Nevus Comedonicus : A Case Report

Nevus Comedonicus is a rare hamartoma of the pilosebaceus unit resulting in numerous dilated keratin filled comedones. This report describes an 18 year old female with multiple pigmented comedones in a linear pattern over the inner aspect of the left thigh

A prospective randomised open labelled comparative study of anti inflammatory effects of topical 5% benzoyl peroxide gel vs topical 4% nicotinamide gel for grade I-II acne in a tertiary care hospital

Background: Acne vulgaris is a dermatological disorder characterised by formation of comedones and inflammatory lesions. The treatment of acne basically involves reduction of lesions. Benzoyl peroxide, in concentrations of 5%, 10%, and 20%, has been used effectively in the treatment of acne for more than 20 years. Nicotinamide/ Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory effect. The present study assessed the efficacy of 5% Benzoyl peroxide gel in comparison to 4% Nicotinamide gel for topical treatment of mild to moderate acne vulgaris.Methods: In this study, the patients with mild to moderate acne vulgaris with inflammation were divided into two groups, group I was treated with topical 5% Benzoyl peroxide gel whereas topical Nicotinamide gel was given to the group II. Assessment of efficacy was done by total lesion counting according acne global severity index, the results were compared at the end of 2 weeks and 4 weeks with the baseline values.Results: At the end of this study, it was found that the reduction of inflammatory and total percentage of decrease in counts of lesions from baseline were highly significant in both the groups (p<0.001), between the groups, differences were statistically significant (p<0.001), therefore 5% Benzoyl peroxide gel has better efficacy than 4% Nicotinamide gel.Conclusions: Benzoyl peroxide is more efficacious than 4 % Nicotinamide gel in mild to moderate acne.

Favre-Racouchot Syndrome with Predominant Nose Involvement.

Favre-Racouchot syndrome (FRS) is a dermatological condition predominantly affecting individuals with an excessive sunexposure. We report a case seen in an elderly male with a predominant involvement of the nose.

Acne: Etiopathogenesis and its management.

Acne vulgaris is one of the commonest skin disorders, which dermatologists have to treat, mainly affect adolescents, though it may present at any age. Acne is chronic inflammatory disease of pilosebaceous units. Clinically it can present as seborrhea, comedones, erythematous papules, pustules and nodules. In recent years, due to better understanding of the etiopathogenesis of acne, new therapeutic modalities are designed. The purpose of this article is to review the etiopathogenesis and treatment options available with us in the present scenario.

Comparison of Cytokine Expression between Acne Comedones and Senile Comedones: Pilot Study / 대한피부과학회지

No abstract available.

Three cases of Dowling Degos disease in two families.

Dowling Degos disease is a rare condition inherited as autosomal dominant trait characterized by numerous, asymptomatic, symmetrical, progressive, small, round-pigmented macules over axillae and groins, face, neck, arms and trunk, scattered comedo-like lesions (dark dot follicles) and pitted acneiform scars. Histopathology is diagnostic. We are hereby reporting three cases of Dowling Degos disease belonging to two families. Our first and second case belonged to the same family, whereas our third case belonged to different family. In our series, all the patients had onset after puberty. All three cases had reticulate pigmentation over face and/or flexures, black comedones and follicular pits. On histopathological examination of the skin biopsy taken from the lesion over the back, all these patients showed classical histopathological features of Dowling Degos disease. We feel that one should investigate the patient presenting with reticulate pigmentation over the face and flexures with blackish comedone-like lesions, because histopathological features of this condition are unmistakable.

Profile of acne vulgaris-A hospital-based study from South India.

