Piloleiomyoma Presented by Multiple Cutaneous Nodules: a Case Report

Introduction. Piloleiomyoma is a rare benign tumor which is caused by erector pili muscle and makes up 5% of all leiomyomas. They can be solitary and multiple. Multiple lesions still pose challenges for clinicians since their treatment option is very limited. Case report. We report a case of a 25-year-old male patient who had painful papules and nodules on the neck and chest for three years. Multiple red-brown papules and nodules in the skin of regio mammaria dextra and regio submandibularis on the left were seen on physical examination. Histopathological examination of punch bi-were seen on physical examination. Histopathological examination of punch biopsy sample revealed well-circumscribed nodule composed of spindle cells. The case was reported as cutaneous leiomyoma (piloleiomyoma). The patient was given 5 mg/day amlodipin and kept under control. Conclusion. The ideal treatment option for piloleiomyoma is surgical excision, but the problem with that treatment is that the lesions have tendency to recur. Medicamentous therapy plays a limited role; however, calcium-channel blockers and α-adrenergic blockers may help in palliating or eliminating associated pain through inhibition of smooth muscle contraction.

Blistering Beetle Dermatitis Mimicking Herpes Zoster Ophthalmicus: a Case Report

Blistering beetle dermatitis is an important dermatological disease of tropical countries. Although the clinical features are classical, little awareness amongst medical practitioners may cause difficulties in the diagnosis of this condition. Further, it may sometimes mimic an unrelated disease which can lead to delay in treatment causing prolonged suffering of the patient. We present a case of blistering beetle dermatitis that was initially misdiagnosed as a case of herpeszoster ophthalmicus. The case is presented to reinforce awareness on this dermatologicaldis-ease and discuss its atypical presentation and its management.

Necrotizing Fasciitis: a Clinical Case and a Review of the Literature

Necrotizing fasciitis is a soft tissue, life-threatening infection with a fulminant and often fatal course. Early diagnosis is usually delayed as the onset of the disease is often masked in the form of erysipelas or cellulite. The condition is characterized by necrosis of the skin, subcutaneous tissue and underlying fascia. We describe a case of a 42-year-old man with a complaint of erythema, fever and severe pain in his right leg 4 days before hospitalization. The patient was admitted and treated with a diagnosis of erysipelas. A few hours after admission, in connection with a drastic deterioration in the general condition and dermatological status, he was transferred to a purulentseptic ward with a fulminant picture of necrotizing fasciitis. Debridement and fasciotomy were performed successfully and timely. Good prognosis and survival in patients with NF correlate directly with the complex of measures. Appropriate antibiotics and intensive general support avoid massive systemic diffusion. Early and adequate surgical debridement and fasciotomy are associated with improved survival.

Secondary Tumor Arising in a Nevus Sebaceous

Introduction. Nevus sebaceous is a rare congenital hamartoma, composed of epidermis, sebaceous glands, sweat glands and hair follicles. It is possible to develop secondary tumors in the area of nevus sebaceous during the lifetime, most often after puberty. Secondary lesions are most often benign, while malignant lesions may occur but significantly less frequently. Case report. We present the case of a 21-year-old patient who came for an examination due to the appearance of a nodule in the area of a yellowish lesion on the head. The yellowish lesion was present since birth, and the nodule appeared about a year before. The dermoscopic examination of the lesion was nonspecific. The final diagnosis of eccrine poroma as a secondary lesion in nevus sebaceous was made by pathohisto-logical analysis. Conclusion. Every secondary tumor in nevus sebaceous deserves full attention, with either close follow up, or excision with pathohistological analysis.

Autoimplantation – An Immunological Treatment For Multiple Warts

Introduction. Warts are benign epithelial lesions that involve skin and mucosa. Successful management depends on the patient’s immunity, site and type of wart. In spite of huge therapeutic armory available, no treatment has been found to be effective so far. Objective. To evaluate the effectiveness of autoimplantation in the management of multiple warts. Material and Methods. This is a hospital based prospective study of forty patients with multiple warts. A prospective, hospital-based study included forty cases of multiple warts for autoimplantation. Resolution of warts within three months was taken as complete clearance; the follow up of any recurrence lasted six months. Results. The majority of patients were males (69.7%), belonging to 21–30 years age group (57.6%). Complete resolution was observed in 25 patients, partial response was achieved in 5 patients and there was no response in 3 patients. The majority of patients did not have any complication or recurrence Conclusion. Autoimplantation is a simple, daycare, effective procedure. It provides resistance by inducing cell mediated immunity and also prevents recurrence to a great extent.

