Indian Journal of Dermatology, Venereology and Leprology

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1064 nm Q switched Nd: YAG laser treatment of nevus of Ota: An Indian open label prospective study of 50 patients.
(2011-09) Kar, Hemanta Kumar; Gupta, Lipy
Background: Nevus of Ota is very common in Asians. Estimated male to female ratio is 1:4.8. Patients seek treatment early in life due to psychological trauma and cosmetic disfigurement. The creation of high power, short pulse Q switched lasers has recently provided tools for considerable therapeutic advances in the treatment of dermal pigmented lesions. Aims: To determine the efficacy and side-effect profile of Q switched Nd:YAG Laser (QSNYL) in fifty Indian patients. Methods: Fifty patients of nevus of Ota underwent multiple treatments (average 5 sessions) at monthly intervals carried out over a period of 2 years with QSNYL (Med-lite C6). Of the 50 patients, 2 were males; and the rest were females. Skin types treated included phototype IV and V. The response after subsequent treatments was documented through serial photographs that were taken before and after every treatment session. Response to the treatment was graded based on quartile grading scale. Results: Near total improvement was seen in 8%, marked improvement in 22%, moderate improvement in 38% and 32% patients reported less than 25% clearing of the lesion. All patients reported some improvement. Transient postinflammatory hyperpigmentation was observed in 4 (8%) patients, which cleared with use of sunscreens and bleaching agents within 2 months. No textural change or scarring was observed in any patient. Conclusions: QSNYL is an easy-to-perform and effective treatment in cases of nevus of Ota in Indian patients with few side effects.
18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot study
(Indian Association of Dermatologists, Venereologists & Leprologists, 2018-11) Kaur, Sharonjeet; Shafiq, Nusrat; Dogra, Sunil; Mittal, BR; Attri, Savita Verma; Bahl, Ajay; Narang, Tarun; Vinay, Keshavamurthy; Rajagopalan, Sujit; Malhotra, Samir
Background: Psoriasis is a systemic inflammatory disorder associated with an increased risk of cardiovascular disease. Objective: To evaluate the utility of [[18]F]-fluorodeoxyglucose positron emission tomography/computed tomography in identifying vascular and systemic inflammation in psoriasis patients with moderate-to-severe disease and to analyze its usefulness in assessing the effect of systemic treatment. Methods: This was a randomized, double-blind pilot study conducted in a tertiary care center. Baseline standardized uptake value score was estimated by18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with moderate-to-severe psoriasis and compared with historical controls. Patients were then randomized using computer-generated randomization list into methotrexate or placebo (with or without pioglitazone) groups.18F-fluorodeoxyglucose positron emission tomography/computed tomography was repeated at 12 weeks and composite standardized uptake value score determined. The correlation between Psoriasis Activity and Severity Index and SUVmax was assessed. Results: A total of 16 patients were randomized to different treatment groups. Significant increase in mean SUVmax was observed in the ascending aorta in psoriasis patients as compared to historical controls (2.03 ± 0.53 vs 1.51 ± 0.36, P < 0.03). There was no difference in composite standardized uptake value score after 12 weeks of treatment in any of the treatment groups (P = 0.82), although an improvement in Psoriasis Activity and Severity Index score in the methotrexate arm was observed. No correlation was found between mean SUVmax and Psoriasis Activity and Severity Index scores in various aortic segments (r = 0.3–0.7). Limitations: Small sample size, short follow-up, historical controls, exclusion of patients with comorbid conditions and lack of surrogate markers of systemic inflammation. Conclusion: 18F-fluorodeoxyglucose positron emission tomography imaging showed higher vascular inflammation in ascending aorta of psoriasis patients as compared to historical controls. Systemic treatment with methotrexate and pioglitazone did not influence the vascular inflammation in the short term.
29th National conference of Indian Association of Dermatologists, Venereologists & Leprologists.
(2001-01-01) Kumar, B
32P-patch contact brachyradiotherapy in the management of recalcitrant keloids and hypertrophic scars.
(2007-09-09) Vivante, H; Salgueiro, M J; Ughetti, R; Nicolini, J; Zubillaga, M
Keloids are the result of excessive fibroblast proliferation and then over-abundant collagen deposition. There is no method able to guarantee absolute success in the therapeutic approach to keloids. Our case report involves a female patient with six lesions treated with a 32P-patch brachyradiotherapy. Pre-treatment and adjuvant treatment of the lesions were performed with thiomucase, 5-fluoruracil, procaine and triamcinolone. Taking into account the activity contained in each of the patches and the total radiation dose to be administered according to clinical practice, dosimetric calculations were done for each lesion. Separate silicone patches with chromic [32P]phosphate were designed for each lesion based on these calculations. Total remission was achieved in three treated lesions. The other lesions did not achieve total remission yet, but their sizes are diminishing. The differences observed in treatment outcome may be related with lesion features, adjuvant treatments and/or treatment schedule.
Abdominal hernia following abdominal herpes zoster.
