Familial pseudoxanthoma elasticum: report of three case series in a single family

Pseudoxanthoma elasticum is a rare autosomal recessive skin disease with a slight female preponderance and often presents a therapeutic challenge due to additional risk to eyes and cardiovascular system. Clumping and distortion of elastic fibres in target organ leads to deposition of calcium and impair the function of elastic fibres of mid and deep dermis, media and intima of midsized arteries, Bruch's membrane in eye. Here we present three cases in the same family who presented with yellowish flat plaques, papules in the front and lateral side of the neck

Leprosy: type 1 reaction precipitated by doxorubicin and cisplatin

Type 1 reaction [T1R] in leprosy is common and characterized by increased inflammation in skin lesions or nerve. Besides antileprotic therapy, T1Rs are associated with intercurrent infection, pregnancy and drugs. Also, T1Rs may be a presenting feature of leprosy. We report a case of T1R in leprosy presenting as drug reaction during cancer chemotherapy with doxorubicin and cisplatin. We propose to explain this unusual occurrence by highlighting the increased production and expression of TNF-alpha by these drugs. Thus, physicians using these drugs should keep this unusual adverse effect in mind

Irritant dermatitis and postinflammatory depigmentation following application of 'sexual massage oils' - a case report

There has been a new hard selling product in the Southeast Asian market - the so called 'sex massage oil'. A variety of such preparations are available freely and are claimed to have sexaugmenting properties. Various effects are claimed upon usage, ranging from enlargement of the male organ to substantial increases in intercourse time. Also is claimed, that, these products being 'herbal' have no side effects. These attractively packaged oils are sold over the counter in large volumes to the unsuspecting public. We present here a case of a young man who suffered from chronic irritant dermatitis from usage of the same. We believe this to be the first case report where irritant dermatitis had resulted from usage of such 'sex massage oils'

Segmental neurofibromatosis: report of two cases of this rare entity and brief review of the literature

Neurofibromatosis [NF] is a group of rare genetic disorder of neural crest derived cells of which neurofibromatosis type-1 is the most common. Riccardi classified NF into eight subtypes [NF-I to NF-VIII], of which NF-V is segmental neurofibromatosis [SNF]. SNF is rare and facial involvement is even rarer. A 52-year-old man presented with complaints of numerous swellings on the right side of his face for the last 20 years. On examination, there were many papules and papulo-nodules only on the right cheek. The swellings were non-tender, firm on palpation and measured from 3 mm to 12 mm in diameter. A biopsy was taken from one of the nodules; the slide revealed non-encapsulated but well circumscribed proliferation of spindle cells with wavy, buckled nuclei arranged in wavy fascicles in myxoid background. This case of facial SNF is described not only for its extreme rarity, but also as an important differential diagnosis for facial tumor-like papules. We have also reviewed the literature briefly

Irritant contact dermatitis from passive contact with sexual massage oils - 'sexual contact dermatitis'

Massage oils for sexual use have flooded the Indian market in recent times. These oils have been claimed to have several sexual augmenting properties. These oils are sold widely over the counter in India to the otherwise unsuspecting and lay public, who use them largely out of curiosity, being driven by clever marketing techniques. We report a patient who suffered irritant contact dermatitis from the oil after passive contact. We consider this to be the first case report of such 'sexual contact dermatitis' resulting from the usage of such penis-massage oils. We intend hereby to emphasize the need for issue of side effects and safety notifications. This condition may also be considered in the differential diagnoses of anogenital ulceration following sexual intercourse.

introspection into the cutaneous manifestations of chronic arsenicosis as reported in a tertiary care centre in Kolkata

To study different patterns of skin manifestations of arsenicosis. A cross-sectional observational study was done on 110 patients of clinically suspected arsenicosis attending the dermatology outdoor of a tertiary care centre in eastern India over a period of one year. Cutaneous indicators like keratosis over palms and soles, melanosis and hypopigmentation over trunk in patients coming from endemic zones were included. Arsenic level estimation was done in drinking water, hair and nails. Systemic evaluation was done in symptomatic cases. Majority of the patients hailed from Nadia, North 24 Parganas and Murshidabad districts. Males and females presented equally. Skin pigmentation was present in almost all patients [95%]. Raindrop pigmentation was the commonest cutaneous manifestation [71%] followed by punctuate palmar keratosis [49%]. Bowen's disease was found in 21% patients whereas squamous cell carcinoma was the commonest cutaneous malignancy [5%]. Raindrop pigmentation was found more in males than females. Peak incidence was found in patients exposed to arsenic containing drinking water for a minimum of 5 years. There was strong correlation of severity of skin manifestations and level of arsenic in drinking water. The most common presentation of arsenicosis was raindrop pigmentation and it was found more in males. The incidence of cutaneous malignancy was 3% with premalignant Bowen's disease being quite high [21%]

Pyoderma gangrenosum in pregnancy: a case with unusual presentation

Pyoderma gangrenosum [PG] is an uncommon idiopathic chronic ulcerative condition, clinically characterized by initial small pustules which develop into ulcers with typical undermined borders with violaceous hue. In most cases, PG is associated with systemic diseases like inflammatory bowel disease, inflammatory polyarthritis and hematological disorders as paraproteinemia and leukemias. Diagnosis is difficult, mostly resting on the exclusion of other similar conditions, due to lack of pathognomonic histological features. We describe a case of PG in pregnancy not only for the rarity of the association, but also because of some unusual presenting features. We treated the patient by intralesional steroid injection and topical steroid application; the ulcers healed within a month