Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei v... more Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei var hominis. It has high prevalence in many tropical countries where crowded people live in resource‐poor settings. The rash is distributed differently in adults and children. Adults manifest lesions primarily on the interdigital web spaces of the hands, flexor aspects of the wrists, dorsal feet, axillae, elbows, waist, buttocks, and genitalia. Palms (along with soles and head) are commonly involved in infants and very young children but typically absent in older age groups. Here, we report 25 older children and adult patients with scabies including involvement of the palms. If patients are left untreated for long periods of time in hot tropical climates, scabies may produce severe infestation with involvement of palms in older children and adults. We should acknowledge palms as potential body sites whose involvement warrants early and aggressive treatment in scabies.
A 10-year-old girl presented with three asymptomatic raised lesions over the dorsal aspect of her... more A 10-year-old girl presented with three asymptomatic raised lesions over the dorsal aspect of her left index finger present for the past 7 years. On examination, there were three skin-colored nodules overlying the middle and distal phalanx of her left index finger, without any attachment to the underlying structures (Figure 1) The nodule over the distal phalanx was the largest with a cobblestone-like surface. All the nodules were firm to touch. Cutaneous, mucosa, hair, nails, and systemic examinations were within normal limits. The two smaller nodules were excised under local anesthesia and sent for histopathologic examination. Histologic study from one of the representative lesion showed type B nevus cells (lymphocytoid), located in the expanded papillary dermis (Figures 2 and 3).
In this paper we report the application and evaluation of the simulated annealing (SA) optimizati... more In this paper we report the application and evaluation of the simulated annealing (SA) optimization method in parameter estimation for vapor-liquid equilibrium (VLE) modeling. We tested this optimization method using the classical least squares and error-invariable approaches. The reliability and efficiency of the data-fitting procedure are also considered using different values for algorithm parameters of the SA method. Our results indicate that this method, when properly implemented, is a robust procedure for nonlinear parameter estimation in thermodynamic models. However, in difficult problems it still can converge to local optimums of the objective function.
Giant porokeratosis (PK) is a rare entity. Many consider it as a variant of PK of Mibelli, while ... more Giant porokeratosis (PK) is a rare entity. Many consider it as a variant of PK of Mibelli, while others describe it as a separate variant. The diameter may range between 10 and 12 cm and the wall of hyperkeratotic ridge may be upto 1 cm. High tropical temperature and long duration of outdoor activities without adequate clothing are known influencing factors of PK. To the best of our knowledge, only five cases of solitary giant PK and a case of disseminated giant PK have been documented from India. We report three cases of giant PK for their rarity.
A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm... more A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm, is reported in a patient of discoid lupus eryt hematosus (DLE). The skin overlying lesions of LEP also showed features of DLE.
Journal of Pakistan Association of Dermatology, 2016
Ichthyosis bullosa of Siemens (IBS) is a rare disease characterized by superficial blistering, mi... more Ichthyosis bullosa of Siemens (IBS) is a rare disease characterized by superficial blistering, mild epidermal hyperkeratosis over flexural areas and characteristic mauserang phenomenon (moulting).We report an interesting case of IBS in a mentally retarded hypothyroid patient who did not give any history of blistering. Histological examination of specimen from margin of an area exhibiting mauserung phenomenon revealed epidermolytic hyperkeratosis in granular and upper spinous layers. In situations where proper clinical history cannot be elicited, the histopathological findings have paramount importance.
Journal of Pakistan Association of Dermatology, 2016
Pityriasis rubra pilaris (PRP) is a rare disease. The lack of pathognomonic features and specific... more Pityriasis rubra pilaris (PRP) is a rare disease. The lack of pathognomonic features and specific clinical or diagnostic features often make identification of PRP very difficult. PRP type 4 (circumscribed juvenile type) is characterized by scaly plaques on elbows, knees and palmoplantar keratoderma. Sometimes these lesions may become extremely difficult to differentiate from those of psoriasis. We report 3 cases of PRP type 4, noted in just 5 months. We feel PRP, specially the type 4, is not so rare in Indian subcontinent. A good clinical knowledge and high index of suspicion may help to identify more cases.