(2001-01-01) Sharma, P K; Gautam, R K; Basistha, C; Jain, R K; Kar, H K
We report a case of abdominal hernia in TIO and 11 segments following herpes zoster at T11 segment.
Abnormal insect bite reactions: a manifestation of immunosuppression of HIV infection?
(2001-03-01) Ajithkumar, K; George, S; Babu, P G
Pruritic papular eruptions are a common manifestation in patients infected with HIV. The significance of these lesions is not known. We have many apparently normal individuals presenting with exaggerated insect bite reaction on the exposed parts of the body as the only manifestation of HIV disease. A pilot study was done to see whether the appearance of exaggerated insect bite reactions is an indicator of impending immune suppression in HIV infected individuals. CD4 count was done in 10 serial patients presenting to our clinic with exaggerated insect bite response of recent onset and HIV infection. Out of the 10 cases, 8 showed low CD4 counts (less than 400/cmm). Further studies may prove that exaggerated insect bite reaction can be a marker of impending immunosuppression.
Acantholysis revisited: Back to basics.
(2013-01) Seshadri, Divya; Kumaran, M Sendhil; Kanwar, Amrinder J
Acantholysis means loss of coherence between epidermal cells due to the breakdown of intercellular bridges. It is an important pathogenetic mechanism underlying various bullous disorders, particularly the pemphigus group, as well as many non-blistering disorders. Although a well-known concept, the student often has to refer to many sources to comprehend acantholysis completely. Thorough knowledge of this topic helps in clinching many diagnoses. The etiopathogenesis, classification, clinical signs, and laboratory demonstration of acantholysis are discussed in detail to help students build clear concepts. We have focused on various distinguishing points in different disorders for an easy grasp of the topic.
Acantholytic dyskeratotic epidermal naevus.
(2012-05) Yaghoobi, Reza; Aliabdi, Maryam; Kheradmand, Parvin; Kazerooni, Afshin; Mehrabian, Abolfath
Acantholytic dyskeratotic epidermal nevus.
(2011-03) Lee, Cheng-Han; Hsiao, Cheng-Hsiang; Chiu, Hsien-Ching; Tsai, Tsen-Fang
Acanthosis nigricans in an HIV seropositive: is there a correlation?
(2006-09-20) Marfatia, Y S; Sharma, Archana
Acanthosis nigricans--An uncommon cutaneous adverse effect of a common medication: Report of two cases.
(2013-07) Sawatkar, Gitesh U; Dogra, Sunil; Bhadada, Sanjay K; Kanwar, Amrinder J
Acanthosis nigricans: a dermatologic marker of metabolic disease.
(2002-03-28) Varthakavi, P K; Waingankar, A; Patel, K L; Wadhwa, S L; Khopkar, U; Sengupta, R A; Merchant, P C; Mehtalia, S D; Nihalani, K D
Most patients with acanthosis nigricans have either clinical or subclinical insulin resistance. We undertook a study to estimate the insulin sensitivity of a group of patients referred from the dermatologist with biopsy proven acanthosis nigricans. Thirty-six patients were evaluated in the Endocrinology clinic. Plasma glucose and serum Insulin levels were estimated after a 75 gms oral glucose load (OGTT). An intravenous Insulin Tolerance Test (ITT) was performed with measurement of Glucose Disposal Rate (GDR). There were 28 females and 8 males (M:F--3.5:1; mean age 26.3+/-1.7 years) in the study. 25/36 patients were morbidly obese (BMI--36.0 +/- 1.2 Kg/m2) with an abnormal body fat distribution (WH ratio--0.9 +/ - 0.02). One patient had generalized lipoatrophy. 16/36 patients with acanthosis nigricans had IGT or overt diabetes and all had highly significant hyperinsulinemia (AUCI = 20825 +/ 1287.7 vs. 6340.0 +/- 984.2 mIU/ml/hr in controls, p < 0.0005). The GDR in patients with acanthosis nigricans was reduced (-0.66 +/- 0.07) compared to controls (-0.39 +/- 0.08; p < 0.01). There was a significant positive correlation between indices of adiposity and insulin resistance in subjects with impaired tolerance.
Acceptability of artificial intelligence among Indian dermatologists
(Scientific Scholar, 2022-04) Pangti, Rashi; Gupta, Sanjeev; Gupta, Praanjal; Dixit, Ambika; Sati, Hem Chandra; Gupta, Somesh
Accessory auricles with ectopic digit a new association.
(2002-05-28) Mittal, R R; ,
A 25-year-old male had accessory auricles at birth and developed ectopic digit since 1 year. As this association could not be traced in literature, it is being reported. Ectopic digit in the present case was differentiated from supernumerary digit because of late onset at the age of 24 years, recurrence after surgery, unilateral appearance, had origin from central depression of a well defined, round plaque on the distal inter-phalangeal joint of left thumb and had curvature simulating cutaneous horn. X-ray thumb did not reveal any bone formation in this ectopic digit.
Accidental high-dose methotrexate toxicity due to an electronic prescribing error.
(2014-05) Çaliskan, Ercan; Tunca, Mustafa; Açikgöz, Gürol; Arca, Ercan; Akar, Ahmet
Accidental occupational fireworks tattoo.
