Searching symptoms on the internet and self-diagnosis is being criticized for its uncertainty in the diagnosis. However, it may help the patient and the doctor in the diagnosis and management of a disease. In this article, we present a case where the use of smartphone and internet search helped the patient and the doctor in the initial management and diagnosis of paederus dermatitis. A 34-year-old male, an urban inhabitant, noticed pain on the right side of his neck while he was sleeping at night. He woke up and noticed a beetle on his pillow. As the beetle was an unfamiliar one, he took pictures on his smartphone and searched about the beetle on the internet. From the results, he identified the beetle as “Nairobi fly,” self-diagnosed it as “paederus dermatitis,” and washed the area with soap and water to remove vesicant secreted by the beetle. Next day morning, he presented with severe pain and mild erythema on the right side of the neck. The diagnosis becomes obvious from the images shown by the patient. The patient was treated with a topical steroid and oral antihistaminic for 7 days. The patient recovered from dermatitis on the 10th day.
{"title":"How internet search and patient's self-diagnosis helped in the management of a case of paederus dermatitis","authors":"Shaikat Mondal, Himel Mondal","doi":"10.4103/jdds.jdds_40_19","DOIUrl":"https://doi.org/10.4103/jdds.jdds_40_19","url":null,"abstract":"Searching symptoms on the internet and self-diagnosis is being criticized for its uncertainty in the diagnosis. However, it may help the patient and the doctor in the diagnosis and management of a disease. In this article, we present a case where the use of smartphone and internet search helped the patient and the doctor in the initial management and diagnosis of paederus dermatitis. A 34-year-old male, an urban inhabitant, noticed pain on the right side of his neck while he was sleeping at night. He woke up and noticed a beetle on his pillow. As the beetle was an unfamiliar one, he took pictures on his smartphone and searched about the beetle on the internet. From the results, he identified the beetle as “Nairobi fly,” self-diagnosed it as “paederus dermatitis,” and washed the area with soap and water to remove vesicant secreted by the beetle. Next day morning, he presented with severe pain and mild erythema on the right side of the neck. The diagnosis becomes obvious from the images shown by the patient. The patient was treated with a topical steroid and oral antihistaminic for 7 days. The patient recovered from dermatitis on the 10th day.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"76 1","pages":"32 - 34"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86259798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.4103/jdds.jdds_109_20
Maya Firsowicz, T. Willenbrink, Nova Shu, J. Reichenberg
Pityriasis amiantacea (PA) is a scalp condition characterized by thick, adherent scales that are silvery or yellow–gray in color and bind down tufts of hair. PA is associated with several underlying dermatologic conditions including psoriasis, seborrheic dermatitis, atopic dermatitis, tinea capitis, pityriasis rosea, and Darier's disease. Although there is no consensus on standard treatment, PA is generally treated with keratolytic agents and/or ketoconazole shampoo. More resistant cases may require systemic therapies, including tumor necrosis factor-alpha inhibitors. We report a case of a 57-year-old female with severe PA resistant to numerous treatments including topical steroids, salicylic acid shampoo, intralesional steroid injections, mycophenolate mofetil, adalimumab, and apremilast. Following treatment with dupilumab, our patient experienced complete resolution of her PA. These results suggest that dupilumab may have in a role in the management of treatment-resistant PA, particularly when associated with eczematous dermatitis.
