Keratoacanthoma

Here is a classical Keratoacanthoma from DermAtlas!

Seborrhoeic keratosis

1.A biopsy proven seborrhoeic keratosis (acanthotic varient).
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2.
The central keratin plug which developed recently made me consider the possibility of keratoacanthoma. However this lesion is there for the last 3 years and is probably just a seborrhoeic keratosis. The patient was adviced a biopsy

NB UVB in Children

This 10 year old patient presented to me with a vitiligo patch of diamension 8cm x 4 cm. She had evidence of dental infection which was corrected first. I was reluctant to start her on Narrow Band UVB. However recent studies have demonstrated its efficacy and safety in children. I started her on a weekly once regimn with excellant results as shown here (Pre treatment photograph is not available.) However lesion still remains over the area of elastic band of the goggles!

Herbal Remedies

A 13 year boy was brought to me by his mother today with this unilateral eczematous and infected lesion over the shin. I came to the following conclusion after a detailed history. He developed a minor asteatotic eczema patch which was entusiastically treated by his parents with a herbal paste which led to this. When I offered the diagnosis the mother promptly agreed though she blamed her husband for it :-). The boy said that he developed intense itching after applying the paste. 

Stasis Ulcer

Stasis Ulcer with Stasis Dermatitis. 

ACD - Hair Dye

This patient came today with characteristic features of hair dye allergy but he insisted that he has been using the same brand for the last 14 years, but he purchased a new pack 1 week back. Hence I feel it is unlikely to be due to PPD but something else added to improve the product. Unfortulately we dont have patch test available. 

Lamellar Ichthyosis

Today a gentleman from UK came to me with photographs of his cousin in Somalia. This is my first ever photographic consultation. He had extensive icthyosis with loss of one eye because of ?exposure keratitis. With 3 photographs (2 photos of the face, which I have not posted here) and little history I came to the diagnosis of Lamellar Ichthyosis. I suggested an antiseptic wash and an emolient/keratolytic. I also told him about the scope of retinoid therapy. Review of literature shows that it is a proliferative hyperkeratosis due to mutation in the gene for transglutaminase 1 (TGM1). Time to explore TGM1 mutations! (Over to my Bioinformatics Blog) 

query

Can cholinergic like urticaria occur on cold exposure? I get these tiny itchy papules on both arms, lasting say 10 mints on cold exposure. Is this cold urticaria or what? Not very troublesome though only on exposure to cold air on arms, not precipitated by cold water or icecream (Thankfully!)

I dont have any photographs to share.Sorry!

Read Next posting first

[Read the next posting first]
He also had lichenoid papules over the exposed parts. Histopathology showed basal cell degeneration. Is this Actinic Lichen planus, PLE or Lichenoid melanodermatitis common in Middle East, which represent hybrids between lichen planus and other conditions rather than as a mere variant of lichen planus. I have started him on Chloroquine. 

Diagnosis

This 30 year old male patient of mine presented with this well defined hyperpigmented patch over the forehead and nose. The lesions started after taking metronidazole for dental infection. However the lesions progressed after stoping the drug. A faint hypopigmented border is visible even in this low resolution picture. 

Lichen Planus

This case of Lichen planus started as hypertropihic form, disseminated to this guttate form after 2 years. 

Cholinergic Urticaria

This patient complained to me that she gets rashes when she comes walking to the clinic in the morning. Today she showed me the lesions, numerous small (1-4 mm in diameter) pruritic wheals with surrounding flares. Lesions used to subside in 30 minutes. A diagnosis of cholinergic urticaria was made.

'Mobile Phone Dermatitis'

This patient presented with a eczematous patch on right thigh which according to him was more painful than itchy. However he finally agreed that the pain radiating from the back is present for 2 years, but the patch started only two weeks back. Further 'Sherlock Holmes' investigation revealed that he carries his mobile phone in his right pocket and he has changed its cover few weeks back! Is this Allergic Contact Dermatitis? I have started him on steroid cream. I have called him for followup after 2 weeks.

Alopecia Areata (Ophiasis)

A 32 year old patient with Ophiasis pattern of Alopecia Areata. Received several sittings of Intralesional triamcinolone and Oral Mini pulse steroid. He was referred to me by Dr Salim from Kerala. I have started him on PUVA. 

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This is a Blog for Dermatologists to post interesting cases.
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