Clinico-Epidemiological Profile of Allergic Contact Dermatitis and Its Correlation With Patch Testing in a Tertiary Care Center in Eastern India.

BACKGROUND: Allergic contact dermatitis (ACD) is one of the most common skin disorders seen among patients attending dermatology clinics in India. Patch testing is the gold standard for diagnosing ACD. The clinical-epidemiological pattern of ACD and the allergen-causing it may be different in different geographic locations. Finding the profile of allergens commonly causing ACD in a particular region will help to formulate prevention strategies for the development of ACD. AIM AND OBJECTIVE: The primary aim of the study was to find out the clinical-epidemiological distribution of allergic contact dermatitis and to identify the common allergens causing it by patch testing in this region of India. MATERIALS AND METHODS: A total of 111 cases of ACD were included in the study. Clinico epidemiological profiles of all patients were documented. The patch testing was performed in the outpatient department using the antigens of the Indian Standard Series kit (Systopic Laboratories Pvt. Ltd., New Delhi, India). Patches were removed after 48 hours (two days) of application. The first reading was taken 15 to 20 minutes after the removal of patches on day two. A second reading was taken on day four (96 hours of application) to confirm the presence of an allergic reaction.  Results: The patch test was found to be positive in 69% of cases. It was observed that male persons from lower socioeconomic status were getting ACD on most accounts. Potassium dichromate (PDC) was found to be the most common allergen (30.43%) followed by parthenium (26.08%), para-phenylenediamine (PPD) (21.73%), nickel sulfate (18.84%), chlorocresol (15.94%), black rubber (14.49%), cobalt sulfate (13.04%), and wool alcohols (7.24%) respectively. CONCLUSION: Our study showed potassium dichromate is the commonest allergen causing ACD in this part of the country. The importance of patch testing lies mainly in educating the patient regarding the avoidance of exposure to particular allergens to avoid the development of new ACD as well as an exaggeration of pre-existing ACD.

Epitheloid hemangioma: a report of two cases.

We report two cases of epitheloid hemangioma presented with multiple nodular lesions over head and neck region. One of them gave history of bleeding on minor trauma. Pyogenic granuloma was considered as a differential diagnosis from the morphological appearance and history of bleeding. Nodular leprosy, sarcoidosis, and secondary syphilis were also considered. Histopathological examination of both was typical of epitheloid hemangioma, an entity commonly overlooked clinically due to its rarity.

Giant inflammatory linear verrucous epidermal nevus: successfully treated with full thickness excision and skin grafting.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a pruritic, erythematous scaly epidermal nevus which follows a Blaschko's lines. Lichen striatus, linear Darier disease, linear porokeratosis, linear lichen planus, linear psoriasis, and the verrucous stage of incontinentia pigmenti may all have similar clinical presentations as the linear verrucous epidermal nevus. ILVEN can be distinguished from true nevoid psoriasis by pruritus and lack of response to antipsoriatic treatments. Various therapeutic modalities have been described, but no one therapy has been successful consistently. Though giant ILVEN is a relative contraindication to surgical excision, here we report a case showing effectiveness of full thickness excision and skin grafting for this condition.

Gorlin syndrome.

Gorlin Syndrome, a rare genodermatosis, otherwise known as Nevoid basal cell carcinoma syndrome (NBCCS) is a multisystem disease affecting skin, nervous system, eyes, endocrine glands, and bones. It is characterized by multiple basal cell carcinomas, palmoplantar pits, jaw cysts, and bony deformities like kyphoscoliosis and frontal bossing. We would like to report a case of Gorlin syndrome with classical features, as this is a rare genodermatosis.

Disseminated cutaneous rhinosporidiosis.

A 48-year-old male patient presented to Skin and VD outpatient with multiple granulomatous growths of different sizes all over the body, including numerous subcutaneous swellings mimicking lipomas of 2 years duration. Two and half years back he was operated for a polypoidal growth of left nostril with subsequent recurrence. Fine needle aspiration cytology and histopathology of the cutaneous lesion confirmed the diagnosis as rhinosporidiosis. We report this rare case of disseminated cutaneous rhinosporidiosis.