2014.3

since 15.July 2014

 

C O N T E N T S   3.2014

 

 

 

 

 


ORIGINAL ARTICLES


Leena Raveendra
A clinical study of geriatric dermatoses

      Our Dermatol Online 2014; 5(3): 235-239          DOI: 10.7241/ourd.20143.59

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The paper describes a cross-sectional study on dermatological signs of ageing.  It is well designed and written in decent English. It is worth to note that the described conditions do nit certainly reflect the situation in the general population, as all recruited subject sought dermatological consultation actively for a certain dermatological condition. Otherwise the paper is of actuality and reaches the quality to be published in the journal.  Razvigor Darlenski, MD PhD (Bulgaria)

This is an interesting paper that deals with the geriatric population. Results obtained in here are to a certain extent similar to other recent findings. For instance, a high incidence of fungal infections has been noted. This is quite usual and a common global problem. A nice review by Havlickova et al 2008 entitled “Epidemiological trends in skin mycoses worldwide” in Mycoses vol 51 provided some of the factors associated with same. Another study in India “A clinical study of skin changes in geriatric population” among 200 patients aged 65+ years, in Bangalore reported that wrinkling, xerosis were quite common (Grover & Narasimhalu 2009). Similar results were obtained by Bilgili et al 2012 (The prevalence of skin diseases among the geriatric patients in Eastern Turkey). It should be noted that apart from the use of less emollients and harsher soaps by subjects, there are age-related dermal changes, altered physiological changes during normal ageing, environmental factors, genetics, and ethnicity that can be contributing factors to a higher incidence of xerosis.   Dr. Rajesh Jeewon Ph.D. (Mauritius)

Neerja Puri, Parveen Kumari
A study on sexually transmitted diseases in patients in a STD clinic in a district hospital in North India

      Our Dermatol Online 2014; 5(3): 240-244          DOI: 10.7241/ourd.20143.60

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The importance of gender selection of even specialist matters is highlighted in the present study. The number of female patients are reported to be more as the specialists here are females. The other important issue, the present study, point towards, is the need of more awareness. I believe ,the other relevant issue is the timings of STD clinics. In crowded government clinics, timings and days are fixed and STD patients tend to go to private for reasons of more privacy,anonymity, and 24×7 availability. Bharti et al presented a study from Amritsar, in 1992 International AIDS conference,pointing out the same. Health authorities should look into the matters of active surveillance as well.  Dr Rakesh Bharti (India)

A good study, the number of patients included in the study was big. The study achieved its main objective which was the profile of patients in a STD clinic in North India. It would be reasonable if the study has screened the patients for HIV and demonstrate any potential correlation with certain STD.   Dr Amani Tresh (Libya)

Vijaya Kumar Subash, Alekhya Pabba, Sasikala Muniappan, Ramchandra Dharak
A preliminary study on clinical outcome of corticosteroid therapy in pemphigus patients

      Our Dermatol Online 2014; 5(3): 245-250          DOI: 10.7241/ourd.20143.61

[abstract-English] , [article in English],   [PDF][HTML]

Chankramat Sujatha Vinod, Hariharasubramony Ambika, Nithya Raghunath, Sushmitha Jayaprasad
Clinical profile of Herpes zoster in a rural tertiary care hospital in South India

      Our Dermatol Online 2014; 5(3): 251-253          DOI: 10.7241/ourd.20143.62

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The incidence of complications and treatment given could be elaborated in Immunocompromised patients.  Prof. Sunderamoorthy Srinivasan (India)  

Deeptara Pathak Thapa, Amit Thapa
Dermatology referrals in a neurological set up

      Our Dermatol Online 2014; 5(3): 254-257          DOI: 10.7241/ourd.20143.63

[abstract-English] , [article in English],   [PDF][HTML]

 


BRIEF REPORT


Rahim Asghariazar, Hamideh Herizchi Ghadim, Shahla Babaeinezhad, Sina Nobahari
The comparison study of 5 Fluorouracil vs. cryotherpy in the treatment of the backhand resistant common wart

      Our Dermatol Online 2014; 5(3): 258-260          DOI: 10.7241/ourd.20143.64

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This study compares the efficacy and safety of 2 important treatment modalities (5FU and cryotherapy) for resistant cases (backhand warts) that can face every dermatologist. The better results shown with the 5FU group could encourage dermatologists to use it in these resistant cases. But we need more comparative studies with larger number of patients and longer follow up period to assess its efficacy and safety over other well documented line of treatment as electrocautery and cryotherapy.   Ass. Prof. Rania Abdel Hay (Egypt)  

