Cytophagic histiocytic panniculitis: report of two cases.

Cytophagic histiocytic panniculitis (CHP) was first described in 1980 by Winkelmann as a chronic histiocytic disease of the subcutaneous adipose tissue, which is characterized clinically by tender erythematous nodules, recurrent high fever, malaise, jaundice, organomegaly, serosal effusions, pancytopenia, hepatic dysfunction, and coagulatory abnormalities. CHP may occur either isolated or as part of cutaneous manifestations of hemophagocytic syndrome. Here, we report two different presentations of CHP.

Anti-phospholipid syndrome preceding a diagnosis of lepromatous leprosy.

A 64-year-old male, with known anti-phospholipid syndrome (APS), which had been diagnosed two years previously, presented to our department with asymptomatic papules over his trunk. Histopathological examination confirmed the diagnosis of lepromatous leprosy. We present this as a case of APS, preceding a diagnosis of lepromatous leprosy.

Electronic medical records in dermatology: practical implications.

BACKGROUND: Electronic medical records (EMRs) can be of great use in dermatological data recording. Unfortunately, not many studies have been carried out in this specific area. AIMS: We attempt to evaluate the use of an EMR system in dermatology, comparing it with a conventional paper-based system. METHODS: Two hundred patient records of patients attending the dermatology outpatient department were studied over a 3-month period. Half the reports were entered in the conventional paper-based format while the other half was entered in an EMR system. The time taken for each consultation was recorded and the same was carried out for the first subsequent follow-up visit. RESULTS: The average time taken for the completion of the EMR-based consultation for new cases was 19.15 min (range, 10-30 min; standard deviation, 6.47). The paper-based consultation had an average time of 15.70 min (range, 5-25 min; standard deviation, 6.78). The P-value (T-test was used) was 0.002, which was significant. The average time taken for consultations and entering progress notes in the follow-up cases was slightly less than 10 min (9.7) for EMR while it was slightly more than 10 min (10.3) for the paper format. The difference was not statistically significant. The doctors involved also mentioned what they felt were the advantages and disadvantages of the system along with suggestions for improvement. CONCLUSION: The use of an EMR system in dermatology (or for that matter in any specialty) may overawe most users at the beginning, but once a comfort level is established, EMR is likely to outscore conventional paper recording systems. More time-motion-case studies are required to ascertain the optimal usage of EMR systems.

Multiple cutaneous leiomyomas: pain relief with pulsed hysocine butyl bromide.

A 35-year-old male patient presented to our outpatient department, complaining of multiple, raised skin lesions on the forehead and back, associated with intermittent pain, especially on exposure to cold. A diagnosis of cutaneous leiomyoma (type 2 segmental) was made, which was confirmed by skin biopsy. The patient was started on a trial of pulsed Hyoscine Butyl bromide tablets, following which the patient had significant relief from pain associated with the lesions.

Basic digital photography in dermatology.

Digital photography has virtually replaced conventional film photography as far as clinical imaging is concerned. Though most dermatologists are familiar with digital cameras, there is room for improvement in the quality of clinical images. We aim to give an overview of the basics of digital photography in relation to dermatology, which would be useful to a dermatologist in his or her future clinical practice.

Palmar and flagellate hyperpigmentation following low dose intralesional injection of bleomycin for cystic hygroma.

A 1(1/2)-year-old boy developed hyperpigmentation of the palms and feet along with flagellate pigmentation over the trunk following intralesional injection of bleomycin for cystic hygroma. We present this case to highlight the possibility of cutaneous pigmentation being induced by bleomycin in low doses through non-intravenous administration.

Allergic contact dermatitis mimicking mammary paget's disease.

A 55-year-old female patient presented to our outpatient department with complaints of persistent erythema, oozing and crusting restricted to the left breast over the last 6 months. The patient underwent investigations to rule out the possibility of mammary Paget'S disease, all of which were negative. A possibility of contact dermatitis to topical medication was considered and confirmed by patch testing.