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Zhao A, Wang Y, Jia N, Lu F, Pan C, Wu F, Cao Q, Li X, Wang X, Wang S, He W, Zeng Q, Huang H, Han J, Li M. Mosaic GJB2 mutations in widespread porokeratotic adnexal ostial nevus: Report of two patients. J Dermatol 2024; 51:1129-1133. [PMID: 38292003 DOI: 10.1111/1346-8138.17127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
Porokeratotic adnexal ostial nevus (PAON) is a rare adnexal hamartoma characterized by keratotic papules following Blaschko's lines, typically located on the unilateral distal extremities. Cutaneous somatic GJB2 mutations have been linked to the pathogenesis of PAON. However, the genetic mechanism underlying bilateral or extended forms, which are less documented, remains unknown. In this study, we presented two cases of PAON with widespread cutaneous lesions and scalp involvement, and demonstrated the presence of GJB2 mosaic mutations in both patients. We further investigated the mosaic frequency in different tissues to gain insights into the mutation events contributing to the phenotype of widespread PAON. Our findings suggest that early postzygotic mutation causing mosaic GJB2 mutations may contribute to the widespread phenotype of PAON, thereby enriching the disease spectrum and mutation profile of PAON.
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Affiliation(s)
- Anqi Zhao
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yumeng Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ning Jia
- Central Laboratory, Shanghai Dermatology Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fangqi Lu
- School of Medicine, Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Chaolan Pan
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fei Wu
- Department of Pathology, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Qiaoyu Cao
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Xin Li
- Department of Dermatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Xinyi Wang
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Shucui Wang
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Wei He
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Qin Zeng
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Haisheng Huang
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
| | - Jianwen Han
- Department of Dermatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Ming Li
- Department of Dermatology, The Children's Hospital of Fudan University, Shanghai, China
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2
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Díez de Los Ríos Quintanero B, Del Pozo Arribas S, Martínez-Mera C, Nájera L. Linear Hyperkeratotic Papules in a Full Term Newborn. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T497-T498. [PMID: 38431122 DOI: 10.1016/j.ad.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/12/2022] [Indexed: 03/05/2024] Open
Affiliation(s)
| | - S Del Pozo Arribas
- Unidad Neonatal, Departamento de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
| | - C Martínez-Mera
- Departamento de Dermatología, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
| | - L Nájera
- Departamento de Patología, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
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3
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Díez de Los Ríos Quintanero B, Del Pozo Arribas S, Martínez-Mera C, Nájera L. Linear Hyperkeratotic Papules in a Full Term Newborn. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:497-498. [PMID: 36740177 DOI: 10.1016/j.ad.2022.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
| | - S Del Pozo Arribas
- Neonatal Unit, Pediatrics Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - C Martínez-Mera
- Dermatology Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - L Nájera
- Pathology Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
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4
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Cuartero-Castro G, Cid-García A, Téllez-Alvarado A, Gutiérrez-Quiroz CT. Cutaneous Horn Presentation in Porokeratotic Eccrine Ostial and Dermal Duct Nevus. A Brief Review and Case Report. Am J Dermatopathol 2024; 46:173-174. [PMID: 38153273 DOI: 10.1097/dad.0000000000002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
ABSTRACT Porokeratotic eccrine ostial and dermal duct nevus is a rare adnexal hamartoma characterized by the presence of a cornoid lamella exclusively overlying eccrine acrosyringia. Different clinical presentations have been reported in the literature. Here, we report a case of a 6-year-old girl diagnosed with porokeratotic eccrine ostial and dermal duct nevus confirmed by histopathologic study. Atypical lesions are described as whitish, warty-looking neoformations located in the anterolateral region of the right hip (cutaneous horn).
