Indian Journal of Dermatology, Venereology and Leprology back issues from January 2009:
A study of clinicohistopathological correlation in patients of psoriasis and psoriasiform dermatitis
Jan 01, 2009; ... Introduction Psoriasis is a common, relapsing chronic inflammatory condition affecting about 1.5-3% of the world's population, causing significant morbidity. [1] The presence of a well-defined margin and a silvery white scale, over a glossy homogenous membrane, is clinically diagnostic ...
Osler-Weber-Rendu syndrome: A case report with familial clustering
Jan 01, 2009; ... Introduction Osler-Weber-Rendu syndrome, or hereditary hemorrhagic telangiectasia (HHT), is a rare genetically determined autosomal dominant disorder identified by the triad of telangiectasia, recurrent epistaxis, and a positive family history for the disorder. [1] Presenting at any age, ...
Polymerase chain reaction is no better than Gram stain for diagnosis of gonococcal urethritis
Jan 01, 2009; ... Sir, Chlamydia trachomatis and Neisseria gonorrhea are the leading reportable causes for sexually transmitted diseases (STDs) in the United States. [1],[2] In UK, gonorrheal disease is considered the second most common sexually transmitted infection of bacterial origin. [3] In France, ...
A brownish-red plaque in an adult
Jan 01, 2009; ... A 50-year-old man was referred to our clinic for further evaluation of a slowly enlarging plaque on his back. His wife gave history of the pimple-sized brownish lesion first being noticed thirty years earlier. Ever since, the lesion has been presenting slowly and continuously enlarging. On ...
Current best evidence from dermatology literature
Jan 01, 2009; ... Olumide YM, Akinkugbe AO, Altraide D, Mohammed T, Ahamefule N, Ayanlowo S, et al. Complications of chronic use of skin lightening cosmetics. Int J Dermatol 2008; 47: 344-53 Skin lightening (bleaching) cosmetics and toiletries are widely used in most African countries. The active ...
Passing the baton
Jan 01, 2009; ... Dear Members, I end my editorial term in Dec 2008 and welcome the new editorial team led by Dr. DM Thappa who takes over the journal from January 2009. The year 2008 was a year of change for IJDVL. The challenge was to seamlessly transfer all the editorial responsibilities of the IJDVL ...
Trace element levels in alopecia areata
Jan 01, 2009; ... Introduction Alopecia areata (AA) is a recurrent, nonscarring type of hair loss that can affect any hair bearing area. The incidence of AA is 1-2%.The pathophysiology of AA is considered to be T-cell mediated autoimmunity that occurs mostly in genetically predisposed individuals. [1] In ...
Teledermatology: Clinical case profiles and practical issues
Jan 01, 2009; ... Introduction Teledermatology is fast expanding into one of the most exciting specialties of dermatology. [1],[2] However, there are a number of practical issues that needs to be rectified before the complete benefit of teledermatology can reach either the patients or the dermatologist, ...
Disseminated cutaneous rhinosporidiosis: Varied morphological appearances on the skin
Jan 01, 2009; ... Introduction Rhinosporidiosis, a chronic granulomatous disorder caused by Rhinosporidium seeberi is endemic in India and Sri Lanka but has also been reported from United States, South America, and Iran. [1] Rhinosporidiosis frequently involves the nasopharynx (70%) presenting as a ...
Generalized morphea, lichen sclerosis et atrophicus associated with oral submucosal fibrosis in an adult male
Jan 01, 2009; ... Introduction Generalized morphea is a disorder of unknown etiology. The onset of disease is insidious with development of plaques resembling those of localized morphea. These plaques are commonly much larger than those seen in localized disease, being many centimetres in diameter. The ...
Retiform hemangioendothelioma with lymph node metastasis: A rare entity
Jan 01, 2009; ... Introduction Retiform hemangioendothelioma (RH) was first described in 1994 as a distinctive form of low grade angiosarcoma. [1] RH is a locally aggressive, very rarely metastasizing vascular lesion, characterized by distinctive arborizing blood vessels lined by endothelial cells with ...
Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia
Jan 01, 2009; ... Introduction Loss of hair and alopecia are the most common problems of modern societies, which create many economical and psychological effects. Recently, a great effort has been made to treat hair loss and alopecia, in which some of them were successful. One of the most common types of ...
Diffuse hair loss in an adult female: Approach to diagnosis and management
Jan 01, 2009; ... Introduction Women presenting with diffuse hair loss is a very common and challenging problem for dermatologists. The condition has several causes [Table 1]. Telogen effluvium (TE) is the most common cause, followed by female pattern hair loss (FPHL) and chronic telogen effluvium (CTE); ...
Authors' reply
Jan 01, 2009; ... Sir, We thank Singh and Lavanya for showing interest and responding to our article "Comparison of potassium hydroxide mount and mycological culture with histopathologic examination using periodic acid-Schiff staining of the nail clippings in the diagnosis of onychomycosis". [1] We agree ...
The reliability of periodic acid-Schiff staining in the diagnosis of onychomycosis
Jan 01, 2009; ... Sir, We read with great interest the article on "Comparison of potassium hydroxide mount and mycological culture with histopathological examination using periodic acid-Schiff staining of nail clippings" in a recent issue of IJDVL. [1] The authors' findings about high sensitivity of ...
Fate of medical dermatology in the era of cosmetic dermatology and dermatosurgery
Jan 01, 2009; ... "The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head." - Sir William Osler Dermatology is one of the many medical specialties, which evolved from the general internal medicine during ...
Periungual acquired digital fibrokeratoma
Jan 01, 2009; ... A 35-year-old female presented with an asymptomatic, slow growing, pedunculated growth on the first toe of her right foot for the past six years. On examination, there was a 2-cm-pedunculated, flesh colored growth arising beneath the proximal nail fold with multiple digitations on the surface ...
Noncicatricial alopecia due to plaque-type psoriasis of the scalp
Jan 01, 2009; ... Sir, Psoriasis is a chronic disease having different facets of clinical presentation. In this letter, we report a fairly uncommon presentation of scalp psoriasis - rounded plaque-type with tufts of hairs at the center, and a partial hair loss in the surrounding area of the ...
Male sex workers: Are we ignoring a risk group in Mumbai, India?
Jan 01, 2009; ... Introduction The organized sex trade has been a focus of intense discussion within the context of the human immunodeficieny virus (HIV) epidemic in Maharashtra as well as in India. [1] The female sex workers and their clients represent a high-risk group for acquisition of sexually ...
Presentation of early onset psoriasis in comparison with late onset psoriasis: A clinical study from Pakistan
Jan 01, 2009; ... Introduction The concept of early and late onset psoriasis was first introduced by Henseler and Christophers in 1985. They studied over 2000 patients with psoriasis and discovered two peaks regarding age of onset; first occurring at 16-22 years and later at 57-60 years. They further ...
Granulomatous rosacea in Cornelia de Lange syndrome
Jan 01, 2009; ... Sir, Cornelia de Lange syndrome (CDLS) is a multisystem disorder characterized by a typical facial appearance, prenatal and postnatal growth retardation, feeding difficulties, psychomotor delay, and behavioral problems. Facial features include cutis marmorata and bluish discolouration of ...
Asymptomatic swelling in a 60-year-old scar
Jan 01, 2009; ... A 65-year-old lady presented with two hard swellings over the forehead for two years before seeking dermatology consultation. She had a penetrative injury in a linear fashion on the forehead when she was 5-year-old. The wound healed with secondary intention leaving behind a single linear scar ....
Opening remarks from the new editor
Jan 01, 2009; ... "I cannot say whether things will get better if we change; what I can say is they must change if they are to get better." G. C. Lichtenberg It is with great pride that I begin my term as the 9th editor of the Indian Journal of Dermatology, Venereology and Leprology (IJDVL). The ...