(2015-05) Bonamonte, Domenico; Vestita, Michelangelo; Angelini, Gianni
Accuracy of indirect immunofluorescence on sodium chloride-split skin in the differential diagnosis of bullous pemphigoid and epidermolysis bullosa acquisita.
(2011-11) Yang, Baoqi; Wang, Chong; Chen, Shengli; Chen, Xuechao; Zhou, Guizhi; Tian, Hongqing; Yu, Meiling; Zhang, Dizhan; Shi, Zhongxiang; Zhang, Furen
Background: Previous reports have shown that indirect immunofluorescence (IIF) performed on sodium chloride-split skin (SSS) is helpful to differentiate epidermolysis bullosa acquisita (EBA) from bullous pemphigoid (BP). Antibodies of BP may bind to the epidermal side of SSS, while antibodies of EBA bind to the dermal side. Aims: To determine the accuracy of IIF-SSS in the differential diagnosis of EBA and BP utilizing immunoblotting (IB) analysis. Methods: Sera from 78 patients, diagnosed with BP by clinical features, histopathology, and direct immunofluorescence (DIF), were assayed using IIF-SSS and IB. Results: Of the 43 serum samples with an epidermal reaction to IIF-SSS assay, 42 were recognized with BP antigens (180 kDa or 230 kDa). Of the 11 serum samples with a dermal reaction pattern, 7 were recognized with the 290 kDa antigen of EBA and 3 with sera bound BP antigens. Seven serum samples with epidermal and dermal combined staining, of which 5 of them reacted with BP antigens, 1 reacted with both BP and EBA antigens. One serum sample from each group showed a negative result by IB. Approximately 9.0% (7/78) of patients diagnosed with BP using regular methods were actually EBA. Conclusions: Epidermal reaction using the IIF-SSS assay highly correlated with the diagnosis of BP. However, dermal reactions correlated poorly with EBA, with some serum samples from BP patients binding to dermal-side antigens. In both epidermal and dermal stained sera using IIF-SSS, there was a possibility of BP and EBA. Differential diagnosis should be confirmed using IB, especially in cases of dermal and double staining patterns assayed using IIF-SSS.
Accuracy of references cited in articles published in Indian Journal of Dermatology, Venereology and Leprology: A pilot study.
(2009-09) Singh, Sanjay; Chaudhary, Rahul
Background: Progress in science takes place when investigators build on the work of others. Therefore, in scientific communications, it is very important that others' work is correctly noted and understood. Cited references have been found to be inaccurate in every journal in which they have been examined. Aim: To analyze references cited in articles published in Indian Journal of Dermatology, Venereology and Leprology for their citation and quotation precision as an indicator of the quality of articles. Methods: Twelve citation and five quotation errors were identified and defined. Fifty cited references were selected randomly from the May-June 2008 issue of the journal. For these citations, we obtained 44 full texts of papers and two abstracts. In one case, only citation errors could be verified from the Internet. Three citations of books could not be verified. Thus, citation errors were examined in 47 and quotation errors in 46 citations. Results: Thirteen cited references (28.3%; 95% confidence interval [CI] 15.3-41.3%) were error-free. Twenty-eight citations (59.6%; 95% CI 45.5-73.6%) contained citation errors and 20 (43.5%; 95% CI 29.2-57.8%) quotation errors. Conclusion: Results of this pilot study suggest that improving accuracy of the references is important. Solutions to this problem are suggested.
Achieving asepsis of banana leaves for the management of toxic epidermal necrolysis.
(2006-05-13) Srinivas, C R; Sundaram, V Shanmuga; Raju, B Appala; Prabhu, S Karthick; Thirumurthy, M; Bhaskar, A C
BACKGROUND: Banana leaf is used in many centers in India during the care of patients with toxic epidermal necrolysis (TEN) and other extensive blistering disorders. Sepsis is an important cause of death in TEN patients and use of banana leaf may be a source of such infection. AIMS: We conducted this study to detect the bacterial flora of the banana leaf and to examine various methods of rendering the leaf aseptic. METHODS: Five pieces of banana leaf, 2 x 2 cm in size, were cultured separately in blood agar as follows: One piece was heated over a flame and one was soaked in boiling water and one was autoclaved. Methylated spirit was applied over one piece and ignited. One piece was placed on the media, 'as is.' The Petri dishes were incubated examined after 48 h. RESULTS: All the pieces except the autoclaved specimen of the leaf grew coagulase-negative staphylococci (CONS) when aseptic precautions were not maintained and aerobic spore bearers when all aseptic measures were subsequently instituted during the procedure. CONCLUSION: We recommend measures to prevent possible transmission of bacterial infection by the leaf. Autoclaved and aseptically handled banana leaves may be used to reduce chance of infection in the treatment of TEN.
Achromatic atrophic macules and patches of upper extremities.
(2013-03) Park, Joon S; Chae, In S; Kim, In Y; Ko, Dong K; Chung, Hyun; Lee, Sung W

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