Phacomatosis cesioflammea: First case report from India

Phacomatosis cesioflammea is a rare condition defined by the simultaneous presence of both vascular and pigmentary nevus in the same patient. We report a case of a 4-year-old Indian female child who presented with diffuse dermal melanosis on the upper shoulders, upper anterior chest and lower back and extending to involve both sides of the arms and forearms, generalized port-wine stain on the back, shoulders and both upper limbs with sparing of the right palm. At places, the two types of lesions were superimposed on each other and were also present discretely on the back, but in close proximity to each other. There was the presence of melanosis bulbi on the right side of the eye. She was otherwise normal. She was clinically diagnosed as a case of phacomatosis pigmentovascularis cesioflammea. The nonallelic twin spotting phenomenon has been proposed in the pathogenesis of this disorder

Co-existence of extramammary Paget′s disease and Bowen′s disease of vulva

Extramammary Paget′s disease and Bowen′s disease are histologically similar and immunohistochemistry is often required to make the diagnosis. We present a case of vulval Paget′s disease with Bowen′s disease in an elderly female. Strong positivity for cytokeratin 7, anti CAM 5.2, carcinoembryonic antigen (CEA) and periodic acid-Schiff (PAS) stain in clitoral, left labial and interface regions of the vulvectomy specimen confirmed the diagnosis of Paget′s disease (PD) while positive staining for p63 in the right labial and interface regions helped in establishing the diagnosis of concurrent Bowen′s disease (BD)

The study of clinical outcome of systemic methotrexate uses in moderate to severe childhood psoriasis

Background: Currently, very few studies exist regarding the use of systemic methotrexate (MTX) in childhood psoriasis. Aim: The aim is to study the effect of systemic MTX with respect to overall efficacy and safety in varied spectrum of severe childhood psoriasis patients and to assess the degree of improvement objectively by measuring psoriasis area severity index (PASI) at each visit. Materials and Methods: All patients 10, not responding to topical therapy and without having any contraindication to systemic MTX use were included in the study done during a period of two years. MTX was prescribed orally at a dose of 0.2–0.4 mg/kg/week and folic acid on daily basis except on the day of MTX to all the patients. Both clinical and laboratory follow-ups were done weekly for the first 2 weeks and then at 15 days interval for 1 month and monthly after that for measuring PASI and to rule out any side effects of MTX. After 75% improvement in PASI score the dose was decreased at rate of 2.5 mg/week and stopped after complete resolution of the lesions. Results: Out of nine cases (M/F - 6/3), quickest response to MTX was seen in pustular psoriasis (4.5 weeks) and one case of plaque psoriasis (5 weeks) and slowest response was seen in rupoid variant (13 weeks). Mean duration to achieve 50% and 75% improvement in PASI overall were 4.6 ± 2.46 weeks and 7.6 ± 3.36 weeks, respectively. The mean cumulative dose of MTX in all cases was 231.1 ± 176.1 mg without any major side effects. Conclusion: MTX is a safe therapeutic option in severe refractory cases of childhood psoriasis if used with proper monitoring and follow-up

Primary cutaneous plasmacytosis: Masquerading as hidradenitis suppurativa

Isolated cutaneous plasmacytosis (CP) is a rare entity with few cases reported in world literature. CP masquerading as hidradenitis suppurativa like presentation is a unique case with some features differentiating it clinically from it which were further confirmed by histopathology and immunostaining. Our case showed hyperplasia of mature plasma cells and polyclonal hypergammaglobulinemia, immunostaining for CD138 positivity and kappa: lambda ratio more than 3:1. Extensive clinical and laboratory investigations failed to reveal any underlying pathology, presence of any underlying disease accompanying the hypergammaglobulinemia and/or plasma cell proliferation

Not Available

Not AvailableBackground Despite repeated outbreaks of poxvirus infections unique to the Indian subcontinent region and veterinary research work in this field, much less diagnostic awareness with resultant treatment protocols have been formulated in the human medical field. Aims With this objective in mind, a combined human medical and veterinary study was conducted on a recent outbreak of buffalopox infection in a village in northern India. Methods A team of doctors did the clinical examination and collected swab and serum samples from both cattle and humans, and these were subjected to viral isolation, cell culture, plaque reduction neutralization test, polymerase chain reaction, and partial genome sequencing. Results A clustered foci of 12 human patients aged 11–60 years, 12 buffaloes, and 10 cows were found to be affected with buffalopox infection with some atypical features. Conclusion Awareness, diagnosis, education, early intervention, and formulation of disaster guidelines are needed in view of the potential epidemiologic outbreak, if this happens in the future.Not Availabl