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   Table of Contents - Current issue
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October-December 2019
Volume 20 | Issue 4
Page Nos. 289-356

Online since Monday, September 30, 2019

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EDITORIAL  

Editorial p. 289
Sandipan Dhar
DOI:10.4103/ijpd.IJPD_92_19  
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CME ARTICLE Top

Nanotechnology in pediatric dermatology p. 290
Sandipan Dhar, Ramkumar Rammoorthy, Samujjala Deb, Deepak Parikh
DOI:10.4103/ijpd.IJPD_95_17  
Nanotechnology is the manipulation of material with size <100 μ. Application of nanotechnology in medicine is also known as nanomedicine. Nanotechnology has found varied applications in medicine, ranging from diagnostic devices, contrast agents, tools for analysis, and most importantly in the field of drug delivery.
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REVIEW ARTICLES Top

Kasabach–Merritt phenomenon p. 295
Sanjay Singh, Neetu Bhari, Rubina Jassi
DOI:10.4103/ijpd.IJPD_2_18  
Kasabach-Merritt Phenomenon (KMP) is a potentially life-threatening condition characterised by thrombocytopenic consumptive coagulopathy. KMP is almost exclusively associated with two uncommon vascular tumours, Kaposiform haemangioendotheliomas (KHE) and tufted angiomas (TA). It is clinically characterized by a rapid increase in the size of the pre-existing vascular plaque and deranged blood coagulation profiles. Early recognition and treatment is of crucial importance. Hemodynamic stability should be achieved as soon as possible with the use of fresh frozen plasma infusions. Surgical excision and embolization, when feasible, are the line of treatment. Oral prednisolone with or without vincristine are most commonly used and effective treatment. Oral sirolimus has shown its efficacy and safety in recent reports and-series. Propranolol and anti-platelet drugs are commonly used as a second-line therapy. Other drugs and combination therapies are used in non-responsive recalcitrant cases.
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Sclerema neonatorum p. 302
Konchok Dorjay, Stanzin Dolker, Tasleem Arif, Mohammad Adil, Sheetal Ganju
DOI:10.4103/ijpd.IJPD_12_18  
Sclerema neonatorum (SN) is a rare clinical condition usually seen during the 1st week of life. It presents as hardening of the skin and has a high mortality rate. It is usually associated with congenital anomalies, hypothermia, respiratory illnesses, and sepsis. Defective lipolytic enzymes, a high melting point, and resultant low solidification point of saturated fatty acids of subcutaneous fat, edema of connective tissue septae, and signs of underlying systemic diseases are the various theories proposed for the development of SN. The skin biopsy shows the thickening of trabeculae, sparse inflammatory infiltrates of lymphocytes, histiocytes and multinucleate giant cells, and X-ray diffraction of a biopsy sample of SN shows crystals in affected sites. The systemic corticosteroids have been used by various authors with variable response. Use of exchange transfusion has recently shown good results in improving the outcome of SN.
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Psychodermatoses in children p. 306
Iffat Hassan, Mohamad Abid Keen, Yasmeen Jabeen Bhat, Insha Latif
DOI:10.4103/ijpd.IJPD_135_18  
The relationship between the skin and the psyche is undeniable. Hence, it becomes mandatory for the dermatologists to be alert for psychological conditions affecting the skin. Since cutaneous diseases are well known to cause a significant impact on a patient's quality of life, the relationship works the other way as well. Stress has been found to contribute to the severity of various dermatoses such as psoriasis, atopic dermatitis, and acne. Awareness of psychodermatological disorders among dermatologists will lead to a more holistic treatment approach and better prognosis in this unique group of patients. This article summarizes various aspects of psychodermatology and focuses on psychodermatological disorders as well as highlights the interaction between psyche and skin.
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REVIEW OF CURRENT LITERATURE Top

Hot topics in paediatric dermatology p. 315
Divya Kamat, Rahul Mahajan
DOI:10.4103/ijpd.IJPD_75_19  
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ORIGINAL ARTICLES Top

