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Subramanian KS, Srinivas BH, Nachiappa Ganesh R, Gochhait D, PS P, Parameswaran S, Haridasan S. Revisit of Polyomavirus Nephropathy Grading in Renal Allograft Recipients According to the Banff 2019 Working Group Classification: A Study From a Large Transplant Center in South India. Cureus 2022; 14:e22377. [PMID: 35321062 PMCID: PMC8935362 DOI: 10.7759/cureus.22377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background In renal transplant patients, the biopsy-proven incidence of polyomavirus nephropathy (PVN) is approximately 5%. There is no consensus in the morphologic classification of definitive PVN, which is attempted in the Banff 2019 Working Group classification, which groups histologic changes, reflects clinical presentation, and facilitates comparative outcome analyses. This study aims to analyze the clinical and histopathological findings and outcomes among the three classes in the recent classification. Materials and methods The study was conducted in the department of pathology and nephrology over a period of six years. All cases diagnosed as PVN on renal allograft biopsies were included. The clinical and biochemical findings were obtained from hospital records. Histopathology slides were reviewed and classified according to Banff 2019 criteria and were analyzed with clinical, laboratory, histopathological parameters along with the clinical outcome. Results Out of 205 renal transplants performed during the study period, 14 patients (6.8%) were diagnosed with PVN. The mean age of diagnosis was 38 years, with a Male: Female ratio of 1.8:1. The median period of diagnosis of the viral infection after transplant was 10 months. Histomorphology grading according to Banff 2019 revealed four cases (28.5%) in PVN class 1, eight cases (57.2%) in PVN class 2, and two cases (14.3%) in PVN class 3. Cases in PVN class 1 presented early. PVN class 1 was associated with a single type of inclusion, and multiple type inclusions were observed in higher classes. Associated diseases were thrombotic microangiopathy (TMA), borderline cellular rejection, antibody-mediated rejection (ABMR), and concomitant infections. PVN class 1 had a better outcome compared to PVN class 2 and class 3. Conclusion PVN1 was observed to have better clinical presentation and outcomes than PVN2 and 3; however, this could not be statistically concluded due to the low sample size and other associated diseases.
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Murugan R, Gochhait D, Manivannan P, Basu D. Extramedullary early T-cell lymphoblastic crisis in a young pregnant chronic myeloid leukemia patient: Diagnosis with fine-needle aspiration cytology and flow cytometry. Diagn Cytopathol 2022; 50:E188-E192. [PMID: 35170252 DOI: 10.1002/dc.24947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/12/2022]
Abstract
Chronic myeloid leukemia (CML) most commonly presents in chronic phase. Blast crisis in CML is usually of myeloid phenotype, whereas among lymphoid lineage, B-cell lymphoblastic crisis is common. T lymphoblastic crisis is rare with near early T-cell precursor (ETP) immunophenotype being exceedingly rare and very little is known about its characteristics, treatment, and prognosis. Blast crisis can occur in extramedullary sites with lymph node being the most common site. CML is also less investigated and studied in pregnancy as it is considered a disease of older adults. We report a rare case of CML presenting in extramedullary site (lymph node) as extramedullary T-cell lymphoblastic crisis of near ETP immunophenotype in a young pregnant female, which was diagnosed on fine-needle aspiration cytology in combination with flow cytometry.