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Affiliation(s)
- Gerardo Cuartero-Castro
- Department of General Surgery, IMSS Hospital General de Zona #20 "La Margarita", Puebla; and
| | - Anahí Cid-García
- Department of General Surgery, IMSS Hospital General de Zona #20 "La Margarita", Puebla; and
| | - Adriana Téllez-Alvarado
- Department of Pathology, IMSS Hospital de Especialidades, Centro Médico Nacional "Manuel Ávila Camacho", Puebla
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5
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Chen T, Ma DL. Generalized, Linear Hyperkeratotic Papules With Numerous White Spicules and Comedo-like Plugs. JAMA Dermatol 2023; 159:213-214. [PMID: 36598782 DOI: 10.1001/jamadermatol.2022.5773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A school-aged boy presents with generalized, linear hyperkeratotic papules with numerous central small filiform keratotic white spicules and brown plugs on the head, face, neck, trunk, and bilateral upper and lower extremities. What is your diagnosis?
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Affiliation(s)
- Tian Chen
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Dong-Lai Ma
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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Kiely L, Ni Mhaolcatha S, Fitzgibbon J, Murphy L, O’Connor C. Porokeratotic adnexal ostial nevus: A paradigm of cutaneous mosaicism. Clin Case Rep 2022; 10:e05728. [PMID: 35432995 PMCID: PMC9005689 DOI: 10.1002/ccr3.5728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/20/2022] Open
Abstract
Porokeratotic adnexal ostial nevus (PAON) is a term encompassing porokeratotic eccrine ostial and dermal duct naevus (PEODDN) and porokeratotic eccrine and hair follicle naevus (PEHFN). We present the case of a 7‐year‐old girl who presented with hyperkeratotic verrucous papules in a blaschkolinear distribution on the sole of her left foot.
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Affiliation(s)
- Lisa Kiely
- Department of Dermatology South Infirmary Victoria University Hospital Cork Ireland
| | | | - Jim Fitzgibbon
- Department of Pathology Cork University Hospital Cork Ireland
| | - Lesley‐Ann Murphy
- Department of Dermatology South Infirmary Victoria University Hospital Cork Ireland
| | - Cathal O’Connor
- Department of Dermatology South Infirmary Victoria University Hospital Cork Ireland
- Department of Paediatrics and Child Health University College Cork Cork Ireland
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Abstract
This article reviews the clinical findings of epidermal nevi and their associated syndromes and provides an update on their pathogenic genetic changes as well as targeted therapies detailed to date.
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Alenezi AK, Al-Sabah H, Attia AF, Nanda A. Linear hyperkeratotic spiny plaques in a child. Pediatr Dermatol 2021; 38:691-693. [PMID: 34224618 DOI: 10.1111/pde.14571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Ahmed F Attia
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - Arti Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
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Kwon BR, Kim R, Byun JY, Choi YW, Choi HY, Lee MY. A case of porokeratotic adnexal ostial nevus misdiagnosed as wart. Clin Case Rep 2021; 9:1092-1094. [PMID: 33768788 PMCID: PMC7981734 DOI: 10.1002/ccr3.3648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/31/2020] [Accepted: 11/10/2020] [Indexed: 11/17/2022] Open
Abstract
Porokeratotic adnexal ostial nevus may be misdiagnosed as wart based on clinical appearance and morphology. An accurate diagnosis through skin biopsy is crucial, as is the inclusion of rare disorders such as porokeratotic adnexal ostial nevus in the differential diagnosis.
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Affiliation(s)
- Bo Ram Kwon
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
| | - Rosa Kim
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
| | - Ji Yeon Byun
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
| | - You Won Choi
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
| | - Hae Young Choi
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
| | - Min Young Lee
- Department of DermatologyEwha Womans University Seoul HospitalSeoulKorea
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Blue E, Abbott J, Bowen A, Cipriano SD. Linear porokeratosis with bone abnormalities treated with compounded topical 2% cholesterol/2% lovastatin ointment. Pediatr Dermatol 2021; 38:242-245. [PMID: 33170511 DOI: 10.1111/pde.14447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022]
Abstract
We describe a case of linear porokeratosis with associated bone resorption in a 17-year-old female with marked improvement after 2% cholesterol/2% lovastatin ointment application. Porokeratosis is a heterogenous group of keratinization disorders characterized by a cornoid lamella, consisting of focal dyskeratotic cells in the granular layer and columns of parakeratosis. The pathogenesis of porokeratosis is not fully elucidated; however, germline mutations have recently been identified in the mevalonate pathway which can lead to a buildup of metabolites that could play a role in dysmaturation. There has only been one prior report of an affected distal digit with underlying bone resorption in association with linear porokeratosis.
