Cutaneous warts are a common skin condition affecting children and young adults and signify infection with human papillomavirus. They are of various types and show association with specific viral genotypes. The aim of this case report is to highlight one such case of deep palmoplantar wart also known as ‘Myrmecia wart’ because of its very peculiar clinical and histopathologic findings. A young male in his mid-20s presented with a warty growth in the index finger of his right hand. Biopsy and subsequent histopathological examination confirmed its categorization as Myrmecia wart. A thorough account of its typical cytopathic effects observed in histopathology as well its differentiating features from other common warts like verruca vulgaris and molluscum contagiosum infection on microscopy is warranted. Further, not so frequent incidence merits detailed review of this entity.

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Objectives To know the prevalence and clinical patterns of infant dermatosis at a tertiary care referral institute. Patients and methods The present observational cross-sectional study was carried out on 508 neonates and infants with physiological and pathological skin conditions from August 1, 2018 to February 1, 2020. A standard study proforma was used to obtain detailed systemic and dermatological findings. Data entry was done in MS Excel, and data analysis was carried out using Statistical Package for Social Sciences, version 22.0. Results The common dermatoses were bacterial infection [folliculitis (29.03%) and staphylococcal scalded skin syndrome (19.35%)], fungal infections [candidal intertrigo (41.67%) and pityriasis versicolor (37.50%)], developmental abnormalities [accessory tragi (21.43%), anencephaly (14.29%), and cleft lip (14.29%)], diaper area eruptions [diaper dermatitis (81.82%), atopic dermatitis (45.92%), hemangiomas: infantile congenital hemangioma (60.87%) and nevus simplex/stork bite (21.74%)], hyperpigmentation disorders [Café-au-lait (44.44%) and congenital melanocytic nevi (22.22%)], hypopigmentation disorder [pityriasis alba (42.31%)], iatrogenic/traumatic disorders [Stevens-Johnson syndrome (40%)], immunologic disorders [insect bite hypersensitivity (41.18%) and acute urticaria (29.41%)], and transient benign disorders [Mongolian spots (23.28%) and Lanugo (14.29%)]. Conclusion Physiological dermatoses are transient and self-resolving and need to be differentiated from the pathological ones for management and parents’ reassurance. The pathological dermatoses are caused most commonly by infections and infestation, which warrants a clean and hygienic living. Owing to wide variety, burden, and public health problem of cutaneous dermatoses in infants, the current data can be useful in creating awareness among the dermatologists, pediatricians, and the health care system.

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Median canaliform nail dystrophy of Heller (MCND), also known as dystrophia unguis mediana canaliformis, solenonychia, and nevus striatus unguis, is an uncommon nail disorder characterized by a paramedian or midline ridge or groove or canal formation in the nail plate of one or both the thumbnails. It rarely involves the other fingernails or toenails. Most of the cases of MCND are idiopathic. However, it may also be secondary to traumatic injury to the base of the nail, subungual skin tumors such as glomus or myxoid tumor, and the use of drugs like oral isotretinoin. Although it is believed to be an acquired condition, few familial cases have also been reported. Here we report three cases of MCND involving fingernails and toenails.

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Introduction Acne scars can play havoc with the social functioning of the patient leading to severe depression with reduced quality of life. Fractional CO₂ laser provides a fine balance between the undesirable side effects of ablative lasers and the limited efficacy of nonablative lasers. Objective The present study was conducted to evaluate the efficacy and safety of fractional CO₂ laser in the treatment of acne scars. Patients and methods Fractional CO₂ laser treatment performed on 30 patients with atrophic acne scar by different protocols depending on the type and its depth. Results were assessed based on serial photographs, clinical improvement, and physician’s global assessment scale. Results Of the 30 participants, 27 completed all three sessions. Out of the 27 patients in the final follow-up, three (10%) had excellent improvement of which two had mild acne scar and one had moderate scar before treatment; 16 (59.2%) had good response of which 13 had moderate acne scar and three had mild scar and eight (29.7%) had fair response of which six had moderate scars and two had mild scars. Conclusion Fractional CO₂ laser as monotherapy in the treatment of mild-to-moderate post-acne scars seems to be effective with good patient satisfaction and reduced side effect profile. In case of severe acne scars, fractional CO₂ laser can be used as a combined procedure along with other therapeutic modalities like subcision, platelet-rich plasma, and TCA CROSS (chemical reconstruction of skin scars using trichloroacetic acid) techniques.

