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  Most popular articles (Since November 17, 2017)

 
 
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CASE REPORTS
Pigmented fungiform papillae of the tongue in a Saudi woman
Nouf Alzahrani, Ruaa Alharithy
January-June 2018, 22(1):39-40
DOI:10.4103/jdds.jdds_9_18  
Pigmented fungiform papillae of the tongue are a benign condition that is characterized by pigmentation involving the fungiform papillae. Our patient is a 25-year-old female who has an asymptomatic pigmentation over the tongue for 13 years. Examination showed pigmentation confined to the fungiform papillae on the dorsum of the tongue. The diagnosis of pigmented fungiform papillae of the tongue was made clinically. The patient was reassured and was given a 3-month follow-up. We are reporting this case to increase the awareness of this diagnosis and to avoid unnecessary workup.
  4,851 193 -
ORIGINAL ARTICLES
The adjunctive effect of desloratadine on the combined azithromycin and isotretinoin in the treatment of severe acne: Randomized clinical trial
Samer A Dhaher, Zahraa M Jasim
January-June 2018, 22(1):21-25
DOI:10.4103/jdds.jdds_7_18  
Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatment of moderate acne; however, its effect in severe nodulocystic acne remained to be elucidated. Aim of the Study: The aim of the study was to evaluate the effect of adding oral desloratadine to the combined azithromycin and isotretinoin regimen for severe acne. Patients and Methods: Patients were randomly classified into two groups: 1st (control) included 38 patients and received alternating isotretinoin and azithromycin orally and 2nd (intervention) group included 38 patients and received same regimen plus desloratadine 5 mg/day. Assessment was made at baseline, 4, 8, and 12 weeks of the trial. Results: In both groups, there was statistically significant reduction in count of inflammatory lesions at 12 weeks compared to baseline (59 ± 19–9 ± 7 for 2nd group and from 57 ± 18 to 21 ± 8 for control) (P < 0.05) and it was significantly higher in 2nd than in 1st control (P < 0.05). Significant reduction in non-inflammatory lesions count (from 18 ± 3 to 8 ± 2 and 18 ± 4 to11 ± 2 for 2nd and 1st group, respectively). At 12th week, 19 (50%) patients in the intervention and 12 (31.6%) of control groups were achieved excellent improvement (>80%). Conclusion: Oral desloratadine had antiacne properties, and when combined with azithromycin plus isotretinoin protocol, it significantly improves severe acne lesions and minimizes the adverse drug reactions.
  2,613 298 -
REVIEW ARTICLE
Noninvasive arm fat reduction
Logan William Thomas, Margit Juhasz, Lance Chapman, Michele Van Hal, Ruzica Conic, Ashley Magovern, Natasha Mesinkovska
January-June 2018, 22(1):2-11
DOI:10.4103/jdds.jdds_8_18  
The demand for new approaches for noninvasive procedures of the upper arm is increasing. This review will present the most recent literature addressing modalities for arm fat reduction. Thirteen papers met inclusion criteria. The greatest arm circumference reduction (2.75 cm) is accomplished with the combination of cryolipolysis and shock therapy. Limited side effects are noted with each treatment modality. The most painful treatment is cryolipolysis. Physicians should be aware of the most common treatment modalities, new advances in devices, and possible side effects that may occur. There is a need to design and implement a universal patient satisfaction scale, such as the Global Aesthetic Improvement Scale. We recommend a standard approach to fat reduction measurement using three-dimensional imaging and suggest using US at a standardized location such as the midpoint between the olecranon and acromion processes. Although preliminary research suggests that noninvasive contouring of the upper arm is successful with limited adverse events, further research in this field will need to be completed to determine the long-term safety.
