Hyalohyphomycosis are opportunistic fungal infections caused by fungi with colorless septate hyphae.
Fusarium
is a hyalohyphomycetes which can cause localized or disseminated infections depending on host immunity. Our patient had an infectious lesion over the coronary artery bypass grafting (CABG) scar which was not responding to antibacterial treatment. Further investigations revealed it to be localized cutaneous
Fusarium
infection. The patient was treated with fluconazole 3 mg/kg/day for 3 weeks and responded very well without any recurrence during the next 3 months follow-up. Thus, this case highlights the effectiveness of fluconazole in uncommon fungal infection.
Background
Literature on the dermoscopic patterns of basal cell carcinoma (BCC) in India is limited.
Aim
To describe the dermoscopic pattern and dermoscopic–histopathological correlation in a large cohort of patients with BCC from India, with a particular focus on skin of colour (SOC).
Methods
This retrospective study was conducted under the aegis of the Dermatoscopy Society of India. Clinical details were collected, and two lead authors independently analysed dermoscopic images of BCC for a predefined set of characteristics. Histopathological slides/blocks were reviewed, and dermoscopic–histological correlation attempted.
Results
In total, 143 patients with BCC and skin phototypes IV–VI were included. The mean largest BCC diameter was 3.10 ± 3.68 cm and there was a significant but weak association between duration and largest dimension of the lesion (Spearman ρ = 0.33, P < 0.01). Nearly half of the cases were diagnosed with pigmented BCC and the most common histological subtype was nodular BCC (37.9%). Dermoscopically, blue–grey dots and arborizing vessels were the most common features (60.0%). Pigmentary changes were found in the majority of cases, and included blue–white veil, blue–grey ovoid nests and maple leaf‐like areas. A third of our patients had short linear telangiectasia, polymorphic vessels and regular dotted vessels, and another third exhibited a dermoscopic rainbow effect. Arborizing vessels were significantly more common with micronodular (78.9%) and nodular variants (74.1%, P = 0.05), whereas regular dotted vessels (68.4%, P = 0.04), blue–white veil (84.2%, P = 0.02) were significantly associated with micronodular variant.
Conclusion
The dermoscopic patterns of blue–white veil and regular dotted vessels are indicators towards micronodular BCC in SOC and can help in prioritizing treatment.
BACKGROUND:Acne vulgaris is an almost universal problem of adolescence characterized by inflammation in and around sebaceous gland. Effective treatment is essential to prevent physical and psychological scarring. Antibiotic requires frequent administration and associated with side effects contributing to reduced compliance . Isotretinoin was a major therapeutic advanced which revolutionized the treatment of acne. Thus it is important to analyze its risk-benefit ratio at lower dosages. Hence the present study carried out with the objective of oral Isotretinoin in patients of moderate to severe grade acne vulgaris. METHODOLOGY: The present prospective study carried out among the acne vulgaris cases attending the out-patient department of dermatology at a tertiary care Centre during January 2007 to December 2007. Oral is otretinoin was started at a dose of 0.5 mg/kg/day for a total duration of 20 weeks. Patients were scheduled for 3 visits i.e. at the end of 1 st , 2nd & 5 th month after start of treatment. All collected data entered and analyzed using SPSS for efficacy of drug on different lesions. RESULTS: 38 (95%) patients completed the study and same were evaluated for efficacy and safety. 50% decrease in comedons at the end of 2 month from the initiation of treatment. The efficacy of oral isotretinoin on inflammatory lesions shows decreased from baseline 36.13 to 4.87 at the time of last visit at 5 month. This was statistically significant (0.0001). Side effects observed an 11% case includes dryness, palmoplantar peeling, exfoliative dermatitis, photosensitivity, facial dermatitis. CONCLUSION: The oral is otretino in is effective and safe as well as showing early response especially for inflammatory lesions.
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