Comment by: Ass. Prof. Antonio Chuh and Prof. Vijay Zawar 

      Our Dermatol Online 2014; 5(3): 261
 

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CASE REPORTS


Nidhi Sharma, Tejinder Kaur, Preeti Garg, Karanjeet Pal Singh Puri
Carcinoma erysipeloides mimicking radiation dermatitis – a case report and review of literature

      Our Dermatol Online 2014; 5(3): 262-263          DOI: 10.7241/ourd.20143.65

[abstract-English] , [article in English],   [PDF], [HTML]

Shricharith Shetty, Vidya Monappa, Kanthilatha Pai, Raghavendra Rao, Sathish Pai
Congenital self-healing reticulohistiocytosis: a case report

      Our Dermatol Online 2014; 5(3): 264-266        DOI: 10.7241/ourd.20143.66

[abstract-English] , [article in English],    [PDF], [HTML]

Jyoti Ramnath Kini, Ancy Susan John, Hema Kini, Flora Dorothy Lobo, Pramod Kumar, Krishna Prasad
Subcutaneous Panniculitis- like T-Cell Lymphoma: Report of two cases

      Our Dermatol Online 2014; 5(3): 267-270          DOI: 10.7241/ourd.20143.67

[abstract-Engli sh] , [article in English],   [PDF], [HTML]

 

Comment by: Ass. Prof. Małgorzata Sokołowska-Wojdyło 

      Our Dermatol Online 2014; 5(3): 271-272
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Archana Shivamurthy, Shaila Talengala Bhat, Padmapriya Jaiprakash
Subcutaneous phaeomycotic cyst: a case report

      Our Dermatol Online 2014; 5(3): 273-275          DOI: 10.7241/ourd.20143.68

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Interesting and classical case of subcutaneous phaeomycotic cyst. You can find some additional information in our recent papers.   References: 1. Isa-Isa R, García C,  Isa M,  Arenas R. Subcutaneous phaeohyphomycosis (mycotic cyst) Clin. Dermatol. 2012;30:425–31;  2. Vásquez del Mercado E, Lammoglia L, Arenas R. Subcutaneous faeohyphomycosis due to Curvularia lunata in a renal tranplant patient. Rev Ibero Am Micol. 2013;30:116-8.   Prof. Roberto Arenas (Mexico)

Congratulations to the authors is an interesting report, though it would be interesting to know the risk factors of the patient and co-morbidity. Phaeohyphomycosis is a rare mycotic opportunist disease witch usually affects immunodepressed patients. The most frequently encountered etiologic agents of subcutaneous phaeohyphomycosis include Exophiala jeanselmei, Exophiala dermatitidis, Phialophora verrucosa and Phaeoacremonium parasiticum. Which are the most frequent cause espcies Phaeohyphomycosis in India.   Dr Max Carlos Ramírez Soto (Peru)

This is a very interesting case of an infrequent presentation of a subcutaneous pheomycotic cyst in an elderly patient. The authors describe very nicely the typical histopathological findings. It is a shame that cultures could not be taken.  Dr. Manuel Valdebran (Dominican Republic)

María Lorena Re Domínguez, Beatriz Di Martino Ortiz, Mirtha Rodríguez Masi, Oilda Knopfelmacher Domínguez, Lourdes Bolla Agüero de Lezcano
Patologias umbilicales en niños. Aporte de dos casos y revisión de la literature
[Umbilical pathologies in children. Report of two cases and review of the literature]
      Our Dermatol Online 2014; 5(3): 276-281          DOI: 10.7241/ourd.20143.69

[abstract-Spanish; English] , [article in Spanish],   [PDF], [HTML]

Iffat Hassan, Parvaiz Anwar Rather, Safiya Bashir, Atiya Yaseen
An interesting case of giant molluscum with florid verruca vulgaris in an immunocompetent patient

      Our Dermatol Online 2014; 5(3): 282-284          DOI: 10.7241/ourd.20143.70

[abstract-English] , [article in English],   [PDF], [HTML]

Sudip Parajuli, Yogesh Acharya, Sandhya Bagariya Rathi
Chronic ulcerating genital herpes simplex virus infection: A diagnosis mislead by HIV infection

