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   Table of Contents - Current issue
Coverpage
January-March 2022
Volume 16 | Issue 1
Page Nos. 1-32

Online since Wednesday, March 9, 2022

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ORIGINAL ARTICLES  

Clinico-epidemiology and histological spectrum of nodular skin lesions: A single-center cross-sectional study p. 1
Dibyendu Basu, Pallawi Bhardwaj, Indrashis Podder, Satyendranath Chowdhury, Debabrata Bandyopadhyay
DOI:10.4103/tjd.tjd_57_21  
Background: Nodular skin lesions are a common diagnostic dilemma because of overlapping clinical features. Histopathology remains the gold standard for diagnostic confirmation. Aims and objectives: The aim of this article is to analyze the clinico-epidemiology and histological spectrum of nodular skin lesions along with clinico-pathological correlation. Materials and methods: A cross-sectional study was conducted including 114 new patients with cutaneous nodules. Each patient was subjected to detailed clinical examination and histopathological examination to obtain the final diagnosis and degree of histomorphological concordance. Results: Neoplastic disorders accounted for 42.9% of the skin nodules among 114 patients (mean age 33.2 ± 11.9 years; M: F 1.7:1), followed by miscellaneous (30.7%), infective (19.3%), and deposition (7%) disorders. The most common cause was lipoma (19.3%), followed by prurigo nodularis (12.3%), leprosy (11.4%), and neurofibroma (9.6%). Most common site was trunk, and pruritus is the commonest symptom. Multiple clinical differentials were considered for almost one-third of patients owing to overlapping clinical features, and histology provided the final diagnosis. On clinico-pathological correlation, 72.8% of the cases showed histopathological concordance, whereas the remaining cases were histologically discordant (7%) or inconclusive (20.2%). Conclusion: Neoplastic disorders (benign> malignant) are the most common cause of nodular skin lesions. In addition to detailed clinical examination, histopathology is necessary to confirm the diagnosis and rule out differentials. Considerable histopathological correlation can be obtained for skin nodules if performed appropriately.
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Mycosis fungoides in children and adolescents: A clinicopathological study in Jordan, Middle East p. 7
Awad H Al-Tarawneh
DOI:10.4103/tjd.tjd_114_21  
Background: Mycosis fungoides usually affects adults but rarely occurs in children and adolescents with a deceptive clinical picture that simulates more common skin diseases at this age; therefore, the diagnosis can be delayed. Objective: To determine the clinical and histopathological features in a group of patients who developed mycosis fungoides during childhood and adolescence to share experience and to highlight the early diagnosis of mycosis fungoides in this age group. Materials and Methods: A retrospective study was performed, and the clinical and histopathological data for all children and adolescent patients with confirmed mycosis fungoides diagnosis for the last five years were retrieved, reviewed, and analyzed. Results: Seven patients were diagnosed with mycosis fungoides with an age ranging from 5 to 17 (mean age, 10) years, comprising five males and two females patients, with a male-to-female ratio of 2.5:1. Three clinical variants of mycosis fungoides were present in our cases: hypopigmented mycosis fungoides in four patients (57%), poikilodermatous mycosis fungoides in two (29%), and classical mycosis fungoides in one (14%). No more than one variant of mycosis fungoides was observed in any patient. Conclusion: Although mycosis fungoides rarely occurs in children and adolescents, sufficient clinical and histopathological features are required to make the diagnosis. Therefore, it should always be considered in our clinical differential diagnosis in any appropriate clinical setting. A skin biopsy should not be delayed. Study Design: Retrospective study.
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Burden of skin diseases: A camp-based cross-sectional study in a tribal area of Maharashtra p. 12
Rukman M Manapurath, Rujuta Hadaye, Chinnu S Varughese, Barsha Gadapani
DOI:10.4103/tjd.tjd_111_21  
Background: Skin diseases, though highly prevalent in tribal regions, are not given due importance. Not much research has been done on skin diseases and their management in these areas. The study aimed to describe the prevailing types of skin conditions in the tribal predominant area, Sakwar, in Maharashtra. Materials and Methods: Community Health Workers in the field practice area created awareness about skin diseases and recruited cases to camp on a single day. A total of 384 beneficiaries attended the camp, which was assessed by four qualified dermatologists. Data collected from clinical case sheets and patient interviews were used for the study. Results: Fungal infection was the most prevalent type of skin disease, followed by scabies, eczema, acne, and hyperpigmentation disorders. Conclusion: Skin diseases especially fungal infections should be given due importance in primary healthcare settings. Capacity building of primary care physicians, as well as frontline workers for accurately diagnosing and managing skin conditions, needs to be done.
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Autoinoculation versus 35% trichloroacetic acid for the treatment of molluscum contagiosum: An open-label randomized controlled trial p. 16
Shweta Saraswat, Paras Choudhary, Yogi R Joshi, Chinmai Yadav, Dilip Kachhawa, Durga Choudhary, Harshvardhan Singh
DOI:10.4103/tjd.tjd_102_21  
Background: Despite the availability of different treatment modalities, molluscum is often recurrent after the treatment. Autoinoculation in molluscum is a recently studied modality. Objective: The aim of this article is to evaluate and compare the efficacy of autoinoculation and trichloroacetic acid (TCA) for the disappearance of molluscum contagiosum (MC). Methods: This prospective, randomized controlled trial was done in which a total of 128 patients of molluscum were divided into two groups of 64 patients each: Group A treated with autoinoculation and Group B received TCA application. The patients were followed-up till 6 months for efficacy and safety. Results: At the end of 3 months, a statistically significant (P=0.023) complete clearance of lesions was noted in Group A (80%) when compared with Group B (62%). At the end of 6 months, the recurrence rate was significantly less in the autoinoculation group (3%) than in the TCA group (42%). Conclusion: We conclude that autoinoculation appears to be a safe, simple, and efficacious procedure with better clearance, minimal expertise, recurrence, and complications when compared with TCA.
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CASE REPORTS Top

Giant trichoblastoma of thigh mimicking dermatofibrosarcoma: An extremely rare entity with unique histology p. 23
Jamuna Jayachandran, Chokka M Kiran, Anita Ramdas, Palaniappan N Kumar
DOI:10.4103/tjd.tjd_84_21  
Trichoblastoma is a rare benign adnexal tumor exhibiting follicular differentiation and is widely familiar for its resemblances with basal cell carcinoma. We report a case of giant trichoblastoma manifesting as a huge cutaneous nodule misdiagnosed as dermatofibrosarcoma on clinical and radiological grounds. The diverse histological features responsible for its uniqueness are discussed along with a brief review of histogenesis and histological subtypes.
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A curious case of resurgence of old scars with pulmonary involvement p. 28
Subhamoy Neogi, Olympia Rudra, Tirthankar Gayen, Ananya Ghatak
DOI:10.4103/tjd.tjd_122_21  
Sarcoidosis is a chronic granulomatous disorder of unknown etiology with multisystemic involvement and myriad clinical manifestations. Scar sarcoidosis is a rare but is a specific form of cutaneous sarcoidosis. Majority of the patients present with systemic disease especially pulmonary involvement. High index of suspicion is required because the diagnosis is often missed. We report a case of a 40-year-old woman presenting with pulmonary involvement and hilar and mediastinal lymphadenopathy with skin lesions that were treated as keloid from elsewhere.
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