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  1. Sachdev SS, Jamil A, Gunabalasingam P, Safdar NA
    Indian J Dermatol, 2022;67(4):349-354.
    PMID: 36578705 DOI: 10.4103/ijd.ijd_328_21
    CONTEXT: Acitretin increases serum lipids. Data on its effects on insulin resistance and glucose metabolism are sparse and contradicting.

    AIMS: The aim of this study is to investigate the effects of acitretin on insulin resistance, glucose metabolism, and lipids.

    METHODS: Dermatology clinic in a public tertiary hospital. A cross sectional study involving chronic plaques psoriasis patients on acitretin plus topical therapy or topical therapy alone was performed. Fasting blood glucose (FBG), serum lipids, serum insulin, and glucose tolerance test (GTT) were performed. Homeostatic model of insulin resistance (HOMA-IR) was calculated. Psoriasis severity was evaluated using Psoriasis Area and Severity Index. Chi square and t-tests determined differences between cases and controls. Pearson's correlation coefficient test determined the relationship between continuous variables.

    RESULTS: A total of 60 patients participated, 30 were on acitretin while 30 were on topical therapy. Psoriasis duration, disease severity, BMI, presence of metabolic syndrome, and other comorbidities between the two groups were similar. There were no significant differences in GTT, FBG, HOMA-IR, and serum lipids. Patients on acitretin >25 mg daily had lower FBG [4.4 (0.8) versus 4.9 (0.9), P = 0.04] and triglyceride [1.05 (0.33) versus 1.57 (1.03), P = 0.02] compared with doses ≤25 mg. Higher acitretin dose correlated with lower FBG (r = -0.36, P = 0.05) and triglycerides (r = -0.37, P = 0.05) while longer therapy duration correlated with lower total cholesterol (r = -0.37, P = 0.05). HOMA-IR showed inverse correlation with acitretin dose and duration (r = -0.10, P = 0.61 and r = -0.12, P = 0.53, respectively).

    CONCLUSION: Acitretin therapy resulted in increased triglyceride. The effect of acitretin on glucose metabolism and insulin resistance maybe dependent on the dose and duration of therapy.

  2. Leong KF, Sato R, Oh GGK, Surana U, Pramono ZAD
    Indian J Dermatol, 2019 9 24;64(5):400-403.
    PMID: 31543536 DOI: 10.4103/ijd.IJD_44_18
    Blau syndrome (BS) is a very rare autosomal dominant juvenile inflammatory disorder caused by mutation in nucleotide-binding oligomerization domain containing 2 (NOD2). Usually, dermatitis is the first symptom that appears in the 1st year of life. About 220 BS cases with confirmed NOD2 mutation have been reported. However, the rarity and lack of awareness of the disease, especially in the regions where genetic tests are very limited, often result in late diagnosis and misdiagnosis. Here, we report a de novo BS case from Malaysia, which may be the first report from southeast Asia. PCR and DNA sequencing of peripheral blood mononuclear cells were performed to screen the entire coding region of NOD2 gene. A heterozygous c.1000C>T transition in exon 4, p. R334W, of the NOD2 gene was identified in the patient. This report further reaffirms the ubiquitousness of the disease and recurrency of p. R334W mutation.
  3. Ng SY
    Indian J Dermatol, 2015 Jul-Aug;60(4):420.
    PMID: 26288431 DOI: 10.4103/0019-5154.160515
    A 3-month-old female patient with a giant ulcerated nodule over the back since birth was diagnosed as congenital giant juvenile xanthogranuloma (JXG) based on clinical and histopathological examination. Congenital giant JXG with ulceration at birth is a rare presentation of JXG and commonly misdiagnosed. This case emphasizes the importance of being aware of the myriad presentations of JXG in order to make a correct diagnosis and avoid unnecessary investigations or treatment.
  4. Pant I, Joshi SC, Kaur G, Kumar G
    Indian J Dermatol, 2010 Oct;55(4):390-2.
    PMID: 21430899 DOI: 10.4103/0019-5154.74566
    Pilomatricoma (PMC) is a relatively uncommon benign skin neoplasm arising from the skin adnexa. Since the first description of PMC in 1880, there has been a gradual increase in understanding of the morphologic features and clinical presentation of this tumor. However, difficulties still persist in making clinical and cytologic diagnosis. We report the clinical and histopathological findings of two cases of pilomatricoma. In case 1, a 10-year-old girl presented with a right upper back mass. In case 2, a nine-year-old girl presented with a left ear lobe mass. The clinical findings in both the cases were suggestive of epidermoid/dermoid cyst. However, subsequent histopathologic examination confirmed these cases as pilomatricoma. This report reveals that pilomatricoma is a frequently misdiagnosed entity in clinical practice. The purpose of this article is to create awareness among clinicians on the possibility of pilomatricoma as a cause of solitary skin nodules, especially those on the head, neck or upper extremities.
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