Kaliaperumal Karthikeyan

Madarosis: A marker of many Maladies

Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.

Crusted scabies presenting as palmoplantar psoriasis in Down's syndrome

Department of Dermatology and Venereology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India Crusted or Norwegian Scabies is characterized by hyperkeratosis and crusting with presence of innumerable mites in the skin.[1] It is rare variant of scabies and can easily mimic other dermatologic disorders.[1,2] Our patient was a child with Down’s syndrome and crusted scabies that had lesions mimicking palmoplantar psoriasis causing diagnostic difficulty.

Integrated modular teaching in dermatology for undergraduate students: A novel approach

Context: Undergraduate teaching in dermatology comprises didactic lectures and clinical classes. Integrated modular teaching is a novel approach, which integrates basic sciences with dermatology in the form of a module. Further the module also incorporates various teaching modalities, which facilitate active participation from students and promotes learning. The pre- and post-test values showed the effectiveness of the integrated module. The students feedback was encouraging. Aims: The aim of this study was to determine the acceptance and opinion of undergraduate students regarding integrated modular teaching as a new teaching aid in dermatology. Settings and Design: This was a descriptive study. Varied teaching methodologies involving multiple disciplines were undertaken in six major undergraduate topics in dermatology for seventh and eighth semester students. Materials and Methods: A total of six modules were conducted over a period of 12 months for students of seventh and eighth semesters. The topics for the various modules were sexually transmitted diseases, acquired immunodeficiency syndrome, oral ulcers, leprosy, connective tissue disorders and psoriasis. Faculty members from different disciplines participated. Pre- and post-test were conducted before and after the modules respectively to gauge the effectiveness of the modules. Results: It was found that almost every student had a better score on the posttest as compared to the pretest. General feedback obtained from the students showed that all of them felt that modular teaching was a more interesting and useful teaching learning experience than conventional teaching. Conclusions: Integrated modular teaching can be an effective adjunct in imparting theoretical and practical knowledge to the students. Further, various teaching methodologies can be used in integrated modules effectively with active student participation. Thus integrated modular teaching addresses two important issues in medical education, namely integration and active student participation.

Turmeric: A condiment, cosmetic and cure

Turmeric (Curcuma longa L.) is an integral part of Asian culture and cuisine. It has been used in traditional medicine since centuries. A myriad of health benefits have been attributed to it. Curcumin, the most biologically active curcuminoid in turmeric, is being investigated in pre-clinical and clinical trials for its role in disease prevention and cure. It has antioxidant, anti-inflammatory, antineoplastic, anti-proliferative and antimicrobial effects. We review the chemistry of this plant, its cultural relevance in Indian skin care, and its uses in dermatology.

Apocrine hidrocystoma arising from nevus sebaceous on the scalp.

Nevus sebaceous is a hamartoma with an uneventful course since birth but many benign or malignant tumors are known to develop in about one third of the patients. A 37-year-old woman with asymptomatic hairless raised lesion over the scalp since birth presented with change in the morphology of the lesions associated with itching and irritation since one month. On examination, multiple well-defined hyperpigmented verrucous plaques coalescing with each other were seen over the right parietal scalp associated with alopecia. A single well-defined soft skin-colored cystic swelling of size 1 × 2 cm was seen interspersed within the plaque. After a clinical diagnosis of nevus sebaceous, a biopsy of the cyst was done, which revealed a large cyst lined by columnar and myoepithelial cells in the dermis. The columnar cells at a few places showed “decapitation secretion” giving the impression of apocrine hidrocystoma. Post-excision of the cyst, biopsy of the entire nevus was done and the histopathological diagnosis correlated with the clinical diagnosis of nevus sebaceous. Apocrine hidrocystoma developing from a sebaceous nevus over the scalp is a rarity with only three other cases of it arising on the scalp being reported and none of them developed from a sebaceous nevus.

Drawstring lichen planus: A unique case of Koebnerization

Drawstring dermatitis is a type of frictional dermatitis that can result from a traditional tightly worn garments such as sari or salwaar-kameez. We report a 54-year-old female patient presented with lichen planus of the drawstring site that was confirmed histopathologically. This case is rare and demonstrates how sociocultural practices can influence the presentation of common dermatoses such as LP.