A 56-year-old man presented with multiple, skin-colored, raised eruptions of the scrotum that had... more A 56-year-old man presented with multiple, skin-colored, raised eruptions of the scrotum that had been present for 2 years. Their onset had been gradual, and they had been increasing in size, resulting in cosmetic disfigurement. A year previously, he had been operated on for a bilateral vaginal hydrocele with partial excision and eversion of the sac (Jabouley method).1 There had been no extramarital or unprotected sexual contact, other hospitalizations, or major surgery, swelling of the legs, or long periods of incumbency. Cutaneous examination revealed multiple, discrete and/or coalescing verrucous papules distributed on the upper portion of the scrotum and associated with edema of the penis (Figure 1). The inguinal lymph nodes were not enlarged. Complete blood counts and ultrasonography of the abdomen were normal. Tissue sections stained with hematoxylin and eosin showed hyperkeratosis and multiple ectatic vessels, primarily confined to the papillary dermis, abutting the overlying...
A 45-year-old male patient, farmer by occupation, presented with multiple disseminated, light bro... more A 45-year-old male patient, farmer by occupation, presented with multiple disseminated, light brown-colored, annular plaques with a raised hyperkeratotic ridge-like border with atrophic center distributed over sun exposed parts like V-area of neck, upper chest, extensor aspect of upper extremity. A thin furrow was typically seen in the center of the keratotic ridge of the lesions. There was no family history of similar lesions. Histopathological examination of the skin biopsy taken from the ridge of the lesions showed histopathological hallmark of porokeratosis the ‘cornoid lamella’. We report a sporadic case of disseminated superficial actinic porokeratosis in dark-skinned male patient.
Journal of Dermatology & Dermatologic Surgery, 2016
A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm... more A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm, is reported in a patient of discoid lupus erythematosus (DLE). The skin overlying lesions of LEP also showed features of DLE.
Kindler syndrome (KS) is a rare autosomal recessive genodermatosis. We report two cases of KS wit... more Kindler syndrome (KS) is a rare autosomal recessive genodermatosis. We report two cases of KS with classical clinical presentations involving skin and mucus membranes. Clinically, both patients had four major features of KS in the form of acral skin blistering, photosensitivity, progressive poikiloderma, and diffuse cutaneous atrophy. Case 1 had associated features in the form of urethral stenosis, skin fragility and palmoplantar keratoderma with extension of the scaling onto the flexor aspect of the wrist and loss of palmar creases. Case 2 had associated features in form of anal stenosis, oesophageal stenosis, skin fragility and palmoplantar keratoderma with loss of palmar creases. An Interesting finding in our report is that both cases have prominent telengectasia involving face and neck regions.
The term dermatitis neglecta was first coined by Poskitt et al. in 1995. Dermatitis neglecta is a... more The term dermatitis neglecta was first coined by Poskitt et al. in 1995. Dermatitis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatitis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris occurs resulting in a localized hyperpigmented patch or a verrucous plaque. Failure to adequately clean or scrub the skin, often in an area of hyperesthesia or prior trauma, can produce dermatitis neglecta. This has similarities to dermatitis artifacta, although in the latter condition the lesions are associated with acts of commission whereas in dermatitis neglecta the dermatitis is associated with acts of omission. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. Treatment includes counseling and encouraging the patient to maintain appropriate hygiene of the affected region in spite of his or her disability. Daily light scrubbing of the affected area with soap and water or al...
Psoriasis is a disease of considerable clinical and histopathological diversity. We report a rare... more Psoriasis is a disease of considerable clinical and histopathological diversity. We report a rare case of elephantine psoriasis responding very well to methotrexate. Histopathology revealed abnormal papillomatosis with finger-like projections in addition to alternating orthokeratosis with overlying hypergranulosis and parakeratosis with overlying hypogranulosis. We believe that this finding may represent an odd histopathologic type in elephantine psoriasis.
Porokeratosis of Mibelli (PM) is a rare genodermatosis. It is caused by proliferation of abnormal... more Porokeratosis of Mibelli (PM) is a rare genodermatosis. It is caused by proliferation of abnormal clones of epidermal cells in response to several stimuli, the most important of which is sunlight. Giant porokeratosis is thought to be a variant of PM. We report two cases of disseminated PM and one case of disseminated giant porokeratosis from the Bankura and Bardhaman districts of West Bengal in India; presenting to a single observer in the summer of 2012. Interestingly we have noted that the majority of cases of porokeratosis in India have been reported from West Bengal. Few patients with a single lesion of giant porokeratosis have been reported in world literature. As far as we know, this is the first case report of disseminated giant porokeratosis in world literature.
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > Current ...
Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei v... more Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei var hominis. It has high prevalence in many tropical countries where crowded people live in resource‐poor settings. The rash is distributed differently in adults and children. Adults manifest lesions primarily on the interdigital web spaces of the hands, flexor aspects of the wrists, dorsal feet, axillae, elbows, waist, buttocks, and genitalia. Palms (along with soles and head) are commonly involved in infants and very young children but typically absent in older age groups. Here, we report 25 older children and adult patients with scabies including involvement of the palms. If patients are left untreated for long periods of time in hot tropical climates, scabies may produce severe infestation with involvement of palms in older children and adults. We should acknowledge palms as potential body sites whose involvement warrants early and aggressive treatment in scabies.
A 10-year-old girl presented with three asymptomatic raised lesions over the dorsal aspect of her... more A 10-year-old girl presented with three asymptomatic raised lesions over the dorsal aspect of her left index finger present for the past 7 years. On examination, there were three skin-colored nodules overlying the middle and distal phalanx of her left index finger, without any attachment to the underlying structures (Figure 1) The nodule over the distal phalanx was the largest with a cobblestone-like surface. All the nodules were firm to touch. Cutaneous, mucosa, hair, nails, and systemic examinations were within normal limits. The two smaller nodules were excised under local anesthesia and sent for histopathologic examination. Histologic study from one of the representative lesion showed type B nevus cells (lymphocytoid), located in the expanded papillary dermis (Figures 2 and 3).
In this paper we report the application and evaluation of the simulated annealing (SA) optimizati... more In this paper we report the application and evaluation of the simulated annealing (SA) optimization method in parameter estimation for vapor-liquid equilibrium (VLE) modeling. We tested this optimization method using the classical least squares and error-invariable approaches. The reliability and efficiency of the data-fitting procedure are also considered using different values for algorithm parameters of the SA method. Our results indicate that this method, when properly implemented, is a robust procedure for nonlinear parameter estimation in thermodynamic models. However, in difficult problems it still can converge to local optimums of the objective function.
Giant porokeratosis (PK) is a rare entity. Many consider it as a variant of PK of Mibelli, while ... more Giant porokeratosis (PK) is a rare entity. Many consider it as a variant of PK of Mibelli, while others describe it as a separate variant. The diameter may range between 10 and 12 cm and the wall of hyperkeratotic ridge may be upto 1 cm. High tropical temperature and long duration of outdoor activities without adequate clothing are known influencing factors of PK. To the best of our knowledge, only five cases of solitary giant PK and a case of disseminated giant PK have been documented from India. We report three cases of giant PK for their rarity.
A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm... more A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm, is reported in a patient of discoid lupus eryt hematosus (DLE). The skin overlying lesions of LEP also showed features of DLE.
Journal of Pakistan Association of Dermatology, 2016
Ichthyosis bullosa of Siemens (IBS) is a rare disease characterized by superficial blistering, mi... more Ichthyosis bullosa of Siemens (IBS) is a rare disease characterized by superficial blistering, mild epidermal hyperkeratosis over flexural areas and characteristic mauserang phenomenon (moulting).We report an interesting case of IBS in a mentally retarded hypothyroid patient who did not give any history of blistering. Histological examination of specimen from margin of an area exhibiting mauserung phenomenon revealed epidermolytic hyperkeratosis in granular and upper spinous layers. In situations where proper clinical history cannot be elicited, the histopathological findings have paramount importance.
Journal of Pakistan Association of Dermatology, 2016
Pityriasis rubra pilaris (PRP) is a rare disease. The lack of pathognomonic features and specific... more Pityriasis rubra pilaris (PRP) is a rare disease. The lack of pathognomonic features and specific clinical or diagnostic features often make identification of PRP very difficult. PRP type 4 (circumscribed juvenile type) is characterized by scaly plaques on elbows, knees and palmoplantar keratoderma. Sometimes these lesions may become extremely difficult to differentiate from those of psoriasis. We report 3 cases of PRP type 4, noted in just 5 months. We feel PRP, specially the type 4, is not so rare in Indian subcontinent. A good clinical knowledge and high index of suspicion may help to identify more cases.
