Acneiform dermatoses

Acneiform dermatoses are follicular eruptions. The initial lesion is inflammatory, usually a papule or pustule. Comedones are later secondary lesions, a sequel to encapsulation and healing of the primary abscess. The earliest histological event is spongiosis, followed by a break in the follicular epithelium. The spilled follicular contents provokes a nonspecific lymphocytic and neutrophilic infiltrate. Acneiform eruptions are almost always drug induced. Important clues are sudden onset within days, widespread involvement, unusual locations (forearm, buttocks), occurrence beyond acne age, monomorphous lesions, sometimes signs of systemic drug toxicity with fever and malaise, clearing of inflammatory lesions after the drug is stopped, sometimes leaving secondary comedones. Other cutaneous eruptions that may superficially resemble acne vulgaris but that are not thought to be related to it etiologically are due to infection (e.g. gramnegative folliculitis) or unknown causes (e.g. acne necrotica or acne aestivalis)

Common Dermatoses in Patients with Obsessive Compulsive Disorders

Obsessive-compulsive disorder is a chronic, debilitating syndrome, consisting of intrusive thoughts- which are experienced as inappropriate by the patient and are producing anxiety- and compulsions, defined as repetitive behaviours produced to reduce anxiety. While patients with obsessive-compulsive disorder typically have xerosis, eczema or lichen simplex chronicus, as a result of frequent washing or rubbing their skin, several other disorders which are included in the group of factitious disorders have also been associated with obsessive-compulsive disorder. A close collaboration between the dermatologist and the psychiatrist is therefore mandatory in order to achieve favourable outcomes for these patients. The aim of the article is to present the most frequent dermatological disorders associated with obsessive-compulsive disorder and to look over some of the rare ones

A case of tinea incognito mimicking subcorneal pustular dermatosis

An 89-year-old woman presented with plaque-like lesions, accompanied with pustules and desquamation on the back and front of the trunk for approximately one year. Long term use of potent topical corticosteroids was ineffective. Because of the chronicity of her condition, the diagnoses of subcorneal dermatosis or subcorneal pustular dermatosis type of IgA pemphigus were considered. However, fungal hyphae were observed in the potassium hydroxide examination. Therefore, we present this case since this clinical appearance of tinea incognito can also mimic various pustular dermatoses

Dermatological disorders during pregnancy: a study from tertiary care hospital

Background: Various types of physiological and pathological mucocutaneous changes are commonly observed during pregnancy. Infectious, non-infectious and pregnancy specific dermatoses are seen during pregnancy. This study was carried out with an aim of studying association of various dermatosis with pregnancy and to find out incidence of pregnancy specific dermatoses v/s non-specific dermatosis.Methods: Total 131 pregnant female presenting with complain of skin lesions were included in study. Detail examination and necessary investigations were carried out to diagnose type of skin disease.Results: Out of 131 patients, only 11(8.4%) patients presented with pregnancy specific dermatoses while rest 120 (91.6%) presented with pregnancy non-specific dermatoses. Among pregnancy non-specific dermatoses, non-infectious conditions were found in 48.1% and 43.5% presented with infectious dermatoses. Most common infectious dermatoses was herpes labialis while most common non-infectious dermatosis was pruritus. Conclusions: Pregnancy specific dermatoses are rare and require vigilant eye to recognize them while wide variety of pregnancy non-specific dermatoses are commonly encountered and require prompt diagnosis and treatment for uneventful pregnancy outcome

Genital Skin Diseases and Their Expression in Sexual Functionality

Sexual functionality acts as an important function of the individual, acting both physically and mentally to create a state of well-being and permitting procreation. A large number of mucosal and cutaneous ailments may affect the genial areas in both males and females, generally leading to local symptoms that impede the sexual act. Genital diseases, sometimes even without impairing the sexual function, may still alter the dynamics just because of the enormous psychological impact that occurs in these situations. We aim to review main dermatological disorders that alter normal function of the genitalia, as well as their physical mechanism by which the sexual functionality is changed

The role of hypothalamus-pituitary-adrenal (HPA)-like axis in inflammatory pilosebaceous disorders

Skin is the largest peripheral endocrine organ and functions as a hormone target and endocrine gland. A cutaneous hypothalamus-pituitary-adrenal (HPA)-like axis enables the skin to respond to stress and regulates its steroidogenic activity. The pilosebaceous unit is a site for production and metabolism of a number of steroid hormones, including stress and sex hormones. This is an overview of the important role that the cutaneous HPA-like-axis plays in the pathogenesis and treatment of inflammatory pilosebaceous disorders, including acne, rosacea, seborrheic dermatitis, and hidradenitis suppurativa

Pattern of specific dermatoses of pregnancy: a hospital based study

Background: The specific dermatoses of pregnanc represent a heterogenous group of ill-defined pruritic skin diseases related specifically to pregnancy and/or the immediate postpartum period. The objective of the study is to determine the patterns of specific dermatoses of pregnancy in a tertiary care hospital.Methods: A total of 450 pregnant females, irrespective of their parity and gestational age were screened for various pruritic skin conditions and those with specific pregnancy dermatoses were identified and evaluated.Results: The age of the study population ranged from 18 to 36 years (mean age 24 years). The study population included 261 (58%) primigravidae and 189 (42%) multigravidae. Seventeen (3.77%) pregnant females had specific dermatoses of pregnancy. Out of these, 9 (52.94%) had pruritic urticarial papules and plaques of pregnancy (PUPPP), followed by pruritic folliculitis of pregnancy in 5 (29.41%), pruritic gravidarum in 2 (11.76%) and pemphigoid gestationis in 1 (5.88%). PUPPP was the commonest specific dermatoses noted in our study.Conclusions: The present study highlights the pattern of specific dermatoses of pregnancy in our hospital. Early diagnosis of specific dermatoses of pregnancy may prevent harmful effect on mother and fetus. The pruritic eruptions of pregnancy, which are not a rare entity can be a source of significant distress to the pregnant female and need timely therapeutic intervention

Frequency and clinical variants of specific dermatoses in third trimester of pregnancy: a study from a tertiary care centre

OBJECTIVE: To determine the frequency of patients with dermatoses in the third trimester of pregnancy and to identify various clinical types of dermatoses in the third trimester. METHODS: The study was carried out at the Department of Dermatology and the Department of Gynaecology & Obstetrics, PNS Shifa Hospital, Karachi, from January 2 to July 1, 2008. Two hundred pregnant women in their third trimester were included in the study. The diagnosis was based on history, clinical examination and relevant investigations. Patients with physiological dermatoses and dermatoses which flare up during pregnancy were excluded. A comprehensive pro-forma was used to evaluate different dermatoses. Skin biopsy for histopathology was also done where necessary. RESULTS: The age of the study population ranged from 17 to 36 years (mean = 27.3 +/- 4.86). Five (2.5%) patients had prurigo of pregnancy, 4 (2%) had dermatoses associated with Intrahepatic Cholestasis of Pregnancy (ICP), 3 (1.5%) patients had polymorphic eruption of pregnancy, and 1 (0.5%) patient had pruritic folliculitis of pregnancy. No case of pemphigoidgestationis was observed. CONCLUSION: In the study, 6.5% patients presented with specific dermatoses. Prurigo of pregnancy was the commonest condition. Polymorphic eruption of pregnancy was more common in primigravida, while dermatoses with intrahepatic cholestasis was seen more often in multigravida