Kaushik Shome

LEWANDOWSKY AND LUTZ DYSPLASIA: REPORT OF TWO CASES IN A FAMILY

Lewandowsky and Lutz dysplasia, also known as epidermodysplasia verruciformis (EV), is an inherited disorder in which there is widespread and persistent infection with human papilloma virus, defect in cell-mediated immunity and propensity for malignant transformation. Differential clinical and histopathologic evolutions of lesions in two cases of familial EV are compared and discussed in detail. Cases were followed up for 7 years. Detailed history, clinical features and investigations, including skin biopsy from different sites at different times, were examined. Generalized pityriasis versicolor like hypopigmented lesions in both the cases, together with variable pigmented nodular actinic keratosis like lesions on sun-exposed areas, were present. Multiple skin biopsies done from various sites on different occasions revealed features typical of EV along with lesions, i.e., actinic keratosis, Bowens disease, basal and squamous cell carcinoma, in the elder sibling. However, skin biopsy of the other sibling showed features of EV and seborrheic keratosis only till date. This study reveals that the disease progression is variable among two individuals of the same family. Malignant lesions were seen only on sun-exposed areas and may be associated with other skin lesions or infections such as angiokeratoma of Fordyce and tinea cruris, as seen in this report.

Penile rhinosporidiosis: An unusual presentation and review of literature

Sir, Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi, a protistan parasite in the class Mesomycetozoea as per its recent taxonomic destination.1 Nose and eyes being the most common sites, penis and urethra manage to secure much lower rank among the sites of occurrence. Being a disease of world‐wide distribution, this menace has managed to intrude into several states of India quite effectively with Tamil Nadu and Kerala being at the top of the list. An increasing number of reports from different parts of West Bengal should sensitize us to know more about the modes of transmission and changing trends of the ecosystem in our state, if any.