  2,349 259 -
ORIGINAL ARTICLES
Bullous pemphigoid: Profile and outcome in a series of 100 cases in Singapore
Siew-Kiang Tan, Yong-Kwang Tay
January-June 2018, 22(1):12-15
DOI:10.4103/jdds.jdds_1_18  
Background: Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease. Objective: We report the profile and outcome of 100 cases of BP seen at our center. Patients and Methods: This was a retrospective study of patients with BP seen at Changi General Hospital, Singapore from 2004 to 2012. Results: There were 57 female and 43 male patients. Other than the usual comorbidities such as diabetes mellitus and neurological diseases, there were a high incidence of osteoporosis (29%), hypothyroidism (6%), malignancy (6%), and hepatitis B carrier (3%). Peripheral blood eosinophilia is seen in almost half of the patients. The study results showed the higher sensitivity of direct immunofluorescence (93.5%) as compared to indirect immunofluorescence (89.1%). Topical and systemic corticosteroids were the standard treatment (96%). The duration to remission ranged from 2 weeks to 34 months, with a mean age of 7 months. Doxycycline and nicotinamide were effective for localized BP. The mortality rate was 35%. Conclusion: In Singapore, BP is associated with significant morbidity and mortality. High mortality of BP is related to the advanced age of the patients, associated medical conditions and complications from the treatment.
  2,168 252 1
CASE REPORTS
Follicular occlusion triad
Yugal Kishore Sharma, Shivanti Chauhan, Kirti Deo
July-December 2018, 22(2):90-92
DOI:10.4103/jdds.jdds_22_18  
Follicular occlusion triad is a complex comprising three conditions – hidradenitis suppurativa (HS), acne conglobata, and dissecting cellulitis of the scalp – which share the same underlying pathological process of follicular occlusion. Although these constituents are frequently occurring conditions, the triad per se is not commonly reported. We report the case of a 32-year-old male with Hurley Stage II HS, acne conglobata, and dissecting cellulitis of the scalp with mild anemia (hemoglobin: 10.2 g/dL) and raised C-reactive proteins (15 mg/dL). To the best of our knowledge, this appears to be the third case of follicular occlusion triad from India; also probably, only one case has earlier been reported from India with the additional condition of pilonidal cyst, i.e., a follicular occlusion tetrad.
  1,800 172 -
ORIGINAL ARTICLES
Acne vulgaris: Prevalence, predictors, and factors influencing quality of life of female medical students at King Abdulaziz University, Jeddah
Nahla Khamis Ibrahim, Sarah Abdulaziz Nagadi, Haifa Jamal Idrees, Logain Ghazi Alghanemi, Rawan Ishaq Essa, Walaa Sadik Gari
January-June 2019, 23(1):7-12
DOI:10.4103/jdds.jdds_39_18  
Context: Acne vulgaris is the most frequent skin condition that reduces patients' quality of life (QOL). Aims: The aim of the study is to determine the prevalence, clinical manifestations, predictors, and factors that influence QOL of female medical students with acne at King Abdulaziz University Hospital (KAUH), Jeddah. Settings and Design: A cross-sectional design was conducted at KAUH, Jeddah. Subjects and Methods: Four-hundred participants were selected through a stratified random sampling technique during the educational year 2016/2017. Data collection included the “Acne-Specific Quality of Life Questionnaire (Acne-QOL)” and “Hospital Anxiety and Depression Scale (HADS).” Clinical examination was conducted by a female clinician, with grading of acne by the global acne grading system. Statistical Analysis Used: Descriptive and inferential statistics were done. Logistic regression analysis was conducted. Results: The prevalence of acne among medical students was 58.8%. Combined type of acne was the most common clinical presentation. Predictors of acne were stress (P < 0.001), menstrual flaring (P < 0.001), and family history of the condition (P < 0.01). Females with severe acne had the lowest score (worse QOL) of all QOL domains compared to others (P < 0.05). Most of QOL domains were lower among students with psychological problems, anxiety, and depression (P < 0.5). Conclusions: Acne is prevalent among female medical students. Stress, menstrual flaring, and family history were the predictors. Acne-QOL was influenced by the severity of acne, psychological problems, anxiety, and depression. Screening of acne, with holistic management approach (by dermatologists and psychologists), is recommended.
