Amyloidosis cutis dyschromica

Cutaneous amyloidosis has been classified into primary cutaneous amyloidosis (PCA, OMIM #105250), secondary cutaneous amyloidosis and systemic cutaneous amyloidosis. PCA is the deposition of amyloid in previously apparent normal skin without systemic involvement. Amyloidosis cutis dyschromica (ACD) is a rare distinct type of PCA. Here, the unique clinical and histological findings of two Chinese female siblings with ACD were described.

Yang et al. Amyloidosis cutis dyschromica in two female siblings: cases report. BMC Dermatology 2011, 11:4

Case report: Acute generalised exanthematous pustulosis and toxic epidermal necrolysis induced by carbamazepine

Goh TK, Pang SM, Thirumoorthy T, Goh SG.

Dermatology Unit, Singapore General Hospital, Outram Road, Singapore. wuzhuqing@yahoo.com

Abstract:

Acute generalised exanthematous pustulosis and Stevens-Johnson syndrome (toxic epidermal necrolysis spectrum of severe cutaneous drug reactions) are believed to have distinct underlying pathophysiologies. Our patient, a 28-year-old Chinese woman, represents the first known reported case of clinically-consistent and histologically-proven acute generalised exanthematous pustulosis and toxic epidermal necrolysis overlap induced by carbamazepine in the English literature.

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CME: Mycosis fungoides: Current trends in diagnosis and management

Saumya Panda
Department of Dermatology, Ruby General Hospital, Kolkata, India

Indian J Dermatol 2007:52(1):5-20
Abstract:

Mycosis fungoides (MF) is the most common group of cutaneous T-cell lymphomas. It is a rare non-Hodgkin's lymphoma of mature, skin-homing, clonal, malignant T lymphocytes, usually observed in mid to late adulthood, that initially presents in the skin as patches, plaques, tumors, or generalized erythema (erythroderma) and can involve the lymph nodes and peripheral blood. Much progress has been made in recent years in understanding the origin of the malignant T cell in MF and the patho-physiology and immunology of the disease. This recent work has made a great impact on diagnosis, prognostication, and treatment. In this review, we survey the MF literature of the last decade and highlight the major trends.

Keywords: Cutaneous lymphoma, mycosis fungoides, Sezary syndrome, T lymphocytes

Summary:
1. Cutaneous T-cell lymphomas (CTCL) accounts for 2/3 of cases of primary cutaneous lymphoma.

2. MF is the most common skin lymphomas, afflicting > 50% of patients with CTCL.

3. MF is a great imitator and clinical diagnosis, particularly in the early stages, is extremely difficult.

4. The clinical presentation of MF may be divided into classic, consistent, and atypical lesions.

5. Clinical subtypes:

a. Hypopigmented MF.
b. Pagetoid reticulosis (Woringer-Kolopp disease).
c. Granulomatous slacj skin syndrome.
d. Granulomatous MF.
e. Folliculotropic MF.

6. Initial assessment: Skin biopsy for HPE/Immunophenotyping/TCR gene analysis, CT scan staging, blood tests (PBF, LFT, RP, CD4/CD8 ratios, HTLV-1 serology, TCR gene analysia), BMA and trephine biopsies. Others: PET scan.

7. Treatment options:

a. Topical corticosteroids.
b. Topical cytotoxic agents.
c. Topical bexarotenes gel.
d. Topical imiquimod.
e. Topical tacrolimus.
f. Phototherapy.
g. Photo dynamic therapy.
h. Radiotherapy.
i. Immunotherapy.
j. Chemotherapy.
k. Monoclonal antibody therapy.
l. Novel retinoids.
m. extracorporeal photochemotherapy.
n. Experimental therapy.

Source: IJD

Evaluation of the commonest site, demographic profile and most effective therapy in scabies

Sudip Das, Tapas Chatterjee, G Banerji and Indranil Biswas

Indian J Dermatol 2006:51(3):186-8

Abstract:
The study was planned to find out the commonest sites of scabies in Indian patients. Attempts was made to study the demographic profile i.e., the commonest age group, affection of family members, friends or sexual partners, type of skin lesions, history of previous affection of scabies, co-association with STDs, and to find out the most effective treatment of scabies. Our study showed that the genitalia and finger webs were the most common sites and papular lesions were by far the commonest lesions in scabies. Oral Ivermectin remained the most effective drug closely followed by topical 5% permethrin cream.

Summary:
1. Papular lesions were the commonest (76%), followed by eczematous lesions (24%) and papulovesicular (23%).

2. Burrows, the most characteristic lesion, was seen in 17% of cases.

3. Previous affection with scabies were seen in 25% of cases and association with STDs were noted in 3.5% (7/200) of cases.

4. Genitalia (60%) was the commonest site, followed by finger webs (57%), lower abdomen (48%), umbilicus (42%), inner thighs (38%), wrists (41%), and buttocks (40%). Other rare sites include palms and soles (9%), lower legs (2%), back (2%), scalp (1%) and face (1%).

5. Ivermectin (200 ug/kg of BW) given in 2 doses at 2 weeks interval showed the best results with 96% improvement clinically and 100% reduction in itching at 4 weeks.

6. Permethrin 5% cream (overnight single application) also showed good results with 90% improvement clinically as well as in itching at 4 weeks.

7. Gamma Benzene Hexachloride 1% (2 consecutive overnight applications) showed 65% improvement clinically and 70% reduction in itching at 4 weeks.

8. No adverse effect was documented in all the patients studied.

Source: IJD

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