Tanning caused by psoralen-photochemotherpy in Indian skin
Jan 01, 2009; ... Sir, One of the common side effects of psoralen-photochemotherapy is excessive tanning of the skin. We had an opportunity to observe the extent of tanning that can occur in an individual with pigmented skin due to sparing of some abnormal skin folds. A 54-year-old man with ...
Prolonged antimicrobial and oral cyclophosphamide therapy in pemphigus: Need for caution
Jan 01, 2009; ... Sir, The report by Dr. Pasricha and Poonam is a welcome confirmation of the effectiveness of DCP regimen for the treatment of pemphigus in the setting of a private clinic. [1] However, I have two concerns about the therapeutic regimen they employed. One of the modifications made ...
Localized pemphigus vulgaris on cheeks responding to topical steroids
Jan 01, 2009; ... Sir, Pemphigus vulgaris (PV) is an autoimmune blistering disease characterized by extensive mucocutaneous vesicobullous lesions. Generally, the mucosal lesions precede skin lesions by weeks or months. Severity of the disease may vary, from localized crusted erosions involving the skin or ...
Nephrogenic fibrosing dermopathy
Jan 01, 2009; ... Introduction Nephrogenic fibrosing dermopathy (NFD) is a recently described fibrosing disorder seen in the setting of renal failure with or without dialysis. The process of fibrosis in patients with NFD has been reported to involve underlying structures and also internal organs ....
Chrysomya bezziana infestation in a neglected squamous cell carcinoma on the face
Jan 01, 2009; ... Sir, Myiasis in cancerous wounds occurs as a complication of skin cancers. [1],[2] Our patient, a 65-year-old woman, was referred to us with blood-tinged, fetid discharge from an old facial wound along with pain and presence of some live worm-like organisms since three days [Figure ...
Concurrent oral and genital involvement in lichen planus
Jan 01, 2009; ... Sir, The true incidence of lichen planus (LP) is unknown as it can affect one or several regions, can have various clinical appearances, and the diagnosis has to confirmed histopathologically. [1] Therefore, the true LP prevalence can be known only with the joint contributions of ...
Pulse therapy for pemphigus: The burden of proof
Jan 01, 2009; ... Sir, Recent retrospective case series on dexamethasone cyclophosphamide pulse (DCP) therapy for pemphigus concludes with "the modifications employed in this study could ensure the cure of all pemphigus patients", "with DCP therapy.pemphigus can now be considered to be a completely ...
Cosmeceuticals: Are they truly worth the cost?
Jan 01, 2009; ... Cosmeceuticals are the advances made within the world of dermatological products and the new beckon in skincare. Cosmeceuticals are topical cosmetic-pharmaceutical hybrids intended to enhance the health and beauty of skin. The concept propounded by Dr. Albert Kligman states that "The ...
The rK39 immunochromatic dipstick testing: A study for K39 seroprevalence in dogs and human leishmaniasis patients for possible animal reservoir of cutaneous and visceral leishmaniasis in endemic focus of Satluj river valley of Himachal Pradesh (India)
Jan 01, 2009; ... Introduction Visceral leishmaniasis (VL) is caused primarily by Leishmania donovani and Leishmania infantum , and the primary causative agent of localized cutaneous leishmaniasis (LCL) is Leishmania tropica , L. major or L. aethiopica in the 'old world'. Recently, L. donovani and L ....
Emergence of dermatology in India
Jan 01, 2009; ... Introduction Dermatology, the science of the skin and its appendages, is one of the many specialties that evolved from general internal medicine during the course of the nineteenth century. Till this time, physicians with few exceptions, were little concerned with the skin, apart from ...
Fitzpatrick skin typing: Applications in dermatology
Jan 01, 2009; ... Introduction Fitzpatrick skin phototypes were developed by Thomas B. Fitzpatrick in 1975 based on a person's skin color and responses to sun exposure in terms of degree of burning and tanning. Though subjective, Fitzpatrick skin typing has a proven diagnostic and therapeutic value. It ...
Adverse reactions to cosmetics and methods of testing
Jan 01, 2009; ... Introduction Cosmetics are "articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance." [1] A recent study found ...