{"title":"Successful use of dupilumab for treatment-resistant pityriasis amiantacea","authors":"Maya Firsowicz, T. Willenbrink, Nova Shu, J. Reichenberg","doi":"10.4103/jdds.jdds_109_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_109_20","url":null,"abstract":"Pityriasis amiantacea (PA) is a scalp condition characterized by thick, adherent scales that are silvery or yellow–gray in color and bind down tufts of hair. PA is associated with several underlying dermatologic conditions including psoriasis, seborrheic dermatitis, atopic dermatitis, tinea capitis, pityriasis rosea, and Darier's disease. Although there is no consensus on standard treatment, PA is generally treated with keratolytic agents and/or ketoconazole shampoo. More resistant cases may require systemic therapies, including tumor necrosis factor-alpha inhibitors. We report a case of a 57-year-old female with severe PA resistant to numerous treatments including topical steroids, salicylic acid shampoo, intralesional steroid injections, mycophenolate mofetil, adalimumab, and apremilast. Following treatment with dupilumab, our patient experienced complete resolution of her PA. These results suggest that dupilumab may have in a role in the management of treatment-resistant PA, particularly when associated with eczematous dermatitis.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"26 1","pages":"3 - 4"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77298337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tomar, B. Supekar, Ravi Bhushan, J. Mukhi, R. Singh, D. Bhat, Abhisek Jaiswal
Porocarcinoma is a malignant tumor arising from intraepidermal eccrine duct epithelium or acrosyringium with an aggressive course. Sites of predilection include lower extremities (50%), trunk (24%), and head and neck (24%), while it is uncommon in the upper extremities and genitals. We report a case of eccrine porocarcinoma in the axillary region with axillary lymph node involvement and pulmonary metastasis in a 78-year-old male.
{"title":"Eccrine porocarcinoma at unusual location","authors":"S. Tomar, B. Supekar, Ravi Bhushan, J. Mukhi, R. Singh, D. Bhat, Abhisek Jaiswal","doi":"10.4103/jdds.jdds_40_21","DOIUrl":"https://doi.org/10.4103/jdds.jdds_40_21","url":null,"abstract":"Porocarcinoma is a malignant tumor arising from intraepidermal eccrine duct epithelium or acrosyringium with an aggressive course. Sites of predilection include lower extremities (50%), trunk (24%), and head and neck (24%), while it is uncommon in the upper extremities and genitals. We report a case of eccrine porocarcinoma in the axillary region with axillary lymph node involvement and pulmonary metastasis in a 78-year-old male.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"19 1","pages":"15 - 18"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85936917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ajeet Singh, R. Arora, Satyaki Ganguly, R. Satarkar
Lethal midline granuloma is a rare aggressive, mutilating disorder of the upper airways. It is most likely secondary to natural killer/T-cell lymphoma and is difficult to diagnose owing to the varied and nonspecific symptoms. It is usually prevalent in the fourth decade of life and carries a poor prognosis. Our patient was a 19-year-old male with disease duration of 3 months, was diagnosed with lethal midline granuloma based on clinical examination, histopathology, and immunohistochemistry. The patient responded well to the first cycle of chemotherapy.
{"title":"A rare case of lethal midline granuloma posing a diagnostic challenge in COVID times and the response to chemotherapy","authors":"Ajeet Singh, R. Arora, Satyaki Ganguly, R. Satarkar","doi":"10.4103/jdds.jdds_56_21","DOIUrl":"https://doi.org/10.4103/jdds.jdds_56_21","url":null,"abstract":"Lethal midline granuloma is a rare aggressive, mutilating disorder of the upper airways. It is most likely secondary to natural killer/T-cell lymphoma and is difficult to diagnose owing to the varied and nonspecific symptoms. It is usually prevalent in the fourth decade of life and carries a poor prognosis. Our patient was a 19-year-old male with disease duration of 3 months, was diagnosed with lethal midline granuloma based on clinical examination, histopathology, and immunohistochemistry. The patient responded well to the first cycle of chemotherapy.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"os-24 1","pages":"23 - 25"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87038538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.4103/jdds.jdds_108_20
S. Desai, H. Pathave, Abigail Syiemlieh, C. Nayak
Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma. It is triggered by hyperlipidemia, thyroid dysfunction, and diabetes mellitus. Madarosis, loss of eyebrows, occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Herein, we present a case of giant XP in a middle-aged female in whom bilateral partial madarosis developed. In polarized contact dermoscopy, the number of hairs on xanthoma plaque was reduced compared to normal.