  1,620 266 -
Reverdin pinch grafts for surgical closure after removal of nonmelanoma skin cancer lesions of the leg
Frank Hofmann, Ammar Faisal Hameed, Thomas Schleussinger, Field Lawrence
January-June 2018, 22(1):16-20
DOI:10.4103/jdds.jdds_3_18  
Background: Surgical closure after removal of nonmelanoma skin cancer on the leg can be challenging. Objective: Reverdin pinch grafting is an old skin transplant approach to treat leg ulcers. We present our experience using Reverdin pinch graft to close leg surgical defects following excision of nonmelanoma skin cancers. Patients and Methods: This was a retrospective study of 35 patients with medium-large sized defects with a median ± standard deviation of 20 ± 2.7 mm. Pinch grafts harvested from the thigh were used to cover the surgical leg defects with a 6-year follow-up period. Results: The average healing time after pinch grafting was 4 weeks ± 1.12 weeks. Ten patients (28.6%) had a failure of one or two single pinch grafts. There was no hypertrophic or keloid scarring in any grafted patients. Wound infection occurred in two patients (5.7%) and postoperative hemorrhage in only one patient (2.8%). Basal cell carcinoma arose in one patient (2.8%). Conclusion: Reverdin pinch graft technique is an easy and effective closure option for medium-large surgical defects of the leg after nonmelanoma skin cancer excision.
  1,402 179 -
REVIEW ARTICLE
Hidradenitis suppurativa: A comparison of guidelines
Verena Isak, Steve R Feldman, Rita O Pichardo
July-December 2018, 22(2):48-59
DOI:10.4103/jdds.jdds_19_18  
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the folliculopilosebaceous unit (FPSU) in the intertriginous skin areas, especially axilla, groin, perineum, and peri- or sub-mammary fold in women, with secondary inflammation of eccrine and apocrine glands. HS disease activity and severity can be divided into three different stages according to the Hurley staging system. Stage I disease consists of single or multiple abscesses, while in Stage II, additional sinus tract formation or scarring can be seen, and in Stage III, interconnected tracts and abscesses have developed over a complete anatomic area. Due to its high disease burden, the extent to which HS negatively impacts patients' quality of life is higher than that of most other chronic dermatological conditions. Pain is considered one of the worst aspects of HS. In this article, we compare different guidelines for the management of HS between hospitals in Europe and the U.S. for Hurley Stage I, II, and III. Existing treatment guidelines were identified through systematic review of medical databases, including PubMed, using the search terms “hidradenitis suppurativa treatment guidelines” as well as “acne inversa treatment guidelines” for the European and German treatment guidelines, as well as American hospital-specific treatment algorithms, including Henry Ford Hospital, Detroit, Michigan, and Mayo Clinic, Rochester, Minnesota. In the German S1 guidelines, the goal is an improvement of one Hurley stage and/or a 25% improvement of the Sartorius score or the dermatology life quality index within 12 weeks. Radical surgical or laser excision, oral combination therapy of clindamycin and rifampin, or alternatively tetracycline, topical clindamycin, and hormonal therapy are recommended, while topical resorcinol, dapsone, finasteride, zinc gluconate, and acitretin are the treatment options that can be taken into consideration. Unlike the European or German S1 guidelines or the algorithm proposed by the Henry Ford Hospital, more systemic antibiotic therapy options are suggested in the Mayo Clinic algorithm before the addition of immunosuppressive therapy. Evaluation for efficacy happens every 3 months, and in case of treatment failure, the antibiotic regimen is changed and reevaluated 3 months later. Options include Trimethoprim-sulfamethoxazole, amoxicillin-clavulanate, fluoroquinolones, clindamycin, and rifampin, as well as rifampin plus moxifloxacin plus metronidazole. If none of the proposed antibiotic therapies help, acitretin, dapsone, or cyclosporine may be used instead. In refractory HS, infliximab or adalimumab is added to the regimen. For Stage III disease or in case of treatment failure so far, wide local excision as an addition to medical therapies can be considered. With the literature of the existing treatment options mostly being low evidence, scarce new randomized controlled trials, and the existing guidelines leaving room to interpretation, a gold standard for the treatment of HS does not yet exist. Further large-scale, randomized studies are necessary to continue treatment exploration and improve treatment regimens.
