Clinical markers of herpes simplex virus infection in patients with pemphigus vulgaris.

BACKGROUND: Herpes simplex virus (HSV) is known to influence the course of pemphigus vulgaris. Relapse, exacerbation, and treatment resistance in patients with pemphigus vulgaris can be due to HSV infection. OBJECTIVES: To characterize the clinical markers of HSV infection among patients with pemphigus. METHODS: This was a hospital-based, descriptive study performed with 60 consecutive patients with pemphigus vulgaris. The clinical and laboratory features of patients with documented HSV infection were then compared with those of patients without infection. RESULTS: HSV infection was confirmed in 23 (38.33%) patients. On univariate analysis, it was noted that male sex (P = .03); presence of fissures (P = .001), hemorrhagic crusts (P = .003), erosions with angulated margins (P = .024), and linear erosions (P = .001); and raised erythrocyte sedimentation rate (P = .015) were found to be significantly associated with HSV infection. In a multivariate analysis, hemorrhagic crusts (P = .015) and linear erosions (P = .008) were found to be independent predictors of HSV infection. LIMITATIONS: We did not use polymerase chain reaction to detect HSV infection, which could have yielded more cases of HSV infection. CONCLUSION: In the clinical setting of pemphigus vulgaris, the presence of fissures, hemorrhagic crusts, linear erosions, erosions with angulated margins and raised erythrocyte sedimentation rate must alert the clinician to the possibility of HSV superinfection.

Dermoscopic features of basal cell carcinoma in skin of color: A retrospective cross-sectional study from Puducherry, South India.

BACKGROUND: Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. AIMS: The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. METHODS: A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. RESULTS: Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. LIMITATIONS: The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. CONCLUSION: We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.

Clinical and Dermoscopic Features of a Case of Idiopathic T-Cell Pseudolymphoma.

Cutaneous pseudolymphomas are a group of benign lymphocyte-rich infiltrates that can mimic cutaneous lymphomas either clinically and/or histologically. Idiopathic T-cell pseudolymphoma (TCPL) usually presents as a solitary nodule or plaque on the trunk or head. A clinicopathologic correlation is mandatory to arrive at a final diagnosis and rule out true lymphomas. There are only sparse dermoscopic reports on cutaneous pseudolymphomas. Hereby, we describe the clinical and dermoscopic features of a case of idiopathic TCPL in a 26-year-old man who presented with an asymptomatic thin reddish-brown "table tennis racquet"-shaped plaque on the right inframammary area.

A Hospital Based Cross Sectional Study of Midline Cutaneous Lesions in Neonates and its Association with Spinal Dysraphism Detected Using Ultrasound.

BACKGROUND: Spinal dysraphism occurs due to incomplete fusion of the midline mesenchymal, bony, or neural elements of the spine. The defects in the spinal cord can be associated with skin lesion since both have same embryonic origin. AIMS AND OBJECTIVES: This study was conducted to determine the association of midline and paramedian cutaneous lesions with spinal dysraphism by using spinal ultrasonography. MATERIALS AND METHODS: Two thousand apparently healthy neonates were screened in the postnatal ward of a tertiary care center in South India. Those neonates with cutaneous lesions in the midline and paramedian region were screened for evidence of spinal dysraphism by using spinal ultrasonography. RESULTS: Among 2000 neonates, 120 (6%) had at least one cutaneous lesion, of which 114 (5.7%) were in the midline and 6 (0.3%) were on the paramedian region of dorsal and ventral aspect of the body. Among these neonates, two cases had more than one skin lesions. The most common cutaneous lesion observed was typical dimple (82, 68%) followed by hypertrichosis (12, 10%). Ultrasonography revealed spinal anomaly in six (5%) of them. The cutaneous lesions associated with spinal dysraphism were obvious midline swelling, dermal sinus, and multiple skin lesions. CONCLUSION: Congenital midline and paramedian skin lesions may be the marker of spinal dysraphism. In the presence of such cutaneous lesions, only 5% of them had associated spinal anomaly in our study.

Disseminated Kaposi's sarcoma as a presenting sign of HIV in an Indian male: A case report with dermoscopic findings.

Kaposi's sarcoma (KS) is one of the AIDS-defining illnesses, which tends to occur at low CD4 count. It is the most common malignancy associated with HIV disease. Yet, there is a paucity of Indian case reports of KS in the English literature. We report the case of a 45-year-old HIV-positive heterosexual male with an unusual presentation of KS in the form of unilateral lymphedema mimicking cellulitis. We also describe the dermoscopic findings of the same.