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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 6 | Issue 2
Page Nos. 67-118

Online since Thursday, November 28, 2019

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ORIGINAL ARTICLES  

A retrospective study of clinical and histopathological spectrum of genital lichen sclerosus in a tertiary care center Highly accessed article p. 67
Sunanda A Mahajan, Shubhangi H Mahajan, Uday S Khopkar, Vidya D Kharkar
DOI:10.4103/ijdpdd.ijdpdd_31_19  
Background: Genital lichen sclerosus (LS) is a chronic, autoimmune, inflammatory dermatosis of genitalia more common in females than males. Diagnosis of early genital LS is difficult clinically; hence, histopathology may help to confirm the diagnosis. Aims: The aim of this retrospective study was to elucidate the epidemiology of genital LS and to correlate the clinical and histopathological features of genital LS. Methods: Records of 30 clinically diagnosed patients of genital LS with 27 biopsies included in the study. Clinical data from the records reviewed. Histopathological parameters noted and accordingly cases classified into early, evolved, and mature LS and correlated with clinical features. Results: Genital LS was more common in females with early age of onset. Adult patients had longer duration of disease. Pruritus was the most common symptom and females were more symptomatic. Hypothyroidism was the associated autoimmune disease in two cases. Out of thirty patients, six had genital with perianal involvement and two had genital with the extragenital disease. Phimosis was the most common complication in males, while introital stenosis was the most common in females. Lymphohistiocytic infiltrate was the most common histopathological finding followed by hyperkeratosis, dilated blood vessels and lymphatics, and collagen homogenization. Duration, symptoms, and clinical features were found to be independent of the histopathology findings. Limitations: It is a retrospective study with limited patient information. Association of genital LS with other autoimmune diseases cannot be commented as required investigations were not done. Our data are cross-sectional without follow-up, hence the disease course and treatment outcome could not be commented. Conclusions: Genital LS is prevalent in adult females but childhood occurrence is uncommon. Perianal affection occurs almost exclusively in women with genital LS. Understanding variations in histopathologic features is vital to appropriate clinicopathologic correlation. Long-term follow-up is recommended.
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Clinical, dermoscopic, and histopathological correlation of lichenoid dermatoses p. 75
Praveen Kumar Shanmugam Reddy, Tharayil Kunneth Sumathy, Arakali Lakshminarayana Shyamprasad, Kanakapura Nanjundaswamy Shivaswamy, Madivalara Yallappa Suparna
DOI:10.4103/ijdpdd.ijdpdd_71_18  
Context: Lichenoid disorders are diverse, and the use of a noninvasive tool like dermoscopy could highlight the pathology in the deeper skin. The present study aimed to compare the accuracy of clinical and dermoscopic findings with histopathology in making a diagnosis of lichenoid dermatoses. Settings and Design: This is a prospective cross-sectional observational study of consecutive, clinically suspected cases of lichenoid skin eruption. Subjects and Methods: Forty patients with various clinical features and dermoscopic features were enrolled. Skin biopsy was taken from all the cases, and the clinical, dermoscopic, and the histopathological correlation was made. Results: Classical lichen planus (CLP) was the most common entity reported (30%), followed by hypertrophic LP (HLP) (15%) and lichen nitidus (15%). Radiating lines were the most common structures seen in as compared with HLP. Comedo-like lesions were significantly seen in HLP than CLP. Compact hyperkeratosis was seen in 66.67% of CLP and in all cases of HLP. There was a significant association in HLP, between blue and black structures on dermoscopy as compared with pigmented melanophages in dermoscopy. Chi-square test was used as a method of comparison, and SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc. was used. Conclusion: Dermoscopic findings give a vital clue about the underlying histopathology which can aid a physician in his/her diagnosis.
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CASE REPORTS Top

