Intra-Operative Dermoscopy in Assessment of Melanonychia and as a Guide for Biopsy.

Background And Aims: Melanonychia can be a manifestation of benign or malignant pathology and often poses a diagnostic challenge on clinical examination. Even with distinguishing dermoscopic features (nail plate), it can be quite difficult to determine the nature of pigmentation as complete assessment of nail bed and matrix is still not possible. Intraoperative dermoscopy (IOD) can serve as a useful tool to appreciate the bed and matrix changes.

Successful Limb Salvage in a Case of Advanced Long-Standing Eumycetoma of the Foot Using Adjunctive Local Amphotericin B Delivery Through Bioabsorbable Beads.

Mycetoma is a chronic, granulomatous infection mainly involving the foot and is caused either by bacteria (actinomycetoma) or fungi (eumycetoma). Eumycetoma is notoriously resistant, posing a therapeutic challenge. There are no specific treatment guidelines but generally a combination of systemic antifungals and local surgical treatment is the accepted standard.

Atypical Presentation of Sweat Dermatitis with Review of Literature.

Sweat dermatitis is a peculiar kind of irritant inflammatory dermatoses occurring due to prolonged exposure of retained sweat over the skin. It is commonly seen in hot and dry climates like tropics during summer months due to thermal stress. Typically, parchment paper or cellophane paper like scaling is seen over occluded areas of back, shoulder, and other areas.

Allergic contact dermatitis to phenylephrine eye drops in an infant.

Ophthalmic medications used for diagnostic or therapeutic purposes are common causes of allergic contact dermatitis around the eyes. We report a case of periocular allergic contact dermatitis due to tropicamide and phenylephrine eye drops in a 1-year-old infant.

Evidence-based Review, Grade of Recommendation, and Suggested Treatment Recommendations for Melasma.

Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available.

Guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis: An Indian perspective.

Background: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor-α inhibitors.

Aim: The ideal therapy of Stevens-Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments.

Primary cutaneous angioplasmocellular hyperplasia.

Angioplasmocellular hyperplasia is a rare clinical condition with blood vessel proliferation and a reactive plasma cell infiltrate. To the best of our knowledge fewer than 20 cases of cutaneous angioplasmocellular hyperplasia have been published in English literature. We report a case of a 65-year-old man who presented with a long standing asymptomatic flesh colored ulcerated nodule on the back.

Treatment of severe refractory erythema nodosum leprosum with tumor necrosis factor inhibitor Etanercept.

Erythema nodosum leprosum (ENL) is a common complication of lepromatous leprosy. Some patients unresponsive to conventional, first-line therapeutics develop recurrent, recalcitrant ENL. Here, we report a case of severe refractory ENL that was successfully treated with Etanercept.

Serum Homocysteine and Total Antioxidant Status in Vitiligo: A Case Control Study in Indian Population.

Background: Oxidative stress is considered as an initial pathogenic event in melanocyte destruction. These free radicals are scavenged by antioxidants, whose sum of activity in serum is measured by total antioxidant status (TAS). In addition, homocysteine (Hcy) may mediate melanocyte destruction via increased oxidative damage.

Shampoo and Conditioners: What a Dermatologist Should Know?

Dermatologists many a times encounter questions from patients and even colleagues asking about how to keep their hair looking clean, healthy and beautiful. Therefore, familiarity and a basic knowledge of the available hair care products will help them to guide their patients properly. A shampoo not only provides the cleaning of the scalp skin and hair as its primary function, but in addition also serves to condition and beautify hair and acts as an adjunct in the management of various scalp disorders.

Cutaneous tuberculosis due to multidrug-resistant tubercle bacilli and difficulties in clinical diagnosis.

This report describes 6 HIV-negative patients including 5 children with scrofuloderma and an adult with lupus vulgaris, out of a total of 303 cases of cutaneous tuberculosis seen during a 4½-year period, who showed a positive tuberculin test and granulomatous histopathology, but failed to respond to first-line antitubercular therapy. They were suspected to have multidrug-resistant infection as no other cause could be ascertained. Tissue aspirate or biopsy was sent for histopathology and culture.

Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy.

A 58-year-old woman, diagnosed as a case of mycosis fungoides (MF), underwent [18F]-fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) examination. The study revealed intense FDG uptake in a large ulceroproliferative right thigh lesion, indurated plaques in the chest wall and left thigh, along with multiple sites of cutaneous involvement, axillary and inguinal lymphadenopathy. The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement.

(18)F-FDG PET/CT in an unusual case of cardiac plexiform neurofibromatosis.

Cardiac involvement is rare in neurofibromatosis 1 (NF 1). Very few cases of cardiac masses in this entity have been documented in the world literature. We present the F-FDG PET/CT findings in a rare case of cardiac plexiform neurofibromatosis.

Multifocal tuberculosis verrucosa cutis.

Tuberculosis Verrucosa Cutis (TBVC), a verrucous form of cutaneous tuberculosis, occurs from inoculation of tubercle bacilli into the skin of a previously sensitized patient with moderate to high degree of immunity. This disease is now rare in western countries and in India; the incidence of cutaneous tuberculosis has fallen from 2% to 0.15%.

Keloidal plaque in a patient with pulmonary tuberculosis: A rare morphological variant of tuberculosis verrucosa cutis.

Tuberculosis verrucosa cutis (TVC), also known as warty tuberculosis, anatomist's wart or prosector's wart is characterized by the presence of verrucous plaque-like lesions, resulting from direct inoculation of the causative organism into the skin of a previously infected patient. A 59-year-old man presented with a hyperpigmented plaque on the chest wall which closely mimicked a keloid. He was a case of sputum-positive pulmonary tuberculosis and had repeatedly been applying early morning saliva on the lesion as a part of the indigenous practices for quick healing.

Porokeratosis ptychotropica: a rare variant of porokeratosis.

Background: Porokeratosis, a well recognized disorder of keratinization, is known to have several clinical variants. This report describes a rare variant characterized by verrucous plaques.

Methods: An adult male presented with a slowly progressive verrucous plaque on the gluteal region that was resistant to conventional therapy.

Post-kala-azar dermal leishmaniasis mimicking leprosy relapse: a diagnostic dilemma.

Objectives: Post-kala-azar dermal leishmaniasis (PKDL) is well recognized in the Indian subcontinent and is not infrequently confused with leprosy. The present report describes findings in an unusual case of PKDL.

Methods: We report an adult male who presented with firm nodules on the face and extremities, along with hypopigmented macules on the neck with deformity and hypoesthesia over the right upper extremity.

18F-fluorodeoxyglucose positron emission tomography/computed tomography in a case of malignant peripheral nerve sheath tumor: An unusual presentation.

Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors, with an estimated incidence of 0.1/100,000/year. They are regarded as a rare variety of soft-tissue sarcomas that derive from peripheral nerves or from cells associated with the nerve sheath.

Nevus lipomatosus cutaneous superficialis: An unusual presentation.

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.

Pemphigus vegetans: An unusual presentation.

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.