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   Table of Contents - Current issue
July-December 2022
Volume 9 | Issue 2
Page Nos. 47-85

Online since Thursday, October 27, 2022

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Mucocutaneous adverse effects of remdesivir and favipiravir in patients with Covid-19 infection: A systematic review p. 47
Pradeep Balasubramanian, Chhakchhuak Laldinthari, Robert Lalnunpuia
Introduction: Remdesivir and favipiravir are two antiviral medicines used in the treatment of Covid-19 infection widely. The studies pertaining to the mucocutaneous adverse events of these two drugs are scarce. Hence, we performed a systematic review to bridge the above gap. Materials and Methods: The study is performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. All original articles, case series, and case reports pertaining to mucocutaneous adverse drug reactions caused by remdesivir and favipiravir, while any of these drugs were administered in Covid-19-infected patients, were included in the present study. Results: Six articles were identified pertaining to the mucocutaneous adverse reactions of remdesivir, of which two were original articles and four were case reports. Four case reports pertaining to the mucocutaneous adverse events of favipiravir are included in this study. The details regarding the same are elaborated in the main manuscript. Conclusion: In the present systematic analysis, the mucocutaneous adverse events of the two widely used antiviral medications in Covid-19 were described. This articles throws light on the aspects which are hardly reported or discussed in the literature.
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A clinico-mycological study of dermatophytoses and their in-vitro sensitivity to antifungal drugs p. 54
Manjunath Kadnur, Shishira R Jartarkar, Girish Narayanaswamy, Ashwath S Manoj Kumar, Sheena Arora, Thushara Balakrishnan
Background: There is an increase in the frequency of resistant and recurrent dermatophyte infections in India. We undertook a study to isolate the organisms in different clinical presentations and to study their sensitivity to clotrimazole, miconazole, fluconazole, and griseofulvin. Aims: The aim of this article was to study the clinico-mycological pattern of dermatophytes and their in-vitro sensitivity to commonly used antifungals. Objectives: The objectives were as follows: (1) to study the clinico-mycological patterns of dermatophytosis and (2) to study the in-vitro sensitivity patterns of culture isolates to clotrimazole, miconazole, fluconazole, and griseofulvin. Materials and Methods: A total number of 48 patients were included in the study. The study period was from August 2019 to February 2021. Skin scrapings and nail clippings were inoculated in Sabouraud dextrose agar. Isolates were identified based on gross colony characteristics and microscopic morphology of their micro- and macroconidia and accessory structures. The isolates were then transferred to sterile distilled water in vials and stored. The clinical isolates stored in the stock solution were subcultured on to Potato dextrose agar. Then, the antifungal disks and Griseofulvin E strip were applied on to the plates. The zones of inhibition around the disks were measured and recorded. In the case of E strip, the minimum inhibitory concentration value is read from the scale in terms of µg/mL, where the ellipse edge intersects the strip. Results: The total number of cases included were 48. Commonest clinical presentation was co-occurrence of Tinea cruris and corporis (33%). Trichophyton mentagrophytes was isolated in 56% of cases. Isolates showed highest sensitivity to clotrimazole (87.5%) followed by miconazole (60.4%). Only 8.3% were sensitive to fluconazole and 37.5% were sensitive to griseofulvin. Conclusion: T. mentagrophytes is the causative organism in significant numbers of dermatophytic infections. Though broth dilution is the standard method for sensitivity assay of dermatophytes, disk diffusion method could become a more simple alternative.
