<p class="abstract">Bleomycin is an antitumour antibiotic commonly used in the management of Hodgkin’s lymphoma and germ cell tumours. Flagellate pigmentation is a very specific and rare cutaneous adverse effect of bleomycin. It is characterised by linear, painless, pruritic, hyperpigmented lesions simulating marks of whiplashes over trunk and extremities. With the advent of targeted therapies resulting in the infrequent use of bleomycin, this unique side effect is also uncommonly encountered nowadays. Here, we report a case of bleomycin-induced flagellate pigmentation in a 35-year-old Indian female with ovarian teratoma. The characteristic patterned hyperpigmented patches developed following 2nd cycle of chemotherapy with bleomycin, etoposide and cisplatin.</p><p class="abstract"> </p>
Background: Thyroid abnormalities are a well-documented endocrine association seen in numerous dermatological conditions. However, there are few Indian studies analyzing the thyroid status in various dermatoses. Materials and Methods: This cross-sectional, observational study was conducted on 805 willing patients with various dermatoses, irrespective of the disease classification. Serum samples were taken and assayed for triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH). Results: Out of the 805 patients, 14.2% (n = 115) had abnormal thyroid function. Hypothyroidism accounted for 86.1% (n = 99) and hyperthyroidism for 13.9% (n = 16). Among the 99 hypothyroid patients, 23.2% (n = 23) had overt hypothyroidism while 76.8% (n = 76) had subclinical hypothyroidism. Vitiligo accounted for 36.1% (n = 291) of the patients, among which 12.3% (n = 36) had thyroid dysfunction involving six hypothyroid and three hyperthyroid cases. Out of 58 cases of melasma, 15 (25.8%) had abnormal thyroid function. Among the twenty patients with lichen planus pigmentosus, five had abnormal thyroid levels. Conclusion: This study demonstrates a strong association of thyroid disorders in certain conditions, such as vitiligo, alopecia areata, diffuse hair loss, dry skin, chronic urticaria, and melasma. Thus, the inclusion of thyroid function tests in routine investigations of these conditions would be helpful.
Background: Dermatologists besides providing service to patients in the outdoors, also play a vital role in the care of inpatients admitted to dermatology unit and other departments. The aim of the study was to evaluate the pattern of referrals sent to the dermatology department by other departments. Methods: A retrospective study was carried out on 487 patient referrals requested to department of dermatology, of Regional institute of Medical Sciences, Imphal, Manipur for a period of 5 years from January 2005 to December 2010. The department maintains a consultation register where the demographic details, specialty requiring dermatological consultation, time frame between admission and referral request and diagnosis, investigation and treatment of the patients were entered. Patients were evaluated within few hours from the time of consultation. Procedures such as skin biopsy, fungal culture or KOH smears etc. were performed wherever required. All these information’s entered in referral register were collected from register. All the patients entered in register from January 2005 to December 2010 were selected and none were excluded. Ethical approval was obtained from research ethics board. Data were entered in IBM SPSS statistics 21 for Windows (IBM Corp. 1995, 2012). Descriptive statistics such as frequency, percentages, mean with standard deviation and median were used. Analysis was done using Chi-square test to check the significance between proportion and p value<0.05 was taken as statistically significant. Results: A total of 487 consultations were recorded. Most (48.3%) consultations were received from general medicine, followed by surgery (14.4%), gynecology (9.4%), chest medicine (5.54%) with the least from PMR (1.23%) and psychiatry (1.84%). Infectious skin diseases were most common (37.5%) followed by eczema (22.3%) and drug reactions (11%). Among infections viral infections topped the list (Herpes simplex- 35.9%), among eczema chronic eczematous dermatitis (22.9%). Among drug reaction severe cutaneous adverse drug reaction was present in 12 cases. Conclusions: Dermatology referrals can enhance the dermatological knowledge of non-dermatologists to diagnose and manage common dermatoses thus improving overall patient care.
<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>
Genital lichen planus (LP) forms a small but significant proportion of non-venereal genital dermatoses. Lesions of vulvovaginal LP are often asymptomatic and may be overlooked on self-examination. Clinical features are very similar to lichen sclerosus which is frequently seen in children whereas mucosal vulval LP commonly affects adult females. Histopathological examination of the lesion is an important diagnostic tool for its early diagnosis as progressive disease poses a risk of scarring. We report a case of vulvovaginal LP in a 56-year-old postmenopausal female presenting with hypopigmented patches on vulva for 10 years.
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