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Sushmitha S, Gochhait D, Stephen N, Amalnath D, Sistla S, Siddaraju N. Cytology of primary nocardiosis of the lymph node: A rare report. Cytopathology 2022; 33:415-417. [DOI: 10.1111/cyt.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
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Kar R, Durgadevi S, Srinivas B, Chandrashekar L, Gochhait D, Sreerekha J. Clinicopathological spectrum of cutaneous lymphomas and distinction of early mycosis fungoides from its mimics—A retro-prospective descriptive study from Southern India. Indian Dermatol Online J 2022; 13:737-746. [DOI: 10.4103/idoj.idoj_137_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022] Open
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Gochhait D, Balasubramaniam V, Mohan S, Reddy S, Rekha J, Siddaraju N. CSF involvement by nonhematolymphoid malignancies: A descriptive study with emphasis on cytomorphological clues. J Cytol 2022; 39:126-130. [PMID: 36277802 PMCID: PMC9585812 DOI: 10.4103/joc.joc_66_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Detection of malignant cells in cerebrospinal fluid (CSF) samples in suspected cases of malignancy is critical for the management of patients. CSF involvement by nonhaematolymphoid malignancies is less common. We aimed to study the cytomorphologic characteristics of various nonhaematolymphoid malignancies in CSF. Methods: A retrospective cytomorphological analysis of 27 CSF cytology smears reported as positive or suspicious for nonhematolymphoid malignancies from January 2010 to April 2020 over 10 years was carried out. Smears in all cases were prepared by cytospin technique and stained with May-Grunwald-Giemsa (MGG) and papanicolaou (Pap) staining procedures. Cell immunohistochemistry/immunocytochemistry was done wherever cell block/extra slides were available. Results: Twenty-four of 27 cases were interpreted as “positive,” while three were reported as “suspicious” of malignancy. Nineteen of 27 cases were metastatic adenocarcinomas including three suspicious malignancy cases with the primary sites of origin being the breast (10), stomach (2), rectum (1), gall bladder (1), lung (1), and four cases of unknown primary. Of the remaining positive cases, there were five cases of metastatic medulloblastoma, two cases of metastatic pineoblastomas, and one case of metastatic extraskeletal Ewings sarcoma. Each of these metastatic malignancies had at least a single diagnostic cytomorphological clue, similar to those observed in other body cavities and primary malignancy sites. Conclusion: Nonhematolymphoid malignancies are readily diagnosable on CSF cytology, most of them are metastatic. Identification of malignant cells in CSF is critical, as it has therapeutic and prognostic implications.
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Kumari R, Behera B, Thappa D, Gochhait D. Dermoscopic features of a case of intradermal nevus with foreign body granulomatous inflammation. Indian Dermatol Online J 2022; 13:434-435. [PMID: 36225995 PMCID: PMC9549545 DOI: 10.4103/idoj.idoj_118_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/26/2019] [Accepted: 05/29/2019] [Indexed: 11/04/2022] Open
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Gochhait D, Patel B, Jinkala S, Rangarajan V, Kannan N, Durgadevi S, Siddaraju N. Preliminary cytomorphologic diagnosis of hematolymphoid malignancies in effusions: A cyto-histo correlation with lessons on restraint. J Cytol 2022; 39:59-65. [PMID: 35814877 PMCID: PMC9262001 DOI: 10.4103/joc.joc_204_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Effusions as part of hematologic neoplasms are rare and as a primary presentation, rarer. In standalone laboratories of developing countries, resorting to techniques such as flow cytometry or immunohisto/cytochemistry may not be possible. A near definitive diagnosis on cytomorphology would, therefore, be an ideal beginning. To that end, we compiled our cases of primary hematolymphoid effusions, devising reproducible reporting categories and looked at their concordance with the final histopathology. Subjects and Methods: Fifty-four cases of primary hematolymphoid effusions over 10 years with cytology-histopathology correlation were chosen. Post morphology assessment, the cases were organized into six categories: suspicious of hematolymphoid malignancy, non-Hodgkin lymphoma-high-grade (NHL-HG), low-grade NHL (NHL-LG), Burkitt lymphoma, acute leukemias, and plasma cell dyscrasias. Discordance with histology was assigned as major and minor based mainly on therapeutic implications. Results: Concordance was seen in a good number (81.5%) of cases. The NHL-HG and NHL-LG categories contributed to 33.3% each of major discordance. Tuberculosis and epithelial malignancies comprised the bulk of the major discordance. Overdiagnosis of a high-grade lymphoma for a histologically proven low-grade follicular lymphoma was the only case with minor discordance. Conclusion: The cytologic categories used are not foolproof for hematologic neoplasms but have a fairly good concordance. A scanty abnormal population should always be viewed with suspicion and definitive labels should be avoided. While morphologic examination is fraught with danger, a good assessment directs the judicious selection of ancillary methods, and hence cannot be supplanted.