Factors precipitating or aggravating acne
Jan 01, 2009; ... Acne is typically vacillating in its course. There are periodic flares, some of which may be accounted for by various triggers and aggravating factors. It is therapeutically rewarding to identify the concerned triggers and aggravating factors and be able to deal with them. Oils: In ...
Clinical features
Jan 01, 2009; ... Acne is the easiest skin condition to diagnose because of its distinctive anatomic distribution, age of occurrence, and polymorphic appearance in which the comedones (blackheads especially) are the most unique and pathognomonic feature [Figure 9],[Figure 10],[Figure 11]. Typically it starts at ...
Introduction
Jan 01, 2009; ... Acne is unique to humans, [1] who tend to view it as a rite of passage. It is stated that 90% of individuals, male and female, between puberty and age 30 years, experience some degree of acne. That is nearly everyone. A report in the British Medical Journal in 1989 opined that in a lifetime a ...
Principles of topical therapy
Jan 01, 2009; ... The availability of topical agents for treatment of acne is as wide and variable as the manifestations of acne itself. As with systemic therapy, the choice of agent for topical therapy depends on the clinical presentation and the general principles of treatment. The general principles of ...
Topical retinoids
Jan 01, 2009; ... Retinoic acid, the progenitor of retinoids, was tested in 1960's by Gunter Stüttgen and Rudolf Baer who discovered its beneficial effects in disorders of keratinization. [1] Subsequently, retinoids have been found to be very useful in the treatment of acne, especially as they affect both ...
Topical antibacterials
Jan 01, 2009; ... Topical antibiotics: Current options include clindamycin, clarithromycin, azithromycin, and nadifloxacin. Tetracycline and erythromycin are no longer easily available. Topically applied antibiotics work slowly and are marginally effective. [1] They are rarely adequate as a monotherapy but are ...
Combination therapy
Jan 01, 2009; ... With the availability of different topical antiacne agents targeting different pathogenetic factors, it makes sense to combine them to enhance therapeutic efficacy, to make therapy more user-friendly, to minimize adverse effects, and to prevent or reduce bacterial resistance. This has been ...
Oral antibiotics
Jan 01, 2009; ... There is more experience and data for antibiotics in acne than any other therapy. [1] Antibiotics target P. acnes and inflammation. [1] They reduce the number of P. acnes and Staphylococcus epidermidis. [1] The anti-inflammatory effect is manifested through inhibition of neutrophil chemotaxis, ...
Antibiotic resistance in acne
Jan 01, 2009; ... Antibiotic resistance is defined as a change in susceptibility of a microorganism to an antibiotic such that a higher concentration of the drug is required to inhibit growth of a resistant strain compared to fully susceptible wild type strain. Widespread use of tetracyclines and ...
Oral retinoids
Jan 01, 2009; ... Isotretinoin (13-cis-retinoic acid) is a derivative of retinol (vitamin A). It is easily the most potent antiacne agent available today, and the only one that addresses all pathogenic mechanisms. [1] Isotretinoin represents the single most important advance in acne therapeutics. It was ...
Epidemiology of acne
Jan 01, 2009; ... Is acne a disease of Western civilization? This question has been asked by an international group of epidemiologists, community medicine specialists, and anthropologists. [1] They aver that acne vulgaris is a nearly universal skin disease afflicting 79-95% of the adolescent population in ...
Hormonal therapy of acne
Jan 01, 2009; ... Hormonal therapy is an excellent choice for female patients with acne who have SAHA syndrome [Figure 44],[Figure 45],[Figure 46], polycystic ovarian syndrome (PCOS), HAIR-AN syndrome (hyperandrogenism, insulin resistance, acanthosis nigricans) [Figure 50],[Figure 51],[Figure 52], or cutaneous ...
Adjunctive therapies
Jan 01, 2009; ... Adjunctive therapies provide therapeutic width, which is often needed to enhance efficacy, limit dosages of primary agents to curtail toxicity (even costs!), and to help individualize treatment programs. In acne therapy several options are available: Corticosteroids: Oral, topical, and ...