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Dermatosis neglecta in inpatients of a tertiary care center: A case series p. 59
Sruthi Kareddy, Spoorthy Babu, Mamatha Pappala
Background: Dermatosis neglecta (DN) is an underdiagnosed localized pigmentary disorder, characterized by asymptomatic hyperpigmented patches and plaques with adherent scales in an inadequately cleansed area. It is a diagnostic challenge leading to unnecessary interventions and burden to patients. Dermoscopy is a noninvasive handy diagnostic tool, though its utility in the diagnosis of DN is unexplored. Objective: To describe the various clinical and dermoscopic patterns in patients with DN. Materials and Methods: An observational study in 10 admitted patients of a tertiary hospital with DN was done, who consulted in department of dermatology in view of hyperpigmented lesions. After a thorough history and clinical examination, dermoscopy was done over the lesions. Results: In 10 patients, DN was confirmed with a resolution of part of lesion on the application of water-soaked gauze. On dermoscopy, dark-brown polygonal, cornflake-like scales are seen arranged in a mosaic pattern with intervening normal skin, sometimes over an erythematous background. On further probing, most patients gave the history of unintentional neglect of the affected part related to their primary illness. Limitations: Small sample size. Conclusions: DN is an underreported localized hyperpigmented disorder, mimicking other dermatoses. It should always be kept in mind in patients with morbidities that lead to the inability to maintain hygiene in the relevant areas, which may not be the classically described sites of DN. Dermoscopy helps to differentiate it from other hyperpigmented lesions, especially in its milder forms, avoiding the act of wiping the lesions especially in areas associated with hyperesthesia and helps in reinforcing the diagnosis. However, the criteria to diagnose DN based on dermoscopy is not definite.
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Clinico-dermatoscopic and histopathological evaluation of a case of generalized lichen nitidus p. 64
Sunanda Arun Mahajan, Surender Singh, Yallappa Ramachandrappa Kabbannavar, Vidya D Kharkar
Lichen nitidus (LN) is a rare asymptomatic skin disease composed of numerous tiny, shiny, flat papules mainly over the chest, forehead, neck, forearm, and glans penis. They are of two types based on distribution, localized which is more common compared to generalized. Dermoscopy helps in differentiating LN from other similar dermatoses such as lichen planus, keratosis pilaris, follicular eczema, lichen spinulosus, which is non-invasive. We describe a 15-year-old female with generalized lichen nitidus with palms, soles, and nail involvement with dermoscopic features and histopathological correlation.
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Histopathologic findings following hemostasis with Gelfoam p. 67
Jose A Cervantes, Kavina Patel, Wendi Wohltmann, Joshua Wisell
Gelfoam, an absorbable gelatin material that can carry thrombin and provide a matrix for the clotting cascade, is commonly used in dermatologic surgery to obtain hemostasis. Gelfoam application is often well tolerated, with minimal surgical site reaction. Gelfoam may be an incidental histopathologic finding following cutaneous surgery, typically without any clinical sequelae. Both dermatologic surgeons and pathologists should be familiar with this histopathologic finding to eliminate confusion and to avoid additional intervention. We present a case of a 76-year-old man with an interesting histopathologic finding of basophilic material predominantly overlying and among keratinocytes in an epithelializing surgical defect that was covered with Gelfoam.
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Multifocal myopericytomas: Rare soft tissue tumor over the sole p. 70
Bhavya Swarnkar, Kanika Sahni, Hena Khandakar, Shipra Agarwal
Myopericytoma is a rare soft tissue tumour which orginates from pericytes. Histopathology shows nodular perivascular proliferation of cells with myoid differentiation. Myopericytomatosis and multifocal myopericytomas are the two uncommon variants of this entity. We report an uncommon case of multifocal myopericytomas over the sole.
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Pigmented epithelioid melanocytoma: A clinico-histopathological enigma p. 73
Pooja Dilip Shah, Raju G Chaudhary, Ashish Jagati, Kalgi D Baxi
Blue nevi are a group of congenital or acquired benign dermal melanocytic tumors. Various clinical and histological variants have been described.Epithelioid blue nevus (EBN), an uncommon variant may present as blue gray nodule over trunk, extremities which might occur either sporadically or in association with Carney complex. Due to clinical and histological overlap with other pigmented melanocytic lesions clinicopathological correlation is essential. We report a case of epithelioid blue nevus on dorsum of right foot in a 22-year-old man.
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Erythroderma secondary to dermatophytosis p. 77
Aseefa Vellattuchola, Thyvalappil Anoop, Pretty Mathew, Sridharan Rajiv
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Eccrine poroma under the dermatoscope p. 80
Aishni Shah, Dhruv Ramanbhai Patel, Jinal Jitendrabhai Tandel, Pragya Ashok Nair
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Scarring alopecia of scalp: It is not always about the hair! p. 83
Richa Kumar, Navya Donaparthi
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