A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital.

The aim of cancer treatment is to target and destroy cancer cells. Adversely it affects rapidly dividing cells of bone marrow, hair, nails, skin and gastrointestinal mucosa. Drug induced side effects are seen in 25% of hospitalized cancer patients resulting in a variety of cutaneous adverse effects. This study analyses the cutaneous manifestations in patients on cancer therapy at a tertiary care hospital.METHODSThis is a hospital based observational study, done over a period of 2 years (September 2016 - September 2018), on cancer patients undergoing chemo or radiotherapy having cutaneous manifestations, referred to the Dermatology OPD from Oncology OPD in a tertiary hospital.RESULTSAmong 106 cases, 47% were males and 53% were females. Majority of patients belonged to the age group of 41-60 years (40%). Carcinoma of breast (13%) and lung (9%) presented in highest frequency. Out of 59 patients who were treated with chemotherapy alone, most common was anagen effluvium (59%) and least common were ichthyosis, erythema multiforme and herpes zoster (each 2%). Among 5 patients who were treated with radiation therapy alone, most common was radiation dermatitis and seborrheic dermatitis (each 40 %). Among 18 patients who underwent combined chemo and radiotherapy, most common was anagen effluvium (39%) and least was folliculitis, lichenoid dermatitis (each 7%). Among 8 patients who underwent surgery followed by adjuvant chemotherapy, most common was anagen effluvium (40%) and least was surgical site infection, eczema, folliculitis (each 12%). Among 16 patients who underwent combined chemo, radiation and surgery, most common was anagen effluvium (25%) and least common was surgical site infection (6%). 14% fungal, 10% bacterial and 6% viral infections were noted. Among 101 patients who received at least 1 chemotherapeutic agent, most commonly used agent was cisplatin (50%) and least commonly used agent was gemcitabine (3%).CONCLUSIONSEarly identification of adverse effects might help us to give a better quality of life and reduce psychosomatic distress of the patients. It might also assist in tailoring the therapy accordingly.

Degos’ Like Nonclear Cell Acanthoma: Could this be a New Entity.

Degos’ acanthoma is a tumor that is clinically and histologically distinct. Typically, the lesions are solitary, sharply delineated red nodules or plaques 1-2 cm in diameter, usually covered by a thin wafer like crust. On microscopy, the striking presence of pale and slightly enlarged epidermal cells is essential to clinch the diagnosis. Here we present a case where the clinical picture was that of Degos’ acanthoma with the absence of glycogen rich clear cells on histology.

Disseminated Tuberculosis with involvement of prostate - A case report.

We present a 55-year-old male who presented with painful non-healing ulcers on the lower lip and scrotum associated with productive cough, fever, anorexia and dysuria. Erythrocyte sedimentation rate was raised, sputum was positive for acid fast bacilli. Chest X-ray was suggestive of pulmonary tuberculosis. A prostate biopsy was also suggestive of tuberculosis. A diagnosis of disseminated tuberculosis was made and the patient showed a good response in two weeks.