In this preliminary open study, azathioprine in weekly pulse doses has been found to be effective without any serious adverse effects in the treatment of parthenium dermatitis. The cost of therapy with this regimen is reduced by 60%.
Pigmented purpuric dermatoses (PPD) are chronic, asymptomatic dermatoses characterized by petechiae, pigmentation and rarely telangiectasias. Familial occurrence of PPD is very rare. We report four individuals in a family over three generations. The inheritance is suggestive of an autosomal dominant pattern.
Our aim was to evaluate the usefulness of TROLAB photopatch test series (supplemented with the plant extracts). 70 patients with dermatitis on photoexposed areas or dermatitis with photosensitivity were studied. Only 2 patients had photocontact allergy - 1 each to fragrance mix 8% and p-aminobenzoic acid 10%. Photocontact allergy to parthenium was seen in 4 and photoaggravation in 6 patients. Our results suggest that the TROLAB photopatch series are not useful for Indian patients with photodematoses.
Cutaneous tuberculosis shows wide clinical variation depending upon the virulence of the organism and host immunity. Tuberculids are difficult to diagnose since the organism often cannot be identified or isolated by microscopy, culture or polymerase chain reaction. The diagnosis rests primarily on the identification of a tuberculous focus elsewhere in the body and response to antitubercular therapy. We present the clinicopathological features of an unusual tuberculid in a 30-year-old man, remarkably mimicking Kyrle's disease. He presented with multiple, symmetrically distributed follicular and perifollicular verrucous papules, nodules and plaques on the face, earlobes and extremities since 4 years. Histopathology revealed parakeratotic follicular plug invaginating into the dermis with multiple caseating epithelioid cell granulomas. PCR for M. tuberculosis was negative. The identification of associated axillary tubercular lymphadenitis, strongly positive Mantoux reaction, tuberculoid granulomas on histopathology and complete resolution of the lesions with antitubercular therapy helped in making the diagnosis. We propose the term "verrucous tuberculid" for this entity.
Twenty nail dystrophy (TND) is a manifestation of several dermatoses and its association with vitiligo is rare. It may be consequent upon a common autoimmune insult to the melanocytes and the nail matrix. We report a patient of acrofacial vitiligo who developed TND. Nail matrix biopsy revealed focal lichenoid reaction and chronic inflammatory infiltrate in the dermal papillae and around blood vessels. Hematological, biochemical and serological investigations showed no evidence of other autoimmune diseases.
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