Swagata Tambe

Three rare cases of cutaneous phaeohyphomycosis

Phaeohyphomycosis is a chronic infectious condition caused by dematiaceous fungi which usually involve the skin and subcutaneous tissue. Subcutaneous phaeohyphomycosis is characterised by papulonodules, verrucous, hyperkeratotic or ulcerated plaques, cysts, abscesses, pyogranuloma, non-healing ulcers or sinuses. In India, commonly associated genera are Exophiala, Phialophora, Cladosporium, Curvularia, Fonsecaea and Alternaria. This condition involves the presence of brown-walled hyphal structures in the dermis and epidermis. Here, we are reporting a rare case series of three patients of phaeohyphomycosis with lesions on finger and dorsum of the hand.

Successful management of dowling-degos disease with combination of Q-switched Nd: YAG and fractional carbon dioxide laser

Journal of Cutaneous and Aesthetic Surgery ¦ Volume 10 ¦ Issue 1 ¦ January‐March 2017 60 Subungual SCC is a low‐grade malignant tumour with >150 cases reported in literature. It may arise from nail bed, matrix, groove or nail folds.[2] It usually affects elderly males with thumb being the most common site of involvement.[3] Early clinical manifestations are paronychia, onychomycosis, onycholysis, dyschromia of the nail plate, subungual hyperkeratosis, chronic granulation of the nail bed, ingrown nail and nail deformity.

Dermatofibrosarcoma protuberans in a 9-year-old child

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue neoplasm of low-to-intermediate grade malignant potential. Childhood onset of DFSP is rare. It is most commonly seen on the trunk and proximal extremities. In children, a high index of suspicion is necessary to avoid delays in diagnosis that can lead to further morbidity. Here, we report a case of DFSP in a 9-year-old female child. Excision biopsy of lesion was performed with 1 cm margin. After confirmation of the diagnosis by histopathology, the patient was observed for recurrence, but there was no recurrence after 1 and half years of follow up.

Chronic vulvovaginitis caused by Candida dubliniensis in an immunologically competent adult female

Candida, a commensal dimorphic fungus, is the most common microorganism that causes opportunistic fungal infections worldwide. It can cause diseases ranging from superficial mucosal infections to disseminated, systemic life-threatening infections. Among Candida species, Candida albicans is the most common infectious agent. Nowadays, non-albicans Candida species are also emerging as significant pathogens. Candida dubliniensis has been implicated as a causative agent of oral candidiasis in HIV-infected individuals but has also been recovered from HIV non-infected individuals with oral candidiasis and rarely from the genital tract of women with vaginitis. Such cases have been under-reported due to phenotypic resemblance to C. albicans. The majority of C. dubliniensis clinical isolates tested to date have been susceptible to fluconazole, but they tend to develop resistance rapidly. Here, we report a case of chronic vulvovaginitis due to C. dubliniensis not responding to standard doses of fluconazole.

Solitary plaque on the chin

© 2018 Indian Dermatology Online Journal | Published by Wolters Kluwer Medknow A 56‐year‐old male patient presented with a solitary asymptomatic growth over the chin since 3 years [Figure 1]. There was history of trauma to the chin while shaving followed by development of a small raised lesion over the same site. There was history of gradual increase in size of the lesion over a period of 2 years. Dermatological examination showed a solitary well‐defined infiltrated skin‐colored plaque on the chin. The rest of the face was unaltered. The differential diagnosis included granuloma faciale, collagen nevus, and gnatophyma. Skin biopsy from the lesion on the chin showed sebaceous gland hyperplasia and peri‐appendageal lymphohistiocytic infiltration with fibrosis in the dermis [Figure 2a and b]. After confirming the diagnosis of gnatophyma, the patient was posted for surgical excision.

Metastatic angiosarcoma of lower extremity

Angiosarcoma (AS) is an uncommon malignant neoplasm characterized by rapidly proliferating, extensively infiltrating anaplastic cells derived from blood vessels. These are aggressive tumors and tend to recur locally, spread widely with high rate of lymph node and systemic metastases. They are more frequent in skin and soft tissue, head and neck being the most common sites. Here we report a case of metastatic AS affecting lower extremity in an elderly patient on a background of chronic lymphedema due to filariasis (Stewart–Treves syndrome).

Successful management of angiolymphoid hyperplasia with eosinophilia by radiofrequency

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare idiopathic condition, usually seen in adults and characterised by the presence of isolated or grouped papules, plaques or nodules in the skin of the head and neck region. Commonly, affected areas include periauricular region, forehead and scalp.[1] Various medical and surgical modalities are used for the treatment of this condition with variable success.

Squamous cell carcinoma of the nail bed: The great mimicker

A 78‐year‐old male presented with a non‐healing ulcer over the right ring finger since 2 years. He gave a history of few raw lesions on the lateral aspect of the right ring finger 2 years ago following a trauma to the right hand. He consulted a local practitioner for the same complaints and was treated with oral antibiotics, antifungals and anti‐inflammatory drugs with topical antibacterial cream, with improvement over a period of 3 months.

Case series of genital tuberculosis

Genital tuberculosis (TB) is a rare, comprising <0.5% cases of extrapulmonary TB. Among cases of genitourinary TB, glandular TB is even rarer. Its a diagnosis of exclusion. Most patients present later in the course of disease due to the associated stigma in view of site of involvement and the hesitancy on the patientss part. We saw two such cases of nonhealing genital ulcers in immunocompetent males.

Utility of high-frequency ultrasonography in the diagnosis of benign and malignant skin tumors.

Various benign and malignant tumors may arise from the skin. These may be of epidermal, dermal, subcutaneous or appendageal origin. Skin biopsy is the gold standard for diagnosis of skin tumors. There is paucity of published data on the role of imaging modalities in diagnosis of skin tumors. High-frequency ultrasonography (7–50 MHz) is a potential non-invasive, objective modality which can be utilized in the diagnosis and localization of skin tumors. It provides valuable information about the tumor characteristics such as size, shape, depth, consistency and vascularity before invasive skin biopsy or surgery is planned. Sentinel lymph nodes in malignant melanoma can be well visualized and studied by this technique. It is also a good modality to detect local recurrence of tumors during post-operative follow up, especially those with a high likelihood of local recurrence or lesions excised with inadequate margins. High-frequency ultrasonography is additive to clinical diagnosis and can be considered a useful non-invasive method to plan the management of various skin tumors and is of prognostic value in some cases.