  1,318 199 -
CASE REPORTS
Anti-tumor necrosis factor-induced palmoplantar psoriasis: Case series
Saad Altalhab
January-June 2018, 22(1):36-38
DOI:10.4103/jdds.jdds_6_18  
Palmoplantar pustular psoriasis (PPP) is a very uncommon form of psoriasis. Patients usually present with sterile, intraepidermal pustules over palms and soles, and it is difficult to treat. Women and smokers may be at a higher risk of getting PPP. Here, we report 2 patients who developed new PPP lesions after initiation of adalimumab (Humira®). Case reports are for a 19-year-old female diagnosed with Crohn's disease on February 2012 after a long history of abdominal pain and bleeding and a 34-year-old female who had psoriatic arthritis with no skin lesions since November 2012. Our recommendation is for the patients to be controlled with potent topical corticosteroids, keratolytics, Vitamin D analogs, phototherapy, increases in baseline methotrexate doses, and cyclosporine as needed.
  1,325 128 -
EDITORIAL
A new look
Steven R Feldman
January-June 2018, 22(1):1-1
DOI:10.4103/2352-2410.224390  
  1,201 181 -
REVIEW ARTICLE
Surgical options in hidradenitis suppurativa
Sree S Kolli, Adrian Pona, Abigail Cline, Malcolm Marks, Steven R Feldman, Rita O Pichardo
January-June 2019, 23(1):2-6
DOI:10.4103/jdds.jdds_35_18  
Hidradenitis suppurativa is a chronic, debilitating disease managed by both medications and surgical therapies. The purpose of this study is to determine the indications for surgical therapies and compare the various surgical options for the treatment of hidradenitis suppurativa. A PubMed search found 32 articles on surgical therapies for hidradenitis. Search terms included hidradenitis suppurativa, cryoinsufflation, laser therapies, reconstructive surgery, and surgical therapies. About 88.9% of patients with Hurley Stage II/III are referred to surgery. Wide excision is superior to local excision based on consistently lower recurrence rates and high patient satisfaction. Healing by primary closure is inferior to skin graft and flap. Recurrence rate is most dependent on disease severity rather than the type of surgical procedure. Surgical options are offered alongside medical therapies as part of the treatment protocol. Procedures range from minimally invasive to aggressive therapies with variable recurrence rates. Minimally invasive surgeries produce better results in Hurley Stage I/II and aggressive options, such as wide excision, are superior to other options in patients with the more severe disease. Poor surgical candidates include those with comorbidities such type 2 diabetes mellitus which limits the use of more aggressive surgical interventions.
  1,024 155 -
ORIGINAL ARTICLES
Comparative study of efficacy of radiofrequency ablation, electrodesiccation, and cryosurgery in the treatment of cutaneous warts
Prashansa Jaiswal, Tapan Kumar Dhali, Paschal D'Souza
January-June 2019, 23(1):24-29
DOI:10.4103/jdds.jdds_37_18  
Background: Even though the older and most common treatment for the wart is a destructive method, there is no published randomized control trial comparing the efficacy of radiofrequency ablation, electrodesiccation, and cryosurgery in warts. Objective: The objective of the study is to compare the efficacy and adverse effect of radiofrequency ablation, electrodesiccation, and cryosurgery in the treatment of cutaneous warts. Methods: It was a randomized control trial. Seventy-five patients were randomly divided into three groups of radiofrequency ablation A (Group A), electrodesiccation (Group B), and cryosurgery (Group C) with a sample size of 25 per group by the computer-generated randomized table. Clinical cases of common and plane warts with age >12 years were included in the study. The assessment was based on the reduction of the total surface area of the reference lesion(s), pigmentation, scarring, reappearance of dermatoglyphics, and patient's satisfaction. Results: Complete cure in Group A was 22 (95%), in Group B was 17 (73%), and in Group C was 14 (58%) which was statistically significant (P ≤ 0.001). Majority (>90%) of the patients were very much satisfied with treatment outcome, particularly with radiofrequency which was statistically significant (P = 0.001). Conclusion: Radiofrequency was seen to have the highest cure rate.
