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   2016| January-June  | Volume 36 | Issue 1  
    Online since November 22, 2016

 
 
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CASE REPORTS
Isolated extragenital lichen sclerosus et atrophicans in a middle-aged male: a case report
Rahulkrishna S Kota, Nidhi B Jivani, Pragya A Nair
January-June 2016, 36(1):20-22
DOI:10.4103/1110-6530.194158  
Lichen sclerosus et atrophicans (LSA) is an idiopathic inflammatory dermatosis. It mainly affects the anogenital area. Extragenital sites are affected rarely in isolation. It presents as ivory or porcelain-white, shiny, round macules or papules, coalescing to form sclerotic plaques with prominent dilated pilosebaceous or sweat duct orifices. Histopathology is indicated to differentiate it from previtiligo, morphea, and atrophic lichen planus. There is no known cure for LSA. Standard treatment modality includes topical corticosteroid and calcineurin inhibitors, such as tacrolimus. We report a case of a middle-aged man with isolated extragenital LSA.
  1,703 126 -
ORIGINAL ARTICLES
Quality of life of Egyptian patients with psoriasis: a hospitalbased cross-sectional survey
Amira A Eid, Heba M Elweshahi
January-June 2016, 36(1):11-17
DOI:10.4103/1110-6530.194155  
Background Quality-of-life (QOL) impairment caused by psoriasis is well documented and is comparable to serious diseases. Several patient-related and disease-related factors can influence the final impact of psoriasis on the QOL. Aims The aims of this study were to assess the QOL of Egyptian patients with psoriasis and to explore factors affecting the QOL in those patients. Patients and methods A total of 274 patients (179 male and 95 female) with chronic plaque-type psoriasis were enrolled in the study. Disease severity was assessed using the Psoriasis Area Severity Index (PASI) and patients were asked to answer the Dermatology Life Quality Index (DLQI). DLQI scores and subscores were calculated, and the impact of different patient and disease characteristics on the DLQI was evaluated. Results The DLQI in patients ranged from 1.0 to 26.0. In 0.7% of the patients, psoriasis exerted no effect on the DLQI, small effect was reported in 10.6% of patients, moderate effect in 28.1% of patients, very large effect in 54% of the patients, and extremely large effect in 6.6% of the patients. A significant direct correlation between the PASI and the DLQI was detected (P<0.001). Both age (r=−0.19, P=0.002) and age at disease onset (r=−0.17, P=0.004) were negatively correlated with the DLQI. Multivariate linear regression analysis revealed the PASI to be an important predictor for QOL impairment in the studied patients. Conclusion The PASI may be a pivotal factor in determining the final impact of psoriasis on the QOL of Egyptian patients.
  1,579 208 -
Quality-of-life assessment in pemphigus vulgaris in Upper Egypt using the Dermatology Life Quality Index and SF-36 questionnaires
Hanan Morsya, Amira A Abdel-Motaleba, Asmaa MA Solimanb
January-June 2016, 36(1):1-3
DOI:10.4103/1110-6530.194152  
Background Autoimmune bullous dermatoses are characterized by recurrent painful erosions in the mucus membranes and blisters all over the body. The objective of this study was to evaluate quality-of-life and mental health status in patients diagnosed as having pemphigus. Patients and methods A total of 40 patients with pemphigus were recruited from the Dermatology Clinic, Assiut University Hospitals, Egypt. They were assessed clinically, and then the Dermatology Life Quality Index (DLQI) was determined and SF-36 questionnaires were administered to patients. Results Of the 40 patients, there were 14 male and 26 female patients. Range of the DLQI for male patients was 8.0–22.0 and that for female patients was 3.0–27.0. The DLQI showed a significant correlation with surface area measured (P=0.048). Conclusion These results suggest that the DLQI and SF-36 can be very useful tools in assessing the outcome criteria for clinical studies of patients with pemphigus. Patient’s quality-of-life is much impaired with this type of disorders.
  1,397 317 2
The effect of ER:YAG plus 5-fluorouracil on the outcome of punch grafting in nonsegmental vitiligo: a left–right comparative study
Tag S Anbara, Ibrahim M El-Ghareebb, Magda I Assafc, Amal T Abdel-Rahmana, Mohamed A El-Khayyata, Waleed A Albalatb
January-June 2016, 36(1):4-10
DOI:10.4103/1110-6530.194154  