      Our Dermatol Online 2014; 5(3): 285-286         DOI: 10.7241/ourd.20143.71

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Thank you for the interesting case report presentation. Overall the presentation is informative and educating. Only one notice is: The patient  was initially diagnosed as Tuberculosis Verrucosa Cutis (TVC) on the basis of clinical, laboratory (Total WBC count: 6310; N48, L45, ESR: 60mm Wintrobes, Mantoux test: induration diameter = 0mm) and histopathological findings (neutrophilic and lymphoplasmacytic infiltrate, necrosis with aggregates of epitheloid cells, Periodic acid Schiff and Ziehl Nelson Stain were negative). Some of these lab findings presented do not seem to strongly support the diagnosis  of  Tuberculosis Verrucosa Cutis (TVC):   1. Wintrobes, Mantoux test: induration diameter = 0mm. In case of TB the induration diameter is usually >10 mm.  2. Periodic acid Schiff and Ziehl Nelson Stain were negative. In  TB. Repeated Acid Fast staining is usually positive.  3. Histological examination of  TB usually shows epithelioid granuloma with multinucleated giant cells (Langhans giant cells),with caseous necrosis, while here we have neutrophilic and lymphoplasmacytic infiltrate, necrosis with aggregates of epitheloid cells. In case of doubt, it might be more beneficial to suggest other sensitive diagnostic measures such as TB-PCR since the early stages than to apply the treatment and then to reconsider a different diagnostic approach.   Dr. Mohamed Wael Daboul (Syrian Arab Republic)

 
Ana Maria Abreu Velez, Bruce R. Smoller, Michael S. Howard
Central centrifugal cicatricial alopecia amalgamated with alopecia areata: immunologic findings

      Our Dermatol Online 2014; 5(3): 287-291          DOI: 10.7241/ourd.20143.72

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It is very interesting this report overlap syndrome between two different entities in the spectrum of alopecia. The patient is well studied from immunology, which invites further research in this field. The association of two or more types of alopecia clinic pathological is not as uncommon in daily practice, which should be reflected in the literature.  Dra. María Bibiana Leroux (Argentina)  

This interesting manuscript highlights about a fact which is indeed very common in clinical practice: the overlapping syndromes o diseases. Particularly in alopecias, where in some certain cases the diagnosis is complex and there's a lack of diagnostic criteria, publications on immunohistochemical and fluorencent features in the different types of alopecia may be of help. While the results obtained by authors are preleminary and based on just one single case, the topic warrants further researches to estimate the real prevalence and incidence of these overlapping syndromes.   Dr. Husein Husein-ElAhmed (Spain)

Piotr Brzezinski, Jarosław Obuszewski, Anca Chiriac
The dancer heel and the alpinist heel (black heel). Case reports

      Our Dermatol Online 2014; 5(3): 292-293          DOI: 10.7241/ourd.20143.73

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Nothing more acute and punctual than this double case report: congratulations to the A.A., that have expressed all their own finesse d’esprit tracing the anamnestic profile, I mean, when they concisely  refer: patients do not remember when the lesions occurred: it gives the proper idea that the patient did not suspect the cogency of the disease just when it began to appear and develop itself, so that  it can be easily argued that the ailment is actually devious and deceptive and worthy to be detected and studied. Besides, the A.A. go strenuously countercurrent with regards to the modern medical practice, I mean, the mercantile and commercial fashion  as it is, hélas, intended in the capitalist and industrialised nations, where the human needs are not anymore wants, desires and demands (Christian Bay, sociologist), but all needs are induced and so generated and thus false. If the study had been conducted in the United States of America or in France or in Italy, the therapy suggested should have been a sequence of sophisticated and insulse medicaments based on voidnesses and vain remedies, here the necessary advices and suggestions only an excellent practitioner can dispense.   Lorenzo Martini, M.Sc.  (Italy)

This is very interesting article for all those who are involved in the health care of athletes. Modern sport is aimed at achieving results that were until recently unimaginable with physiological aspects of the human body.   Vjeroslava Slavic, MD PhD (Montenegro)

Rakesh Tilak Raj, Hemant Kumar, Surinder Pal Singh
Bullosis Diabeticorum involving an unusual site- a diagnostic dilemma; managed successfully with antidiabetic drugs: A case report

      Our Dermatol Online 2014; 5(3): 294-296         DOI: 10.7241/ourd.20143.74

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Bullosis Diabeticorum is an uncommon condition in daily practice and this site is totally unusual occurrence. The article is complete and easy to read. It is very didactic adding of What is Known? and What is new? Congratulations to the authors!   Dra. María Bibiana Leroux (Argentina)