  983 140 -
SHORT COMMUNICATIONS
Revamping the broken electronic medical record in academic dermatology in the United States: An “Epic” endeavor
Molly B Hirt, Maria K Hordinsky, Brittney Schultz, Ronda S Farah
January-June 2018, 22(1):30-32
DOI:10.4103/jdds.jdds_5_18  
Many Healthcare institutions face continued challenges related to electronic medical record use (EMR). Within this viewpoint article, we seek to share with our dermatology colleagues our institutional experience on the creation of standardized dermatology records. In our experience, key elements are needed to implement a standardized record, including faculty buy-in, reconciliation with dictation, selection of a leader, and design of the standardized record template. Creation of a standardized record should not only account for the clinic but also patient handouts and support staff templates. We have obtained preliminary evidence that the use of an EMR template not only reduces the cost of dictation but also improves documentation. In addition, we have not seen evidence of over documentation. However, more studies are needed to understanding how a standardized EMR impacts billing, coding, teaching and overall, patient care.
  1,005 117 -
ORIGINAL ARTICLES
Women's experiences regarding isotretinoin risk reduction counseling in Riyadh
Shoug Algoblan, Sehrish Bakhsh, Ru'aa Alharithy
January-June 2019, 23(1):13-15
DOI:10.4103/jdds.jdds_50_18  
Context: Isotretinoin is an effective acne treatment and a known teratogen. Contraception counseling may reduce isotretinoin-exposed pregnancies. Aims: The aim of the study is to assess the efficacy of contraception counseling in married females of childbearing age who are on isotretinoin or have used isotretinoin in the past 6 months. Settings and Design: This cross-sectional study in dermatology clinics at multiple centers in Riyadh, Saudi Arabia, between June and November, 2017. Subjects and Methods: Cross sectional study using surveys filled out by married women of child bearing age who were taking isotretenoin during the past 6 months. The questionnaires were distributed in paper as well as electronic version. Statistical Methods Used: Descriptive analysis was primarily done. Results: Most of the patients who received isotretinoin belong to the age group of 33–40 years, married females. Doctors discussed teratogenicity risks in 81% of the patients, but only 44% of patients received written information about risks and 52% signed the consent form. Contraception methods were discussed in 58% of patients. Only 49% of patients were advised to start contraception 1 month before starting isotretinoin. About 79% did not do pregnancy tests while on isotretinoin. Conclusions: This study has identified a gap in risk reduction counseling in married females who are on isotretinoin. Measures such as providing written materials explaining teratogenicity risks associated with isotretinoin, referring patients to specialist for starting contraception before prescribing isotretinoin, and ensuring strict adherence to monthly pregnancy test starting 1 month before, during, and 1 month after the treatment may help minimize the teratogenicity risk.
  957 137 -
CASE REPORTS
Distended striae distensae in a patient with nephrotic syndrome
Archana J Lokhande, Tapan Kumar Dhali, Priya Chaudhary, Rishi Goel, Soni Rathore
July-December 2018, 22(2):82-84
DOI:10.4103/jdds.jdds_20_18  
Striae distensae (SD) are very common dermatological condition produced as a result of overstretching of skin leading to depressed linear irreversible atrophic dermal scars. We report a case of oral corticosteroid induced extensive striae distensae in a patient with nephrotic syndrome, who developed sudden bulging and fluid collection in these atrophic skin scars during the course of disease. Laboratory analysis of aspirated fluid from the oedematous SD revealed it to be transudate in nature. Thus it was concluded that, as part of anasarca the extracellular fluid got preferentially accumulated within the weaker atrophic scarred skin of striae.
  1,023 70 -
ORIGINAL ARTICLES
Outcomes among scalp psoriasis patients: Is scalp psoriasis resistant to topical treatment?
Toral S Vaidya, Michael E Farhangian, Kathryn L Anderson, Alyson Snyder, Steven R Feldman
July-December 2018, 22(2):64-67
DOI:10.4103/jdds.jdds_24_18  
Background: Scalp psoriasis is considered notoriously difficult to treat, despite good percutaneous absorption of topical corticosteroids through scalp skin. Poor adherence to treatment is often the cause of poor treatment outcomes. Purpose: Our objective was to gain preliminary assessments of scalp psoriasis treatment outcomes from our patients' perspectives and to assess the feasibility of telephone-based follow-up of scalp psoriasis treatment. Methods: Chart review identified adults seen for scalp psoriasis in the past 3 years. Thirty patients were queried regarding their current disease state, treatment satisfaction, and whether they called the office to report disease progress. Results: Eight-seven percent of the patients reported “doing well” or “moderate improvement;” of these patients, 69% were on only one topical treatment. 90% were on topical treatments alone; of these patients, 93% reported “doing well” or “moderate improvement.” Three of 15 patients who were told to call their provider and report treatment progressfollowed the instruction; those 3 reported “doing well.” Patients given a simple topical corticosteroid treatment regimen and encouraged to report their progress to achieve at least moderate improvement. Conclusions: The dogma that scalp psoriasis treatments are resistant to treatment should be reassessed and larger controlled trials should be done to develop and test adherence interventions to improve scalp psoriasis outcomes.
