Ophthalmic manifestations of Paederus dermatitis.

PURPOSE: To report the pattern of ophthalmic manifestations associated with Paederus dermatitis (PD). SETTING: Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India. DESIGN: Clinic-based retrospective study. METHODS: Medical charts of patients presenting to the eye clinic with clinical features consistent with the diagnosis of PD from May 1, 2014 to April 30, 2016 were retrospectively reviewed. Relevant demographic and clinical data of periocular and ocular findings were collected and analyzed. The patients with a history of chronic skin disorders or allergies were excluded from the study. RESULTS: A total of 56 patients were included in the study, of which 39 (69.6 %) were males. The age range was 4-65 years with a median of 27 years. On presentation, common subjective symptoms were burning sensation in 49 (87.5 %), itching in 37 (66.1 %), watering in 25 (44.6 %), foreign body sensation in 19 (33.9 %), blurring of vision in 17 (30.4 %), and photophobia in 12 (21.4 %) patients. Visual acuity at presentation was 20/20 in 39 (69.6 %) patients, between 20/30 and 20/80 in 9 (16.1 %) patients, and less than 20/80 in 8 (14.3 %) patients. Lid swelling, erythema, crusts, and vesicles were the common periocular findings; and conjunctival hyperemia, discharge, and corneal erosions were the common ocular findings. CONCLUSIONS: The current study shows that PD can cause significant ocular morbidity. Ophthalmologists, especially those who work in endemic areas, should be aware of this entity both in terms of management as well as for educating patients about the preventive measures.

Topical hyaluronic Acid in the management of oral ulcers.

Hyaluronic acid is a hygroscopic macromolecule formed by the polymerisation of glucuronic acid and N-acetylglucosamine disaccharide. It is a primary component of the extracellular matrix in various body tissues. Ihe use of topical Hyaluronic acid in the treatment of oral ulcers has been recently reported. This article reviews the mechanism of action, indications and efficacy of topical Hyaluronic acid gel in the management of oral ulcers.

Fibromatosis of breast mimicking sarcoidosis.

Primary mammary fibromatosis is a rare skin condition which can arise after trauma or previous surgery. The exact etiology is unknown. Very few cases have been reported in literature and the main emphasis is to differentiate this condition from breast carcinoma. We report here an unusual case of a 60 year old female who presented with skin lesion which clinically looked sarcoid with history suggestive of sarcoidosis, but on histopathology fibromatosis of breast was revealed. Complete work up ruled out any carcinomatous changes. Surgical excision of the lesion was done with no recurrence seen in one year follow up period.

Laugier-hunziker syndrome: a rare cause of oral and acral pigmentation.

Laugier-Hunziker syndrome (LHS) is an acquired, benign pigmentary skin condition involving oral cavity including lower lip in the form of brown black macules 1-5 mm in size, frequently associated with longitudinal melanonychia. There is no underlying systemic abnormality or malignant predisposition associated with LHS, and therefore the prognosis is good. Important differential diagnoses include Peutz Jeghers syndrome and Addison's disease among other causes of oral and acral pigmentation. Treatment is sought mainly for cosmetic reasons and Q-switched Nd-Yag laser/ Q-switched alexandrite therapy and cryosurgery have been tried with varying success.

Lymphangioma circumscriptum treated with radiofrequency ablation.

Lymphangioma circumscriptum (LC), a hamartomatous lymphatic malformation, is a therapeutic challenge for the dermatologist. Various modalities like surgical excision, lasers, and sclerotherapy have been used in the past to treat this notorious skin condition. We report the efficacy of a radiofrequency ablation in a patient with LC. The treatment efficacy of radiofrequency was satisfactory in our patient with no recurrence during 1 year follow-up period. The radiofrequency technique is a safe and economic treatment for management of LC.

Ulcerated cutaneous epithelioid hemangioendothelioma in an 8-month old infant.

Epithelioid hemangioendothelioma is an uncommon malignant vascular tumour usually involving soft tissue and rarely only skin. It is considered to be a borderline neoplasm between angiolymphoid hyperplasia with eosinophilia and an epithelioid angiosarcoma and is mostly found in adults with few cases reported in children. We herein report a case of ulcerated cutaneous epithelioid hemangioendothelioma in an infant of 8 months. This tumour has not been reported at such a young age in literature.

Nonablative fractional laser resurfacing in Asian skin--a review.

Skin resurfacing has been a part of cosmetic dermatology for more than two decades now, and most of it has been ablative with traditional aggressive lasers including the CO(2) and erbium. The last few years have seen a revolutionary change with the invention of nonablative lasers for skin tightening. Fractional resurfacing is a new concept of cutaneous remodeling whereby laser-induced zones of microthermal injury are surrounded by normal untreated tissue that helps in quicker healing. The various wavelengths used are 1320, 1440, and 2940 nm with depth of penetration ranging from 25 µ to 1.2 mm. This article reviews the history of nonablative fractional laser resurfacing, its indications, contraindications, and a review of use in Asian skin with Fitzpatrick type III-VI.

Lactic acid peeling in superficial acne scarring in Indian skin.

INTRODUCTION: Chemical peeling with both alpha and beta hydroxy acids has been used to improve acne scarring with pigmentation. Lactic acid, a mild alpha hydroxy acid, has been used in the treatment of various dermatological indications but no study is reported in acne scarring with pigmentation. AIMS: To evaluate the efficacy and safety of full strength pure lactic acid 92% (pH 2.0) chemical peel in superficial acne scarring in Indian skin. MATERIAL AND METHODS: Seven patients, Fitzpatrick skin type IV-V, in age group 20-30 years with superficial acne scarring were enrolled in the study. Chemical peeling was done with lactic acid at an interval of 2 weeks to a maximum of four peels. Pre- and post-peel clinical photographs were taken at every session. Patients were followed every month for 3 months after the last peel to evaluate the effects. RESULTS: At the end of 3 months, there was definite improvement in the texture, pigmentation, and appearance of the treated skin, with lightening of scars. Significant improvement (greater than 75% clearance of lesions) occurred in one patient (14.28%), good improvement (51-75% clearance) in three patients (42.84%), moderate improvement (26-50% clearance) in two patients (28.57%), and mild improvement (1-25% clearance) in one patient (14.28%).

Hirsutism: evaluation and treatment.

Hirsutism is a common clinical condition seen in female patients of all ages. It affects around 5-10% of the women and is a common presenting complaint in the dermatological out patient department for cosmetic reasons. The cause is mainly hyperandrogeneism, which may be ovarian or adrenal. It may be part of a rare metabolic syndrome, drug induced, or just idiopathic. Hirsutism has a huge psychosocial impact, especially in the young females. This article reviews the current evaluation guidelines and management of hirsutism.

The dermatoses of pregnancy.

The skin changes in pregnancy can be either physiological (hormonal), changes in pre-existing skin diseases or development of new pregnancy specific dermatoses. Pregnancy-specific skin dermatoses include an ill-defined heterogeneous group of pruritic skin eruptions which are seen only in pregnancy. These include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis and intrahepatic cholestasis of pregnancy. Atopic eruption of pregnancy is the most common of these disorders. Most skin eruptions resolve postpartum and require only symptomatic treatment. Antepartum surveillance is recommended for patients with pemphigoid gestationis and intrahepatic cholestasis of pregnancy as they carry fetal risk. This article deals with the classification, clinical features and treatment of the specific dermatoses of pregnancy.