Sharad Mehta

Hutchinson-Gilford progeria syndrome

Progeria is a rare genetic disorder characterized by premature aging, involving the skin, bones, heart, and blood vessels. We report a 4-year-old boy who presented with clinical manifestations of progeria. He had characteristic facies, prominent eyes, scalp and leg veins, senile look, loss of scalp hair, eyebrows and eyelashes, stunted growth, and sclerodermatous changes. The present case is reported due to its rarity.

Kaposi's sarcoma as a presenting manifestation of HIV

Kaposis sarcoma is a multi-focal vascular tumor involving skin and the other organs. HIV associated Kaposis sarcoma is one of the AIDS defining condition. It is rarely reported from India. We report a 40-year-old heterosexual married male with widespread cutaneous lesions of Kaposis sarcoma without any oral lesions or systemic association as a presenting manifestation of HIV.

Intralesional mumps, measles and rubella vaccine in the treatment of cutaneous warts.

Background: Coronary artery calcification (CAC) is a specific indicator of and a sensitive marker for the atherosclerotic disease process. However, calcium scoring may miss noncalcified plaques with clinical importance. The present study aimed to identify the presence and extent of coronary plaques in computed tomography coronary angiography (CTCA) in patients with a zero CAC score and the secondary endpoint was to evaluate the association between coronary risk factors and the presence of noncalcified plaques. Materials and Methods: In a retrospective descriptive-analytic study, a total of 2000 consecutive patients who undergone CTCA between September 2012 and September 2014 at Alzahra Hospital in Isfahan, Iran were analyzed. Three hundred and eighty-five patients with a zero calcium score were included in the study. The demographic information and coronary artery disease (CAD), risk factors including diabetes mellitus (DM), hypertension, hyperlipidemia, smoking, and family history of CAD, were obtained from the questionnaire. Furthermore, the presence of plaques and extent of stenosis were evaluated in patients with zero CAC score. Results: Of the 385 patients with a zero calcium score, 16 (4.2%) had atherosclerotic plaques. Among them, 6 (1.6%) had significant (>50%) coronary stenosis, and 10 (2.6%) had no significant (<50%) coronary stenosis. Hyperlipidemia, DM, and smoking were significantly associated with obstructive CAD. Furthermore, in patients with zero calcium score, DM, hyperlipidemia, and smoking had odds ratios of 5.9, 14, and 32.5 for the development of coronary artery plaques, respectively. Conclusion: Although, CAC scoring is a noninvasive and valuable method to evaluate CAD; but zero CAC score does not absolutely exclude the CAD, especially in the presence of risk factors such as diabetes, hyperlipidemia, and smoking.

Chemical reconstruction of skin scars therapy using 100% trichloroacetic acid in the treatment of atrophic facial post varicella scars: A pilot study

Context: Chickenpox (varicella) is a common viral disease caused by Varicella zoster virus. Facial atrophic scars after varicella infection are not uncommon and pose a cosmetic problem. Like atrophic scars of other aetiologies, they are a difficult condition to treat. There are not enough references in the literature regarding efficient treatment of post varicella scars. High strength Trichloroacetic acid (TCA), which is known to cause dermal collagen remodelling, was used to treat varicella scars in the present study. Aims: The study was undertaken to assess the efficiency of Chemical Reconstruction of Skin Scars (CROSS) technique using 100% TCA in the treatment of atrophic facial post varicella scars. Settings and Design: Open label, pilot study. Materials and Methods: A total of 16 patients with atrophic facial post varicella scars were treated by focal application of 100% TCA solution by pressing down upon the scar surface by a toothpick (CROSS technique). Total 4 sittings were given at 2 weekly intervals and the results evaluated after 3 months of follow-up. Statistical analysis was carried out using Fischers exact t-test. Results: All of the 13 patients who completed the study showed good clinical improvement, with 69% patients grading the response as excellent (>75%) improvement, whereas the rest 31% patients reporting good (51-75%) improvement. No significant complications were seen in any patient. Conclusions: CROSS technique using 100% TCA is a safe, cheap and effective therapy for the treatment of post varicella scars.

Phacomatosis cesioflammea in a 5-week-old infant

A 5-week-old male infant presented with extensive lesions of nevus flammeus and Mongolian spots affecting the face, trunk, buttocks and extremities. In addition, the child had ocular melanosis and a café-au-lait spot on the trunk. The case is being reported on account of its rarity.

The H syndrome

The H syndrome is a rare autosomal recessive genodermatosis caused by mutations in the nucleoside transporter hENT3. It is characterized by progressive skin sclerosis, hyperpigmentation, and hypertrichosis, along with multiple systemic manifestations including insulin-dependent diabetes mellitus. We report this case for its rarity.

A curious case of hourly attacks of disabling episodic spontaneous hypothermia with hyperhidrosis

Sir, A 55-year-old female patient presented with complaints of episodic generalized sweating for the past 8 years. These episodes consisted of 5–10 min of disabling hyperhidrosis occurring at a fixed interval of 1 h, 24 times a day [Figure 1]. Each episode was preceded by a characteristic aura of epigastric discomfort. There was no history of any confusion, abnormal behavior or movements, seizures, flushing, palpitations, dizziness, or any other physical symptoms during the episode. There was no seasonal or diurnal variation and the episodes persisted even during bathing and sleeping. The only relieving factor was any febrile illness. There was no history of shivering, chills, or rigors during or after the episode. There was no past history of head trauma or spinal injuries. Family history and treatment history were not contributory.

Phacomatosis cesioflammea with Klippel Trenaunay syndrome: A rare association

A 30-year-old Indian male presented with bilateral Nevus of Ota, extensive nevus flammeus over the trunk and left lower limb with soft tissue hypertrophy and varicosities affecting the left lower limb. He was otherwise in good general health. A diagnosis of Phacomatosis cesioflammea or Phacomatosis pigmentovasularis Type II with Klippel Trenaunay syndrome was made. The case is being reported on account of its rarity.

Pros and Cons of Topical Corticosteroids in Lactating Females

Breastfeeding provides significant advantage to both mother and child. There are many inflammatory dermatoses which can present exclusively over breast and nipple area or can present in generalized form during this period. These dermatoses could be the cause of cessation of breastfeeding in mother. Topical corticosteroid is the mainstay of therapy in such dermatosis. The advantage that topical corticosteroids offer should not be denied to the patient because of fear of their side effects. Using less potent steroid and that too on smaller area can reduce the risk to both mother and breastfed infant.

Chronic cutaneous lupus erythematosus in a blaschkoid pattern over face

Linear lesions following the lines of Blaschko of chronic cutaneous lupus erythematosus is a highly unusual variant of cutaneous lupus, particularly in adult. The lesions are restricted to one anatomical site with facial predilection in most of the reported cases. We herein, report a case of chronic cutaneous lupus erythematosus due to rarity of presentation and later age of onset.