  882 181 -
EDITORIALS
Don't trust what I tell you
Steven R Feldman
July-December 2018, 22(2):45-45
DOI:10.4103/jdds.jdds_34_18  
  868 177 -
ORIGINAL ARTICLES
Knowledge, attitude, and misconceptions of public regarding vitiligo
Fawwaz Freih Alshammrie, Ibrahim G Al Reshidi, Maram O Al Rashidy, Salwa M Al Anazi
January-June 2019, 23(1):16-19
DOI:10.4103/jdds.jdds_45_18  
Background: Previous studies of vitiligo have discussed attitudes of vitiligo patients toward their disease. However, few studies have addressed this issue from the public's point of view. Objectives: The main objective is to explore the knowledge, perceptions, misconceptions, and attitudes of the public toward vitiligo. Subjects and Methods: This cross-sectional survey was done using a self-constructed questionnaire. Participants were recruited from the students and employees of Hail University from April 1, 2015 to the end of November 2015. The data were collected and analyzed using Statistical Package for the Social Sciences (SPSS release 20.0). P < 0.05 was accepted for statistical significance. Results: The study included 1004 participants; 440 (43.8%) were male and 564 (56.2%) were female. 231 participants (23%) had no information about vitiligo (P = 0.011). 90.2% of the participants reported that available sources of information about the disease in general are not enough. The main source of information for males and females was the internet. Majority of surveyed participants believed that vitiligo is an inherited disease (59%). Conclusion: The misconceptions and negative attitudes about vitiligo among public are generally prevalent. Educating the public about vitiligo could lead to increased self-confidence, psychological well-being, and resulting in better adaptation of vitiligo patients in the society.
  839 158 -
EDITORIAL
We don't see things as they are; We see them as we are
Sree S Kolli, Steven R Feldman
January-June 2019, 23(1):1-1
DOI:10.4103/jdds.jdds_3_19  
  842 153 -
ORIGINAL ARTICLES
Electrodermal energy wave at acupuncture points may be a biomarker of aging
Min Chen, Zhengqin Chen, Qian Liu, Yuwei Pan, Qian Gao, Cangcun Xu, Qincui Zhang, Zhaoqing Xi, Huailiang Zhang
July-December 2018, 22(2):60-63
DOI:10.4103/jdds.jdds_21_18  
Objective: The main objective is to study the electrodermal energy wave at some acupuncture points on Chinese people with different ages. Methods: The electrodermal screening device MORA-Super (German) was applied to measure the electrodermal energy at 38 acupuncture points and nonacupuncture points on 3949 candidates. Results: There are five groups, including 17 cases ≤12 year, 41 cases between 13 and 18 years, 722 cases between 19 and 39 years, 2995 cases between 40 and 59 years, and 174 cases ≥60 years. The electrodermal energy of candidates older than 60 years increased significantly compared with other groups (P < 0.01). There is positive correlation between electrodermal energy and age (R = 0.582). Conclusion: The electrodermal energy may become a biomarker of aging.