Tattoo reactions as the initial presentation of lepromatous leprosy and cutaneous sarcoidosis: Report of two cases p. 83
Geeti Khullar, Niti Khunger, Khushpreet Kaur Mann, Sharma Shruti
DOI:10.4103/ijdpdd.ijdpdd_33_19  
There has been a rising trend of tattooing in the recent years, resulting in an increased incidence of cutaneous adverse effects. A wide range of infectious and noninfectious dermatoses have been described to occur within tattoos. Cutaneous complications developing in tattooed skin as the initial manifestation of the disease are uncommon. We describe two interesting cases with black tattoo-related reactions as the presenting feature of lepromatous leprosy and cutaneous sarcoidosis, respectively.
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Masson's tumor on the forehead: A rare and Benign entity Highly accessed article p. 86
Bhushan A Darkase, Atul M Dongre, Paras Choudhary, Uday S Khopkar
DOI:10.4103/ijdpdd.ijdpdd_53_19  
Masson's tumor is a rare, benign, reactive proliferating vascular lesion. The most commonly affected sites are the head, neck, and extremities. We present a 29-year-old male, a case of Masson's tumor over the forehead. Masson's tumor, with the involvement of the forehead is rare and intriguing in this case. Masson's tumor is a benign tumor that may get confused on histopathology with malignant tumors; hence, dermatologists need to understand this entity to avoid unnecessary confusion.
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Papuloerythroderma secondary to granulocytic sarcoma of lymph node p. 89
Ashish Jagati, Bela J Shah, Trusha Gajjar
DOI:10.4103/ijdpdd.ijdpdd_7_19  
Papuloerythroderma (PE) is a rare cutaneous condition characterized by intensely pruritic, papular eruptions sparing major skin folds. These lesions later coalesce to form plaques and potentially evolve into erythroderma. The characteristic sparing of large skin folds in PE is known as the deck chair sign. Various associations for PE have been identified. We are here reporting a case of PE secondary to granulocytic sarcoma of lymph node. To the best of our knowledge, PE associated with granulocytic sarcoma has not been reported before.
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Neurocristic cutaneous hamartoma: Case report of a rare entity p. 93
BN Kumarguru, N Haripriya, AS Ramaswamy, MJ Nirmala
DOI:10.4103/ijdpdd.ijdpdd_9_19  
Neurocristic cutaneous hamartoma (NCH) is a rare entity characterized by hamartomatous proliferation of melanocytic, neuroid, and mesenchymal tissues. It results from the aberrant development of the neural crest cells. A 29-year-old female presented with a painless pedunculated swelling over the lower back for 1 year. Grossly, the lesion was skin covered polypoidal tissue. Cut section showed gray-white to gray-yellow areas. Histologically, the lesion was composed of mesenchymal elements and ectodermal elements. Mesenchymal elements were composed of lobules of adipocytes, bundles of smooth muscle tissue, and bone tissue. Ectodermal derivative tissues were composed of nerve bundles and melanocytes. Melanocytes showed a normal maturation pattern. Features were suggestive of a hamartomatous lesion favoring NCH. On immunohistochemistry (IHC), melanocytic cells showed strong positivity for S100. They were also positive for HMB45. Spindle-shaped cells in the connective tissue were positive for CD34. IHC supported the histopathological diagnosis. NCH is a rare entity and poses a diagnostic challenge. IHC may be helpful, but a pathologist has to primarily depend on the histopathological characteristics of the lesion for diagnosing the condition.
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Syringofibroadenoma: Benign eccrine sweat gland tumor – A rare case report p. 97
Banyameen Iqbal, Prachi Khandekar, Indranil Dey, Harsh Kumar
DOI:10.4103/ijdpdd.ijdpdd_40_19  
Eccrine syringofibroadenoma (ESFA) is a rare adnexal tumor. It was first described by Mascaro in 1963. They are predominantly seen on the extremities of middle aged to elderly patients. Clinically, ESFA is classified into five subtypes. Solitary ESFA, the most common subtype, usually presents as a skin-colored papule, plaque, or nodule. The histomorphological and immunohistochemical features are necessary for their diagnosis and are also required to differentiate them from their malignant counterpart, eccrine syringofibrocarcinoma.
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Endogenous ochronosis with keratoelastoidosis marginalis p. 100
R Mythreyi, Adikrishnan Swaminathan, Anuradha Priyadarshini, Sudha Rangarajan, S Murugan
DOI:10.4103/ijdpdd.ijdpdd_50_18  
Endogenous ochronosis is a manifestation of alkaptonuria, a rare metabolic disease due to homogentisic acid oxidase deficiency. Darkened urine and arthropathy are the other two components that complete the triad of alkaptonuria. Pigmentation of skin, the presenting feature, is common over the face and ears. A few cases of pigmentation of the palms and soles are reported. Here, we report a case of endogenous ochronosis presenting as keratoelastoidosis marginalis, which is a rare manifestation.
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Dermoscopy of localized cutaneous nodular amyloidosis resembling granulomatous disorders p. 104
Bhavesh Sonagara, Hita Mehta, Prachi Gajjar
DOI:10.4103/ijdpdd.ijdpdd_74_18  
Cutaneous amyloidosis refers to a group of skin diseases, which is characterized by the deposition of amyloid material in the skin. Among them, Localized cutaneous nodular amyloidosis (LCNA) is the rarest type of cutaneous amyloidosis. A 38-year-old male presented to dermatology OPD with a single soft nodular lesion on left cheek. On basis of clinical and dermoscopic examination we thought it as granulomatous disease but histopathologically confirmed diagnosis of LCNA. Systemic amyloidosis is excluded on clinical as well as laboratory bases. The patient was treated with topical tacrolimus with slight improvement and followed up for 1 year and no systemic abnormalities were found.
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LETTERS TO EDITOR Top

Rainbow sign in dermatoscopy of nodular basal cell carcinoma p. 107
Balakrishnan Nirmal, AS Krishnaram, Ramamoorthy Sudhagar
DOI:10.4103/ijdpdd.ijdpdd_27_19  
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Clinicopathological correlation in diagnosis of generalized eruptive histiocytosis p. 109
Sandhya Kumari Chauhan, Anchana Gulati, Geeta Ram Tegta, Mudita Gupta
DOI:10.4103/ijdpdd.ijdpdd_44_18  
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Dermoscopy as an additional tool in a case of woolly hair with palmoplantar keratoderma p. 112
Shilpitha Srinivas, Kallappa C Herakal, Srinivasa Krishnamurthy Murthy, Shwetha Suryanarayan
DOI:10.4103/ijdpdd.ijdpdd_76_18  
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Retroauricular bowen's disease of skin in an elderly female p. 115
Pooja Garg, Pradeep Balasubramanian
DOI:10.4103/ijdpdd.ijdpdd_21_19  
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A late presentation of Hailey–Hailey disease with clinical-dermoscopic-histological correlation p. 117
Resham Vasani, Sushrut Save
DOI:10.4103/ijdpdd.ijdpdd_34_19  
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