Bhagat Ram Garg

Childhood Lichen Planus (LP)

In adults, lichen planus (LP) is relatively more common than in children. Among 222 cases of LP, there were 25 (11.2%) children in our study. The majority of the cases were females in the age group of 8–14; the youngest child was 3 years old. Papular and linear types of LP were common in children. There was no familial history of LP in any of the cases. The patients with classic LP lesions responded well to dapsone therapy. This study supports the suggestion of Ramsay and Hurley that childhood LP is more common in the tropics.

AN UNUSUAL ASSOCIATION OF ACANTHOSIS NIGRICANS AND CROUZON'S DISEASE-: A CASE REPORT

A sporadic case of Crouzons disease associated with benign acanthosis nigricans in a 14 year‐old‐boy is described as an interesting dermatologic rarity. To our knowledge this is the first documented case in the literature to describe such an association. The concurrence of both these disorders is explained by their common genetic background.

Unilateral nevoid hyperkeratosis of the nipple and areola.

To the Editor: A 35-year-old woman presented with hyperpigmented and thickened skin of the right nipple. These skin changes started 7 years ago (i.e., 3 years after her last childs birth), were slowly progressive for the first 5 years, with occasional itching, and had become nonprogressive for the past 2 years. The patient had had two normal pregnancies and had breast-fed both children. No discharge from the nipple, associated warts, ichtbyosis, or acanthosis nigricans were reported. No family member had similar lesions. The skin of the left nipple and areola was hyperpigmented and hypertrophic with a rugose appearance (Fig. 1). On palpation, the involved skin was not indurated; it was nontender and not adherent to tbe underlying structures. There was no discharge from the nipple and no significant lymphadenopathy. Other systems were clinically normal and all baseline investigations were within normal limits. Histopathologic examination showed hyperkeratosis, papillomatosis, and acanthosis with keratotic plugging, consistent with nevoid hyperkeratosis (Fig. 2).

Hereditary Palmoplantar Keratodermas in South India

Thirty‐one patients with inherited palmoplantar keratodermas (PPKs) were screened from 59,490 cases who visiting the OPD of JIPMER, Pondicherry. The prevalence rate was 5.2 per 10,000 population (1:2000 approx.). PPKs were more common in males (25 patients) than females (6 patients); the overall male to female ratio was 4.2:1. The incidence was highest in the group from 0–10 years of life (67.7% of cases). Unna‐Thost syndrome topped the list with 38.7% of cases and its prevalence 1:6000 (approx.), followed by Greithers disease (22.9%) and others‐Vohwinkel (3 cases), idiopathic punctate (2 cases), ichthyosis vulgaris associated PPK (2 cases) etc. This study has for the first time reported the prevalence and patterns of hereditary PPKs in South India.

Multiple Leiomyoma Cutis Associated with Becker's Nevus

To the Editor: The constituent epidermal, melanocytic, and pilar elements of Beckers nevus may demonstrate a spectrum of hamartomatous changes that may be congenital or acquired (1). We report a case of multiple leiomyoma cutis with mottled pigmentation and open comedones, probably representing the extreme form of Beckers nevus. Case Report: A 22-year-old male presented with a 10 year history of painful multiple swellings over the left side of the back. The number of lesions and pigmentation suddenly started increasing about 3 years previously. A 15 x 20 em area over the left side of the lumbar region crossing the midline of the back (Fig. 1) was involved with background freckle-like pigmentation and blackheads (open comedones). These were topped by 0.5 to 2 em sized, multiple, tender, skin-colored, soft to firm papular and nodular lesions. Histopathological examination of multiple sections of the representative skin lesion showed an ill-defined tumor with overlying epidermis (Fig. 2). The tumor was composed of interlacing bundles of smooth muscle fibers, which had eosinophilic cytoplasm and blunt-edged nuclei. Masson trichrome stain stained these muscle fibers densely red and the collagen blue. The epidermis showed a slight increase in the basal layer pigmentation. No nevus cells were seen in the dermis. The diagnosis of leiomyoma cutis with Beckers nevus was based on the above findings. Comments: The smooth muscle bundles in Beckers nevus, indistinguishable from those seen in smooth muscle hamartoma, have led to some controversy about the relationship of these two entities (2). Clinically, smooth muscle hamartoma presents as an asymptomatic single patch, most commonly in the lumbar region (3). It may present at birth or arise in childhood Or early adulthood (2, 4). Usually, there are small, follicular papules throughout the patch, 719

Cutaneous Horn: A Brief Review and Report of a Case

A case of extensive verrucae vulgaris with cutaneous horns in a 32‐year‐old man is reported. Accompanying terminal phalangeal bone absorptive changes in the fingers of both hands, resulting from subungual warty lesions, are highlighted. The existing literature on the subject of cutaneous horn is briefly reviewed.

Multiple Trichoepitheliomas with Rare Features

A case of multiple trichoepitheliomas associated with epidermal cysts is reported. The trichoepithelioma lesions were florid and extensive with large nodulo‐cystic lesions on the face and a new variant simulating hidradenitis suppurativa near the gluteal cleft.

Punctate keratoses of palms in lichen planus

Observation chez un homme de 45 ans qui presente des lesions cutanees depuis plus de 6 mois. Les 2 paumes des mains presentent de nombreuses lesions ponctuees hyperkeratosiques, les voutes sont normales

Clinico-epidemiological profile of ichthyosis in south Indian patients.

A high frequency rate of hereditary ichthyosis (141.89 per 1000) was detected in a 1029 member South Indian study population selected at random from the skin outpatients of a teaching hospital. An age and sex matched control population screened from the medical and pediatric outpatients of the same institute recorded the incidence of ichthyosis vulgaris as 150 per 1000 population which is even higher.

Pyoderma Gangrenosum in Childhood: Case Report

Two cases of pyoderma gangrenosum occurring in children after an exanthem are reported because of rarity and clinical interest.