Shylaja Someshwar

Idiopathic eruptive macular pigmentation: What is it actually?

Idiopathic eruptive macular pigmentation (IEMP) is a rare condition characterized by asymptomatic macular pigmentation involving the neck, trunk, and proximal extremities. The term IEMP was initially coined by Degos et al. in 1978. In 1996, de Galdeano et al. established diagnostic criteria for the same. Subsequently, many cases of IEMP have been reported. After Joshi’s report with the additional feature of prominent papillomatosis on histopathology similar to that seen in acanthosis nigricans, and subsequent similar reports, it is now debatable whether papillomatosis should be considered as a necessary criterion for the diagnosis of IEMP or IEMP with papillomatosis should be considered as a separate entity. We report two cases showing asymptomatic macular pigmentation, both of which fulfill the criteria for IEMP as defined by Galdeano et al., with one of the two cases showing papillomatosis on histopathology.

Facial solar porokeratosis.

Features Angioma serpiginosum Unilateral nevoid telangiectasia Age of onset Appears before puberty Congenital or acquired Gender Almost exclusively women Male: Female=1:2 Site Mostly extremities lower > upper Trigeminal or C3-C4 dermatome Lesions Multiple, minute copper-colored to bright red angiomatous puncta in small clusters and sheets often in a serpiginous pattern Fine, thread-like telangiectasia

Childhood pyoderma gangrenosum

Pyoderma gangrenosum (PG) is rare in children. We report a case of PG in a 4-year-old male who presented with ulcers over face, axillae, and gluteal area. The ulcers healed with cribriform scarring after starting systemic steroids and azathioprine. The patient, however, was unable to follow-up regularly. He had a recurrence of lesions developed sepsis and septic shock and unfortunately expired.

A case of psoriasis vulgaris aggravated with atorvastatin, aided by concomitant cyclosporine

1. Kumar R, Bumb RA, Ansari NA, Mehta RD, Salotra P. Cutaneous leishmaniasis caused by Leishmania tropica in Bikaner, India: Parasite identification and characterization using molecular and immunologic tools. Am J Trop Med Hyg 2007;76:896-901. 2. Sharma NL, Mahajan VK, Kanga A, Sood A, Katoch VM, Mauricio I, et al. Localized cutaneous leishmaniasis due to Leishmania donovani and Leishmania tropica: Preliminary findings of the study of 161 new cases from a new endemic focus in Himachal Pradesh, India. Am J Trop Med Hyg 2005;72:819-24. 3. Paramsothy Y, Lawrence CM. ‘Tin-tack’ sign in localized pemphigus foliaceus. Br J Dermatol 1987;116:127-9. 4. Cowley NC, Lawrence CM. ‘Tin-tack’ sign in seborrhoeic dermatitis. Br J Dermatol 1991;124:393-4. 5. Thomas RJ, Smith NP, Spittle MF. The ‘tin-tack’ sign in post-irradiation scalp skin scales. Br J Dermatol 1992;126:90. 6. Baba M, Uzun S, Acar MA, Gümürdülü D, Memisoglu HR. ‘Tin-tack’ sign in a patient with cutaneous B-cell lymphoma. J Eur Acad Dermatol Venereol 2001;15:360-1. 7. Cox NH, Tapson JS, Farr PM. Lichen planus associated with captopril: A further disorder demonstrating the ‘tin-tack’ sign. Br J Dermatol 1989;120:319-21.

An asymptomatic swelling on the neck

How to cite this article: Tambe S, Someshwar S, Dedhia A, Jadhav R, Bhatt K, Jerajani H. An asymptomatic swelling on the neck. Indian J Dermatol Venereol Leprol 2015;81:221-3. Received: June, 2014. Accepted: September, 2014. Source of Support: Nil. Confl ict of Interest: None declared. Figure 2: (a) High-resolution ultrasonography of the lesion showed a well-defi ned hypoechoic round mass lesion in the subcutaneous tissue with hyperechoic center and specks of calcification. (b) Color Doppler study showed increased vascularity in the lesion with branching tree pattern of blood vessels b a

Leprosy in a Child—A Matter of Great Concern

An 11-y-old girl presented with complaints of two raised circular lesions with decreased sensations on the left upper back and left foot since the past 5 y with no history of sensory or motor weakness of the extremities. There were no similar complaints in the family and patient had not taken any treatment previously for the same. Cutaneous examination revealed twowell defined annular plaques of sizes ranging from 2×2 cm on the dorsum of left foot to 6×5 cm on left upper back with raised borders. Two satellite lesions were observed just adjacent to the lesion on the back (Fig. 1). No feeding nerves or other peripheral nerves were palpable. Sensations were found to be reduced over the patches. Motor system examination was normal. None of the family members on examination showed any signs of leprosy. A clinical diagnosis of borderline tuberculoid (BT) leprosy was made. Complete hemogram, urine examination, chest X-ray, liver function tests, G6PD levels were within normal limits. Slit skin smear done from the plaque did not reveal any acid fast bacilli. Findings of skin biopsy taken from the plaque on the back were consistent with BT leprosy. The patient was started on paucibacillary multidrug therapy (PB-MDT) according to her weight which consisted of tablet Dapsone 50 mg daily and capsule Rifampicin 450 mg once a month to be given for 6 mo and currently the patient has completed the treatment and is under surveillance for 2 y. The lesions have completely flattened with resolution of satellite lesions (Fig. 2).

Pseudokaposi's sarcoma.

Monilethrix is generally considered to be an autosomal-dominant disorder with variable penetrance. It is caused by mutations of the genes encoding type 2 hair keratins, hHb1 and hHb6. It is mapped to epithelial keratin gene cluster on 12q11-q13. Defective keratins in cortical cells, leading to wrinkling of the cells at internodes and makes them fragile. While nodes represent normal growth.[4] Mutations have been found in desmoglein 4 in the autosomal-recessive form.[2]