Introduction Histopathologically, in vitiligo lesions, functioning melanocytes are absent and the inflammatory infiltrate is usually minute and trivial. Among the surgical methods used is minigrafting, which is considered the safest and easiest by many practitioners. Best results were obtained in segmental type and in the lesions involving the face. Application of topical 5-fluorouracil (5FU) on ER : YAG-ablated skin had been previously used with success in treating vitiligo lesions even in difficult-to-treat areas such as the fingers. Aim of the study In this study, we tried to explore the effect of the prior application of 5FU on ER : YAG-ablated skin on the outcome of punch grafting in lesions that were unresponsive to phototherapy and were known to have moderate prognosis with surgery. Patients and methods The study was a prospective left–right comparative study that was carried out on 20 patients with nonsegmental vitiligo who were in need for surgery after the exclusion of facial and periungual lesions. Histopathological and immunohistochemical comparison between the two modalities were also made using the sequential biopsy technique. Results The clinical outcome was significantly better on the site pretreated with ER : YAG laser ablation and 5FU (P=0.001). Inflammatory cells in the form of dermal CD4+ and CD8+ cells were present in all operation sites showing depigmentation (32 lesions). Of them, 28 cases (87.5%) showed invasion of the lower layers of the epidermis in close proximity to the melanocytes by the CD8+ cells. Histopathological and immunohistochemical results were similar on both sides. Conclusion The prior application of 5FU on ER : YAG-ablated skin yields better clinical results that were not explained by the histopathological findings. We suggest that both mechanical and immunologic mechanisms were involved in the process of repigmentation on using this manoeuvre.
  1,285 143 -
CASE REPORTS
Neurofibromatosis with borderline lepromatous Hansen's disease: a rare coexistence
Pankaj K Tiwary
January-June 2016, 36(1):23-25
DOI:10.4103/1110-6530.194159  
Leprosy and neurofibromatosis are two diseases having varied etiology and pathology. Neurofibromatosis has earlier been reported to coexist with lepromatous, histoid, pure neuritic, and borderline tuberculoid leprosy but not with borderline lepromatous leprosy. A 15-year-old boy presented with numerous soft, skin-colored papules and nodules distributed over his entire abdomen and back and also involving his upper limbs, and multiple, pale, and slightly numb patches over his back and both upper arms, which were gradually increasing in size. Biopsy from the hypopigmented lesion over the back revealed a periadnexal and perivascular infiltrate of epithelioid and histiocytic cells with lymphocytes, whereas biopsy from the lesion of neurofibroma over his arm showed a dermal proliferation of wavy spindle cells with a myxoid stroma containing mast cells. Coexistence of these two disorders is usually difficult to diagnose owing to overlapping clinical features. This case has been reported for its diagnostic implications and therapeutic hindrances.
  1,123 108 -
Cutaneous lesion of dental origin: convenience of dermatological ultrasound diagnosis by an experienced specialist
Paula Fernandez-Canga, Alicia Perez-Bustillo, Manuel A Rodriguez-Prieto
January-June 2016, 36(1):18-19
DOI:10.4103/1110-6530.194157  
Periapical granuloma is a common dental pathology that can progress into sinus tract formations to the skin and develop lesions that simulate primary dermatological pathology. Cutaneous lesions of this origin are rare, and differential diagnosis can be difficult as clinical appearance can be varied. A high clinical suspicion has to be supported by adequate complementary techniques. Ultrasound is an expanding, noninvasive, and reliable procedure to approach this diagnosis and has been demonstrated to be successful when practiced by cutaneous imaging experts, aiding to avoid unnecessary, aggressive diagnostic methods or erroneous surgical treatments. We report a case where ultrasonography failed and discuss the reasons for its failure.
  1,080 110 -
CASE REPORT
Dyschromatosis universalis hereditaria with sensorineural hearing loss
Mrinal Gupta
January-June 2016, 36(1):26-27
DOI:10.4103/1110-6530.194160  
  833 101 -
ERRATUM
Erratum: Role of dermatoscope in diagnosing and differentiating different types of seborrheic keratoses

January-June 2016, 36(1):28-28
DOI:10.4103/1110-6530.194161  
  706 88 -
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