A study on clinical spectrum of lichen sclerosus in a tertiary care Centre in North India.

Introduction: Lichen sclerosus (LS) is a chronic dermatosis frequently located over labial, perineal, and perianal areas. The etiology is multifactorial and includes genetic, autoimmune, hormonal, and infectious aspects. Materials and Methods: A series of twenty genital LS patients was carried out to evaluate the signs, symptoms, complications, and affliction of quality of life. Results: Eighteen out of twenty patients were female between 30 and 73 years and showed smooth, glistening, and whitish plaques. The mean duration was 8.4 years. Itching and burning was the most common symptom (75%) corresponding to excoriation and fissuring of genitalia (75%). Malignancy was seen in two cases (10%). The mean Vulvar Quality of Life Index was 9.2, higher in younger patients. Discussion: LS is a disorder of older age group with female preponderance. It is a source of significant morbidity, and long-standing cases predispose to vulvar malignancy. Conclusion: To conclude, early diagnosis with proper counselling of the patient and his/her partner regarding various aspects of disease are essential for a wholesome approach.

A Randomized Comparative Study of MIP and MMR Vaccine for the Treatment of Cutaneous Warts.

OBJECTIVES: To evaluate and compare the efficacy of MMR vaccine and MIP vaccine for resolution of Cutaneous warts (Cw). METHODS: The hospital-based prospective randomized interventional study was done where a total of 60 patients of Cw were divided into two groups of 30 patients each: Group A received 0.1 ml of intralesional injection of MIP vaccine and Group B received 0.5 ml of MMR vaccine. The treatment protocol involved three intralesional injection of vaccines at intervals of 3 weeks (maximum of three injections). The follow-up was done every 4 weeks for at least 24 weeks for the comparison of the two groups. The primary outcomes were the decrease in size of the wart or clearance of primary warts. The secondary outcomes were the improvement in the distant warts and any complications related to the use of vaccines. The data were entered in MS Excel and analyzed using SPSS 17.0 version. A P value of <0.05 was considered statistically significant. RESULTS: The baseline demographic and wart characteristics were comparable between the two groups (P > 0.05). As compared to MMR, MIP showed an early (9.41 vs 11.71 weeks, P = 0.027), and a significantly higher complete response (90% vs 76.67%) with P < 0.05. The less duration of the warts was significantly associated with the higher complete response (P < 0.05) in both the groups. The common side effects were erythema/inflammation [19 (63.34%)] in Group A and pain during the injection [19 (63.34%)] in Group B with P < 0.0001. CONCLUSION: In conclusion, MIP intralesional injections have a quicker response and are more efficacious compared to MMR in the treatment of Cw, though each vaccine carries its own sets of side effects.

Extramammary Paget's disease of the penis: A rare case report.

Extramammary Paget's disease (EMPD) of the penis is a rare, intraepidermal adenocarcinoma. We describe the case of a 60-year-old male who presented with an erythematous plaque on his penis, previously treated with various topical and oral drugs. Punch biopsy from the lesion revealed the diagnosis of EMPD. Early diagnosis and treatment is necessary for this rare neoplastic condition.

Hair and Scalp Disorders in Children below 2 Years: An Unremarked Sphere.

CONTEXT: Hairs contribute significantly to our appearance and are mirror to many systemic diseases. Hair and scalp disorders in children are associated with profound psychological effects arising from concerns of chronicity, severity, and contagiousness, in addition to cosmetic outline. Studies have documented children below 2 years as the most common age group affected by hair and scalp disorders in the pediatric population; however, to the best of our knowledge, none has been carried out exclusively on this age group, so far. AIMS: To determine the pattern of hair and scalp disorders and their underlying etiologies in children below 2 years. SETTINGS AND DESIGN: Observational and analytical. SUBJECTS AND METHODS: Fifty consecutive patients, aged 0-24 months presenting with complaints of hair and scalp disorder, to the outpatient department of dermatology of a tertiary care hospital in North India, constituted the study population. RESULTS: The most common disorder was seborrheic dermatitis (SD) 56%, followed by transient neonatal hair loss 22%. We also came across interesting cases of plica neuropathica (PN) 4%, trichotillomania 2%, and traction alopecia 6%, apart from a list of other disorders noted. The most common age group was 0-6 months. CONCLUSIONS: Hair and scalp disorders vary greatly with different demographic areas. In this region of the world, we came across cases of PN due to religious practices. SD was the most prevalent disorder as seen elsewhere. Trichotillomania noted in such a young child was not as a mere habit (as popularly believed), rather an act of anger. Hence, with this study, we want to emphasize the role of detailed history and examination, besides outlining the spectrum of disorders in this age group.

Lipoid proteinosis: A case with distinct histopathological and radiological findings.

Lipoid proteinosis is a rare inherited genodermatosis characterized by hyaline deposits in various tissues. Clinically, it manifests with cutaneous as well as extracutaneous features. Periodic acid-Schiff (PAS)-reactive hyaline deposits in the upper dermis, with localization around blood vessels and eccrine sweat glands, in particular, is the histopathological hallmark finding. On brain imaging, bilateral symmetrical temporal lobe calcifications are considered to be pathognomonic of this disorder. We report a case of lipoid proteinosis in which hyaline deposits were present in the papillary and reticular dermis, without being seen at the periphery of eccrine sweat glands, along with dystrophic calcification. Magnetic resonance imaging (MRI) of brain revealed hydrocephalus, subependymal heterotropia and absent splenium of corpus callosum with no evidence of temporal lobe calcification. Thus, our case highlights the inherent diverse nature of lipoid proteinosis.