{"title":"Madarosis in a normolipidemic woman: Is giant xanthelasma palpebrarum the culprit?","authors":"S. Desai, H. Pathave, Abigail Syiemlieh, C. Nayak","doi":"10.4103/jdds.jdds_108_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_108_20","url":null,"abstract":"Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma. It is triggered by hyperlipidemia, thyroid dysfunction, and diabetes mellitus. Madarosis, loss of eyebrows, occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Herein, we present a case of giant XP in a middle-aged female in whom bilateral partial madarosis developed. In polarized contact dermoscopy, the number of hairs on xanthoma plaque was reduced compared to normal.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"10 1","pages":"5 - 7"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78541593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lichenoid drug reaction is a cutaneous drug eruption due to a Type IV delayed hypersensitivity reaction. It usually occurs months to years following the intake of the drug and is characterized by purple, flat, polygonal papules that spread symmetrically and diffusely across the body. We report the case of a 26-year-old female, who was on chlordiazepoxide for the treatment of insomnia, and presented with multiple, annular, purple, scaly, itchy plaques over her breasts. The eruption progressed to involve the thighs and buccal mucosa and did not respond to topical antifungals. Skin biopsy revealed lichenoid lymphocytic infiltrate consistent with lichen planus. After discontinuation of chlordiazepoxide, her skin eruption significantly improved within 3 months. To our knowledge, this is the first case report of a patient who developed a lichenoid drug reaction to chlordiazepoxide.
{"title":"Lichenoid drug eruption induced by chlordiazepoxide","authors":"Osamah Alkhuzaim","doi":"10.4103/jdds.jdds_35_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_35_20","url":null,"abstract":"Lichenoid drug reaction is a cutaneous drug eruption due to a Type IV delayed hypersensitivity reaction. It usually occurs months to years following the intake of the drug and is characterized by purple, flat, polygonal papules that spread symmetrically and diffusely across the body. We report the case of a 26-year-old female, who was on chlordiazepoxide for the treatment of insomnia, and presented with multiple, annular, purple, scaly, itchy plaques over her breasts. The eruption progressed to involve the thighs and buccal mucosa and did not respond to topical antifungals. Skin biopsy revealed lichenoid lymphocytic infiltrate consistent with lichen planus. After discontinuation of chlordiazepoxide, her skin eruption significantly improved within 3 months. To our knowledge, this is the first case report of a patient who developed a lichenoid drug reaction to chlordiazepoxide.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"68 1","pages":"29 - 31"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78981292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.4103/jdds.jdds_142_20
S. Nayak, Shukriti Shenoi, S. Prabhu, R. Rao
Koebner phenomenon (KP) or isomorphic phenomenon often helps in diagnosis of certain conditions and often reflects disease activity. Although commonly reported with psoriasis, vitiligo, and lichen planus, KP has been occasional reported with other conditions. Bullous pemphigoid has a rare association with this and we report a case with scratching being the inciting factor. A 50-year-old female with no comorbidities presented with itchy fluid-filled lesions all over the body for 15 days. Examination showed generalized distribution of bullae and vesicles with linear bulla on the forearms. Histopathology and immunofluorescence studies were conclusive of bullous pemphigoid. KP has been reported in general due to mechanical trauma, therapy, dermatoses, or reactions. KP in bullous pemphigoid is rarely reported and it is mentioned in the category IV of Boyd and Nelder classification. The linear nature of bulla in our patient was suggestive of scratching being the inciting factor for KP, which has not been reported to the best of our knowledge.
{"title":"Bullous pemphigoid: Associating with the multifaceted phenomenon of koebner","authors":"S. Nayak, Shukriti Shenoi, S. Prabhu, R. Rao","doi":"10.4103/jdds.jdds_142_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_142_20","url":null,"abstract":"Koebner phenomenon (KP) or isomorphic phenomenon often helps in diagnosis of certain conditions and often reflects disease activity. Although commonly reported with psoriasis, vitiligo, and lichen planus, KP has been occasional reported with other conditions. Bullous pemphigoid has a rare association with this and we report a case with scratching being the inciting factor. A 50-year-old female with no comorbidities presented with itchy fluid-filled lesions all over the body for 15 days. Examination showed generalized distribution of bullae and vesicles with linear bulla on the forearms. Histopathology and immunofluorescence studies were conclusive of bullous pemphigoid. KP has been reported in general due to mechanical trauma, therapy, dermatoses, or reactions. KP in bullous pemphigoid is rarely reported and it is mentioned in the category IV of Boyd and Nelder classification. The linear nature of bulla in our patient was suggestive of scratching being the inciting factor for KP, which has not been reported to the best of our knowledge.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"1 1","pages":"19 - 20"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89903630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.4103/jdds.jdds_138_20
Lama Altawil, Nojoud Alajroush
Coronavirus disease 2019 (COVID-19) has many cutaneous manifestations. We describe a 30-year-old otherwise healthy male with a generalized purpuric exanthem. Ten days after the onset of the rash, he presented with fatigue, dry cough, shortness of breath, anosmia, and ageusia and was diagnosed as having COVID-19. The presence of an extensive exanthem in an otherwise healthy patient could raise suspicion for underlying COVID-19.
