Nidhi Jindal

Nanocarriers and nanoparticles for skin care and dermatological treatments

Nanotechnology (nano: One billionth) is a novel arena with promising applications in the field of medicine, especially pharmaceuticals for safe and targeted drug delivery. The skin is a phenomenal tool for investigation of nanocarriers for drug delivery for topical and dermatological application. The physicochemical characteristics of the nanoparticles, such as rigidity, hydrophobicity, size and charge are crucial to the skin permeation mechanism. Many nanocarriers such as polymeric, inorganic and lipid nanoparticles and nanoemulsions have been developed and some like carbon nanotubes and fullerenes still need further exploration for future use in skin care and dermatological treatments. Risks of nanopollution and cytotoxicity also need to be kept in mind while exploring various nanoparticles for medical use.

Fruit and food eponyms in dermatology

Dermatology world is brimming with myriad of interesting clinical conditions, signs and syndromes. It is infinite, which has systemic clinical connotations too. Complicated pronunciations of diagnosis have always placed residents in an intricate state. Each one is trying his best to make this cumbersome subject comparatively more acceptable and convenient. The present paper is an attempt to further simplify the subject by correlating difficult conditions with commonly used and seen things such as fruit and food. A total of 45 dermatological conditions were found to be based on fruit and food eponyms. For example, strawberries can remind us of strawberry gums of Wegeners granulomatosis and strawberry nevus.

Lyme disease in Haryana, India.

Lyme disease is a multiorgan animal-borne disease caused by the spirochete Borrelia burgdorferi. This case series highlights its presence in Haryana, a nonendemic zone. The first case was a 27-year-old housewife who presented with an annular erythematous patch with a central papule following an insect bite on the left upper arm. The second case was a 32-year-old farmer who gave a history of insect bite on the right arm followed by the development of an erythematous patch with a central blister. The third case, a 17-year-old boy presented with a history of tick bite over right thigh and a typical bulls eye lesion with central ulceration. These cases were managed with oral doxycycline 100 mg twice daily for 14 days. The fourth case was a 7-year-old boy with typical erythema migrans on the right check and neck while the fifth case, a 30-year-old housewife, presented with an erythematous patch with a central papule on the right buttock. These patients were treated with oral amoxycillin 25 mg/kg, thrice daily for 14 days. All patients showed IgM antibodies to B. burgdorferi. Treatment led to clearance of lesions in all the patients. Lyme borreliosis was diagnosed in these patients based on the history of established exposure to tick bites, presence of classic signs and symptoms, serology and the response to treatment.

Inflamed psoriatic plaques: Drug toxicity or disease exacerbation?

We are presenting a case of Methotrexate treated stable plaque psoriasis, in whom inflamed psoriatic plaques of drug toxicity were misdiagnosed as disease exacerbation. Erosive psoriatic plaques were present in the absence of biochemical or hematological derangements. Ulceration of psoriatic plaques in the presence of disturbed hematological profile is well described as a harbinger of methotrexate toxicity, but this kind of erosions in the absence of any systemic involvement is the first report of its kind.

Narrowband UVB phototherapy in pityriasis rosea

Objective: Pityriasis rosea (PR) is an acute self-limiting disease. Despite vigorous efforts by generations of researchers since nearly 150 years, present treatment modalities for PR are not very gratifying. Ultraviolet radiation has been recommended in PR, although only a few studies validate this proposal. This study was conducted to explore the therapeutic effect of NBUVB on the symptoms, course, and severity of PR. Materials and Methods: This study involved a hundred patients who were randomly divided into two groups, using computer-generated randomization chart. Group A underwent treatment with fixed dose NBUVB of 250 mJ/cm2 three times (nonconsecutive) a week for 4 weeks. Group B formed the placebo group who did not receive any treatment. The two groups were compared with each other for the intensity of pruritis, course and duration of disease, and PR severity score (PRSS). Results: The t values of improvement in PRSS score in Group A (t = 12.796) were higher as compared with that in Group B (t = 10.066). Similarly, the t value of the pruritus scale in Group A (t = 7.758) was higher than Group B (t = 5.754) indicating the symptomatic improvement in itching. Conclusion: Fixed-dose NBUVB phototherapy resulted in marked improvement in the severity and symptoms of the disease as quantitatively assessed by PRSS.

Animals eponyms in dermatology

The world of Dermatology is flooded with inflexions among clinical conditions and signs and syndromes; making it interesting, but a tougher subject to remember. Signs and syndromes have always fascinated residents, but simultaneously burdened their minds, as these attractive names are difficult to remember. This work was undertaken to review dermatological conditions and signs based on commonly encountered daily words and objects like animals, etc. Fifty dermatological conditions were found to be based on animal eponyms. For example, the usage of animal terminology in dermatology like leonine facies is present in leprosy, sarcoidosis, mycosis fungoides (MF), and airborne contact dermatitis (ABCD).

Giant congenital melanocytic nevus with developmental dysplasia of bilateral hip: A rare association

Giant congenital melanocytic nevi are rare congenital disfiguring benign neoplasms with a risk of transformation to malignant melanoma. They often present with various extra-cutaneous features. Here, we describe a case of giant melanocytic nevus with developmental dysplasia of bilateral hip, a novel association.

Clinico-etiological study with response to specific treatment in childhood urticaria

Background: Urticaria is a common dermatological manifestation in adults with relatively infrequent occurrence of chronic urticaria (CU) in childhood. The etiology of urticaria in childhood remains incompletely understood because of limited data on children. Objective: We carried out this retrospective data-based study to determine different etiological factors and response to treatment in pediatric patients presenting with urticaria. Materials and Methods: Eighty children (M : F 49 : 31) between the ages of 1 and 14 years, who presented with urticaria excluding patients of physical urticaria attending the Outpatient Department of Pediatrics and Dermatology were included in the study. Patients were evaluated after taking a detailed history, doing a thorough physical examination, and basic laboratory investigations. Specific in vivo and in vitro tests were performed after the initial evaluation and consent of patients. Results: Out of eighty patients, 35 (43.75%) presented with acute urticaria and 45 (56.25%) gave a history of chronic urticaria.CU. An underlying cause was suspected in 53 cases (66.25%), although a definite association with response to a specific treatment was correlated in 30 (37.5%). Infection was the most common underlying causative factor. Underlying thyroid dysfunction was observed in 12 patients, of whom two had thyroid anti peroxidase antibodies. Autologous serum skin test was positive in 17 patients. Conclusions: In the present study infections were the most common etiological factor for urticaria in children.

Localized Pemphigus Vegetans without Mucosal Involvement.

Pemphigus vegetans is a rare variant of pemphigus vulgaris. A 62-year-old woman presented with erythematous moist vegetative plaque on the left breast and left groin. There was no mucosal involvement. Histopathological and direct immunofluorescence findings were suggestive of pemphigus vegetans. She showed excellent response to oral steroids. Literature is scarcely available on the limited involvement with pemphigus vegetans without mucosal involvement.

Cutaneous metastasis from signet-ring gastric adenocarcinoma in a carcinoma en cuirasse pattern: An unusual clinical-diagnostic sequence

Cutaneous metastasis (CM) of gastric adenocarcinoma (ADC) is rare and usually presents late in the course of the disease. We report a rare case of carcinoma en cuirasse (CEC) pattern of CM secondary to gastric malignancy in a 55-year-old male patient—the interesting part being that CM was the first-presenting sign, which on further histopathological and immunohistochemical evaluation led to the diagnosis of hidden gastric carcinoma. The finding of signet ring cells (SRCs) on cutaneous biopsy further added a differential of the rare possibility of primary cutaneous tumors.