Vijay Gandhi

Topical tretinoin in Indian male with zosteriform porokeratosis.

International Journal of Dermatology 2003, 42 , 919–920 919 XXXX Topical tretinoin in Indian male with zosteriform porokeratosis A 28-year-old Indian male presented with the complaint of the gradual appearance, over the course of 1 year, of multiple asymptomatic skin lesions on the left shoulder and back. He gave a history of applying topical medicaments (the nature of which could not be ascertained) for 2 months without any relief. The patient was a young healthy adult with a normal general physical and systemic examination. Cutaneous examination revealed multiple annular plaques of variable size (3–10 mm in diameter) arranged in a zosteriform pattern on the dorsolateral aspect of the arm, shoulder and back extending to the medial border of the left scapula ( Fig. 1 ). Each lesion was reddish brown in color and had a conspicuous thread-like border with a mildly atrophic center ( Fig. 2 ). In a few places, annular lesions had coalesced to form large polycyclic plaques. Histopathological evaluation of a punch biopsy specimen taken from the edge of an annular lesion stained with hematoxyline and eosin showed a markedly hyperkeratotic epidermis with a conspicuous parakeratotic column suggestive of cornoid lamella. The granular layer was absent below the cornoid lamella and a mild lymphocytic infiltrate was present in the dermis below it. The patient was started on topical application of tretinoin (0.1%) gel every night. He responded dramatically, with complete resolution of lesions over the next 4 months, leaving mild residual pigmentation. At further follow-up after 2 months, the mild pigmentation persisted without the appearance of any new lesions.

Calcium Dobesilate (Cd) in Pigmented Purpuric Dermatosis (PPD): A Pilot Evaluation

Pigmented purpuric dermatosis (PPD) is a chronic disorder of unknown etiology. It is quite common, and no therapy is significantly effective. Calcium dobesilate (Cd) has been tried successfully in many vascular disorders. The aim of this study was to evaluate the usefulness and efficacy of Cd in PPD. Nine male patients (7 with Schambergs and 1 each with lichenoid dermatosis of Gougerot and Blum and lichen aureus) were given Cd 500 mg twice daily for two initial weeks and then 500 mg once daily for a total period of three months. All the patients were followed up for one year after cessation of therapy. The improvement was moderate in 11.11% and mild in 66.67% of cases; 22.22% did not show any improvement. New lesions stopped appearing in two weeks in all patients, and itching also improved in symptomatic cases without any significant side effects. Based upon the results of this pilot study we recommend Cd as the first line therapy for PPD.

Exogenous ochronosis after prolonged use of topical hydroquinone (2%) in a 50-year-old Indian female

Ochronosis is a rare disease characterized by speckled and diffuse pigmentation symmetrically over the face, neck, and photo-exposed areas. It is characterized histologically by banana-shaped ochre-colored deposits in the dermis. It can present in exogenous or endogenous form. We report a case of exogenous ochronosis in a 50-year-old Indian woman after prolonged use of topical hydroquinone which is a rare complication with a commonly used drug which is available over the counter.

Apocrine chromhidrosis localized to the areola in an Indian female treated with topical capsaicin

A 28-year-old North Indian female presented with complaints of black staining of undergarments over the breasts for the last five to six years. Staining was more prominent during summer. There was no history of relevant drug intake during this period including oral contraceptives. Examination revealed a dark black secretion over the areola of breasts, which could be expressed out in multiple droplets on squeezing the surrounding area [Figure 1]. The surrounding skin was normal in appearance. No evidence of colored sweat was found on the face and axillary areas. A skin swab from the involved area was negative for bacterial growth. Urine examination for pregnancy was negative and serum prolactin levels were normal. On the basis of history

Lichen scrofulosorum on the genitalia – an unusual presentation

Introduction Lichen scrofulosorum is an eruption of lichenoid papules occurring in children and adults with active tuberculosis. It is commonly associated with tuberculosis of the lymph nodes and bones. It is uncommonly associated with pulmonary tuberculosis. It has also been reported after bacillus Calmette–Guérin (BCG) vaccination. Lichen scrofulosorum is considered to arise as a result of hematogenous spread of bacilli or antigens in individuals with high immunological responsiveness to mycobacterial antigens. The Mantoux test is invariably positive. Response to antitubercular drugs is rapid. Histopathology shows superficial granulomas surrounding hair follicles and sweat ducts. The lesions are usually present on the trunk in discrete or grouped patterns. Rarely, lesions extending to the genitalia have been reported. Lesions confined to the genitalia and perineum only, in the absence of truncal involvement, as observed in the case presented here, are extremely rare and pose a diagnostic challenge.

Eccrine hidrocystoma successfully treated with topical synthetic botulinum peptide

Journal of Cutaneous and Aesthetic Surgery May-Aug 2011, Volume 4, Issue 2 154 Figure 1: Dilated unilocular cystic spaces lined by two layers of squamous epithelial cells without any evidence of decapitation secretions, (H and E, ×40) Sir, Eccrine hidrocystomas (EHs) are benign cystic lesions of eccrine ducts that are associated with a chronic course and seasonal variations. They are more frequent in females than in males.[1] Solitary EH can be treated easily by surgical excision; however, the treatment of multiple lesions is problematic. We report a case of multiple eccrine hydrocystomas over the face, which responded completely after 4 weeks of treatment with topical Botulinum Toxin (Boxtlak-BL) like preparation.

Incontinentia pigmenti in a male neonate

We report a case of incontinentia pigmenti in a 3-day-old male neonate presenting with multiple vesicular and hyperkeratotic papular crusted lesions over the right leg and trunk in a blaschkoid pattern since birth, with characteristic histopathological findings. A good clinical acumen is required for diagnosing a rare disorder in the absence of genetic analysis and karyotyping.