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Background Erythroderma is a rare disease, characterized by generalized erythema and scaling of the skin. Aims The aim of this study was to clinicopathologically assess patients with erythroderma who attended the Department of Dermatology at the Faculty of Medicine, Sohag University, Upper Egypt. Patients and methods This was a cross-sectional clinical research study that was carried out on 33 patients with erythroderma. All of the patients were subjected to complete medical history taking and general and dermatological examinations. All of the patients were subjected to laboratory, radiological, and cutaneous histopathological evaluations. Results The mean age of the patients was 46.86 years. According to the clinical and histopathological findings, the erythrodermic patients were categorized into 26 (78.78%) patients who had preexisting dermatoses, four (12.12%) patients had malignancies, and three (9.1%) patients had drug reactions. Moreover, there was moderate and perfect interrater reliability agreement between clinical and histopathology evaluations in the diagnosis of different etiological causes of erythroderma. Limitations A small sample size and small number of included patients were the limitations of the study. Conclusion This study concluded that the main causes of erythroderma were preexisting dermatoses followed by malignancies and drug reactions. Psoriasis was the main preexisting dermatoses in erythrodermic patients. Clinical and histopathology evaluations are essential for accurate diagnosis of different etiological causes of the erythroderma.

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Background Acanthosis nigricans (AN) is characterized by pigmented velvety thickening of the intertriginous body areas and neck. Many studies linked it to metabolic syndrome. Aim To detect the prevalence of AN among primary school children and to identify the associated risk factors. Patients and methods We included 2060 primary school students who were selected from two rural and four urban schools. The data were collected by questionnaire sheets that were fulfilled from each student in which present and past history for any disease were taken. Results The prevalence of AN was 17.7% of all examined students, higher in females (18.6%) than males (16.3%), but it was not statistically significant. More than half of the students 55.0% were of normal weight, 23.3% were overweight, and 21.7% were obese. In the current study, 69.1% of obese children were having AN. Conclusions Regular dermatologic examination for early identification of AN is required. AN in the knuckles should be considered as a classic site and highly prevalent. It should be borne in mind that coordinated efforts of medical professional teams may be required aiming to correct the underlying disease to improve the skin symptoms. Strict follow-up of patients with AN for early detection and management of insulin resistance and metabolic syndrome.

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Background Vitiligo is an acquired and visible leucoderma that can lead to social stigmatization. The aim of this study was to establish the epidemiological and clinical profile of childhood vitiligo in Abidjan. In fact, very little data is available on this chronic child disease in sub-Saharan Africa, particularly in Côte d’Ivoire. Methods We carried out a cross-sectional study at University Teaching Hospital of Treichville from June 2017 to June 2018. All children under 16 years old with vitiligo who meet our selection criteria were included. CSPRO 7.2 and SPSS 23 software were used for data analysis and the significance threshold was set at 0.05. Results The prevalence of childhood vitiligo was 1.78%. Our series consisted of 19 boys and 21 girls (sex ratio M/F: 0.9). Children aged between 9 and 15 years old were the most affected (45%). The main family history were diabetes (37.5%), early canitis (30%) and vitiligo (17.5%). Atopic dermatitis was the main dermatosis associated with the childhood vitiligo (17.5%). The main clinical form of vitiligo was the non-segmental form (47.5%). The segmental and mixed forms had rates of 42.5% and 10% respectively. The vitiligo lesions were mainly located in sun-exposed areas (52.5%) and the segmental vitiligo significantly reached the face (P=0.04). Segmental vitiligo was also more common in children aged 0 to 3 years (P=0.03). The Koebner phenomenon was present in 5 children and was statistically associated with non-segmental vitiligo (P=0.04). Conclusion The prevalence of vitiligo in our series was 1.78%. This pathology occurs mainly in older children. The main clinical form was the non-segmental form. The affection was most often located on the sun-exposed areas.