  871 118 -
CASE REPORTS
Facial lupus vulgaris neglected for 50 years
Naoufal Hjira, Rachid Frikh, Adil Boudhas, Noureddine Baba, Mohammed Oukabli, Mohammed Boui
January-June 2018, 22(1):33-35
DOI:10.4103/jdds.jdds_4_18  
Tuberculosis (TB) is still a problem in the developed and underdeveloped countries, and cutaneous TB is a small part of extrapulmonary forms. Lupus vulgaris (LV) is the most common form of cutaneous TB among Western populations. In Morocco, scrofuloderma is the most common form of cutaneous TB followed by LV. LV results both from inoculation and from the endogenous spread through hematogenous or lymphatic route from an underlying infectious focus. We report a case of facial LV with a long delay in diagnosis of 50 years. A 59-year-old man presented with a right cheek slow-growing lesion for 50 years. Skin biopsy showed tuberculoid granulomas without caseous necrosis, and the culture of cutaneous biopsy was negative. The polymerase chain reaction of Mycobacterium complex-specific DNA sequences on a fresh skin biopsy material was positive. The patient was given antituberculous treatment with which lesion improved. The delayed diagnosis of 50 years is atypical, especially that the lesion had a display character. Delayed diagnosis of cutaneous TB will cause a significant increase in morbidity. Early diagnosis and treatment is the key to reduce the morbidity.
  852 128 -
SHORT COMMUNICATIONS
Eccentric hyperbola: A new modified cutaneous scar re-excision on convex surfaces
Georgios Pafitanis, Michalis Hadliandreou, Onur Gilleard, Graeme Moir
January-June 2018, 22(1):28-29
DOI:10.4103/jdds.jdds_2_18  
“Re-excision of scar” is a common procedure following diagnostic or therapeutic excision of skin cancer cutaneous lesions. With the conventional techniques, skin tension on convex surfaces results in deformity and elongated scars. We present a modified technique for cutaneous scar re-excision that designed along the skin tension lines to enable improved outcomes; the “eccentric hyperbola”. We demonstrate the effectiveness and outcomes of this modification using geometrical regression analysis. This modified technique proves to demonstrate benefits over conventional elliptical excisions on convex surfaces resulting in reduction final scar length and to our experience, enables improved cosmetic outcomes.
  869 93 -
ORIGINAL ARTICLES
Follicular unit extraction technique in treating stable vitiligo with leukotrichia
Arragudla Vikram Kumar, Anchala Parthasaradhi
July-December 2018, 22(2):72-74
DOI:10.4103/jdds.jdds_25_18  
Background: There are several surgical modalities to repigment vitiligo patches, and follicular unit extraction (FUE) is one among them. This procedure is based on the concept of the presence of undifferentiated stem cells in the hair follicle which are a very good source of melanocytes. These melanocytes spread to the surrounding skin and repigment the epidermis. Materials and Methods: Three cases with few lesions of stable vitiligo over nonglabrous areas were treated with follicular unit grafts using the FUE method. Repigmentation in the vitiligo patches was assessed by subjective analysis. Results: Repigmentation was noticeable in all cases with an average duration of 3 weeks. Almost complete repigmentation was seen in all cases with an average duration of 7.3 weeks. Conclusion: FUE appears to be an effective method in treating vitiligo patches with leukotrichia.
  835 99 -
EDITORIALS
Electrodermal acupuncture as a marker for aging
Adrian Pona, Sarah L Taylor, Steven R Feldman
July-December 2018, 22(2):46-47
DOI:10.4103/jdds.jdds_32_18  
  796 126 -
CASE REPORTS
Primary cutaneous extraskeletal Ewing's sarcoma: A case report of an extremely rare entity
Diana Costa Santos, Rui Barbosa, Rosa Azevedo, Marco Rebelo, Carlos Pinho, Miguel Choupina, Rita Valença Filipe, Matilde Ribeiro
January-June 2018, 22(1):41-44
DOI:10.4103/jdds.jdds_11_18  
Primary cutaneous extraskeletal Ewing's sarcoma is an extremely uncommon entity. Patients are mostly female in the second decade of life, and the clinical presentation usually consists of a single superficial mass of 2–3 cm, oval-shaped, flesh-colored, soft, moveable, and sometimes painful. The diagnosis is difficult and depends on histological, immunohistochemical, and cytogenetical analysis. The prognosis is usually favorable with a survival rate of 91% in 10 years. We describe a 20-year-old man with a primary cutaneous Ewing's sarcoma localized on the pulp of the right 5th finger. It is very important to report all cases to improve the characterization of this pathology. In the presence of a cutaneous lesion with this clinical presentation, it is important to request the anatomopathological study and include this entity as a differential diagnosis, so that we can improve the diagnostic timing and therefore the prognosis.
  796 97 -