A clinical profile of childhood alopecia areata in a tertiary care hospital in Chennai, India p. 320
Naveen Chandra Atluru, Vritika Gaddam, Sudha Rangarajan, Krishnakanth Muralidhar, Mahalakshmi Veeraraghavan
DOI:10.4103/ijpd.IJPD_13_17  
Background: Data of Clinical profile of childhood alopecia areata (AA) is inadequate in India. Hence this study was carried out. Materials and Methods: All new cases of childhood alopecia areata (AA) were studied from September of 2015 to September 2016, for a total duration of 1 year. In this prospective study, a total of 150 patients were diagnosed with AA, out of which 39 pediatric patients were enrolled in our study. Results: A total of 23 girls (58.97%) and 16 boys (40.02%) were seen with a ratio of 1.4:1 (female:male). All 39 patients are of South Indian decent and had an age of onset ranging from 2- to 18-year-old with the mean being 10.7 years. Twenty-four patients (61.5%) had a rapid onset of the disease, <6 months duration and only one patient had a previous episode of patchy hair loss. The majority of patients, 30 (76.9%), had a mild type of involvement, which was <25% of the scalp. A positive family history of AA was observed in 3 (7.7%) patients. A total of 17 (43.6%) patients had a history of atopy while only 7 (17.95%) patients had family members with a history of atopy. A positive family history of AA was seen in 3 (8.3%). Other systemic associations such as vitiligo, lichen planus, and Down's syndrome were rare. Conclusions: The age of onset, a positive family history of AA, and associated autoimmune diseases or atopic disorders were observed to not have any influence on the severity of the disease. The results were compared with those reported elsewhere for the similar age group.
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Childhood leprosy: A retrospective descriptive study from Delhi p. 325
Sneha Ghunawat, Vineet Relhan, Shankila Mittal, Jaspriya Sandhu, Vijay Kumar Garg
DOI:10.4103/ijpd.IJPD_15_18  
Background: Childhood leprosy is an important marker of the status of the ongoing leprosy control program, as it is an indicator of active disease transmission in the community. Despite achievement of elimination status of leprosy in 2005, the reported prevalence of childhood cases continues to be high. Materials and Methods: A retrospective analysis of 10-year records of leprosy patients aged <15 years in a tertiary care hospital of central Delhi was carried out from 2005 to 2015. Data were analyzed using the SPSS 22.0 system. Results: A total of 113 (7.6%) cases of childhood were reported during the 10-year period from 2005 to 2015. Multibacillary cases constituted a total of 57 (50.4%) cases, whereas paucibacillary constituted 56 (49.5%) cases. The M:F ratio noted was 2.5:1. Signs of reaction were noted among 15% of cases, while deformity was noted in 24.7% of cases. Conclusion: The rate of childhood leprosy continues to be high. Lack of proper access to health facilities, ignorance among the general population, high susceptibility due to immature immune system, etc., make this population highly vulnerable.
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Nits and pseudonits in Indian children: A dermoscopic perspective p. 329
Aakash Gupta, Balachandra S Ankad, Priyanka Jaju, Nicholas Roland Drago
DOI:10.4103/ijpd.IJPD_129_18  
Background: Hair casts or pseudonits are tubular accretions that are movable encircling the hair shafts of the scalp. It is commonly confused as head lice or pediculosis capitis, which is a common concern in pediatric age group. Hair casts are common in psoriasis, seborrheic dermatitis, and pityriasis amiantacea. This misdiagnosis is a reason of patient and physician anxiety. We attempted to evaluate significance of trichoscopy in differentiating nits and pseudonits and therefore a better treatment plan. Aims and Objective: To evaluate trichoscopic patterns in nits and pseudonits. Methodology: The study was conducted in a tertiary hospital. Ethical clearance and consent from patients were obtained. DermLite 3 with ×10 magnification was employed for trichoscopy. Tiny concretions on the hair shafts were examined with trichoscopy. Patterns were analyzed. Results: Totally, 25 patients were included in the study with 7 boys and 18 girls. The mean age was 9 years. Trichoscopy demonstrated cylindrical white sheaths (2–7 mm) encircling the hair shafts in 15 patients (60%). Forty percent of the patients showed pyriform-shaped translucent and yellowish structures (0.8 mm) attached to hair shafts. Based on the trichoscopy patterns, diagnosis of pseudonits and nits was made in former and latter groups, respectively. Conclusion: Trichoscopy plays an important role in differentiation of nits and pseudonits. Since nits are contagious, correct diagnosis is of utmost importance for better management. Thus, trichoscopy is a reliable diagnostic procedure in daily practice of dermatologists.
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A clinico-epidemiological study of tinea capitis in children attending a Tertiary Care Hospital in Karimnagar p. 332
Narendar Gajula, Nishita Vumma, Vontela Rohit, Anusha Kalikota
DOI:10.4103/ijpd.IJPD_119_18  
Background: Tinea capitis is dermatophytic infection of scalp and associated hair. Incidence of the disease remains unknown. It commonly occurs in children between 3-14 yrs of age group. Etiological agents vary from time to time and place to place. Aim: To delineate the various patterns of Tinea capitis observed in Karimnagar district and to assess for any correlation between the clinical, microscopic and microbiologic findings in the patients seen. Also, to identify the common fungal species responsible for producing Tinea capitis. Material and Methods: Clinical morphology and KOH findings were studied in 65 patients who attended DVL OPD at Chalmeda Anand Rao Institute of Medical College, Bommakal, Karimnagar with the suspected diagnosis of Tinea capitis. Fungal culture was performed for all the cases. The epidemiological factors associated with the disease were also assessed. Results: Out of 65 children,36 (55.4%) belonged to 5-10yrs of age with a slight male predominance (1.4:1). Most of the children were living in crowded conditions 52(80%). Hair loss was the commonest symptom in 100% followed by itching in 41(62.9%) of cases. Greypatch variety was the commonest 24 (36.9%) followed by black dot 18(27.7%), kerion 12(18.5%) and agminate folliculitis 11(16.9%). KOH mount was positive in 78.4% and culture in 57.4% of cases. T.violaceum was the commonest 16(37.5%) species isolated followed by T.mentagrophyte 11(25.5%), T.tonsurans 8(18.6%), T.rubrum 6(13.9%) and M.gypseum was the least 2(4.6%). Conclusion: In the present sudy, clinical examination and microscopic findings along with epidemiological factors were considered which attributed that the most common group affectedis the lower socioeconomic population. Though the causative fungi was found to vary between different regions and time, T.violaceum was the most common organisum isolated in our study.
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CASE REPORT Top

