tissue infections and the problems encountered in their management in children have been discussed.Item 'Custard apple' scalp.(2010-05) Inamadar, Arun C; Palit, Aparna; Ragunatha, SItem Cutaneous mastocytosis: report of six cases.(2006-01-17) Inamadar, Arun C; Palit, AparnaCutaneous mastocytosis is a rare infiltrative disorder of the skin. Though often asymptomatic, systemic features may be associated with any clinical pattern of the disorder at any age group. We present our experience with six cases of cutaneous mastocytosis, including three with diffuse cutaneous mastocytosis, a rare entity.Item Cutaneous reactions simulating erythema multiforme and Stevens Johnson syndrome due to occupational exposure to a plant-growth regulator.(2007-09-09) Inamadar, Arun C; Palit, AparnaBACKGROUND: In India, hydrogen cyanamide (Dormex) is a plant growth regulator used mainly for the bud-breaking of grapevines. The use of this chemical may result in severe cutaneous reactions simulating erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). METHODS: Studies were conducted on four seasonal grapevine workers who developed severe cutaneous reactions following the unprotected use of Dormex (hydrogen cyanamide). RESULTS: Two of the patients had EM-like skin lesions and the other two developed SJS-TEN-like skin lesions. A latent period of 5-7 days existed between the contact with the chemical and the development of the skin lesions. The histopathological picture was suggestive of EM. All the patients responded to systemic steroids and antihistamines. CONCLUSIONS: Hydrogen cyanamide may act as a hapten, initiating cytotoxic immunological attack on keratinocytes, resulting in EM- and SJS-TEN-like clinical picture. Awareness regarding such severe cutaneous reactions due to the inappropriate handling of Dormex is required. The use of personal protection equipment while handling agricultural chemicals is essential.Item Cutaneous signs in heritable disorders of the connective tissue.(2004-07-24) Inamadar, Arun C; Palit, AparnaItem Dermatoses with “collarette of skin”(Indian Association of Dermatologists, Venereologists & Leprologists, 2019-01) Adya, Keshavmurthy A; Inamadar, Arun C; Palit, AparnaItem Dermoscopic features of clofazimine-induced pigmentation in a borderline tuberculoid leprosy plaque(Scientific Scholar, 2022-02) Behera, Biswanath; Palit, Aparna; Sethy, Madhusmita; Nayak, Ashish Kumar; Dash, Siddhartha; Ayyanar, PavithraItem An elderly man with a violaceous nodule and anemia.(2005-09-06) Palit, Aparna; Inamadar, Arun C; Athanikar, S B; Sampagavi, V V; Deshmukh, N S; Yelikar, B RItem Flexural scaly papules and plaques(Indian Association of Dermatologists, Venereologists & Leprologists, 2018-11) Adya, Keshavmurthy A; Inamadar, Arun C; Palit, AparnaItem Histopathological study of pruritic papular eruptions in HIV-infected patients in relationship with CD4, CD8 counts.(2009-07) Annam, Vamseedhar; Yelikar, B R; Inamadar, Arun C; Palit, AparnaBackground: Pruritic papular eruptions (PPE) are common cutaneous manifestations in HIV-infected patients. Their frequencies, patterns and associated factors vary from region to region. There is no clear consensus on the etiology of PPE, the exact spectrum of the condition, the pathologic findings, or treatment. The present study is aimed at documenting the histopathological patterns of PPE, and their relation with CD4, CD8 counts in HIV-infected patients. Materials and Methods: The present study lasted for 12 months (September 2005 to August 2006). After informed consent, data on skin disorders, HIV status, CD4 and CD8 counts were obtained by physical examination and laboratory methods. Results: Of the 36 HIV-infected patients with clinical diagnosis of PPE, the most common histopathological patterns were prurigo simplex and eosinophilic folliculitis. The mean CD4 count of PPE was 186.49 cells/mm 3 with mean CD8 count of 619.60 cells/ mm 3 , and the CD4:CD8 ratio was 0.32. Patients with prurigo simplex had significantly lower mean CD4 counts (50.36 ± 30.67 cells/cmm 3 , P < 0.001) while in eosinophilic folliculitis, the mean CD8 counts were higher (1239.77 ± 402.30 cells/cmm 3 ). Conclusion: We conclude that histopathology helps in specifying the pattern of PPE and also indicates underlying immunosuppression and can be a marker of advanced HIV infection. Thus, correlation between the histopathology and immunology findings helps to know the disease process.Item Hyperpigmented patch on the trunk of a neonate. Congenital smooth muscle hamartoma (CSMH) or congenital arrector pili hamartoma.(2005-05-06) Palit, Aparna; Inamadar, Arun C; Athanikar, S B; Sampagavi, V V; Deshmukh, N S; Yelikar, B R