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Kasturi N, Sarkar S, Gokhale T, Hanuman SB, Gochhait D. Amniotic membrane transplantation for recurrent giant melanocytic nevus of conjunctiva. INDIAN J PATHOL MICR 2021; 64:852-854. [PMID: 34673625 DOI: 10.4103/ijpm.ijpm_890_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Behera B, Chandrasekhar L, Thappa DM, Gochhait D. A Flat-Topped Plaque over the Mammary Area. Indian Dermatol Online J 2021; 12:780-782. [PMID: 34667777 PMCID: PMC8456243 DOI: 10.4103/idoj.idoj_797_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/18/2020] [Accepted: 03/19/2021] [Indexed: 11/04/2022] Open
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Behera B, Kumari R, Thappa DM, Gochhait D, Ayyanar P. Photosensitive generalised guttate lichen sclerosus et atrophicus: A rare presentation. Australas J Dermatol 2021; 63:135-136. [PMID: 34633067 DOI: 10.1111/ajd.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 08/20/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
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Mazumder S, Jinkala SR, Gochhait D, Manivannan P, Amalnath D. Concomitant Diagnosis of Plasmablastic Lymphoma and Chronic Lymphocytic Leukemia: A Rare Phenomenon. Int J Appl Basic Med Res 2021; 11:201-203. [PMID: 34458127 PMCID: PMC8360227 DOI: 10.4103/ijabmr.ijabmr_384_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 04/22/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare, aggressive non-Hodgkin lymphoma which shows blastic morphology and an immunophenotype of plasma cell differentiation while chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma is an indolent B-cell lymphoma and has a variable clinical course. A CLL transforming into a PBL and the coexistence of CLL with PBL are both extremely rare findings. We report an unusual case of a 72-year-old HIV-negative male who presented with a gingival swelling which was diagnosed as PBL with simultaneous CLL in the blood and bone marrow. Further, in this case, the PBL spontaneously regressed postbiopsy adding to the peculiarity and rarity of this case. This could be due to immune system modulation and can open up a new window to the treatment strategies of PBL in the future.
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Behera B, Kumari R, Gochhait D, Ayyanar P. Unilateral Pompholyx in a Patient of Anterior Horn Disease: An Unusual Presentation. Dermatol Pract Concept 2021; 11:e2021047. [PMID: 34414006 DOI: 10.5826/dpc.1103a47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 10/31/2022] Open
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Gochhait D, Balakrishnan K, Venkatesan D, Basu D, Siddaraju N, Govindarajalou R, Kayal S. The cytological evaluation of ascitic fluid led to the diagnosis of mediastinal T-lymphoblastic lymphoma: A simplified algorithmic approach to diagnosis of lymphoid cell-rich effusion. Cytopathology 2021; 31:359-361. [PMID: 32306465 DOI: 10.1111/cyt.12837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/16/2022]
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Behera B, Kumari R, Mohan Thappa D, Gochhait D, Hanuman Srinivas B, Ayyanar P. Dermoscopic features of primary cutaneous amyloidosis in skin of colour: A retrospective analysis of 48 patients from South India. Australas J Dermatol 2021; 62:370-374. [PMID: 34227687 DOI: 10.1111/ajd.13662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/26/2021] [Indexed: 11/27/2022]
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Behera B, Remya R, Chandrashekar L, Thappa DM, Gochhait D. Tufted angioma successfully treated with topical timolol gel-forming solution. Indian J Dermatol Venereol Leprol 2021; 87:581-584. [PMID: 34219431 DOI: 10.25259/ijdvl_822_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/01/2020] [Indexed: 11/04/2022]
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Sinha NK, Kohli PS, Nagarajan K, Gochhait D, Ganapathy S, Swamiappan E, Ganesan S, Penumadu P. A nomogram for predicting the risk of neck node metastasis in oral cavity carcinoma using acoustic radiation force impulse imaging (ARFI). Oral Oncol 2021; 118:105311. [PMID: 33932875 DOI: 10.1016/j.oraloncology.2021.105311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The study was conducted to assess the accuracy power of Acoustic radiation force impulse imaging (ARFI) and generate a nomogram using ultrasound and ARFI to predict malignant cervical lymph nodes in head and neck squamous cell carcinoma. MATERIAL AND METHODS 374 cervical lymph nodes from 67 patients were evaluated. The B-mode ultrasonography and the elastography findings were compared with the final histopathological diagnosis. Radiological variables were used to construct nomogram and clinical utility of the nomogram was cross-validated. RESULTS In univariate analysis, status of the hilum, Long Axis Diameter, Short axis diameter, colour virtual touch imaging grade (VTI) and shear wave velocity were significant in predicting metastasis in the cervical lymph nodes. In multivariable analysis, it was found that predominance of red over yellow area on colour VTI was significantly associated with lymph node metastasis. A multiple logistic regression performed to ascertain the effects of on the likelihood that patients had lymph node metastasis on histopathology was statistically significant, χ2(10) = 44.96, p < 0.001. The model was able to correctly classify 93.28% of cases and the concordance index (c-index) was estimated to be 0.8773. A nomogram was thus established to predict metastasis in cervical lymph nodes. CONCLUSIONS ARFI increases the diagnostic accuracy of conventional USG in predicting metastatic lymph nodes in HNSCC. Adding the constructed nomogram to the conventional diagnostic pathway can provide an alternative option to frozen section and FNAC.