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Background Psoriasis is a chronic multifactorial autoimmune disease that has significant impacts on the quality of life. Adiponectin exhibits important anti-inflammatory, antioxidants, and antidiabetic effects. The role of fatty acid-binding protein 4 (FABP4) in psoriasis may be linked to tumor necrosis factor-α, which is one of the main cytokines contributing to the etiopathogenesis of this disease. Aim To understand the role of serum levels of FABP4 and adiponectin in disease pathogenesis and their correlation to disease severity. Patients and methods A case–control study was conducted on two groups. The first group included 35 psoriatic patients; the second group included 35 healthy volunteers matched for age, sex, and weight. Serum FABP4 and adiponectin levels were evaluated. Results The mean level of adiponectin among the patients was 4.3±1.4 ng/dl. The mean level of FABP4 among controls was 2.1±1.5 ng/dl. The difference between both groups was statistically significant (P<0.05). Conclusion In this study, serum FABP4 level and adiponectin levels were decreased in patients with psoriasis with no relation to disease severity. So, they cannot be used as clinical biomarkers of inflammation and disease activity in psoriasis

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Objectives To determine the prevalence of Helicobacter pylori infection in patients with chronic plaque psoriasis and to determine the association of H. pylori infection with the severity of chronic plaque psoriasis. Patients and methods The prospective case–control pilot study was conducted in the outpatient Department of Dermatology from November 2017 to April 2019. A total of 50 patients with chronic plaque psoriasis and 50 consenting healthy controls were included in the study. A cutaneous examination of the morphology, site, and extent of the lesions was done. Psoriasis area and severity index scores were calculated for all patients. H. pylori stool antigen test was performed for all cases and controls. The data were entered into MS Excel spreadsheet, and analysis was done using the Statistical Package for the Social Sciences (SPSS), version 21.0. Results The mean age of patients with psoriasis was 37.24±11.7 years, with 64% males and 36% females. H. pylori was positive in 24/50 patients with psoriasis. Compared with controls, patients with psoriasis had significantly higher H. pylori positivity rate (48 vs. 26%, P=0.023). Compared with the patients with H. pylori negative status (n=26), H. pylori positivity (n=24) showed significant association with site and disease progression (P=0.016) but not with disease duration (P=0.907). The median psoriasis area and severity index score in H. pylori-positive patients was significantly higher than that in patients with negative H. pylori (13.55 vs. 4.65, P=0.002). Conclusion The small number of patients studied showed that H. pylori infection is associated with psoriasis, with the progression and the severity of psoriasis, bearing a direct association with increased positivity for H. pylori.

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Background Psoriasis disease is a chronic hyperproliferative inflammatory disease, in which genetic and environmental factors have an important role, but the exact cause is yet unknown. Lipoxin A4 plays a role in improvement of psoriasis cases, it blocks the production of the proinflammatory cytokine tumor necrosis factor with increasing the production of the anti-inflammatory cytokine, c–c chemochine receptor-5 by T lymphocytes, and it reduces the perception of pain due to inflammation. Aim Detection of the expression of lipoxin A4 in the tissue and serum of psoriatic patients as compared with normal-control persons to investigate the possible role of lipoxin A4 in the psoriasis pathogenesis and its correlation with disease severity. Patients and methods The present study included 25 psoriatic patients and 25 age, sex-matched healthy controls. Four-mm punch-skin biopsy was taken from patients (psoriatic lesion) and control persons and it was kept in lysis solution for the stability of the studied parameters and it was kept frozen at –80°C till analysis of lipoxin A4 by PCR. Peripheral blood samples for detection of serum lipoxin A4 were taken. Blood samples were centrifuged and the serum was stored at –80°C and used for enzyme-linked immunosorbent assay. Results Psoriatic patients had significantly lower tissue and serum lipoxin A4 levels as compared with normal-control persons. Conclusions Lipoxin A4 could contribute to psoriasis pathogenesis through its immunomodulatory role.

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Background Psoriasis is a chronic hyperproliferative inflammatory disease, in which genetic and environmental factors have an important role, but the exact cause is yet unknown. Autophagy is a strictly regulated lysosomal degradation pathway that is crucial for maintaining intracellular homeostasis and normal development. Dysregulation of autophagy-related genes has been recognized to increase susceptibility to diseases, such as inflammation, cancer, and autoimmune disorders. Aim Our study aimed to detect the expression of the autophagy-related gene 16L1 (ATG 16L) in psoriasis patients compared with normal controls to investigate the role of autophagy in the pathogenesis of this disease. Patients and methods This case–control study included 30 psoriasis patients and 30 healthy controls. Punch skin biopsies of 4 mm were taken from psoriatic lesions and then from the controls and they were kept in a lysis solution for the stability of the studied parameters and were kept frozen at –80°C till analysis of ATG 16L using real-time PCR. Results The level of the ATG 16L1 in the lesional skin of psoriasis was significantly increased compared with normal controls (P<0.001). Limitation Limited number of patients were included in this study (30 patients). Conclusion Autophagy process may play an important role in the pathogenesis of psoriasis disease.

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