International journal of dermatology, Jan 20, 2015
Skin biopsies are an invaluable tool in the diagnostic armamentarium of a dermatologist and have ... more Skin biopsies are an invaluable tool in the diagnostic armamentarium of a dermatologist and have several factors that determine outcome. The aim of this study was to retrospectively assess the quality of data included in the pathology request forms and reports and to assess the level of clinicopathological correlation in the reported biopsy specimens. We retrospectively analyzed 3006 histopathology request forms and reports of skin, mucosal, and nail biopsies to assess the quality of data included in them and assessed the level of clinicopathological correlation in these biopsies. Two hundred discordant histopathology slides were randomly reviewed by a pathologist in the presence of a dermatologist to analyze the causes for discordance. The pathological diagnosis was concordant with clinical diagnosis in 1798 (59.8%) biopsies, partially concordant in 228 (7.6%) biopsies, and discordant in 929 (30.9%) biopsies. In a clinicopathologically concordant category, the duration for reportin...
Lichen planus (LP) is a chronic papulosquamous dermatosis in which both skin and mucous membranes... more Lichen planus (LP) is a chronic papulosquamous dermatosis in which both skin and mucous membranes may be involved. To date, there have been only five reports of human immunodeficiency virus (HIV)-positive patients with hypertrophic LP. In the present report, we describe a 37-...
Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pos... more Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pose a clinicopathological challenge. We present a case of pigmented hypertrichotic plaque over lumbosacral region and discuss the differential diagnosis and its clinical, histopathological and immunohistochemistry features which may aid in differentiation. We highlight the difficulties faced in differentiating neurotized congenital melanocytic nevus from pigmented neurofibroma.
IntroductionNevus depigmentosus presents with areas of hypopigmen-tation along Blaschko’s lines a... more IntroductionNevus depigmentosus presents with areas of hypopigmen-tation along Blaschko’s lines and may be associated withdisorders of the central nervous system, musculoskeletalsystem, eyes, and teeth. Nevus of Ito is a dermal melano-cytosis of the acromioclavicular and upper chest area.Although both nevus depigmentosus and nevus of Itooccur commonly, their coexistence in a manner represen-tative of allelic twin spotting has not previously beenreported.Case ReportA 28-year-old man of normal intellectual ability, bornof a non-consanguineous marriage, presented with abirthmark of hypopigmented areas on the left side ofthe back. There was no history of bullous, verrucous,or hyperpigmented lesions preceding the appearance ofthe hypopigmentation. The patient had suffered fromprogressively worsening tremors of the hands over theprevious 10 years, as well as from generalized tonic clo-nic seizures and myoclonus over the previous two years,for which he was receiving sodium valproate. Hisgrandfather, paternal aunt, and father had experiencedthe onset of seizures and tremors in the third decade oflife and had died by the end of the fifth decade afterdeveloping severe tremors, ataxia, and refractory sei-zures. His younger brother and sister also had tremorsand seizures, the onset of which had occurred in thethird decade.Cutaneous examination revealed large hypopigmentedmacules distributed in a phylloid pattern over the left sideof the back and extending to the midline of the back andleft side of the abdomen (Fig. 1a,c). The subject also dem-onstrated ill-defined, bluish-gray macules over the rightshoulder which were suggestive of nevus of Ito (Fig. 1a,b). Electroencephalographic recordings and computedtomography of the brain produced normal results. Therewere no biochemical or hematological abnormalities. Thefindings of electrocardiography and echocardiographywere normal. Ultrasound of the abdomen showed a fattychange in the liver. Histopathological examination of askin biopsy specimen from a hypopigmented area on thesubject’s back revealed an unremarkable epidermis anddermis (Fig. 2a,b). Examination of a biopsy obtainedfrom the bluish-gray area on the patient’s shoulderrevealed an unremarkable epidermis and scattered den-dritic melanized melanocytes in both the superficial anddeep dermis within collagen bundles (Fig. 2c,d), consis-tent with nevus of Ito. Karyotyping from a blood samplewas found to be normal.
Lepra reaction in histoid leprosy (HL) is rare; there are few reports of type 2 lepra reaction in... more Lepra reaction in histoid leprosy (HL) is rare; there are few reports of type 2 lepra reaction in HL. We report a 42-year-old woman with HL in type 1 lepra reaction after 10 weeks of multibacillary multi-drug therapy (MBMDT). A 42-year-old woman presented with asymptomatic multiple papules, plaques, and nodules over the face, trunk, and extremities and no history of prior treatment with anti-leprosy drugs. A biopsy of a skin nodule on the forearm revealed spindle-shaped, non-vacuolated histiocytes in a whorled pattern with abundant acid-fast bacilli (AFB). The patient was diagnosed with HL and started on MBMDT. Ten weeks later, she developed pruritic, painful, erythematous, and edematous papules, plaques, and nodules over the face, trunk, and extremities, without constitutional symptoms. Histopathology revealed an atrophic epidermis, preserved grenz zone, and papillary dermal edema. Elongated AFB were visible on Fite's stain. The MBMDT was continued, along with nonsteroidal anti...
