Chloracne in a Farming Family.

An 11-year-old boy presented with a 1-year history of multiple comedonal lesions distributed over his body. The lesions (Figure 1) were densely distributed throughout his body. Ophthalmologic examination revealed hyperpigmented conjunctival mucosae and enlarged meibomian glands (Figure 2). His nails were also hyperpigmented. In addition, he had been coughing and had a fever, each present for a month. Significant laboratory studies included mild anemia (hemoglobin 11.6 gm%) and leukocytosis of 20,800. A chest x-ray was suggestive of interstitial lung disease. Similar lesions were present on his two siblings and parents. Additionally, his father had developed multiple, acne-like lesions, large abscesses, palmar and plantar peeling, and severe jaundice with hepatic failure. He had a history of frequent exposure to a pesticide mixed with a herbicide, as a result of leakage from a spray container. The patient was diagnosed with chloracne, based on the history, clinical features, and histologic examination.

Familial dyskeratotic comedones: A rare entity.

Familial dyskeratotic comedones is an inherited disorder with distinctive clinical features and a disease course that is refractory to treatment. It is clinically characterized by numerous, discrete, disseminate, hyperkeratotic papules and comedones. On histopathology, it shows crater-like invaginations filled with keratinous material and evidence of dyskeratosis. We report here one family from central India with this rare disorder.

Sarcoidosis detected due to tattoo swellings in an Indian female.

A female patient presented with asymptomatic swellings in old blue-black tattoo marks of her forearms. On careful skin examination, few raised erythematous, circular plaques were also found on the non-tattooed skin on her back, about which she was unaware. The diagnosis of cutaneous and systemic sarcoidosis was confirmed after classical histopathological findings from skin lesions from her non tattooed back and from papulonodular tattooed lesions, ruling out other causes of granulomas and supported by a negative Mantoux test, raised serum angiotensin converting enzyme level, high resolution computed tomography thorax, etc. She responded well to oral steroid therapy. The importance of a careful skin examination, easy access provided by skin lesions in suspected cases of cutaneous/systemic sarcoidosis, the value of sudden tattoo changes in the diagnosis here and the possible contribution of tattoos toward the causation of cutaneous and/or systemic sarcoidosis are highlighted.

Transepidermal elimination of Mycobacterium leprae in histoid leprosy: a case report suggesting possible participation of skin in leprosy transmission.

An Indian patient of histoid leprosy presenting de novo, having numerous solid staining bacilli inside the intact epidermis and eliminating bacilli from the intact and the eroded epidermis, is reported. The diagnosis, suggested by the clinical features, was confirmed histopathologically. This unusual report indicates possible participation of skin in leprosy transmission.