Immunomodulators in the treatment of psoriasis

The efficacy of cyclosporine and related drugs in the treatment of psoriasis was the key to the development of the concept that psoriasis is an immune mediated disorder. These therapies demonstrably reduce the number of activated T-lymphocytes, which correlates with clinical remission. Monoclonal antibodies directed against key components of the inflammatory process have been studied in an attempt to produce safer, more effective and selective immunosuppressive agents. This review summarizes the information available on cyclosporine and related drugs, and cytokine therapy, including monoclonal antibodies directed against T-cell mediated inflammation. It should be realized that biologic therapies for psoriasis are very new and that efficacy and safety information from clinical trials is just becoming available

Immunomodulators in the treatment of psoriasis

The efficacy of cyclosporine and related drugs in the treatment of psoriasis was the key to the development of the concept that psoriasis is an immune mediated disorder. These therapies demonstrably reduce the number of activated T-lymphocytes, which correlates with clinical remission. Monoclonal antibodies directed against key components of the inflammatory process have been studied in an attempt to produce safer, more effective and selective immunosuppressive agents. This review summarizes the information available on cyclosporine and related drugs, and cytokine therapy, including monoclonal antibodies directed against T-cell mediated inflammation. It should be realized that biologic therapies for psoriasis are very new and that efficacy and safety information from clinical trials is just becoming available

Case Report - Papillary eccrine adenoma

A 28-year-old man came to us with a solitary skin colored, mildly tender nodule of 6 months duration on the dorsum of the right hand. On histological examination, multiple dilated ducts without apparent continuity with the surface were found in the dermis. These dilated ducts had branching tubules with eosinophilic amorphous material filling most of the lumina. The peripheral cells of the tubules resembled myoepithelial cells, whereas the luminal border cells were cuboidal or low columnar. Papillary projections arising from the inner cells were seen extending into the lumen. These features were diagnostic of a rare tumor, papillary eccrine adenoma

Papillary eccrine adenoma

A 28-year-old man came to us with a solitary skin colored, mildly tender nodule of 6 months duration on the dorsum of the right hand. On histological examination, multiple dilated ducts without apparent continuity with the surface were found in the dermis. These dilated ducts had branching tubules with eosinophilic amorphous material filling most of the lumina. The peripheral cells of the tubules resembled myoepithelial cells, whereas the luminal border cells were cuboidal or low columnar. Papillary projections arising from the inner cells were seen extending into the lumen. These features were diagnostic of a rare tumor, papillary eccrine adenoma

Viral Warts-A Clinico-Epidemiological Study

Although clinical criteria, laboratory diagnosis and treatment are well established, scanty attention has been paid to prevalence and pattern of viral warts in India. HIV is widely prevalent and its influence on the number and morphology of viral warts has not yet been studied in our setup. Hence, this study was undertaken. One hindered and forty four cases of viral warts were studied between September 2000 and June 2002 at the department of Dermatology and STD, JIPMER, Pondicherry. These included 81childeren and 63 adults. In Children, viral warts were most commonly seen in the age group of 10to14 years (41.9%), whereas in adults, the most commonly seen in the age 14to20 years (46.03%). The average age at presentation was 11.5 years. The male to female ratio was 2.2 to 1 in children and 1.8 to 1 in adults. Family history of warts was observed in 27.7% of the cases. In children, multiple site involvement (62.9%) was more common than single site involvement. The most commonly involved site was hand in children as also in adults. In adults, single site involvement (66.6%)was more common than multiple site involvement. The most common type of wart seen in both children and adults was the common wart. Twenty percent of the cases showed koebnerization. Four cases were found to be seropositive for HIV infection, who were adult with genital warts, but florid manifestations were not seen

Solitary papule over scalp

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region

Quiz - Asymptomatic nodules over forearm and hand

A 30-year-old milkmaid had asymptomatic 1.5-2.0 cms crusted nodules over her left forearm, right index (Figure 1) and right middle finger of two and an half weeks duration. She gave a history of similar lesions occurring over the teats of her cows three weeks back. The lesions had initially started as papules, which turned vesicular in four days time and were followed by crusting a week later. There was no evidence of fever or lymphadenopathy. Histopathological examination of the skin nodule (over the finger) showed hyperkeratosis, marked parakeratosis and acanthosis. There was vacuolization of cells in the upper third of the stratum malpighi and the dermis showed vasodilatation and chronic inflammation (Figure 2). Higher magnification demonstrated eosinophilic inclusion bodies in the cytoplasm of vacuolated epidermal cells (Figure 3)

Solitary papule over scalp

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region