Background: Acne vulgaris is believed to be the most common disease of the skin. There is no Indian study on the profile of acne vulgaris, markers of severe forms of acne vulgaris and a possible correlation between acne vulgaris and markers of androgenicity in females. Aim: To study the profile of acne vulgaris, its seasonal variation, relationship with smoking and possible correlation between acne vulgaris and markers of androgenicity in females. Methods: The study was conducted between August 2006 and June 2008. All patients with acne vulgaris who consented to participate in the study were included. The parameters evaluated included age, gender, age of onset, duration of lesions, site of lesions, grade, relation with menstrual cycle, markers of androgenicity, number of acne lesions such as comedones, papules pustules and nodules, number and site of post-acne scarring, post-acne hyperpigmentation, seasonal variation and history of smoking. Results: A total of 309 patients with acne vulgaris were included in the study. The frequency of acne vulgaris in our study was 1.068%. Mean age of the study group was 19.78 years. Male to female ratio was 1.25:1. The most common age group involved was 16 to 20 years (59.8%). Mean age of onset was 15.97 years. Face was involved in all the patients, followed by back (28.2%), chest (20.1%), neck (9.4%) and arms (10%). In the older age groups, women were more likely to report having acne vulgaris than men ( P = 0.01). The closed comedones outnumbered open comedones by a factor of 4.9:1. A total of 186 patients (60.2%) had grade 1 acne vulgaris, 85 (27.5%) had grade 2 acne, 8 (2.6%) had grade 3 acne and 30 (9.7%) had grade 4 acne vulgaris. There was a higher incidence of scarring (39.5%) and post-acne hyperpigmentation (24.6%) in our study. In female patients, 57.7% had premenstrual flare and 12.4% had cutaneous markers of androgenicity. There was no association between severity of acne vulgaris and other markers of androgenicity ( P = 0.108). Seborrheic dermatitis (21.35%) was the most common disease associated. Seasonal variation was observed only in 80 patients (25.9%); 71 patients (23%) exacerbated in summer and 9 patients (2.9%) in winter. Smokers had more severe grade of acne vulgaris compared to nonsmokers ( P = 0.001). Conclusion: This study brings out the clinical profile of acne vulgaris in a tertiary care hospital in South India.

A Case of Favre-Racouchot Syndrome / 대한피부과학회지

Favre-Racouchot syndrome is a cutaneous disease characterized by a degenerative process of dermis associated with comedones, furrows and nodules. It occurs on the face of aged men, a remarkable preference for the male, after prolonged exposure to sunlight. The pathogenesis of Favre-Racouchot syndrome is uncertain. The damage by UV exposure has been strongly suggested as a major cause. We present a typical case of Favre-Racouchot syndrome in a 65 year old male. The patient had numerous yellowish cysts, comedones and nodules on both cheeks. Histopathology of the lesion showed dilated pilosebaceous openings and large cyst-like spaces filled with multi-layered horny material in addition to pronounced solar elastosis in the dermis.

Comedones Appearing after Herpes Zoster / 대한피부과학회지

Isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. Various diseases have been reported in terms of isotopic response associated with herpes zoster, but the development of comedones is uncommon. We report a case of comedones that had developed on the site previously affected by herpes zoster in a 59-year-old male, which is thought to be an isotopic response. Eight months ago, he visited with herpes zoster lesions on the left upper eyelid, forehead and scalp(dermatome cranial nerve V1). He had grouped and discrete, slightly elevated, skin colored papules with dark, firm hyperkeratotic plug on the healed site of herpes zoster.

The Isolation of Malassezia Yeasts in the Comedones of Acne Vulgaris / 대한의진균학회지

BACKGROUND: Both Malassezia yeast and Propionibacterium acnes form part of the normal flora of the human skin and hair follicles. The former is the etiological agent of Malassezia(Pityrosporum) folliculitis and the latter is one of the major factors in the pathogenesis of acne vulgaris. These two follicular diseases can coexist on a certain area of the skin, but there have been few reports about their coexistence in the literature. OBJECTIVE: The aim of this work was to investigate the distribution of Malassezia yeasts in the comedones of patients clinically diagnosed as acne vulgaris for elucidation of the coexistence of the two diseases, and for information on the predominance of the colonized Malassezia species and on relationship between certain species and Malassezia folliculitis. METHODS: The spore load in the comedonal plugs of 32 patients with acne vulgaris was graded using direct microscopy of KOH/Parker ink mounts. The comedonal specimens were cultured on Looming & Notman's media and the isolated Malassezia yeasts were identified to species level by their colony morphologies, microscopic morphologies and physiological characteristics. RESULTS: On direct microscopy, 8 of 32 patients (25%) showed a 4+ spore load, which is considered as a diagnostic grading index of Malassezia folliculitis. The predominant Malassezia(M.) species from 32 patients with acne vulgaris were M. restricta, M. globosa, M. furfur in descending order. Three strains of M. restricta, 4 strains of M, globosa, 2 strains of M. furfur and 1 strain of M. obtusa were isolated from the comedones of the 8 patients with 4+ spore load. CONCLUSION: This study shows that Malassezia folliculitis might coexist with acne vulgaris on the face, but there was no relationship between certain species and Malassezia folliculitis. The results suggest that antibiotic resistant acne vulgaris should be examined by direct microscopy of KOH/Parker ink mounts to confirm the coexistence of Malassezia folliculitis and acne vulgaris.