Clinico-Epidemiological Profile of Childhood Alopecia Areata Along with Dermoscopic Correlation: A Cross-Section, Observational Study.

BACKGROUND: Childhood alopecia areata (AA) is a common cause of dermatologic consultation; however, data is scarce in the present set-up. OBJECTIVES: To evaluate the clinico-epidemiological profile of childhood AA along with dermoscopic correlation. METHODS: We conducted a cross-sectional study including 50 new cases of childhood AA for 1 year. Dermoscopy was performed in each child and findings recorded. RESULTS: Childhood AA was more common in girls (M: F 1:1.4), mean age being 11.1 ± 3.7 years. Scalp was commonest site of involvement in 86% cases, while 32 (64%) children had mild disease (<25% involvement). Localized circumscribed patch was the commonest presentation in 37 (74%) children, while sisaipho was the least (2%). A positive family history of AA was noted in 5 (10%) children. Twenty-four children (48%) provided a history of atopic disorders, while 30% had a positive family history of atopy. Stress was the commonest precipitating factor in 13 (26%) subjects. Nail involvement was observed in 19 (38%) children (pitting >thinning), while systemic associations like vitiligo and thyroid dysfunction were present in 26% and 24% cases, respectively. Dermoscopy revealed yellow-dots to be the commonest finding in 44 (88%) cases, followed by short vellus hair and black dots in 76% and 28% children, respectively, while exclamation-mark hair was rare. CONCLUSION: Female gender, younger age, nail involvement, and presence of concomitant atopy, vitiligo, and thyroid dysfunction were associated with severe disease, but not statistically significant (p > 0.05). Regression model failed to detect any risk factors for severe AA. Dermoscopy is an important non-invasive tool for evaluating childhood AA.

Secondary Syphilid Developing Over Healed Lesions of Varicella: Wolf's Isotopic Response?

Isotopic response is a distinctive phenomenon in which a new skin disorder occurs at the site of another, unrelated, and already healed skin disease. Most of the cases documented in the literature were associated with herpes zoster as primary disease while the list of "second" diseases is quite long. We report here a hitherto unreported occurrence of isotopic response in which secondary syphilis occurred on the healed lesions of varicella.

Squamous cell carcinoma developing in a long-standing case of tuberous xanthoma: An incident unreported hitherto.

Cutaneous squamous cell carcinoma, characterized by malignant transformation of normal epidermal keratinocyte is the second most common nonmelanoma skin cancer that has many predisposing factors. Tuberous xanthomas have not yet been reported as a predisposing factor. We report here the case of long-standing tuberous xanthoma in a middle-aged gentleman complicated by cutaneous squamous cell carcinoma, probably the first such report in the Indian literature.

Unilateral nevoid acanthosis nigricans: Uncommon variant of a common disease.

Acanthosis nigricans (AN) is a fairly common dermatosis characterized by hyperpigmented velvety plaques, having a predilection for the intertriginous areas. We herein present a case of unilateral nevoid acanthosis nigricans over the left lateral chest, in an adult male. The rarity of documentation of this entity in the world literature prompted us to report the case.

Generalized benign acanthosis nigricans in an infant.

The generalized form of acanthosis nigricans, especially in infants, is extremely rare. Herein we report a 1-year-old female child who developed generalized acanthosis nigricans without any evidence of internal malignancy or endocrine disorder. This case is being reported for its rarity.

Zinc and skin: a brief summary.

Zinc is an essential trace element that is an integral component of many metallo-enzymes in the body and thus serves many biological functions. The clinical presentation of zinc deficiency varies and depends on serum zinc level. Whereas a significantly low serum zinc level results in clinical features similar to acrodermatitis enteropathica, mild hypozincemia presents with a less characteristic appearance; hence it may be underdiagnosed. Recognition of various cutaneous lesions is required for suspecting and identifying cases of zinc deficiency. Although many laboratory tests are useful, therapeutic response in suspected cases remains the gold standard of diagnosis. Serum zinc estimation alone is not very reliable because disease activity may not necessarily correlate with serum zinc level. Zinc supplementation results in a rapid response and the skin lesions heal without permanent sequelae. However, pigmentary alterations may persist longer. Predisposing factors should be identified and corrected. This brief review summarizes the identification and management of clinical zinc deficiency.

A clinico-histopathological study of appendageal skin tumors, affecting head and neck region in patients attending the dermatology opd of a tertiary care centre in eastern India.

INTRODUCTION: Appendageal skin tumors (ATs) are those neoplasms that differentiate toward/arise from pilosebaceous apparatus, apocrine, or eccrine sweat glands. Pilosebaceous apparatus are concentrated in head-neck area; thus it is expected that ATs would account for a major fraction of skin tumors over this site. AIMS: This study aims at finding the clinico-histopathological correlation in cases ATs in head-neck region among attendees of dermatology OPD. MATERIALS AND METHODS: Cross-sectional descriptive study, conducted over 1-year period. All clinically suspected cases of ATs were evaluated and subjected to histopathological examination. Confirmed cases of ATs were finally analyzed. RESULTS: Among twenty eight thousand four hundred sixty six new patients attending OPD, 30 suspected cases of ATs underwent histopathological examination. Histopathology was confirmatory in only 23 (76.67%) cases. Out of 23, syringoma were found in 9 (39.13%), trichoepithelioma in 6 (26.08%), syringocystadenoma papilliferum in 4 (17.39%), sebaceous gland hyperplasia in 3 (13.04%), and vellous hair cyst in 1 (4.34 %). Females (65.21%) outnumbered males (34.78%) in our study population. CONCLUSIONS: ATs of head-neck region constitute a meager population (0.08%) attending dermatology OPD, and were more common among young population. Often it is over-diagnosed clinically thus necessitating histological confirmation. Young females being cosmetically more conscious are more eager to seek advice for this condition.

Dyshidrosiform Pemphigus vulgaris: Report of an unusual case.

Dyshidrosiform Bullous pemphigoid is a well-known entity, but dyshidrosiform pemphigus vulgaris has rarely been described. Our patient, a 36-year-old female, with a known case of pemphigus vulgaris (PV) for the last 6 years, presented with a 3 month history of a dyshidrosiform eruption of the soles. On the basis of histopathological and direct immunofluorence (DIF) findings, the new eruption was diagnosed as PV. We report our case as dyshidrosiform pemphigus vulgaris.

Verrucous plaque on the face: what is your diagnosis?

A 46-year-old male patient presented with hyperpigmented verrucous plaques and papules mainly on the left cheek and malar region that had evolved over a 7 month period. Histopathology demonstrated the presence of a large number of classical copper penny bodies or muriform bodies and a predominantly neutrophilic dermal infiltrate that confirmed the diagnosis of chromoblastomycosis.