<p class="abstract">Lupus panniculitis of scalp is an uncommon manifestation of lupus erythematosus, which presents as non-scarring linear, arched, or annular alopecia along the lines of Blaschko. A 7 year old child presented with localised linear non-scarring alopecia on scalp. Examination revealed a single linear alopecic patch on the left parietal scalp. There were no associated systemic complaints. Skin biopsy showed atrophic lining epithelium, diffuse and nodular lymphocytic and plasma cells infiltrates in the superficial and deep dermis, lobular inflammatory infiltration of lymphocytes, histiocytes and plasma cells, with minimal involvement of septa in the subcutaneous tissue. Antinuclear Antibody (ANA) and anti-ds DNA tests were negative. Patient responded well with regrowth of terminal hair within 3 weeks to a combination treatment of hydroxychloroquine, topical and intralesional steroids, and topical calcineurin inhibitor. Linear lupus panniculitis of scalp should be considered in cases of patterned, non-scarring alopecia. Regular follow-up is also essential due to the possibility of recurrence and development of systemic lupus erythematosus.</p>
Kaposi sarcoma (KS) is a low-grade vascular neoplasm caused by proliferation of lymphatic endothelium associated with human herpes-8 (HHV-8) infection. An 81-year-old male presented with 1-year history of multiple brownish papular lesions on lower limbs. He gave no history of high risk behaviour or treatment with immunosuppressants. Cutaneous examination revealed bluish-black discrete papules, small nodules and non-pitting edema on lower limbs, and large ulcerative plaques on left foot. Mucous membranes, lymph nodes and systemic examination were normal. Histopathological examination of the papular lesions showed spindle cell proliferation and vascular slits with extravasated red blood cells. Human immunodeficiency virus (HIV) serology was negative. However, total lymphocyte and absolute CD4+ T lymphocytes counts were reduced. We report this case of Classic Kaposi sarcoma (CKS) because of it’s rarity in India as well as being the first report from Northeast India, indicating wide ethnic and geographical distribution of this condition.
<p><strong>Background:</strong> Syphilis is an important sexually transmitted disease known for quite a long time. Its recognition and efficient treatment have become all the more necessary in the era of HIV epidemic in many clinical situations.</p><p><strong>Methods:</strong> A retrospective observational study of 7 years (January 2013 to December 2019) in 43 patients of confirmed syphilis attending regional institute of medical sciences (RIMS), Imphal.</p><p><strong>Results:</strong> During 7-year study period a sharp rise in syphilis cases were present from 2018 till the end of the study. Out of 43 patients, 39 were males. The most common age group was 25-40 years. Half of them were married. Maximum were heterosexuals and only 8 were homosexuals. Premarital and extra marital exposures were seen in 18 and 3 patients respectively. Patients presented in different forms-primary (48.6%), latent (25.7%) and secondary syphilis (22.8%). No cases of congenital syphilis and neurosyphilis were seen. VDRL titres ranged from 1:4 to 1:32. Six patients had HIV co-infection. No atypical presentations were seen.</p><p><strong>Conclusions:</strong> Increasing cases of syphilis have been observed in recent years. Syphilis screening and prompt treatment amongst risk groups have become crucial along with proper surveillance and public health measures to prevent disease transmission.</p>
<p>Dermatomyositis is a rare autoimmune myopathy with distinctive cutaneous changes. It has been associated with a wide range of malignancies like carcinoma ovary, lung, breast, gastrointestinal tract and non-Hodgkin’s lymphoma. The malignancy can be concurrent or can occur before or after the onset of myositis. We report a case of dermatomyositis in a 63-year-old Indian male with nasopharyngeal carcinoma. The characteristic cutaneous features and muscle weakness developed concomitantly with the onset of nasopharyngeal carcinoma.</p>
<p class="abstract"><strong>Background:</strong> Connective tissue diseases (CTDs) are a heterogeneous group of autoimmune disorders having overlapping clinical features. Skin is often involved and it may be the earliest sign of the disease. This study highlighted the various cutaneous manifestations of common CTDs.</p><p class="abstract"><strong>Methods:</strong> A hospital-based cross-sectional study was carried out for a period of two years in 83 patients with CTDs in dermatology OPD, RIMS, Imphal. Detailed history taking, examination and relevant serological tests were performed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age was 39.78±17.29 years with female to male ratio of 4.5:1. Majority of the patients had lupus erythematosus (LE) (N=45) followed by systemic sclerosis (SSc) (N=25), rheumatoid arthritis (RA) (N=6), mixed connective tissue disease (MCTD) (N=4) and morphea (N=3). The most common presentation was raised skin lesions (45.8%) followed by Raynaud’s phenomenon (36.1%), photosensitivity (27.7%), skin tightness (26.5%) and joint pain (19.3%). Among LE patients, chronic cutaneous lupus erythematosus (CCLE) was the commonest variant and localised discoid lupus erythematosus (DLE) (22.9%) was the commonest presentation followed by malar rash and annular subacute lupus erythematosus (SCLE). Skin induration, microstomia and sclerodactyly were seen in most patients of SSc. Antinuclear antibodies were positive in 89.1% of patients. Anti-dsDNA and anti-Sm antibodies were positive in 62.2% and 33.3% of LE patients, anti-Scl 70 antibody was positive in 68% of SSc patients.</p><p class="abstract"><strong>Conclusions:</strong> CTDs are rare but potentially life-threatening. Proper understanding of the spectrum of cutaneous manifestations of CTDs is therefore necessary for early diagnosis and efficient management.</p>
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