Trichofolliculoma is a pilosebaceous follicle hamartoma in which several hairs are formed within ... more Trichofolliculoma is a pilosebaceous follicle hamartoma in which several hairs are formed within single pilosebaceous unit and protrude out of single orifice. Herein we report a 45-year-old woman with a trichofolliculoma of the eyebrow. Case synopsis A 45-year-old woman presented with an asymptomatic slowly growing swelling over the right eyebrow of 6 months duration. There was no history of similar lesion elsewhere in the past and no similar skin lesion in any family members. The patient could not recall any history of trauma at the site of swelling.
The elbow is not recognized as common site for cutaneous lupus erythematosus (CLE) lesions. Twelv... more The elbow is not recognized as common site for cutaneous lupus erythematosus (CLE) lesions. Twelve cases of CLE over the elbows were evaluated for systemic involvement and Cutaneous Lupus Disease Area and Severity Index activity and damage scores and Systemic Lupus Erythematosus Disease Activity Index scoring was done. Histopathological examination of the affected skin was performed in doubtful cases. Most of the patients were women (10, 83.3%) with mean age of 28.75 years. Three patients had only elbow lesions and the remaining nine patients had CLE lesions at sites other than the elbows, of which five had elbow lesions preceding skin lesions elsewhere over the body and three patients were not aware of whether elbow lesions preceded or succeeded CLE lesions at other sites, and one patient had noticed malar rash 9 months prior to elbow lesions. All the patients antinuclear antibody positivity, systemic involvement, and fulfilled criteria for systemic lupus erythematosus. This peculi...
Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicu... more Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region.
Eccrine syringofibroadenoma (ESFA) is a rare cutaneous tumor with eccrine differentiation with va... more Eccrine syringofibroadenoma (ESFA) is a rare cutaneous tumor with eccrine differentiation with varied clinical manifestations. We report a case of reactive eccrine syringofibroadenomatosis associated with chronic bilateral plantar ulcers in a patient with diabetes mellitus presenting as plantar hyperkeratosis and verrucous growth at margins.
A 2-year-old male child was diagnosed with erythrokeratoderma variabilis, and showed an excellent... more A 2-year-old male child was diagnosed with erythrokeratoderma variabilis, and showed an excellent response to low-dose isotretinoin, with remarkable improvement in all the affected areas within just 2 weeks of treatment.
Indian Journal of Sexually Transmitted Diseases and AIDS, 2008
The recent years have witnessed a renewed interest in human sexual behavior, partly because of th... more The recent years have witnessed a renewed interest in human sexual behavior, partly because of the growing AIDS pandemic. We undertook a study of the pattern of sexual behavior among outpatients attending our dermatology clinic. Sexually active patients attending the ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
... A clinical study of vulval lichen sclerosus at a tertiary care hospital in South India Nidhi ... more ... A clinical study of vulval lichen sclerosus at a tertiary care hospital in South India Nidhi Singh 1 , Devinder Mohan Thappa 1 , Telanseri J Jaisankar 1 , Syed Habeebullah 2 1 Department of Dermatology and STD ... [1] Women complain of intractable pruritus (worse at night), [1],[15 ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
Prostitution describes sexual intercourse in exchange for remuneration. The legal status of prost... more Prostitution describes sexual intercourse in exchange for remuneration. The legal status of prostitution varies in different countries, from punishable by death to complete legality. The great degree of social stigma associated with prostitution, of both buyers and sellers, has lead to ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2008
Homosexuality can be described as the orientation and inclination of a person to have sexual rela... more Homosexuality can be described as the orientation and inclination of a person to have sexual relations with a person of his or her own sex. The clustering of Acquired immune deficiency syndrome (AIDS) cases among male homosexuals in the initial phase of the HIV epidemic in the ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
A 25-year-old married woman presented with swelling of vulva with oozing of watery fluid from vul... more A 25-year-old married woman presented with swelling of vulva with oozing of watery fluid from vulval skin surface for the past 8 years. She also complained of swelling in the inguinal region (occasionally painful) on both sides for the past 8 years. Local genital examination ...
