Syed Suhail Amin

Childhood leprosy: lest we forget:

Leprosy remains an important public health and social issue in South Asia, particularly in India. Its presence in childhood is an immense social burden because of the associated disabilities and widely prevalent misconceptions regarding communicability and treatment potential. The prevalence of leprosy among children suggests a possible gap in the national programmes aimed at leprosy elimination. This article reports a 10-year retrospective study of childhood leprosy in a tertiary care hospital setting (2000–2009) along with an analysis of selected socio-epidemiologic correlates. We stress the importance of early detection and the application of appropriate prophylactic measures in susceptible children.

Erythromelanosis follicularis faciei et colli: A clinicoepidemiologic study

We describe 25 cases of erythromelanosis follicularis faciei et colli from India. The male:female ratio was 5.25:1 and the average age of onset was 12.3 years. The cheeks, preauricular area, and submandibular region were the sites most commonly affected. Keratosis pilaris was seen in 22 (88%) of the patients.

A case of giant lupus vulgaris

Lupus vulgaris, the commonest form of tuberculosis of the skin, presents with a plaque that enlarges slowly with advancing edges while showing atrophy at other areas. It may be acquired by the blood stream, via lymph, by contiguous spread or from external inoculation. We describe a case of lupus vulgaris with a large erythematous-scaly plaque of 44 × 26 cm over the back and a similar 7 × 5 cm plaque over the right thigh. The plaque over the back was gradually progressive for the previous ten years and showed scarring and atrophy at places. Histopathology of the area showed caseating granulomas with Langhans giant cells, epitheloid cells and lymphocytes. A diagnosis of lupus vulgaris was made. This case is being presented owing to the large size of the lesion.

Pilomatricoma of the eyelid

Clinically, the lesion appears as a slowly enlarging, irregularly shaped, rock hard, nodular, non tender mass freely movable over the subcutaneous tissue. The skin usually has reddish to blue discoloration due to dilated blood vessels and chalky white nodules may be seen through the skin. There is typically no history of inflammation or trauma [4]. In this article we present a case of pilomatricoma involving the eyelid.

Reticulate dyschromia, congenital atrichia, papules, and speech delay in a child: An intriguing diagnostic dilemma

Disorders of reticulate dyschromia can be diagnosed on the basis of the distribution and type of pigmentation in association with coexisting abnormalities. We describe a 4-year-old male child with reticulate dyschromia of the dorsal aspects of hands and feet and over the axillae, buttocks, and groins. The child had near complete absence of hair over body since birth. Skin-colored firm papules were present over dorsal aspects of hands and feet, and milestones were delayed for speech. We discuss the probable differentials in this article and why it fits none of the existing differentials.

Clinico-epidemiological study of morphea from a tertiary care hospital

INTRODUCTION Morphea is an uncommon disease that presents with skin induration and sclerosis. The disease is common in Caucasians and there are few studies describing the clinicoepidemiological profile of these patients from the Indian subcontinent. METHODS This prospective study was conducted during a three year period from June 2014 to May 2017. All patients of morphea presenting to the dermatology outpatient department were evaluated for parameters like age, sex, duration, age of onset, clinical subtype and possible disease associations and triggering factors. The data was analysed, tabulated and mean, standard deviation and percentages calculated. RESULTS 47 patients were incorporated into the study. These comprised of 10 (21.28%) males and 37 (78.72%) females. The average age of the patients was 23.92 ± 12.07 years with a mean age of onset being 22.13 ± 12.51 years. 22 (46.80%) patients presented within one year of onset of disease. Plaque morphea was the commonest type seen in 31 (65.96%) patients followed by linear morphea in 9 (19.15%) patients. We found preceding trauma in 3 patients and morphea developed following herpes zoster and intramuscular injection in one patient each. CONCLUSION Morphea is an uncommon disease that is seen predominantly in females and young individuals. Circumscribed plaque morphea is the commonest variant. Certain predisposing factors like trauma can precede it.

A Case of Erythema Annulare Centrifugum Following Wood Injury: Is it the First Report?

A 15 year old male presented to us with complaint of a red lesion over the right shin for 3 weeks that was constantly increasing in size. The patient gave history that he sustained injury at the site with a wooden object around 6 weeks back. The wood was implanted in the skin and was removed by an unqualified local practitioner. He was given some topical ointment for application and the wound healed in around 10 days’ time. Three weeks back, he noticed red scaly lesion over the site of trauma that started to spread outwards. There was no history of fever, pain, itching or discharge from the site. There was no history of similar lesions elsewhere on the body. The patient was apparently healthy and had not been ill lately. He was not taking any medications. On examination, a large annular plaque of the size of 10 cm diameter was seen on the lower half of the right anterior leg with erythema and slight swelling of the periphery and central clearing. The erythematous plaque was extending distally towards the ankle (Figure 1). The scales over the lesion were trailing behind the advancing edges. Rest of the cutaneous, mucosal and systemic examination was normal. A potassium hydroxide mount from the edge of the lesion was negative. Lab investigations including complete blood counts, liver and renal function tests, urine and stool examination, thyroid function tests were within normal range. Antinuclear antibodies, Rapid plasma reagin test, hepatitis and herpes viral serology, serology for Borrelia burgdorferi and HIV screening ELISA were negative. Chest radiograph was normal and Montoux test was negative. Histopathology of the skin from the lesion showed mounds of parakeratosis, spongiosis and dense lymphohistiocytic infiltrate in the upper dermis, particularly in the perivascular location (Figure 2). Based on these features,

Atrophoderma of Pasini and Pierini in a blaschkoid pattern

Idiopathic atrophoderma of Pasini and Pierini (IAPP) is a disease characterized by well-defi ned skin patches with a “cliffdrop” border that show no signs of sclerosis and induration [ 1 ] . Idiopathic atrophoderma of Pasini and Pierini can be distinguished from linear atrophoderma of Moulin (LAM) by the latter’s earlier onset, nonprogressive course, blaschkoid distribution, as well as lack of infl ammation and absence of dermal changes. Herein, we present a case of progressive IAPP in a blaschkoid distribution. A 41-year-old female patient presented to us with a sixmonth history of gradually progressive, band-like, asymptomatic, dark-colored streaks on the left side of the abdomen. There was no history of previous lesions at that particular site. Clinical examination revealed multiple linear, hyperpigmented, atrophic plaques in a blaschkoid distribution, extending from the anterior midline across the left upper abdomen to the mid-back (Figure 1 ). The plaques had “cliff-drop” borders, and the affected skin was found to be normal, showing no sclerosis, induration, or signs of infl ammation. Routine lab tests were within normal limits; ANA testing was negative. Histopathological examination showed an unremarkable epidermis, a mononuclear infi ltrate and edema in the dermis, as well as clumping and homogenization of dermal collagen fi bers (Figure 2 ). ELISA for Borrelia burgdorferi was negative. Based on the clinical and histopathological fi ndings, our patient was diagnosed with IAPP in a blaschkoid pattern. She

Autoimmune hypothyroidism in jobs syndrome: An extremely rare finding

4. James WD, Elton DM, Berger TG. Andrews’ Diseases of the Skin: Clinical Dermatology. 11th ed. UK: Saunders Elsevier; 2011. p. 675‐93. This is an open access article distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‐commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Unilateral striate-punctate keratoderma: An extremely rare presentation of punctate keratoderma

© 2017 Indian Journal of Dermatology, Venereology, and Leprology | Published by Wolters Kluwer Medknow This is an open access article distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‐commercially, as long as the author is credited and the new creations are licensed under the identical terms. Access this article online