Porokeratosis of gluteal region: A case report.

Genitogluteal porokeratosis is a rare localized disorder of keratinization. Due to the rarity of the case and non-specific keratotic lesion, it is often misdiagnosed until a histological examination is performed. Treatment of this condition can be challenging, which comprises various topical and systemic drugs, lasers, cryotherapy, phototherapy, and also surgical intervention. Regular follow-up is necessary in the view of this disorder being a premalignant condition.

Skin Prick Test Positivity in Chronic Urticaria.

BACKGROUND: Skin prick tests identify allergens for chronic urticaria. The objective of this study was to determine skin prick test positivity in patients with chronic urticaria visiting skin outpatient department in one of the tertiary referral centre of Nepal. METHODS: This was a hospital based cross-sectional study conducted at Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital. All patients of chronic urticaria aged more than 16 years were taken into study and were prick tested with seven groups of 21 allergens, taking normal saline as negative control and histamine as positive control as per the standard protocol by the Global Allergy and Asthma European Network. Frequency of positivity to each allergen was assessed. RESULTS: Out of 62 patients of chronic urticaria enrolled in the study, 52% were females and 48% were males. Overall, 71% were positive for at least one allergen. The most common allergens which tested positive included Dermatophagoides farinae (50%), Cotton dust (17.7%), Mosquito (16%), hay dust (14.5%), Cladosporium herbarum (14.5%), Candida albicans (12.9%), Parthenium hysterophorus (9.6%), House fly (9.6%), Soya bean (9.6%) and fish sardine (8%). Out of all these patients, 55% patients showed positivity to more than one allergens. CONCLUSIONS: A significant proportion of cases with chronic urticaria demonstrated sensitivity to various allergens. Skin prick test can be considered as important diagnostic procedure in cases of chronic urticaria in our population.

Fine needle aspiration cytology as a preliminary diagnostic tool in chondroid syringoma: a case report and review.

We report a case of chondroid syringoma (CS) in a 44-year-old male. He presented with a firm asymptomatic nodule in his left upper lip of 2-year duration. The initial clue to the diagnosis was made on fine needle aspiration cytology (FNAC), and a final diagnosis was based on histopathological examination. The case highlights the importance of FNAC in providing clues to the diagnosis of suspected cases of chondroid syringoma before performing large excisions and repair, which would require more skill and time. We have also reviewed the cytological findings of all the cases of benign CS reported until the current date.

Idiopathic calcinosis cutis of the scrotum: a case report and review of the literature.

BACKGROUND: Abnormal deposition of calcium in the skin or subcutaneous tissue is termed calcinosis cutis. Idiopathic calcinosis cutis of the scrotum is an uncommon entity. The pathogenesis of idiopathic calcinosis cutis of the scrotum is debatable. The condition presents as several brown to yellowish nodules on the scrotum, gradually progressive, and mostly asymptomatic. Here we report a case of idiopathic calcinosis cutis of the scrotum with a brief review of the literature and a discussion on pathogenesis. CASE PRESENTATION: A healthy looking, 50-year-old Nepali man presented with multiple growths on his scrotum for 15 years, which were mostly asymptomatic with an occasional complaint of itching. On physical examination, multiple pink to brown nodules ranging in size from 0.5 × 0.5 × 0.5 cm to 3 × 3 × 1 cm, which were painless and firm in consistency, were noted. On laboratory examinations the following were found to be within normal limits: serum calcium, phosphorus, parathyroid hormone, and vitamin D hormone levels; uric acid; alkaline phosphatase; and lipid profile. Based on clinical features and laboratory reports, a diagnosis of idiopathic calcinosis cutis of the scrotum was made. The nodules were excised under local anesthesia in several sittings, which gave a good cosmetic result with no evidence of recurrence in 1-year follow-up period. A histopathological examination revealed dermis with areas of fibrosis and calcification along with numerous multinucleated giant cells and an absence of any cystic structure. CONCLUSIONS: Idiopathic calcinosis cutis of the scrotum is a benign condition, which remains mostly asymptomatic. It presents as progressive multiple nodules of varying numbers and sizes. A histopathological evaluation reveals areas of calcification. The cause is either dystrophic calcification of cysts or idiopathic. Excision is the treatment of choice.

Dystrophic Epidermolysis Bullosa.

Epidermolysis bullosa is a rare inherited blistering disease with an incidence of 8-10 per million live births. Dystrophic epidermolysis bullosa is a type of epidermolysis bullosa caused by mutation in type VII collagen, COL7A1. There are 14 subtypes of dystrophic epidermolysis bullosa and 400 mutations of COL7A1. Electron microscopy is the gold standard diagnostic test but expensive. Immunofluorescence study is a suitable diagnostic alternative. Trauma prevention along with supportive care is the mainstay of therapy. Squamous cell carcinoma develops at an early age in epidermolysis bullosa than other patients, particularly in recessive dystrophic epidermolysis bullosa subtypes. Regular follow-up is imperative in detecting and preventing complications. Gene therapy, cell therapy and bone marrow transplantation are the emerging novel therapeutic innovations. Preventing possible skin and mucosal injury in patients requiring surgery should be worked on. Here, we present a case of dystrophic epidermolysis bullosa in a 26-year-old male. Keywords: blister; dystrophic epidermolysis bullosa; epidermolysis bullosa; knee disarticulation; surgery.

Apocrine carcinoma developing in a naevus sebaceous of scalp.

Apocrine skin carcinoma is an aggressive cutaneous tumour. We report a case of apocrine carcinoma developing in a naevus sebaceous of scalp in a 45 years old male. Malignant transformation of Naevus sebaceous is a rare complication usually found in elderly patients. Most of these tumours are basal cell carcinoma or squamous cell carcinoma. Only few cases of apocrine carcinoma on naevus sebaceous have been previously reported. This report highlights the potential of naevus sebaceous for malignant transformation.

Morphoea profunda presenting with atrophic skin lesions in a 26 year old female: a case report.

Morphoea Profunda is a rare variant of Morphoea that presents clinically as a solitary fibrotic plaque. Morphoea Profunda presenting with atrophic lesions has rarely been reported in literature. We report the case of a 26 year old Nepalese lady who presented to us with multiple non-inflammatory atrophic lesions on her body without significant skin induration, pigmentation and texture change. The findings on histopathology confirmed a diagnosis of Morphoea Profunda. Hence, Morphoea Profunda should be considered in the differential diagnosis of anyone presenting with asymptomatic atrophy of the skin.