{"title":"Generalized exanthem as a presenting symptom of COVID-19","authors":"Lama Altawil, Nojoud Alajroush","doi":"10.4103/jdds.jdds_138_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_138_20","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has many cutaneous manifestations. We describe a 30-year-old otherwise healthy male with a generalized purpuric exanthem. Ten days after the onset of the rash, he presented with fatigue, dry cough, shortness of breath, anosmia, and ageusia and was diagnosed as having COVID-19. The presence of an extensive exanthem in an otherwise healthy patient could raise suspicion for underlying COVID-19.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"1 1","pages":"21 - 22"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84163322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Connective tissue nevi (CTN) are hamartomas consisting of the various components of the dermal connective tissue. The predominant element of the extracellular connective tissue within an individual nevus can be collagen, elastic fibers, or glycosaminoglycans. Those predominantly composed of collagen are called collagenomas. CTN can be classified as congenital or acquired, and independent or in association with a systemic disease. Collagenomas are asymptomatic and can be seen over the trunk, arm, thigh, and soles. We present the case of an 18-year-old boy with an isolated collagenoma over the lower back.
{"title":"Nonfamilial isolated collagenoma","authors":"F. Taj, Dilsha Shareef","doi":"10.4103/jdds.jdds_2_20","DOIUrl":"https://doi.org/10.4103/jdds.jdds_2_20","url":null,"abstract":"Connective tissue nevi (CTN) are hamartomas consisting of the various components of the dermal connective tissue. The predominant element of the extracellular connective tissue within an individual nevus can be collagen, elastic fibers, or glycosaminoglycans. Those predominantly composed of collagen are called collagenomas. CTN can be classified as congenital or acquired, and independent or in association with a systemic disease. Collagenomas are asymptomatic and can be seen over the trunk, arm, thigh, and soles. We present the case of an 18-year-old boy with an isolated collagenoma over the lower back.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"116 1","pages":"35 - 37"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78286533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raghad Alharthi, Fatimah S. Alowirdi, Saba Alsuhaymi, Mohammed Alqahtani, Afaf Alsheikh
Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. Alopecia universalis (AU) is the advanced form of AA characterized by complete scalp and body hair loss. Traditional medical therapies for AA include topical and intralesional corticosteroids, topical anthralin immunotherapy, and light therapy. Tofacitinib is a Janus kinase-1 and 3 inhibitor used in the treatment of AA. In this report, we describe a 20-year-old female with AU refractory to topical therapies; thus, she was started on tofacitinib. Mild peripheral neuropathy was an unanticipated side effect that could be kept into consideration.
{"title":"Peripheral neuropathy associated with tofacitinib use in alopecia universalis","authors":"Raghad Alharthi, Fatimah S. Alowirdi, Saba Alsuhaymi, Mohammed Alqahtani, Afaf Alsheikh","doi":"10.4103/jdds.jdds_69_19","DOIUrl":"https://doi.org/10.4103/jdds.jdds_69_19","url":null,"abstract":"Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. Alopecia universalis (AU) is the advanced form of AA characterized by complete scalp and body hair loss. Traditional medical therapies for AA include topical and intralesional corticosteroids, topical anthralin immunotherapy, and light therapy. Tofacitinib is a Janus kinase-1 and 3 inhibitor used in the treatment of AA. In this report, we describe a 20-year-old female with AU refractory to topical therapies; thus, she was started on tofacitinib. Mild peripheral neuropathy was an unanticipated side effect that could be kept into consideration.","PeriodicalId":15535,"journal":{"name":"Journal of Dermatology and Dermatologic Surgery","volume":"13 1","pages":"48 - 50"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90433659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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