A 56-year-old man presented with multiple, skin-colored, raised eruptions of the scrotum that had... more A 56-year-old man presented with multiple, skin-colored, raised eruptions of the scrotum that had been present for 2 years. Their onset had been gradual, and they had been increasing in size, resulting in cosmetic disfigurement. A year previously, he had been operated on for a bilateral vaginal hydrocele with partial excision and eversion of the sac (Jabouley method).1 There had been no extramarital or unprotected sexual contact, other hospitalizations, or major surgery, swelling of the legs, or long periods of incumbency. Cutaneous examination revealed multiple, discrete and/or coalescing verrucous papules distributed on the upper portion of the scrotum and associated with edema of the penis (Figure 1). The inguinal lymph nodes were not enlarged. Complete blood counts and ultrasonography of the abdomen were normal. Tissue sections stained with hematoxylin and eosin showed hyperkeratosis and multiple ectatic vessels, primarily confined to the papillary dermis, abutting the overlying...
A 45-year-old male patient, farmer by occupation, presented with multiple disseminated, light bro... more A 45-year-old male patient, farmer by occupation, presented with multiple disseminated, light brown-colored, annular plaques with a raised hyperkeratotic ridge-like border with atrophic center distributed over sun exposed parts like V-area of neck, upper chest, extensor aspect of upper extremity. A thin furrow was typically seen in the center of the keratotic ridge of the lesions. There was no family history of similar lesions. Histopathological examination of the skin biopsy taken from the ridge of the lesions showed histopathological hallmark of porokeratosis the ‘cornoid lamella’. We report a sporadic case of disseminated superficial actinic porokeratosis in dark-skinned male patient.
Journal of Dermatology & Dermatologic Surgery, 2016
A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm... more A case of lupus erythematosus profundus (LEP), with classical involvement of cheeks and upper arm, is reported in a patient of discoid lupus erythematosus (DLE). The skin overlying lesions of LEP also showed features of DLE.
Kindler syndrome (KS) is a rare autosomal recessive genodermatosis. We report two cases of KS wit... more Kindler syndrome (KS) is a rare autosomal recessive genodermatosis. We report two cases of KS with classical clinical presentations involving skin and mucus membranes. Clinically, both patients had four major features of KS in the form of acral skin blistering, photosensitivity, progressive poikiloderma, and diffuse cutaneous atrophy. Case 1 had associated features in the form of urethral stenosis, skin fragility and palmoplantar keratoderma with extension of the scaling onto the flexor aspect of the wrist and loss of palmar creases. Case 2 had associated features in form of anal stenosis, oesophageal stenosis, skin fragility and palmoplantar keratoderma with loss of palmar creases. An Interesting finding in our report is that both cases have prominent telengectasia involving face and neck regions.
The term dermatitis neglecta was first coined by Poskitt et al. in 1995. Dermatitis neglecta is a... more The term dermatitis neglecta was first coined by Poskitt et al. in 1995. Dermatitis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatitis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris occurs resulting in a localized hyperpigmented patch or a verrucous plaque. Failure to adequately clean or scrub the skin, often in an area of hyperesthesia or prior trauma, can produce dermatitis neglecta. This has similarities to dermatitis artifacta, although in the latter condition the lesions are associated with acts of commission whereas in dermatitis neglecta the dermatitis is associated with acts of omission. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. Treatment includes counseling and encouraging the patient to maintain appropriate hygiene of the affected region in spite of his or her disability. Daily light scrubbing of the affected area with soap and water or al...
Psoriasis is a disease of considerable clinical and histopathological diversity. We report a rare... more Psoriasis is a disease of considerable clinical and histopathological diversity. We report a rare case of elephantine psoriasis responding very well to methotrexate. Histopathology revealed abnormal papillomatosis with finger-like projections in addition to alternating orthokeratosis with overlying hypergranulosis and parakeratosis with overlying hypogranulosis. We believe that this finding may represent an odd histopathologic type in elephantine psoriasis.
Porokeratosis of Mibelli (PM) is a rare genodermatosis. It is caused by proliferation of abnormal... more Porokeratosis of Mibelli (PM) is a rare genodermatosis. It is caused by proliferation of abnormal clones of epidermal cells in response to several stimuli, the most important of which is sunlight. Giant porokeratosis is thought to be a variant of PM. We report two cases of disseminated PM and one case of disseminated giant porokeratosis from the Bankura and Bardhaman districts of West Bengal in India; presenting to a single observer in the summer of 2012. Interestingly we have noted that the majority of cases of porokeratosis in India have been reported from West Bengal. Few patients with a single lesion of giant porokeratosis have been reported in world literature. As far as we know, this is the first case report of disseminated giant porokeratosis in world literature.
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > Current ...
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