A. Mittal, Rini Makhija, M. Meena, Manisha Balai, Lalit Kumar Gupta, S. Mehta
Pemphigus is a potentially life-threatening autoimmune blistering disease which characteristically affects skin and mucosae. Pulse therapy for the treatment of pemphigus has been in vogue for several years and considered better than conventional corticosteroids. This study was conducted to evaluate the efficacy and safety of pulse therapy in pemphigus patients treated over a period of 10 years. This retrospective study was based on medical records of Pemphigus patients treated at Department of Dermatology from January 2008 to December 2017. Diagnosis of pemphigus was made on clinical ground, Tzanck smear and histopathology of skin/mucous membrane lesions. Patients were put on DCP/DAP depending on the completion of family. A total of 124 patients were included in the study. Age of patients ranged from 18 years to 72 years with mean of 41.21±12.71 years. Amongst 124 patients, 114 (92%) had pemphigus vulgaris and 10 (8%) had pemphigus foliaceous. 89 patients received DCP and 35 patients received DAP therapy. Number of pulses received by patients in phase I ranged from 4 to 27, average being 8.16±4.63. 106 patients completed the phase I of which 83 completed the phase II. 54 patients had successfully completed phase III of which 22 are currently in phase IV and 28 patients have completed their five year follow up period and considered as cured. Pulse therapy is a cheap and easily available mode of therapy in treatment of pemphigus in India even in the present era of modern molecules like Rituximab. With pulse therapy, it is now possible to induce and maintain remission, and achieve cure, provided the patients strictly adhere to the prescribed schedule.
{"title":"Pulse Therapy in Rituximab Era: A Retrospective Study of 124 Patients of Pemphigus from a Tertiary Care Center of South Rajasthan","authors":"A. Mittal, Rini Makhija, M. Meena, Manisha Balai, Lalit Kumar Gupta, S. Mehta","doi":"10.4103/cdr.cdr_21_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_21_23","url":null,"abstract":"\u0000 \u0000 \u0000 Pemphigus is a potentially life-threatening autoimmune blistering disease which characteristically affects skin and mucosae. Pulse therapy for the treatment of pemphigus has been in vogue for several years and considered better than conventional corticosteroids.\u0000 \u0000 \u0000 \u0000 This study was conducted to evaluate the efficacy and safety of pulse therapy in pemphigus patients treated over a period of 10 years.\u0000 \u0000 \u0000 \u0000 This retrospective study was based on medical records of Pemphigus patients treated at Department of Dermatology from January 2008 to December 2017. Diagnosis of pemphigus was made on clinical ground, Tzanck smear and histopathology of skin/mucous membrane lesions. Patients were put on DCP/DAP depending on the completion of family.\u0000 \u0000 \u0000 \u0000 A total of 124 patients were included in the study. Age of patients ranged from 18 years to 72 years with mean of 41.21±12.71 years. Amongst 124 patients, 114 (92%) had pemphigus vulgaris and 10 (8%) had pemphigus foliaceous. 89 patients received DCP and 35 patients received DAP therapy. Number of pulses received by patients in phase I ranged from 4 to 27, average being 8.16±4.63. 106 patients completed the phase I of which 83 completed the phase II. 54 patients had successfully completed phase III of which 22 are currently in phase IV and 28 patients have completed their five year follow up period and considered as cured.\u0000 \u0000 \u0000 \u0000 Pulse therapy is a cheap and easily available mode of therapy in treatment of pemphigus in India even in the present era of modern molecules like Rituximab. With pulse therapy, it is now possible to induce and maintain remission, and achieve cure, provided the patients strictly adhere to the prescribed schedule.\u0000","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689079","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}
Ekalavya Bilkhiwal, Arun C Inamadar, Ajit B Janagond
Nail examination plays a critical role in dermatologic conditions. Children with nail changes involve fewer physician consultations. Nail signs in early childhood can indicate the presence of a syndrome or underlying systemic disorder. The aim of the study was to investigate the frequency of nail findings in patients under 5 years of age. The study involved 368 pediatric patients under the age of 5 years. It was an observational study conducted in dermatology, obstetrics and gynecology, and pediatric departments. A Dermlite handyscope FFH2 (×10 zoom) was used to magnify visible nail changes during a comprehensive nail examination. Out of 368 cases, 213 were male and 155 were female. The average age of the patients was 22.74 months (range: 0–60). Nail findings were observed in 130 (35.3%) patients. In the study, single nail changes were observed in 123 (33.42%), whereas multiple nail changes were seen in 5 (1.35%) patients. The most common clinical nail finding was white striations in 60 (16.3%) cases, followed by punctate leukonychia in 21 (5.7%), onychoschizia in 13 (3.5%), pseudohypertrophy of the hallux in 12 (3.3%), koilonychia in 7 (1.9%), Beau’s lines in 3 (0.8%), and subungual hematoma in 3 (0.8%) cases. Median canaliform nail dystrophy, Muehrcke’s lines, onychophagia, and pitting were found in only one case each (0.3%). Physiological nail findings were more prevalent than pathological ones. The use of an onychoscope facilitated a more precise identification of nail changes by highlighting their features.
