Lupus vulgaris of centrofacial area - a peculiar presentation

Lupus vulgaris is a cutaneous manifestation of Mycobacterium tuberculosis infection. It assumes various clinical forms including plaque, ulcerative, hypertrophic, vegetative, papular and nodular type. We here present an unusual case of a ten-year-old girl diagnosed as hypertrophic lupus vulgaris of centrofacial area including nose. Histopathological examination and bacteriological studies were carried out to establish the diagnosis. Unlike plaque type, hypertrophic variety is quite uncommon and only few cases have been reported. Its peculiar appearance on the face which is hardly described in previous literatures and well response to antitubercular therapy prompted us to report it

Onychomycosis in Eastern India - study in a peripheral tertiary care centre

To find out various clinical patterns, etiologic agents and to evaluate the clinicomycologic correlation. Two hundred and forty nine cases of clinically suspected onychomycosis were included in this study. Clinical patterns were noted and sample collected from most severely affected nail. They were subjected to direct microscopy and culture. Distal and lateral subungual onychomycosis was the commonest clinical pattern [56.6%] followed by proximal subungual onychomycosis [15.7%], total dystrophic onychomycosis [12.1%], white superficial onychomycosis [10.8%] and chronic paronychia [4.8%]. 126 cases [50.6%] were confirmed by either microscopy or culture whereas 123 cases [49.4%] were negative by both. Dermatophytes were most common [55.9%] cause of onychomycosis. Amongst them Trichophyton rubrum was the most common isolate [65.9%]. Candida albicans was important [79.2%] amongst the yeast isolates. Nondermatophytic moulds were involved in 15.5% of cases. Onychomycosis might be an important cause of absenteeism amongst the working classes in this part of India. Yeasts and nondermatophytic moulds are gradually becoming an important cause of onychomycosis in different areas of the world. So, early diagnosis and initiation of antifungal treatment should be the approach to safeguard the social, emotional and physical well being of the patients

Association of alopecia areata with segmental vitiligo and segmental lichen planus: a case report

Alopecia areata [AA] is a chronic inflammatory condition that affects the hair follicles and sometimes, the nails. It is believed that AA is caused by T cell-mediated autoimmune response and increased frequency of other autoimmune diseases in persons suffering from AA supports this hypothesis. A 12-year-old boy presented with extensive alopecia areata with pitting in all nails for 6 years. He had developed lesions of vitiligo and lichen planus on trunk in a segmental manner. While the association of alopecia areata and vitiligo as well as lichen planus is well known, segmental nature of both vitiligo and lichen planus is quite rare

Perifollicular hemorrhagic lesions and broken twisted hairs on legs

A 17-year-old girl presented with multiple perifollicular hemorrhagic lesions on legs for 2 weeks. There was history of intermittent gum bleeding for last 2 months. Clinical examination revealed follicular keratosis and broken twisted hair [corkscrew hair], in addition to hemorrhagic lesions. Perifollicular hemorrhagic lesions and corkscrew hair are virtually pathognomonic for scurvy. When specifically asked, mother revealed that the girl was on self-imposed diet with almost no citrus fruits. Based on history and clinical findings, diagnosis of scurvy was made. The response to vitamin C supplementation was very good and all the lesions disappeared within one month. Scurvy has been reported in increasing numbers in recent literature; hence, recognition of scurvy is essential to avoid many serious complications including internal bleeding and even, death

Cutaneous metastasis as presenting feature of internal malignancy - report of two cases

Cutaneous metastasis [CM] from internal malignancy is usually seen in advanced stage and hence is associated with bad prognosis. Sometimes, CM alone is a presenting feature without any obvious feature of internal malignancy. High index of suspicion and histopathology can establish the diagnosis of CM. Identification of underlying malignancy is based on clinical futures, histopathology, immunohistochemistry and other investigations. CM was the presenting feature in our cases and identification of CM led to search for underlying malignancy and then initiation of therapy