A Case Report of Pediatric Langerhans Cell Histiocytosis: Current Approach and Diagnostic Challenges for Dermatologist

Langerhans Cell Histiocytosis (LCH) is a chronic and rare myeloproliferative disorder caused by disorders in Lang-erhans cell proliferation in various organs and tissues. LCH has a wide variety of clinical manifestations, making it difficult to diagnose. Cutaneous manifestations are polymorphic in the form of purpura, papule, vesicles and pustules. LCH can involve vital organs such as the liver and lungs as well as the hematopoiesis system that usually gives a poor prognosis. The prognosis is also influenced by the age of patient, organ dysfunction and response to the first 6 weeks of chemotherapy treatment. A 3-year-old girl reported a major complaint of an abscess-like lesion in the region of neck accompanied by an extensive purpura of scalp, neck and inguinal areas accompanied by vulvar erosions. The immunohistochemical and histopathologic examination support LCH and the clinical improvement after intravenous administration of intravenous 3 mg/m2 Vinblastine chemotherapy, 75 mg/m2 etoposide, oral 40 mg/m2 per prednisone. After the 6th cycle of chemotherapy, the patient died.

Harlequin Ichthyosis (HI) Associated with Atrial Septal Defect (ASD) and Choanal Atresia

Harlequin ichthyosis (HI) is a severe form of congenital ichthyosis with autosomal recessive inheritance. Incidence of harlequin ichthyosis is 1 in 3,00,000 live births. We report a case of HI associated with bilateral choanal atresia and atrial septal defects, which is a rare association in this skin disorder. A-month-old preterm male baby born out of consanguineous marriage presented with features of armour-like scales and erythema all over body, ectropion, eclabium and fissures over flexures. The patient was born with a colloidion membrane at birth. The baby was operated for bilateral choanal atresia soon after birth because he developed cyanosis upon breast feeding which improved on crying. Upon flexible nasal endoscopy, diagnosis of membranous type of choanal atresia was confirmed by ENT (ear, nose, throat) surgeon. Heart auscultation revealed a murmur in our patient. Electrocardiogram and 2D Echocardiography was reported as atrial septal defect (4.5 mm OsASD). The patient was started on acitretin (1 mg/kg/day) and emollients after complete evaluation and is currently on regular follow up. Harlequin ichthyosis is linked to mutation of ABCA12 gene. It is often associated with eclabium, ectropion, hypoplastic nose, ears and fingers. Congenital heart diseases are rarely reported with HI in literature. This makes it mandatory to screen HI patients for internal defects.

Recurrent Pregnancy Induced Pemphigus Vulgaris: A Rare Case Report

Pemphigus vulgaris is a potentially life-threatening bullous autoimmune disease that can be triggered by various factors, one of which is pregnancy. Cases of pregnancy induced pemphigus are rare, and can result in devastating outcomes, both from the maternal or fetal perspectives if not treated promptly and adequately. The use of systemic corticosteroids is paramount to improve the outcome of the patient and fetus and it is a first-line treatment for the disease. Patients with a history of pemphigus should plan their pregnancies carefully, taking into consideration a minimum of 6 months remission before conception. This case report is about a 28-year-old woman with a history of pemphigus vulgaris that did not seek medical treatment of her pemphigus, which resulted in the intrauterine fetal death. The patient was treated with systemic corticosteroids and achieved great resolution to her blisters and overall wellbeing.

Hand, Foot and Mouth Disease in Immunocompetent Adult with Severe Oral Manifestation

Hand-foot-mouth Disease (HFMD) is an acute, self-limited, and highly contagious disease caused by a virus and generally affects children under 10 years old. The etiology of this disease is enterovirus 71 or coxsackievirus A16 which usually causes symptomatic infection or mild disease. Immunocompetent adults are rarely affected. However, recently the incidence of HFMD in immunocompetent adults has increased. We report a 41-year-old woman with severe oral lesions and painful papulovesicular eruption on the palms of her hands and feet.

Salicylic Acid Peel and Fusion Peel with Salicylic & Mandelic Acid Peel for Treatment of Acne Scars - A Comparative Study

Introduction. Acne vulgaris is one of the most common skin diseases affecting more than 85% of individuals worldwide. The study aimed to compare the therapeutic efficacy of Salicylic acid peel and Salicylic acid - mandelic acid peel for treatment of acne scars. Material and Methods. A comparative study was conducted on 41 patients, divided into two groups based on treatment choice by the subjects. Group A (23) were treated with 30% salycilic acid peels, and group B (18) were treated with 20% salycilic acid and 10% mandelic acid peels at an interval of 2 weeks for three sessions. The physician’s global assessment scale and clinical photographs were used at the end of three sessions. All the data were analysed using SPSS considering P<0.05 as significant. Results. Of the total 41 patients analyzed, the mean age in both the groups were comparable. (Group A: 20.4 years; Group B: 20.5 years). Duration of acne was >12 months in both the groups 13 (56.52%) & 10 (55.56%)). Thirteen patients (56.52%) in group A and 1 (5.56%) in group B had no side effects which was statistically significant (p=0.01). Using the physician’s global assessment scale 51-75% (Good) an improvement was seen in grade I 4 (17%) and 18 (78%) in grade II in group A and 2 (11%) in grade I and 12 (67%) in grade II in group B, respectively which was statistically significant (p=0.001). Conclusion. Both agents showed almost equal efficacy in improving mild-to-moderate acne scars. Adverse effects were less with Salicylic acid peel compared with mandelic acid peel..