{"title":"Clinical and Onychoscopic Nail Findings in Preschool Children: An Observational Study","authors":"Ekalavya Bilkhiwal, Arun C Inamadar, Ajit B Janagond","doi":"10.4103/cdr.cdr_56_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_56_23","url":null,"abstract":"\u0000 \u0000 \u0000 Nail examination plays a critical role in dermatologic conditions. Children with nail changes involve fewer physician consultations. Nail signs in early childhood can indicate the presence of a syndrome or underlying systemic disorder.\u0000 \u0000 \u0000 \u0000 The aim of the study was to investigate the frequency of nail findings in patients under 5 years of age.\u0000 \u0000 \u0000 \u0000 The study involved 368 pediatric patients under the age of 5 years. It was an observational study conducted in dermatology, obstetrics and gynecology, and pediatric departments. A Dermlite handyscope FFH2 (×10 zoom) was used to magnify visible nail changes during a comprehensive nail examination.\u0000 \u0000 \u0000 \u0000 Out of 368 cases, 213 were male and 155 were female. The average age of the patients was 22.74 months (range: 0–60). Nail findings were observed in 130 (35.3%) patients. In the study, single nail changes were observed in 123 (33.42%), whereas multiple nail changes were seen in 5 (1.35%) patients. The most common clinical nail finding was white striations in 60 (16.3%) cases, followed by punctate leukonychia in 21 (5.7%), onychoschizia in 13 (3.5%), pseudohypertrophy of the hallux in 12 (3.3%), koilonychia in 7 (1.9%), Beau’s lines in 3 (0.8%), and subungual hematoma in 3 (0.8%) cases. Median canaliform nail dystrophy, Muehrcke’s lines, onychophagia, and pitting were found in only one case each (0.3%).\u0000 \u0000 \u0000 \u0000 Physiological nail findings were more prevalent than pathological ones. The use of an onychoscope facilitated a more precise identification of nail changes by highlighting their features.\u0000","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844089","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. Murthy, Ullas Biradar, C. Raghuveer, Lakshmipathi Y Pattar
Scleredema is an uncommon fibromucinous connective tissue disease occurring frequently in adults but rarely in children. It is most commonly seen in postinfectious settings or linked to hematological disorders or diabetes. A 5-year-old male child presented with induration and thickening of the skin over the extremities, face, and neck. Clinical and histological features were consistent with scleredema. Various treatment modalities are available for scleredema. The patient responded well to systemic steroids. This case is being reported for its rare occurrence in young children.
{"title":"Scleredema in a Young Child: Response to Systemic Steroids","authors":"S. Murthy, Ullas Biradar, C. Raghuveer, Lakshmipathi Y Pattar","doi":"10.4103/cdr.cdr_70_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_70_23","url":null,"abstract":"\u0000 Scleredema is an uncommon fibromucinous connective tissue disease occurring frequently in adults but rarely in children. It is most commonly seen in postinfectious settings or linked to hematological disorders or diabetes. A 5-year-old male child presented with induration and thickening of the skin over the extremities, face, and neck. Clinical and histological features were consistent with scleredema. Various treatment modalities are available for scleredema. The patient responded well to systemic steroids. This case is being reported for its rare occurrence in young children.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715080","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}
Insects can cause a variety of dermatological problems ranging from asymptomatic cutaneous pigmentation to life threatening anaphylaxis. The pigmentation caused by burrowing bug, is oval to bizarre in shape, brown-black in colour, seen mainly over exposed areas. There are handful of case reports describing the dermoscopic features of Cydnidae pigmentation. We have tried to summarise all the literature available on clinical and dermoscopic details of Cydnidae pigmentation.
