Ichthyosis Linearis Circumflexa (ILC) of Netherton Syndrome (NS)

This 4 year old female patient presented with history of congenital erythroderma (without Colloidal membrane), which was evident during the first weeks of life and severe pruritic dermatosis. History of hair loss was given though it was not severe when she presented to me. Though lesions where predominantly ichthyosiform with a predilection for extremities, she also had eczematous peri-oral lesions characteristic of NS. However flexural lichenification was not prominent. ILC is a characteristic serpiginous migratory annular/polycyclic rash with double-edged scale.

More on the genomic and molecular aspects of this disease in my Applied - Bimatics (http://gulfdoctor.net/bioblog/2006/02/plasmin.html) Blog.

Lupus Vulgaris

This 18 yr girl was brought for asymptomatic lesion on left elbow since last 3 months.It was a small papule to begin with, then grew slowly but steadily to attain present size. There is spontaneous healing with atrophy in the upper half .Secondary infection at the lower border is since last 5 days,Another small lesion inferior to the main lesion is post traumatic ecthyma (since 10 days.)There is no h/o injury prior to the main lesion.She also developed slightly tender matted epitrochlear lymphadenopathy 1month after the onset of the lesion.She had taken Anti tubercular treatment for 9 months(1 yr back )for pulmonary Kochs.Her father also had pulmonary Kochs. 

Nodulocystic Acne

Nodulocystic acne is a severe form of acne affecting the face, chest and back characterised by multiple inflamed and uninflamed nodules and frequently, scars. It is more common in males. Acne conglobata is an uncommon form of nodulocystic acne in which there are interconnecting abscesses and sinuses. Nodulocystic acne may very rarely be a manifestation of a genetic disorder, PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum and Acne. Autosomal Dominant). This patient was treated with isotretinoin, but lesions recurred after few months of stoping therapy.

 

Forehead Lesions

A 30 year old male patient with these hyperpigmented hyperkeratotic lesions over the forehead since 2 years. What is your diagnosis?