International journal of dermatology, Jan 20, 2015
Skin biopsies are an invaluable tool in the diagnostic armamentarium of a dermatologist and have ... more Skin biopsies are an invaluable tool in the diagnostic armamentarium of a dermatologist and have several factors that determine outcome. The aim of this study was to retrospectively assess the quality of data included in the pathology request forms and reports and to assess the level of clinicopathological correlation in the reported biopsy specimens. We retrospectively analyzed 3006 histopathology request forms and reports of skin, mucosal, and nail biopsies to assess the quality of data included in them and assessed the level of clinicopathological correlation in these biopsies. Two hundred discordant histopathology slides were randomly reviewed by a pathologist in the presence of a dermatologist to analyze the causes for discordance. The pathological diagnosis was concordant with clinical diagnosis in 1798 (59.8%) biopsies, partially concordant in 228 (7.6%) biopsies, and discordant in 929 (30.9%) biopsies. In a clinicopathologically concordant category, the duration for reportin...
Lichen planus (LP) is a chronic papulosquamous dermatosis in which both skin and mucous membranes... more Lichen planus (LP) is a chronic papulosquamous dermatosis in which both skin and mucous membranes may be involved. To date, there have been only five reports of human immunodeficiency virus (HIV)-positive patients with hypertrophic LP. In the present report, we describe a 37-...
Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pos... more Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pose a clinicopathological challenge. We present a case of pigmented hypertrichotic plaque over lumbosacral region and discuss the differential diagnosis and its clinical, histopathological and immunohistochemistry features which may aid in differentiation. We highlight the difficulties faced in differentiating neurotized congenital melanocytic nevus from pigmented neurofibroma.
IntroductionNevus depigmentosus presents with areas of hypopigmen-tation along Blaschko’s lines a... more IntroductionNevus depigmentosus presents with areas of hypopigmen-tation along Blaschko’s lines and may be associated withdisorders of the central nervous system, musculoskeletalsystem, eyes, and teeth. Nevus of Ito is a dermal melano-cytosis of the acromioclavicular and upper chest area.Although both nevus depigmentosus and nevus of Itooccur commonly, their coexistence in a manner represen-tative of allelic twin spotting has not previously beenreported.Case ReportA 28-year-old man of normal intellectual ability, bornof a non-consanguineous marriage, presented with abirthmark of hypopigmented areas on the left side ofthe back. There was no history of bullous, verrucous,or hyperpigmented lesions preceding the appearance ofthe hypopigmentation. The patient had suffered fromprogressively worsening tremors of the hands over theprevious 10 years, as well as from generalized tonic clo-nic seizures and myoclonus over the previous two years,for which he was receiving sodium valproate. Hisgrandfather, paternal aunt, and father had experiencedthe onset of seizures and tremors in the third decade oflife and had died by the end of the fifth decade afterdeveloping severe tremors, ataxia, and refractory sei-zures. His younger brother and sister also had tremorsand seizures, the onset of which had occurred in thethird decade.Cutaneous examination revealed large hypopigmentedmacules distributed in a phylloid pattern over the left sideof the back and extending to the midline of the back andleft side of the abdomen (Fig. 1a,c). The subject also dem-onstrated ill-defined, bluish-gray macules over the rightshoulder which were suggestive of nevus of Ito (Fig. 1a,b). Electroencephalographic recordings and computedtomography of the brain produced normal results. Therewere no biochemical or hematological abnormalities. Thefindings of electrocardiography and echocardiographywere normal. Ultrasound of the abdomen showed a fattychange in the liver. Histopathological examination of askin biopsy specimen from a hypopigmented area on thesubject’s back revealed an unremarkable epidermis anddermis (Fig. 2a,b). Examination of a biopsy obtainedfrom the bluish-gray area on the patient’s shoulderrevealed an unremarkable epidermis and scattered den-dritic melanized melanocytes in both the superficial anddeep dermis within collagen bundles (Fig. 2c,d), consis-tent with nevus of Ito. Karyotyping from a blood samplewas found to be normal.
Lepra reaction in histoid leprosy (HL) is rare; there are few reports of type 2 lepra reaction in... more Lepra reaction in histoid leprosy (HL) is rare; there are few reports of type 2 lepra reaction in HL. We report a 42-year-old woman with HL in type 1 lepra reaction after 10 weeks of multibacillary multi-drug therapy (MBMDT). A 42-year-old woman presented with asymptomatic multiple papules, plaques, and nodules over the face, trunk, and extremities and no history of prior treatment with anti-leprosy drugs. A biopsy of a skin nodule on the forearm revealed spindle-shaped, non-vacuolated histiocytes in a whorled pattern with abundant acid-fast bacilli (AFB). The patient was diagnosed with HL and started on MBMDT. Ten weeks later, she developed pruritic, painful, erythematous, and edematous papules, plaques, and nodules over the face, trunk, and extremities, without constitutional symptoms. Histopathology revealed an atrophic epidermis, preserved grenz zone, and papillary dermal edema. Elongated AFB were visible on Fite's stain. The MBMDT was continued, along with nonsteroidal anti...