{"title":"Cydnidae Pigmentation: A Dermoscopic Case Series","authors":"Shipra Agrawal, Shilpi Sharma","doi":"10.4103/cdr.cdr_106_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_106_23","url":null,"abstract":"\u0000 Insects can cause a variety of dermatological problems ranging from asymptomatic cutaneous pigmentation to life threatening anaphylaxis. The pigmentation caused by burrowing bug, is oval to bizarre in shape, brown-black in colour, seen mainly over exposed areas. There are handful of case reports describing the dermoscopic features of Cydnidae pigmentation. We have tried to summarise all the literature available on clinical and dermoscopic details of Cydnidae pigmentation.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712648","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}
Itraconazole is an effective triazole antimycotic drug that has a desirable pharmacokinetic profile to combat various fungal pathogens. It acts by inhibiting ergosterol biosynthesis in fungal cell membranes. Itraconazole is not totally selective toward Cytochrome P450 family 3 subfamily A member 4 (CYP450 3A4), but exhibits the most potent inhibition of CYP450 3A4. Thus, these drugs interfere with CYP450 3A4 proteins expressed in the liver, intestine, kidney, adrenals, ovary, and testis. We present a case report of metrorrhagia and hematochezia following intake of itraconazole, a commonly used azole drug against dermatophytic infection. This article strongly highlights eliciting menstrual history and gynecological- and surgical-related problems before prescribing itraconazole. Also, to be aware of the vaginal bleeding being the unusual side effects of itraconazole.
{"title":"An Unusual Case Report of Iatrogenic Metrorrhagia and Hematochezia Following Itraconazole","authors":"Yashaswi Rai","doi":"10.4103/cdr.cdr_25_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_25_23","url":null,"abstract":"\u0000 Itraconazole is an effective triazole antimycotic drug that has a desirable pharmacokinetic profile to combat various fungal pathogens. It acts by inhibiting ergosterol biosynthesis in fungal cell membranes. Itraconazole is not totally selective toward Cytochrome P450 family 3 subfamily A member 4 (CYP450 3A4), but exhibits the most potent inhibition of CYP450 3A4. Thus, these drugs interfere with CYP450 3A4 proteins expressed in the liver, intestine, kidney, adrenals, ovary, and testis. We present a case report of metrorrhagia and hematochezia following intake of itraconazole, a commonly used azole drug against dermatophytic infection. This article strongly highlights eliciting menstrual history and gynecological- and surgical-related problems before prescribing itraconazole. Also, to be aware of the vaginal bleeding being the unusual side effects of itraconazole.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700774","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}
{"title":"Topical Tacrolimus and Pimecrolimus in Dermatology: An Overview","authors":"A. Bubna","doi":"10.4103/cdr.cdr_121_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_121_23","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705413","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}
Malignant disorders are a leading cause of mortality and morbidity. Cutaneous manifestations may be presenting features of internal malignancies, leading to diagnosis of occult tumors, while others may occur as adverse reactions to therapeutic modalities. To classify cutaneous manifestations among patients with malignant disorders, document their clinical profile, and analyze them with respect to age, gender, type of malignancy, and treatment. One hundred twenty patients with proven malignancy presenting with mucocutaneous lesions were enrolled in the cross-sectional study. On the basis of history, clinical examination, investigations and skin biopsy, the lesions were classified as (1) Primary cutaneous malignancy, (2) Cutaneous metastasis, (3) Paraneoplastic syndromes, (4) Mucocutaneous manifestations not related to malignancies, (5) Adverse effects secondary to treatment modalities. One hundred twenty patients comprised 70 females (58.3%) and 50 males (41.7%). They were categorized as primary cutaneous malignancy (20.2%), hematological malignancies (15%), solid organ malignancy (50.9%), and gastrointestinal malignancies (5%). HIV seropositivity was seen in two patients (1.6%). Maximum belonged to Category 5 (60, 50%), of which 52 (86.7%) were adverse effects of chemotherapy with single patient showing radiation dermatitis and one patient in Category 3 (0.8%). Eleven patients showed cutaneous metastasis (9.1%), predominantly carcinoma breast. Clinically, primary cutaneous malignancies often presented as ulceronodular growths with squamous cell carcinoma being the most common histopathological type (30%). Anagen effluvium was the most common (35%) manifestation overall and in solid organ malignancies followed by melanonychia (16, 13.33%), cutaneous xerosis (9, 7.5%), and mucocutaneous hyperpigmentation (23, 19.16%). Mucocutaneous manifestations need prompt attention to facilitate timely diagnosis and improved outcomes.