Physical modalities
Jan 01, 2009; ... Lights and lasers have received immense attention in the management of acne in the past five years. They have been discovered to be effective in inflammatory acne through two mechanisms, namely: their biological effects on P. acnes and thermal effects on sebaceous glands. [1] Lasers that emit ...
Genetics in acne
Jan 01, 2009; ... Although acne is not an inherited condition, there is an inherited predisposition. Several genes are believed to be involved, of which only the gene for cytochrome P-450-1A1 and the gene for steroid 21-hydroxylase are documented.[1] There is high concordance rate among identical twins. [2] XYY ...
Acne and quality of life
Jan 01, 2009; ... The impact of skin diseases in general and acne in particular, on quality of life (QoL) has been recognized for over 30 years. Acne is associated with greater psychological burden than a variety of disparate chronic disorders. [1] The levels of social, psychological, and emotional impairments in ...
Surgery in acne
Jan 01, 2009; ... Dermatologists have traditionally resorted to various surgical and physical procedures as adjunctive treatment to deal with different aspects of active acne and its sequelae. Some commonly employed procedures are: Comedone expression: This is a simple and safe way to treat both open and ...
Acne scars
Jan 01, 2009; ... Clearance of scars is the first request of the acne patients. There is lack of data on the epidemiology and pathophysiology of acne scars. There is limited data on clinical characteristics and management. There is often discrepancy between patient's perception of scars and dermatologists ...
Postinflammatory hyperpigmentation in acne
Jan 01, 2009; ... Postinflammatory hyperpigmentation (PIH) is a common sequela in acne patients, more so in those with skin of color. [1] PIH in acne is also called acne hyperpigmented macule (AHM). [1] AHM's were noted in 65.3% of blacks, 52.7% of Hispanics, and 47.4% of Asians in a study of acne in the USA. [1] ...
Cosmetics and skin care in acne
Jan 01, 2009; ... A cosmetic is defined as an "article intended to be rubbed, poured, sprinkled, or sprayed on the human body for the purpose of cleaning, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or function." [1] Appropriate skin care contributes to ...
Acne in children
Jan 01, 2009; ... Acne can be seen in the first year of life, early childhood, prepubertal age, and puberty. [1] However, in mid-childhood, between 1-7 years, acne is uncommon, and when it is encountered it should be evaluated for hyperandrogenism. [2] There are several subsets in childhood acne. Neonatal ...
Acne in pregnancy
Jan 01, 2009; ... Acne and pregnancy interact in a variable way. In the majority, pregnancy has a beneficial effect on the activity of acne, and this is through the sebosuppressive effect of estrogens. In a small number of cases, there is a flare-up of acne requiring active intervention, especially if scarring is ...
Pathogenesis of acne
Jan 01, 2009; ... Acne represents obstruction and inflammation of the sebaceous follicles, a subtype of pilosebaceous units [Figure 1]. [1] Sebaceous follicles show dominant sebaceous gland and rudimentary hair. The primary and pathognomonic lesion of acne is microcomedo, a microscopic lesion invisible to the ...
Diffificult acne
Jan 01, 2009; ... Difficult acne may be defined as "Acne that fails to respond to elected treatment approach, or acne that presents with constraints and/or challenging clinical features." Failure to respond, that is, under-responsiveness, may arise from a variety of reasons. Failure to address the ...
Acne prevention
Jan 01, 2009; ... Presently, little is known about preventing the onset of acne. Lifestyle and wellness modifications could conceivably help, but are generally ignored. Primary Prevention Diet: Role of diet in acne causation and prevention is complex and controversial. On the one hand, there is no ...
Algorithms for the management of acne
Jan 01, 2009; ... Algorithm 1: Treatment of mild acne - [SUPPORTING:1] Algorithm 2: Treatment of moderate acne - [SUPPORTING:2] Algorithm 3: Treatment of severe acne - [SUPPORTING:3] Algorithm 4: Endocrine evaluation - [SUPPORTING:4] [Reference] 1. Fulton JE, Plewig ...