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Behera B, Kumari R, Thappa DM, Gochhait D. Dermoscopic features of a case of solitary reticulohistiocytoma. Indian J Dermatol Venereol Leprol 2021; 86:435-438. [PMID: 32445312 DOI: 10.4103/ijdvl.ijdvl_916_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Behera B, Kumari R, Thappa DM, Gochhait D, Srinivas BH, Ayyanar P. Dermoscopy of Bowen's disease: A case series of five patients. Indian J Dermatol Venereol Leprol 2021; 87:576-580. [PMID: 33969658 DOI: 10.25259/ijdvl_987_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/01/2021] [Indexed: 11/04/2022]
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Behera B, Kumari R, Thappa DM, Gochhait D, Srinivas BH, Ayyanar P. Dermoscopic features of basal cell carcinoma in skin of color: A retrospective cross-sectional study from Puducherry, South India. Indian J Dermatol Venereol Leprol 2021; 89:254-260. [PMID: 33969659 DOI: 10.25259/ijdvl_420_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 01/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. AIMS The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. METHODS A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. RESULTS Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. LIMITATIONS The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. CONCLUSION We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.
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Behera B, Chandrashekar L, Thappa DM, Gochhait D, Srinivas BH, Ayyanar P. Dermoscopic features of benign cutaneous adnexal tumours in dark skin: A retrospective study from South India. Australas J Dermatol 2021; 62:e249-e255. [PMID: 33797080 DOI: 10.1111/ajd.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
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Stephen N, Gochhait D, Anbalagan A, Siddaraju N. Haemosiderin-laden mesothelial cells in ascitic fluid: A soft pointer for endometriosis in a female of reproductive age. Cytopathology 2021; 32:553-554. [PMID: 33606306 DOI: 10.1111/cyt.12968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 12/01/2022]
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Behera B, Kumari R, Gochhait D, Ayyanar P. Dermoscopic Appearance of an Annular Subacute Cutaneous Lupus Erythematosus. Dermatol Pract Concept 2021; 11:e2021013. [PMID: 33747626 DOI: 10.5826/dpc.1102a13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2020] [Indexed: 12/21/2022] Open
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Behera B, Chandrashekar L, Thappa DM, Gochhait D, Ayyanar P. Atypical clinical and dermoscopic features of hobnail hemangioma. Indian J Dermatol Venereol Leprol 2021; 87:93-97. [PMID: 33580930 DOI: 10.25259/ijdvl_181_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
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Behera B, Kumari R, Mohan Thappa D, Gochhait D, Ayyanar P. Dermoscopy in the diagnosis of generalized acute cutaneous lupus erythematosus. Int J Dermatol 2021; 60:e306-e308. [PMID: 33410507 DOI: 10.1111/ijd.15413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/12/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
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Behera B, Kumari R, Mohan Thappa D, Gochhait D, Ayyanar P. Pigmented infundibulocystic basal cell carcinoma: A diagnostic challenge in dark skin. Australas J Dermatol 2021; 62:e349-e351. [PMID: 33393096 DOI: 10.1111/ajd.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 11/26/2022]
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