{"title":"Mucocutaneous Manifestations among Patients with Malignancies at a Tertiary Care Center in Maharashtra: A Cross-Sectional Study","authors":"S. Kachare, V. Belgaumkar, S. Pradhan","doi":"10.4103/cdr.cdr_84_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_84_22","url":null,"abstract":"\u0000 \u0000 \u0000 Malignant disorders are a leading cause of mortality and morbidity. Cutaneous manifestations may be presenting features of internal malignancies, leading to diagnosis of occult tumors, while others may occur as adverse reactions to therapeutic modalities.\u0000 \u0000 \u0000 \u0000 To classify cutaneous manifestations among patients with malignant disorders, document their clinical profile, and analyze them with respect to age, gender, type of malignancy, and treatment.\u0000 \u0000 \u0000 \u0000 One hundred twenty patients with proven malignancy presenting with mucocutaneous lesions were enrolled in the cross-sectional study. On the basis of history, clinical examination, investigations and skin biopsy, the lesions were classified as (1) Primary cutaneous malignancy, (2) Cutaneous metastasis, (3) Paraneoplastic syndromes, (4) Mucocutaneous manifestations not related to malignancies, (5) Adverse effects secondary to treatment modalities.\u0000 \u0000 \u0000 \u0000 One hundred twenty patients comprised 70 females (58.3%) and 50 males (41.7%). They were categorized as primary cutaneous malignancy (20.2%), hematological malignancies (15%), solid organ malignancy (50.9%), and gastrointestinal malignancies (5%). HIV seropositivity was seen in two patients (1.6%). Maximum belonged to Category 5 (60, 50%), of which 52 (86.7%) were adverse effects of chemotherapy with single patient showing radiation dermatitis and one patient in Category 3 (0.8%). Eleven patients showed cutaneous metastasis (9.1%), predominantly carcinoma breast. Clinically, primary cutaneous malignancies often presented as ulceronodular growths with squamous cell carcinoma being the most common histopathological type (30%). Anagen effluvium was the most common (35%) manifestation overall and in solid organ malignancies followed by melanonychia (16, 13.33%), cutaneous xerosis (9, 7.5%), and mucocutaneous hyperpigmentation (23, 19.16%).\u0000 \u0000 \u0000 \u0000 Mucocutaneous manifestations need prompt attention to facilitate timely diagnosis and improved outcomes.\u0000","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695784","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}
Zeynoire Anderson, A. Fotouhi, S. Tolliver, Darius Mehregan
Recently, there has been discussion to reclassify pediatric Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) as drug-induced epidermal necrolysis (DEN), separating it from infectious etiologies and redefining pediatric mucocutaneous eruptions as either reactive infectious mucocutaneous eruption (RIME) or DEN. In this report, we describe a previously healthy 4-year-old girl with rapidly progressive mucocutaneous blistering involving four mucosal membranes and 37.5% of total body surface area (BSA) following a prodromal rhinovirus and enterovirus infection. The symptoms occurred in the absence of an inciting medication and improved with only supportive care. This case illustrates a rare occurrence of RIME with TEN-like BSA involvement, prompting a review of the literature exploring the relationship between BSA involvement in RIME and its influence on patient outcomes. Findings support the proposed reclassification of SJS/TEN as DEN and postinfectious mucocutaneous eruptions as RIME.
最近，有人讨论将小儿史蒂文斯-约翰逊综合征/毒性表皮坏死症（SJS/TEN）重新归类为药物诱发表皮坏死症（DEN），将其与感染性病因分开，并将小儿粘膜糜烂重新定义为反应性感染性粘膜糜烂（RIME）或DEN。在本报告中，我们描述了一名原本健康的 4 岁女孩，在鼻病毒和肠道病毒感染前驱症状出现后，她的粘膜水疱迅速进展，累及四层粘膜，占体表总面积（BSA）的 37.5%。这些症状是在没有使用诱发药物的情况下出现的，并且仅通过支持性护理就得到了改善。该病例说明了一种罕见的 RIME，即 TEN 样 BSA 受累，这促使人们对文献进行回顾，探讨 RIME 中 BSA 受累之间的关系及其对患者预后的影响。研究结果支持将 SJS/TEN 重新分类为 DEN 和将感染后粘膜糜烂重新分类为 RIME 的建议。
{"title":"Reactive Infectious Mucocutaneous Eruption with Extensive Cutaneous Involvement","authors":"Zeynoire Anderson, A. Fotouhi, S. Tolliver, Darius Mehregan","doi":"10.4103/cdr.cdr_109_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_109_23","url":null,"abstract":"\u0000 Recently, there has been discussion to reclassify pediatric Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) as drug-induced epidermal necrolysis (DEN), separating it from infectious etiologies and redefining pediatric mucocutaneous eruptions as either reactive infectious mucocutaneous eruption (RIME) or DEN. In this report, we describe a previously healthy 4-year-old girl with rapidly progressive mucocutaneous blistering involving four mucosal membranes and 37.5% of total body surface area (BSA) following a prodromal rhinovirus and enterovirus infection. The symptoms occurred in the absence of an inciting medication and improved with only supportive care. This case illustrates a rare occurrence of RIME with TEN-like BSA involvement, prompting a review of the literature exploring the relationship between BSA involvement in RIME and its influence on patient outcomes. Findings support the proposed reclassification of SJS/TEN as DEN and postinfectious mucocutaneous eruptions as RIME.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694709","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}
Sebaceous carcinoma is a rare variety of malignant tumor involving sebaceous glands. Compared to its ocular counterpart, the extraocular variant is even more rare, accounting for only one-fourth of all cases. It is a great mimicker of a plethora of benign and malignant tumors, hence often misdiagnosed. Surgical excision is the preferred mode of treatment in most cases. Here, we present the case of a 72-year-old male with airborne-contact dermatitis who was initially misdiagnosed with acrochordon, which was later found to be a case of sebaceous carcinoma on histopathology. There is a paucity of literature regarding sebaceous gland carcinomas located outside the head-and-neck region, which makes this case even more interesting.