Tackling scabies: novel agents for a neglected disease

The scabies mite, Sarcoptes scabiei var hominis, is an obligate ectoparasite of humans. It has been a source of distress for humanity since antiquity. The troublesome mite is emerging triumphant over current acaricidal agents with reports of emerging resistance and treatment failures. Scabies in endemic areas and crusted scabies offer additional management challenges. Exploration of indigenous plants and better understanding of mite biology and pathogenesis provide opportunities for the development of novel agents for this common pest. We review the recent diverse approaches to scabies, including the use of novel plant products with a better safety profile, translating the use of moxidectin from veterinary practice to human scabies, vaccination, immunotherapy, and development of drugs that directly target mite molecules.

Hypotrichosis in a child with olmsted syndrome

1. Subhadarshani S, Singh A, Ramteke PP, Verma KK. Idiopathic eruptive macular pigmentation in an Indian male. Indian Dermatol Online J 2018;8:367‐70. 2. Joshi R. Idiopathic eruptive macular pigmentation with papillomatosis: Report of nine cases. Indian J Dermatol Venereol Leprol 2007;73:402‐5. 3. Joshi R, Palwade PK. Idiopathic eruptive macular pigmentation or acanthosis nigricans? Indian J Dermatol Venereol Leprol 2010;76:591. 4. Sanz de Galdeano C, Leaute‐Labreze C, Bioulas‐Sage P, Nikolic M, Taieb A. Idiopathic eruptive macular pigmentation: Report of five patients. Pediatr Dermatol 1996;13:274‐7. 5. Joshi RS, Rohatgi S. Idiopathic eruptive macular pigmentation: A critical review of published literature and suggestions for revision of criteria for diagnosis. Indian J Dermatol Venereol Leprol 2015;81:576‐80. 6. Kumarasinghe SP. Understanding macular pigmentation of uncertain etiology. Indian J Dermatol Venereol Leprol 2015;81:581‐3.

A lagging lock: Hair cycle abnormalities in follicular vitiligo?

A 32‐year‐old Indian lady presented with a history of localized short white hair over the scalp for the past 3 months and scalp depigmentation for the past 1 month. There was no history of loss of hair over the area or family history of premature canities. On examination, a well circumscribed 5 cm × 1.7 cm area of depigmentation with a lock of coarse white hair [Figures 1 and 2a] was seen over the frontal region. Patchy hypopigmented macules and few spared black hairs were also present in the depigmented area. Some white hairs showed an abrupt transition to pigmented black hair in the distal shaft [Figure 2b]. Isolated short white hairs without scalp depigmentation were noticed over the vertex [Figure 3]. Hair pull test was negative. Biopsy from the frontal area revealed hair follicles with preserved follicular density, normal anagen:telogen ratio and absence of hair follicle melanocytes. The patient was treated with a combination of topical tacrolimus, topical steroids, and narrow band ultraviolet B phototherapy for depigmented skin and intralesional steroids for depigmented hair.

An Experimental Evaluation of Mechanical Properties of Hybrid Reinforcements

This paper presents the mechanical properties of unidirectional hybrid reinforcements formed from continuous fibres impregnated with a fibre binding material which are used for reinforcing the concrete. Recently FRP (Fibre Reinforced Polymer) manufacturers and suppliers have been increased all over the world because of the superior performance of FRP products in the construction industry. Its non-corrosive nature has turned the attention of many researchers to make several studies on different type of FRP products. Through a vast research, several standards also have been formulated. In this regard a new combination of FRP materials is tried in this paper and its properties have been derived. Carbon fibre and glass fibres fuse in this study to form a new hybrid rebar. The design properties such as tensile strength, tensile modulus, and compressive strength have been studied as per ASTM standards and it has been identified that the Hybrid rebar show a superior performance in comparison with GFRP (Glass FRP) and Steel rebars. This extraordinary performance of hybrid composite material increases the extensive engineering applications such as transport industry, aeronautics, naval, automotive industries.