We read with pleasure the article and we want to congratulate the authors for the presentation. Bullosis diabeticorum is a rare skin manifestation of diabetes mellitus, not very well recognized, with tense blisters, mostly on the feet, diagnosed by ruling out other bullous disorders, with a controversial pathogenic mechanism and unpredictable evolution, despite the good control of glycemic metabolism. This is the definition, but the article highlights some important issues:    1. rare ,non-acral presentation of bullosis diabeticorum in a female patient; the ration being in favor of men over women, in recent publications;   2. new onset of type II diabetes mellitus ;no correlation with diabetic neuropathy or other diabetic complications;   3. blisters have some features:  multiple, large, semi-flaccid, haemorrhagic and based on  subcorneal acantholysis;   4. non-scarring healing as a response to andiabetic medication or spontaneous evolution;   5. no previous trauma reported.   Although bullosis diabeticorum or diabetic bullae, as an entity, was described for the first time by Krane in 1930, but it still remains unreported, probably being unrecognized or misdiagnosed. This is why the present article is of great impact on clinical practice not only for dermatologists, but also to other medical personnel who work with diabetic patients.   Prof. Anca Chiriac (Romania)

 

CLINICAL IMAGES


Anca Chiriac, Anca E Chiriac, Piotr Brzezinski
Neonatal occipital alopecia in a newborn

      Our Dermatol Online 2014; 5(3): 297          DOI: 10.7241/ourd.20143.75

[article in English],   [PDF], [HTML] 

Shrikiran Aroor, Sandeep Kumar, Suneel Mundkur
Transient cutaneous hyperpigmentation of extremities following dengue fever

      Our Dermatol Online 2014; 5(3): 298-299          DOI: 10.7241/ourd.20143.76

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Niloofar Mehrolhasani
Nevus Comedonicus

      Our Dermatol Online 2014; 5(3): 300          DOI: 10.7241/ourd.20143.77

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TWe read with great interest the article sign by Dr Niloofar Mehrolhasani, MD on nevus comedonicus. The present case is attractive by the following reasons: 1. is a classical nevus comedonicus(NC); there are two entities: nevus comedonicus and nevus comedonicus syndrome (NC associated with skeletal, ocular, and central nervous system abnormalities);   2. is a delayed development of nevus comedonicus, quite rare in the literature;   3. the location is quite unusual: the abdomen, knowing that NC is localized mostly on the face and neck and exceptionally on other anatomical areas (genital, palms, thorax, and soles);   4. is a non-pyogenic type of NC (acne-like) in contrast to pyogenic type(NC type characterized by formation of cysts, papules, pustules, and abscesses in various stages of development;   5. a localized, asymptomatic and small NC that can be left without any attempt of therapy; 6. no genetic examination was made known, but we agree that it was not obligatory;   7. histopathological report and imagine was of great importance.   We appreciate the presentation for bringing into attention such a rare clinical disease.   Prof. Anca Chiriac (Romania)

 

LETTER TO THE EDITOR  –  Practical Issues


Neerja Puri
Is beauty skin deep – an approach to a beautiful face

      Our Dermatol Online 2014; 5(3): 301-303             DOI: 10.7241/ourd.20143.78

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This is an interesting overview of facial beauty. What makes a face attractive has always been a matter of debate, especially among psychologists. Facial attractiveness has always intrigued one or more and has even caught the attention of many researchers. This is a nice summary of the different aspects of facial beauty and some of the precautions dermatologists/plastic surgeons should pay attention to. What pops in my mind when reading this paper is another interesting article entitled: Is Beauty in the Face of the Beholder? by Laeng et 2013 published in PLoS ONE 8(7). All of us are, to a certain extent, genetically preprogrammed for facial beauty which can largely be affected by lifestyle and environmental factors. Although from an evolutionary viewpoint, partners chose for phenotypic similarity and a simple glance is enough to trigger a number of emotions, we are still far away from a thorough understanding of how parental genes could have influenced our skin and face and how our preferences are linked to attractive traits.   Dr. Rajesh Jeewon Ph.D. (Mauritius)

