MyMedR

Fulltext Pilomatricoma as a diagnostic pitfall in clinical practice: report of two cases and review of literature

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.

Fulltext Myeloma Associated Primary Systemic Amyloidosis

Kamal WS, Taib T, Noor NM, Jong TJ

Indian J Dermatol, 2016 Jan-Feb;61(1):124.

PMID: 26955151 DOI: 10.4103/0019-5154.174166

Fulltext Solitary Ulcerated Congenital Giant Juvenile Xanthogranuloma

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.

Fulltext Blau Syndrome Associated with Nucleotide-binding Oligomerization Domain Containing 2 Mutation in a Baby from Malaysia

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.

THE SUNGEI BULOH LEPROSARIUM

JOHN JC

Indian J Dermatol, 1965 Jan;10:62-4.

PMID: 14266440

Fulltext Widespread Indurated Plaques and Nodules

Yap E, Lee S, Tey KE, Choon SE

Indian J Dermatol, 2017 6 7;62(3):325-327.

PMID: 28584382 DOI: 10.4103/ijd.IJD_597_16

Fulltext The Effects of Acitretin on Insulin Resistance, Glucose Metabolism, and Lipid Levels in Patients with Psoriasis

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.

Juvenile Pityriasis Rubra Pilaris in a 4-year-old Child Treated Successfully with Secukinumab

Albela H, Lee WQ, Nordin SN, Gopinathan LP, A Ramli MN, Leong KF

Indian J Dermatol, 2022;67(5):601-603.

PMID: 36865822 DOI: 10.4103/ijd.ijd_1079_21

Fulltext Coronavirus Disease of 2019 (COVID-19) Facts and Figures: What Every Dermatologist Should Know at this Hour of Need

Manchanda Y, Das S, De A

Indian J Dermatol, 2020;65(4):251-258.

PMID: 32831363 DOI: 10.4103/ijd.IJD_360_20

Coronavirus disease of 2019 (COVID-19) pandemic has affected India and the world as a whole, like nothing in the recent history and we, dermatologists, are also affected directly or indirectly. In this review, we have tried to address the COVID-19-related information we need to be aware of as a health-care professional. We have discussed the relevant details of the disease: the agent, the symptomatology, common preventive measures, investigations, and management outline. We have also discussed the implications of COVID-19 in dermatology practice and given a basic guideline for dermatology practice during the pandemic.

Fulltext Genital Psoriasis: A Prospective, Observational, Single-Centre Study on Prevalence, Clinical Features, Risk Factors, and Its Impact on Quality of Life and Sexual Health

Yi OS, Huan KY, Har LC, Ali NM, Chiang TW

Indian J Dermatol, 2022;67(2):205.

PMID: 36092244 DOI: 10.4103/ijd.ijd_754_21

BACKGROUND: Genital psoriasis is often under-recognized and the exact burden is unknown in Malaysia.

OBJECTIVES: To identify the prevalence of genital psoriasis, its clinical features, risk factors, and impact on quality of life and sexual health.

METHODS: This prospective, observational study was conducted in the dermatology clinic of our hospital from 1st September 2020 until 31st March 2021, involving all adult patients with psoriasis. The genital examination was performed and the subjects were interviewed using questionnaires.

RESULTS: A total of 262 patients were recruited, with a male to female ratio of 1.5:1 (mean age of 51 years old). They comprised 42.0% Chinese, followed by 36.6% of Malay, 21.4% of Indians and others. Up to 46.1% of patients had a current or history of genital psoriasis. The most common area involved for males was the scrotum (44.1%) and labia majora (62.5%) for female patients. Itching (79.2%) was the most frequent symptom encountered. Chinese patients had 2.67 times odd (CI 1.55-4.61) of having genital psoriasis compared to non-Chinese patients. Other independent risk factors included flexural involvement, male gender, and Type 1 psoriasis. Genital psoriasis was associated with greater impairment on quality of life and sexual health (mean total Dermatology Life Quality Index: 8.8 vs 6.5, P = 0.006), International Index of Erectile Function (mean: 48.5 vs 57.0, P = 0.011) and revised version of Female Sexual Distress Scales (mean: 20.7 vs 11.4, P = 0.022).

CONCLUSIONS: Genital psoriasis is common and it has a profound impact on patients.

Fulltext Autologous Serum Therapy in Recalcitrant Chronic Spontaneous Urticaria: Experience from Three Dermatology Clinics in Malaysia

Ting Pao Lin I, Ghazali NI, Teo Y, Lai SL, Bakhtiar MF, Tang MM

Indian J Dermatol, 2024;69(5):406-410.

PMID: 39649968 DOI: 10.4103/ijd.ijd_172_24

Autohemotherapy is a commonly used treatment for recalcitrant chronic urticaria in some countries. Herein we report our experience using autologous serum therapy in eight patients with recalcitrant chronic spontaneous urticaria. Autologous serum therapy was initiated weekly for nine weeks followed by every fortnightly. Urticaria Activity Score (UAS) 7, Dermatology Life Quality Index (DLQI), and reduction of antihistamine usage were used to assess the treatment response. Eight patients (age range: 25-76 years old; four females and four males) had one to ten years of duration of recalcitrant chronic spontaneous urticaria. All failed to respond to high doses of second-generation antihistamines and five to immune-modulating agents. Three did not respond to omalizumab. At week nine, the reduction of UAS7 ranged from 76.2% to 100%. There was more than an 80% improvement in DLQI in all patients. The number of wheals seemed to be reduced first followed by pruritus. Three patients had stopped antihistamines by week eight of treatment. No adverse events were reported in all eight patients. Autologous serum therapy may serve as an alternative treatment for recalcitrant chronic spontaneous urticaria. Apart from the practicality, which requires frequent clinic visits, venipuncture, and centrifugation, it is cheap and effective with minimal adverse events.

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