Trichofolliculoma is a pilosebaceous follicle hamartoma in which several hairs are formed within ... more Trichofolliculoma is a pilosebaceous follicle hamartoma in which several hairs are formed within single pilosebaceous unit and protrude out of single orifice. Herein we report a 45-year-old woman with a trichofolliculoma of the eyebrow. Case synopsis A 45-year-old woman presented with an asymptomatic slowly growing swelling over the right eyebrow of 6 months duration. There was no history of similar lesion elsewhere in the past and no similar skin lesion in any family members. The patient could not recall any history of trauma at the site of swelling.
The elbow is not recognized as common site for cutaneous lupus erythematosus (CLE) lesions. Twelv... more The elbow is not recognized as common site for cutaneous lupus erythematosus (CLE) lesions. Twelve cases of CLE over the elbows were evaluated for systemic involvement and Cutaneous Lupus Disease Area and Severity Index activity and damage scores and Systemic Lupus Erythematosus Disease Activity Index scoring was done. Histopathological examination of the affected skin was performed in doubtful cases. Most of the patients were women (10, 83.3%) with mean age of 28.75 years. Three patients had only elbow lesions and the remaining nine patients had CLE lesions at sites other than the elbows, of which five had elbow lesions preceding skin lesions elsewhere over the body and three patients were not aware of whether elbow lesions preceded or succeeded CLE lesions at other sites, and one patient had noticed malar rash 9 months prior to elbow lesions. All the patients antinuclear antibody positivity, systemic involvement, and fulfilled criteria for systemic lupus erythematosus. This peculi...
Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicu... more Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region.
Eccrine syringofibroadenoma (ESFA) is a rare cutaneous tumor with eccrine differentiation with va... more Eccrine syringofibroadenoma (ESFA) is a rare cutaneous tumor with eccrine differentiation with varied clinical manifestations. We report a case of reactive eccrine syringofibroadenomatosis associated with chronic bilateral plantar ulcers in a patient with diabetes mellitus presenting as plantar hyperkeratosis and verrucous growth at margins.
A 2-year-old male child was diagnosed with erythrokeratoderma variabilis, and showed an excellent... more A 2-year-old male child was diagnosed with erythrokeratoderma variabilis, and showed an excellent response to low-dose isotretinoin, with remarkable improvement in all the affected areas within just 2 weeks of treatment.
Indian Journal of Sexually Transmitted Diseases and AIDS, 2008
The recent years have witnessed a renewed interest in human sexual behavior, partly because of th... more The recent years have witnessed a renewed interest in human sexual behavior, partly because of the growing AIDS pandemic. We undertook a study of the pattern of sexual behavior among outpatients attending our dermatology clinic. Sexually active patients attending the ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
... A clinical study of vulval lichen sclerosus at a tertiary care hospital in South India Nidhi ... more ... A clinical study of vulval lichen sclerosus at a tertiary care hospital in South India Nidhi Singh 1 , Devinder Mohan Thappa 1 , Telanseri J Jaisankar 1 , Syed Habeebullah 2 1 Department of Dermatology and STD ... [1] Women complain of intractable pruritus (worse at night), [1],[15 ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
Prostitution describes sexual intercourse in exchange for remuneration. The legal status of prost... more Prostitution describes sexual intercourse in exchange for remuneration. The legal status of prostitution varies in different countries, from punishable by death to complete legality. The great degree of social stigma associated with prostitution, of both buyers and sellers, has lead to ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2008
Homosexuality can be described as the orientation and inclination of a person to have sexual rela... more Homosexuality can be described as the orientation and inclination of a person to have sexual relations with a person of his or her own sex. The clustering of Acquired immune deficiency syndrome (AIDS) cases among male homosexuals in the initial phase of the HIV epidemic in the ...
Indian Journal of Sexually Transmitted Diseases and AIDS, 2007
A 25-year-old married woman presented with swelling of vulva with oozing of watery fluid from vul... more A 25-year-old married woman presented with swelling of vulva with oozing of watery fluid from vulval skin surface for the past 8 years. She also complained of swelling in the inguinal region (occasionally painful) on both sides for the past 8 years. Local genital examination ...
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