Are henna tattoos harmless? Report of clinical cases p. 338
Monica Davalos-Tanaka, Barbara Rivera Fernández Galán, Laura Isabel Ramos Gómez
DOI:10.4103/ijpd.IJPD_51_19  
The black henna tattoo has been of use in Mexico for a long time. It has become popular in the last few years mostly in young children and adolescents. The traditional henna tattoo is obtained from the Lawsonia alba and inermis plant. However, para-phenylenediamine (PPDA) is added to this so it can last longer, look darker, and look like a permanent tattoo. This increases its allergic potential since it has no sanitary regulation of the concentration of PPDA that it is used. We present three cases of children with contact allergic dermatitis caused by black henna which resolved with low potency topical steroids. The objective of this is to educate contact health-care professionals to be aware of this adverse effect on black henna and also to educate patients and patients' families about the risk of applying it, since it can have severe allergic reactions.
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RESIDENT CORNER Top

Forgetting the cardinal sign is a cardinal sin: Slit-skin smear p. 341
Manjyot Gautam, Aditi Jaiswal
DOI:10.4103/ijpd.IJPD_74_19  
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LETTERS TO EDITOR Top

Occurrence of filiform wart over nevus sebaceous: A report of two cases of locus minoris resistentiae p. 345
Tejal Devidas Ghanate, Rakesh P Roge, Bhagyashree Babanrao Supekar, Vaishali H Wankhade, RP Singh
DOI:10.4103/ijpd.IJPD_59_19  
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Defining the dermoscopic characteristics in aplasia cutis congenita on the body p. 347
Subrata Malakar, Samipa Samir Mukherje
DOI:10.4103/ijpd.IJPD_111_17  
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Rosette: An additional in vivo dermoscopic finding in molluscum contagiosum p. 349
Subrata Malakar, Samipa Samir Mukherjee
DOI:10.4103/ijpd.IJPD_89_17  
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Use of oral ketotifen and vitamin D in the management of papular urticaria p. 351
Ashimav Deb Sharma
DOI:10.4103/ijpd.IJPD_151_18  
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Erythema ab igne over soles in a young boy p. 352
Sabha Mushtaq
DOI:10.4103/ijpd.IJPD_46_19  
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Asymptomatic freckle-like hyperpigmentation of the palms: A rare pigmentation caused by cydnidae (burrowing bug) p. 353
Rashmi Agarwal, Sahana M Srinivas, BS Chandrashekar
DOI:10.4103/ijpd.IJPD_41_19  
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A case report of pediatric pyoderma gangrenosum: A diagnostic and treatment challenge p. 355
Margaret Stephanie Lagman Jimenez, Jennifer Aileen Ang Tangtatco, Maria Vinna Nicodemus Crisostomo, Michaela Mendoza Tabalon
DOI:10.4103/ijpd.IJPD_146_18  
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