{"title":"Curious Case of Swelling over the Back: A Case Report of Sebaceous Cell Carcinoma in a Patient of Airborne Contact Dermatitis","authors":"Sonia Jain, Sangeeta Galui, Pratiksha Sonkusale","doi":"10.4103/cdr.cdr_123_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_123_23","url":null,"abstract":"\u0000 Sebaceous carcinoma is a rare variety of malignant tumor involving sebaceous glands. Compared to its ocular counterpart, the extraocular variant is even more rare, accounting for only one-fourth of all cases. It is a great mimicker of a plethora of benign and malignant tumors, hence often misdiagnosed. Surgical excision is the preferred mode of treatment in most cases. Here, we present the case of a 72-year-old male with airborne-contact dermatitis who was initially misdiagnosed with acrochordon, which was later found to be a case of sebaceous carcinoma on histopathology. There is a paucity of literature regarding sebaceous gland carcinomas located outside the head-and-neck region, which makes this case even more interesting.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709002","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}
IFNγ is a pleiotropic cytokine and through the regulation of immunologically relevant genes, they coordinate a wide range of cellular programs.[1] As a potent pro-inflammatory cytokine, it plays a pivotal role to induce depigmentation in vitiligo. In this study, we aim to assess the role of IFNγ in the activity, duration and extent of the disease and the antagonistic action of IL-10 is also assessed in vitiligo. A case-control study was conducted with 100 study participants with 50 cases clinically diagnosed as Vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). And blood investigations done were IFN-γ and IL-10. We observed significantly higher levels of serum IFNγ levels in the patient group when compared with those of the normal controls (p=0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (p=0.05) and VIDA score (p=<0.001). The mean serum IL-10 (p<0.001) in patients with vitiligo was significantly lower than that in the control group. This study showed significantly high serum levels of IFN-γ and correspondingly low levels of IL-10. New strategies, such as the combination of IFNγ blockade with inhibition of other signalling pathways, may further improve IFNγ targeted immunotherapy of the disease.
{"title":"Role of Serum IFN-γ and IL-10 as Predictive Biomarkers of Vitiligo Disease Activity: A Case-Control Study","authors":"Karishma Desai, H. Yadalla","doi":"10.4103/cdr.cdr_1_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_1_23","url":null,"abstract":"\u0000 \u0000 \u0000 IFNγ is a pleiotropic cytokine and through the regulation of immunologically relevant genes, they coordinate a wide range of cellular programs.[1] As a potent pro-inflammatory cytokine, it plays a pivotal role to induce depigmentation in vitiligo. In this study, we aim to assess the role of IFNγ in the activity, duration and extent of the disease and the antagonistic action of IL-10 is also assessed in vitiligo.\u0000 \u0000 \u0000 \u0000 A case-control study was conducted with 100 study participants with 50 cases clinically diagnosed as Vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). And blood investigations done were IFN-γ and IL-10.\u0000 \u0000 \u0000 \u0000 We observed significantly higher levels of serum IFNγ levels in the patient group when compared with those of the normal controls (p=0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (p=0.05) and VIDA score (p=<0.001). The mean serum IL-10 (p<0.001) in patients with vitiligo was significantly lower than that in the control group.\u0000 \u0000 \u0000 \u0000 This study showed significantly high serum levels of IFN-γ and correspondingly low levels of IL-10. New strategies, such as the combination of IFNγ blockade with inhibition of other signalling pathways, may further improve IFNγ targeted immunotherapy of the disease.\u0000","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713271","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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