Sanjiv Grover

A clinical study of skin changes in geriatric population

Wrinkling was seen in 191 (95.5%) of cases. Most of the wrinkling was in the form of glyphic wrinkles on sun-exposed areas viz. face, neck, forearms and dorsa of hands. Generalized pruritus was present in 37 patients (18.5%) and psoriasis in 25 (12.5%). Fungal infection was the most common infection (70, 35%), followed by viral infections (10, 5%), pyodermas (4, 2%) and leprosy (3, 1.5%). Macular amyloidosis was the most common pigmentary disorder (7, 3.5%) and dermatosis papulosa nigra (DPN) the most common skin tumor (149, 74.5%). Greying of hair was present in 196 patients (98%), androgenetic alopecia in 142 (71%), vertical ridging of nails in 145 (72.5%), lusterless nails in 128 (64%) and onychomycosis in 24 (12%) patients [Table 1]. Other miscellaneous conditions are summarized in Table 2. There were no cases of malignancy.

Scoring systems in pemphigus.

Pemphigus is a dreaded disease encountered not infrequently in dermatology settings. While scoring systems in various dermatological conditions exist, objective parameters for assessing disease activity and therapeutic responses in pemphigus are not uniform and foolproof. This article presents various scoring systems in pemphigus.

A cross section of skin diseases in rural Allahabad.

Background: The pattern of skin diseases varies form one country to another and across different parts within the same country. A two-day multispecialty medical camp was held among the local population at the district of Kausambi, Allahabad, UP, in October 2005. A cross section of pattern of skin diseases observed at the camp is reported and compared with similar studies in literature. Materials and Methods: All cases attending the medical camp were included in the study. All those with dermatological complaints were examined in detail, brief relevant history was elicited and clinical diagnosis was made. Results: Skin diseases comprised 7.86% of all those who attended the camp. The 11–20 year age group was the most common age group involved with 164 (31.4%) cases. Infective disorders were found in 59.1% and noninfective disorders in 40.9% of all the skin cases. Among the infective disorders, fungal infections were most common (54.52%), and among the noninfective dermatoses, eczemas were most common (39.2%) cutaneous disorders. Conclusion: Our study brought out a higher prevalence of infective dermatoses and a relatively higher, but statistically insignificant, prevalence of fungal infections, scabies and eczemas, thereby reflecting minor regional variance in our study group.

Skin in aviation and space environment

The aerospace environment is a dynamic interaction between man, machine and the environment. Skin diseases are not particularly significant aeromedically, yet they could permanently affect an aviators status for continued flying duty. A number of dermatological conditions lend themselves to flying restrictions for the aviator. Aircrew and ground crew are exposed to a myriad of elements that could also adversely impact their flying status. Inflight stresses during flights as well as space travel could impact certain behaviors from a dermatological standpoint. With the advent of space tourism, dermatological issues would form an integral part of medical clearances. With limited literature available on this subject, the review article aims to sensitize the readers to the diverse interactions of dermatology with the aerospace environment.

Osler-Weber-Rendu syndrome: a case report with familial clustering.

Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder manifested by telangiectases of the skin and mucous membranes and arteriovenous malformations of various organ systems. We present a case of Osler-Weber-Rendu syndrome with 11 affected members in her family.

Idiopathic eruptive macular pigmentation: Report on two cases

Idiopathic eruptive macular pigmentation (IEMP) is a rather under-reported condition of unknown etiology. Clinically consisting of benign hyperpigmented macules, the condition is characterized histopathologically by dermal melanization. It must be differentiated from lichen planus pigmentosus, erythema dyschromicum perstans, fixed drug eruption and mastocytosis.

Pillar knocker’s callosities

keratotic plugs. The lesions tend to have an acral predisposition though a few cases have also been reported with lesions over the forehead, neck, and trunk. Histopathology of PEODDN shows hyperkeratosis, acanthosis, and cornoid lamellae-like columns of parakeratosis arising at the level of the mid-dermis and lying within the epidermal invaginations with a thinned granular layer and underlying dilated eccrine ducts. Vacuolated and dyskeratotic keratinocytes are also typically present within the epidermal invagination. This parakeratotic column is nearly always found overlying an eccrine duct with a dilated acrosyringium; often the eccrine duct is tortuous and hyperplastic as well. An orthokeratotic variant of this condition, showing orthokeratotic keratin plugs overlying dilated acrosyringia, has also been reported previously. The similarities between PEODDN and our case were the occurrence of lesions in a blaschkoid pattern over the acral region as well as histology showing parakeratotic mounds overlying the acrosyringia with absence of granular layer. However, our case is distinct from PEODDN in that it had histopathology showing epidermal invagination containing keratotic plug of alternating mounds of orthokeratosis and parakeratosis with entrapped neutrophils overlying a dilated acrosyringium resembling the findings seen in psoriasis. Hence, on clinicopathologic correlation, we propose our case to be a psoriasiform variant of PEODDN.