This excellent article by Dr Neerja Puri highlights the importance , methods and other aspects of cosmiatric procedures. This is a complicated ethical issue. To achieve comprehensive individualized treatment based on patient anatomy and personal expectation, the dermatologist or plastic surgeon needs proper training and experience. Desire and eagerness for quick profits by poorly trained (by courses on weekends, for example) or – worse – by non-medical professionals has led to tragic cosmetic results worsening the patient self esteem. Beyond that , all commercially available products must be approved by the US Food and Drug Administration (FDA) or a national parallel. The doctor must be a certified specialist to minimize the possibility of side effects and complications of these procedures.   Dr Cesar Bimbi (Brazil)


LETTERS TO THE EDITOR  –  Observation


Ryszard Galus, Katarzyna Borowska, Marian Jędrych, Barbara Jodłowska-Jędrych, Longin Niemczyk, Marek Antiszko, Agnieszka Terlikowska-Brzósko, Witold Owczarek, Stanisław Zabielski
Low-dose ciclosporin therapy of erythrodermic psoriasis

      Our Dermatol Online 2014; 5(3): 304-305             DOI: 10.7241/ourd.20143.79

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Cyclosporine is a potent immunomodulatory drug and best choice in refractory or severe chronic plaque Psoriasis type with immediate improvement in clinical manifestations. Kidney functions test should be monitored before and during therapy. FDA approved that cyclosporine not be used more than one year. Alternation with other forms of treatment should be considered in long term management of patients with lifelong disease.   Dr. Yugandar Inakanti (India)

The effectiveness of cyclosporine in psoriasis was initially reported by Mueller and Herrmann at the end of the 70s.1 Since then its use as a part of the therapeutic armamentum in psoriasis is well recognized. Newer evidence suggests that doses of 2.5-3 mg/kg/day may have better risk/benefit ratio as mentioned by Colombo and coworkers.2 In fact she quotes the article published by Yoon3 where 61 severe psoriasis patients were assigned to an increasing regimen of cyclospornine starting at 2.5mg/kg/day or a decreasing regimen starting at 5 mg/kg/day. The PASI 50 response rates at 12 weeks were slightly higher for the decreasing regimen but not statistically significant. However, the higher is the dosage, the better and quicker are the results of treatment as expressed by the results of PASI 75. The favorable outcome seen in this report reminds us that low cyclosporine doses may be effective in the treatment of severe psoriasis as addressed by other authors. However clinician should not expect a quick result as seen when using higher doses.   References:   1. Mueller W, Herrmann B. Cyclosporin A for psoriasis. N Engl J Med. 1979;301:555;  2. Colombo MD, Cassano N, Bellia G, Vena GA. Cyclosporine regimens in plaque psoriasis: an overview with special emphasis on dose, duration, and old and new treatment approaches. Scient World J. 2013;2013:805705;   3. Yoon HS, Youn JI. A comparison of two cyclosporine dosage regimens for the treatment of severe psoriasis. J Dermatolog Treat. 2007;18:286-90.    Dr. Manuel Valdebran (Dominican Republic)

Mankesh Lal Gambhir, Yukti Aggarwal, Kritika Pandey, Suresh Kumar Malhotrai
Herpes Zoster Duplex Symmetricus in an immunocompetent 70-year female

      Our Dermatol Online 2014; 5(3): 306-307             DOI: 10.7241/ourd.20143.80

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LETTERS TO THE EDITOR


Yasunobu Kato, Toshiyuki Yamamoto
Vitiliginous lesions during contact immunotherapy for alopecia in a patient with autoimmune thyroiditis

      Our Dermatol Online 2014; 5(3): 308-309             DOI: 10.7241/ourd.20143.81

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Hideo Takenoshita, Toshiyuki Yamamoto
Bullous pyoderma gangrenosum in patients with ulcerative colitis and multiple myeloma
      Our Dermatol Online 2014; 5(3): 310-311             DOI: 10.7241/ourd.20143.82

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Good example of this uncommon pyoderma gangrenosum (PG) form with both typical associations. This type is probably under-recognized because of fast development of ulcers. Due to its grave prognosis, dermatologists should be aware of the presentation of early PG forms and its rare presentations.   Viktoryia Kazlouskaya, MD, PhD (USA)


HISTORICAL ARTICLES


Piotr Brzeziński, Patrice Bourée, Anca Chiriac, Jerry E. Bouquot, Carmelo Schepis, Thomas Hofer, Susheera Chatproedprai, Hitoshi Mizutani
Dermatology Eponyms – sign –Lexicon (M)

      Our Dermatol Online 2014; 5(3): 312-326          DOI: 10.7241/ourd.20143.83

[abstract-English] , [article in English],   [PDF][HTML]

 
 




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