A pocket-friendly and sustainable iontophoresis apparatus for palmoplantar hyperhidrosis: Advancement over a previously described homemade design

Introduction and Objectives: Tap water iontophoresis is a promising therapy for palmoplantar hyperhidrosis. Non-affordability and nonavailability of the marketed device restrict its usage for many patients hailing from villages or small cities. Materials and Methods: In an article named “A simple user-made iontophoresis device for palmoplantar hyperhidrosis” published previously in this journal, a simple inexpensive homemade device that runs on 12 V direct current battery was described. We made a small modification by using a 220–12 V alternate current to direct current semiconductor diode–based transformer for the current supply. Results: The added innovation made the device lightweight, cheaper, and usable with domestic electric supply at home/clinic. Sustained supply of current at same voltage without dip and non-requirement to change/replace battery are added advantages. Cost of the whole assembly is ₹310. Working and clinical efficacy of our device were comparable to the commercially available apparatus as reported by 13 patients who received thrice a week of 15min sessions with our device. Mild electric pricking sensation was felt by all patients. Four of thirteen reported that pricking sensation was a bit more with our device as compared to the marketed device. No calibration for intensity is available in our device. Conclusion: This simple to assemble and inexpensive device makes iontophoresis applicable in many needy patients with similar efficacy and few limitations compared to expensive marketed devices

Epidermodysplasia Verruciformis misdiagnosed as Pityriasis Versicolor

Epidermodysplasia verruciformis is an inherited autosomal recessive disorder characterized by widespread and persistent infection with HPV commonly HPV3 and 10, giving rise to a characteristic combination of plane warts, pityriasis versicolor like lesions and reddish plaques like lichen planus. It is an autosomal recessive condition though autosomal dominant and X- linked dominant cases has also been reported. In EV, there are mutations in the EVER1 or EVER2 genes on chromosome 17q25, which, due to a defect of cell-mediated immunity, lead to an abnormal susceptibility of the patients to a specific group of HPV genotypes known as EV HPV. The disease usually begins in childhood with equal prevalence in both sexes affecting persons of all races. Malignant changes like squamous cell carcinoma, basal cell carcinoma occurs in 30- 70% of cases on the sun exposed parts in the age group 20-40 years, but metastasis is rare. EV diagnosis must be suspected when persistent verrucas are present in large body areas and are thus difficult to treat. We report a case of a 20 years old male patient who came to our OPD with the complaints of asymptomatic white patches over upper chest, upper back, B/L upper limb & neck since 1½ year