Buffalopox: An emerging cutaneous disease in humans.

BACKGROUND: Buffalopox virus (BPXV) infection is an under-recognized zoonotic disease associated with recently reported outbreaks in humans in South Asia. It is frequently isolated from skin lesions in cattle and buffalos, and can be transmitted to humans by direct contact with the skin of infected animals and fomites. Very little data exist to inform treatment guidelines. CASE REPORT: We present a case report of a 50-year-old male with this rare but emerging disease. CONCLUSION: As outbreaks of viral skin disease such as buffalopox become more common, it is essential for dermatologists to be familiar with their cutaneous manifestations.

A Prospective Study to Compare the Efficacy of Cryotherapy Versus Intralesional Steroid in Alopecia Areata.

Background: Alopecia areata (AA) is an autoimmune disease that results in the loss of hair on the scalp and elsewhere on the body. The present study was conducted to compare the intralesional steroid and cryotherapy in the treatment of AA. Materials and Methods: The present clinical study was conducted in the Department of Dermatology, Venereology, and Leprology, Muzaffarnagar Medical College. The simple random sampling technique was used for randomly dividing the subjects into two groups: group I (local cryotherapy) and group II (intralesional corticosteroid). Results: A positive response was significantly more among the intralesional steroid group (86.0%) when compared with the cryotherapy group (62.0%). There was a significant difference in relapse between intralesional steroid group (22.0%) and cryotherapy group (16.0%). An excellent response was significantly more among the intralesional steroid group (44.0%) when compared with the cryotherapy group (18.0%). Poor response was significantly more among the cryotherapy group (18.0%), compared with the intralesional steroid group (0.0%). The mean pre-treatment, post-treatment, and the change from pre- to post-treatment Severity of Alopecia Tool [SALT] were compared between cryotherapy and intralesional steroid groups using the unpaired t-test. The mean pre-treatment, post-treatment, and the change from pre- to post-treatment SALT were significantly more among the intralesional steroid group when compared with the cryotherapy group. Conclusion: The authors found that superficial cryotherapy could be a meaningful adjuvant treatment option for AA patients. There was a significantly less relapse rate with cryotherapy. Among the currently available topical modalities for the treatment of AA, the best response was to the intralesional steroids followed by cryotherapy.

Incidence of Vesicobullous and Erosive Disorders of Neonates: Where and How Much to Worry?

OBJECTIVE: To analyse the incidence of dermatoses in neonates, stress the importance of simple noninvasive diagnostic procedures with perspective to actual need of active intervention. METHODS: Forty four neonates with vesicobullous lesions in Departments of Dermatology and Pediatrics were evaluated with respect to diagnosis, required treatments and follow ups. RESULTS: Of the total 44 neonates, 29 were boys and 15 girls. Low birth weight (weight at birth less than 2,500 g as per WHO criteria) was seen in 19 neonates. Of the infectious dermatoses, most common were pyodermas. Four cases (9%) were diagnosed to be of staphylococcal pyoderma and impetigo and two cases each of Group A Streptococcal impetigo and neonatal tinea faciei (4.5% each), one case each of neonatal candidiasis, neonatal varicella/chickenpox and scabies (2.3% each) were seen. Of the transient skin lesions, erythema toxicum neonatorum was commonest of all, being seen in 18 neonates (41%), followed by four cases (9%) of miliaria crystallina, three cases of neonatal acne (6.8%) and two cases of sucking blisters (4.5%) and one case each of transient neonatal pustular melanosis, epidermolysis bullosa simplex, incontinentia pigmentii, eosinophilic pustular folliculitis, pemphigus vulgaris and neonatal herpes simplex (2.3% each) were enrolled in this study (Fig. 1). Fig. 1 Piechart showing percentage and number of neonates with different diagnostic profiles in the study CONCLUSIONS: Certain specific considerations have to be born in mind while evaluating and managing neonatal dermatoses. Care has to be instituted to identify accurately infectious diseases and distinguish them from benign transient neonatal dermatoses. Some disorders first manifesting during the neonatal period may also represent harbingers of potential problems during adulthood. Finally, treatment modalities are instituted taking in account the actual diagnosis and judging if the treatment really is required or not.

Acral pebbles: A novel manifestation of partially treated syphilis.

Atypical manifestations in syphilis are known and pose a diagnostic dilemma. Early suspicion, timely investigations, diagnosis, and treatment, is the key to successful management. We report a patient of secondary syphilis, who presented as genital ulcer and small pebbles like eruptions on the palmar aspect of his fingers.

Woronoff Ring: A Novel Manifestation of Molluscum Contagiosum.

Woronoff ring has been mostly discussed as a phenomenon in psoriasis, especially during therapy. It has also been reported in a few other conditions unrelated to psoriasis; however, the association of Woronoff ring has not been reported in immunocompetent, healthy, and untreated patients with molluscum contagiosum who have no apparent systemic illness. The authors report a case series of Woronoff ring seen in untreated immunocompetent patients with molluscum contagiosum involving different age groups.

Primary Cutaneous Plasmacytosis: Masquerading as Hidradenitis Suppurativa.

