Proteus syndrome: A rare cause of gigantic limb.

A congenital disorder with variable manifestations, including partial gigantism of the hands and feet with hypertrophy of soles, nevi, hemihypertrophy, gynecomastia, macrocephaly and other skull abnormalities, and abdominal lipomatosis. The cause is unknown, although a genetic origin, generally of autosomal-dominant transmission, has been conjectured. Symptoms can be treated, but there is no known cure. We present the case of a young male with grotesque overgrowth of the right lower limb, splenomegaly and multiple nevi. Angiography revealed venous malformation within the limb. The findings are in conformity to the criteria for the Proteus syndrome.

An observational study of cutaneous manifestations in diabetes mellitus in a tertiary care Hospital of Eastern India.

BACKGROUND: Diabetes mellitus and its impact on the human body have been extensively dissected over the years. However, skin which is the largest organ in the body, has received minimum attention. Therefore, this study was designed to analyze the prevalence and pattern of skin disorders among diabetic patients from Eastern region of India. MATERIALS AND METHODS: This is an observational study, conducted in the General Medicine and Endocrinology departments of a Medical College and Hospital in Eastern India. The data were collected prospectively and systematically in a pre-established proforma designed by us, where clinical findings along with investigations were recorded. RESULTS: Six hundred and eighty (680) diabetic patients were examined, there were (64.8%) male and (35.1%) were female, of them 95.3% were Type 2 diabetics while 4.7% were Type 1. Five hundred and three patients (503) out of six hundred and eighty. i.e. 73.9% were found to have skin lesions. Thirteen (13) (41%) Type1 diabetics demonstrated skin lesions commonest being diabetic xerosis, infections and diabetic hand. Among Type2 diabetics 490(75.61%) showed skin lesions. Here infections, xerosis, hair loss beneath the knees, diabetic dermopathy were the most frequent. Majority of patients (67%) had combination of more than one type of skin lesion. There was statistically significant correlation of skin lesions with duration of diabetes, however similar correlation could not be demonstrated regarding metabolic control. CONCLUSION: Involvement of skin is inevitable and multifarious in diabetes mellitus. Higher prevalence is seen in Type 2 diabetic population. The duration of diabetes is positively correlated with lesions and infective dermatologic manifestations were associated with higher HbA1C values.

Drug interactions in dermatology: what the dermatologist should know.

A drug interaction is a process by which a drug or any other substance interacts with another drug and affects its activity by increasing or decreasing its effect, causing a side effect or producing a new effect unrelated to the effect of either. Interactions may be of various types-drug-drug interactions, drug-food interactions, drug-medical condition interactions, or drug-herb interactions. Interactions may occur by single or multiple mechanisms. They may occur in vivo or in vitro (pharmaceutical reactions). In vivo interactions may be further subdivided into pharmacodynamic or pharmacokinetic reactions. Topical drug interactions which may be agonistic or antagonistic may occur between two drugs applied topically or between a topical and a systemic drug. Topical drug-food interaction (for example, grape fruit juice and cyclosporine) and drug-disease interactions (for example, topical corticosteroid and aloe vera) may also occur. It is important for the dermatologist to be aware of such interactions to avoid complications of therapy in day-to-day practice.

Ashy dermatosis: a controversial entity.

We present here the case of a young Indian male with slowly progressive, diffuse darkening of the face, arms, neck, and trunk. The patient was not taking any medication and there was no history of any previous skin disease and the mucous membrane was not involved. These findings are consistent with a diagnosis for ashy dermatosis of unknown etiology.

Black tea (Camellia sinensis) decoction shows immunomodulatory properties on an experimental animal model and in human peripheral mononuclear cells.

BACKGROUND: Black tea (Camellia sinensis) has been used as a daily beverage for time immemorial. Immunomodulatory effects of tea are recognized as it stimulates the proliferation of cultured human peripheral blood mononuclear cells. Anti-inflammatory effects of tea have also been depicted in the available literature. Therefore, we designed this study to examine the potential immunemodulatory and anti-inflammatory activities of black tea in a rat model and in human peripheral mononuclear cells. AIMS: The purpose of the study was to determine (1) evaluation of anti-inflammatory effects of black tea on rats, (2) evaluation of immunemodulator effects of black tea on rats, and (3) evaluation of immunemodulator effects of black tea on human peripheral mononuclear cells. MATERIALS AND METHODS: Black tea decoction (10% and 20%) was prepared. Acute anti-inflammatory activity of tea decoction was evaluated using carrageenan and dextran whereas chronic anti-inflammatory (Immunomodulatory) effects were evaluated in a complete Freunds' adjuvant-induced arthritis model. Immunostimulatory role was evaluated in cultured human (in vitro) peripheral mononuclear cells (T-lymphocytes) by using methyl thioazolyl tetrazolium (MTT) and Trypan blue assay. STUDY DESIGN: An experimental study was designed. RESULTS: Black tea decoction (10% and 20%) strength has shown significant anti-inflammatory effects (64.8% and 77% reduction, respectively), on carrageenan-induced acute inflammatory models (rat paw edema) which can be comparable with the standard drug indomethacin (89.1%). In a chronic anti-inflammatory model, black tea decoction (10% and 20%) has shown significant suppressive effects on rat paw edema (38.56% and 69.53%) observed on 21(st) day. Lymphoproliferative action of tea was evaluated on human peripheral mononuclear cells using an MTT assay where the number of living cells were expressed in terms of optical density at 570 nm. An experiment has shown that black tea increases the maximum number of T-lymphocytes at 72 h with a maximum strength of 20%. Maximum number of viable cells (T-lymphocytes) was observed with black tea at 20% strength at 72 h. The results were expressed as mean ± SD, and the significance was evaluated by Student's t-test versus control, with P < 0.05 implying significance. CONCLUSIONS: Taken together, our data indicate that black tea has potential anti-inflammatory and immunomodulatory action and this corroborates with the current trend of tea being promoted as a 'health drink'.

A case of dyskeratosis congenita with primary amenorrhea and adenocarcinoma of stomach.

Dyskeratosis congenita (DC) is a rare disease characterized by hyperpigmentation, nail dystrophy and mucous membrane abnormality. Commonly occurring in males, the patients die young usually due to bone marrow suppression. Malignancies of various descriptions have been reported in this disease, the commonest being solid tumors of head/neck (squamous cell carcinoma). We report the case of a female patient with DC, who presented to us with severe wasting and primary amenorrhea and died of carcinoma stomach in our hospital 3 weeks later.