Isolated cutaneous plasmacytosis (CP) is a rare entity with few cases reported in world literature. CP masquerading as hidradenitis suppurativa like presentation is a unique case with some features differentiating it clinically from it which were further confirmed by histopathology and immunostaining. Our case showed hyperplasia of mature plasma cells and polyclonal hypergammaglobulinemia, immunostaining for CD138 positivity and kappa: lambda ratio more than 3:1. Extensive clinical and laboratory investigations failed to reveal any underlying pathology, presence of any underlying disease accompanying the hypergammaglobulinemia and/or plasma cell proliferation.

Disseminated anetoderma in a patient with nodal Epstein-Barr virus-associated classical Hodgkin lymphoma: Anetodermic form of a concurrent discordant cutaneous marginal zone lymphoma.

Patients with a lymphoma have an increased risk of developing a second lymphoproliferative disorder. The association of nodal Hodgkin lymphoma and primary cutaneous marginal zone lymphoma (MALT type) is exceptional, and only very few cases have been documented. Anetoderma represents a circumscribed loss or rarefication of elastic fibers. Different underlying processes may result in anetoderma, including cutaneous marginal zone lymphoma. We report a 50-year-old male patient with Epstein-Barr virus (EBV)-associated nodal Hodgkin lymphoma who presented with disseminated anetodermic skin lesions. Biopsies of the skin lesions revealed a B-cell infiltrate containing monoclonal plasma cells but without detection of EBV. The skin lesions represent an anetodermic form of primary cutaneous marginal zone lymphoma. It is the first case report of an association of anetodermic cutaneous marginal zone lymphoma and a synchronous EBV-associated nodal Hodgkin lymphoma.

Terra firma-forme dermatosis: report of a series of 11 cases and a brief review of the literature.

BACKGROUND: Terra firma-forme dermatosis (TFFD) is a benign, yet little known disorder with very few cases reported in the literature. TFFD is considered to be only a cosmetic problem but can be a cause of embarrassment for the patients. METHODS: Eleven patients with TFFD presenting in a tertiary care center over a period of 5 years were analyzed with respect to disease presentation, treatment, and possible factors involved in causation. RESULTS: The commonest cause in our series was ignorance regarding proper cleansing techniques, inadequate pressure while scrubbing the affected area, and a lack of concern, fear, or pain as in the case of surgical sites. CONCLUSION: Awareness among the clinicians about the existence of TFFD is essential to save time for the clinician and to reduce the economic burden on the patient by avoiding costly investigations and treatment. Proper counseling regarding the cleansing of surgery sites may help prevent the development of this condition in such situations.

Lymph node abscess and cardiac involvement in a patient with nodular lepromatous leprosy (LL) with erythema nodosum leprosum (ENL): a rare occurrence.

With the world's focus on reducing the leprosy patient load to the extent of elimination, finding and reporting the rarer presentations of leprosy becomes important for prompt treatment. Also, these untreated patients may serve as a potential source of infection in community. We report a 35-year old man diagnosed to have lepromatous leprosy and erythema nodosum leprosum with inguinal lymph node abscess and suspected cardiac involvement that proved fatal. We stress the importance of detailed workup to look for associated systemic involvement for timely intervention and favourable outcome.

Co-existence of extramammary Paget's disease and Bowen's disease of vulva.

Extramammary Paget's disease and Bowen's disease are histologically similar and immunohistochemistry is often required to make the diagnosis. We present a case of vulval Paget's disease with Bowen's disease in an elderly female. Strong positivity for cytokeratin 7, anti CAM 5.2, carcinoembryonic antigen (CEA) and periodic acid-Schiff (PAS) stain in clitoral, left labial and interface regions of the vulvectomy specimen confirmed the diagnosis of Paget's disease (PD) while positive staining for p63 in the right labial and interface regions helped in establishing the diagnosis of concurrent Bowen's disease (BD).

Ectopia cilia with pedigree analysis: Second case report in the world.

We present a case of ectopia cilia in a 28-year-old male patient. Ectopia cilia was were seen in the outer third of left upper eyelid. The patient's maternal grandfather also had ectopia cilia of the left upper eyelid as reported by the patient's mother. Ectopia cilia is a rare condition seen in humans. Only 12 cases of ectopic cilia in humans have been reported so far in the world. The present case of ectopia cilia is the second case report in the world with pedigree analysis.

Lupus vulgaris in a young girl.

With the estimated global burden of TB being 8.8 million incident cases and 1.1 million deaths from TB in HIV-negative cases and additional 0.35 million deaths in HIV-associated cases,1 the total number of cutaneous TB cases ( < 1-2 % of total cases) becomes significant. With the WHO setting up public-private mix partnerships and a millenium development goal of a 50% reduction in the total number of incident cases, the case detection and reporting of unusual cutaneous TB cases becomes very important. We present a case of lupus vulgaris in a young girl with rapid progression of a large plaque with hypertrophic features in the periphery. The case is unusual due to its rapid progression, unusual site and extensive giant form which have never been reported previously.