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Affiliation(s)
- Elliot Blue
- Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - James Abbott
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Anneli Bowen
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Sarah D Cipriano
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
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Agrawal R, Karanovic S, Gee BC, Carr RA. A pruritic hyperkeratotic plaque on the foot of a 35-year-old woman. Clin Exp Dermatol 2020; 45:771-774. [PMID: 32320098 DOI: 10.1111/ced.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- R Agrawal
- Departments of, Department of, Dermatology, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - S Karanovic
- Departments of, Department of, Dermatology, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - B C Gee
- Departments of, Department of, Dermatology, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - R A Carr
- Department of, Pathology, South Warwickshire NHS Foundation Trust, Warwick, UK
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12
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Maghfour J, Kane J, DiMarco C, Robinson-Bostom L, Chai S. Multiple proliferating pilar tumors with porokeratotic adnexal ostial nevus: A rare association. JAAD Case Rep 2020; 6:344-347. [PMID: 32258317 PMCID: PMC7103661 DOI: 10.1016/j.jdcr.2019.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jalal Maghfour
- Tulane Medical School, Tulane University, New Orleans, Louisiana
- Correspondence to: Jalal Maghfour, MS, Tulane Medical School, Tulane University, 1430 Tulane Avenue, New Orleans, LA 70130.
| | - Jennifer Kane
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Christopher DiMarco
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Leslie Robinson-Bostom
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sandy Chai
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Chowdhary B, Sharma A, Mahajan VK. Porokeratotic Eccrine Ostial and Dermal Duct Nevus and Porokeratotic Eccrine and Hair Follicle Nevus: Is Nomenclature "Porokeratotic Adnexal Ostial Nevus" More Appropriate? Indian Dermatol Online J 2019; 10:478-480. [PMID: 31334079 PMCID: PMC6615371 DOI: 10.4103/idoj.idoj_341_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Bhumika Chowdhary
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Petkiewicz S, Baltz J, Cornejo K, Deng A, Wiss K. Widespread presentation and spontaneous regression of porokeratotic eccrine ostial and dermal duct nevus. JAAD Case Rep 2018; 4:972-975. [PMID: 30406170 PMCID: PMC6214893 DOI: 10.1016/j.jdcr.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Stephanie Petkiewicz
- Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Canada
- Correspondence to: Stephanie Petkiewicz, MD, CM, PhD, FRCPC, Pathologist, The Ottawa Hospital, 4th Floor CCW, Room W4223, 501 Smyth Road, Ottawa, ON K1H 8L6.
| | - Julia Baltz
- Department of Dermatology, University of Massachusetts Medical School, UMass Memorial Healthcare, Worcester, Massachusetts
| | - Kristine Cornejo
- Department of Pathology, University of Massachusetts Medical School, UMass Memorial Healthcare, Worcester, Massachusetts
| | - April Deng
- Department of Pathology, University of Massachusetts Medical School, UMass Memorial Healthcare, Worcester, Massachusetts
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Medical School, UMass Memorial Healthcare, Worcester, Massachusetts
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15
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Chokoeva AA, Wollina U, Lotti T, Maximov GK, Lozev I, Tchernev G. Disseminated Porokeratosis with Idiopathic Thrombocytopenia - Case Report and Literature Review of Porokeratosis and Related Disorders. Open Access Maced J Med Sci 2018; 6:139-142. [PMID: 29484012 PMCID: PMC5816286 DOI: 10.3889/oamjms.2018.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/12/2017] [Accepted: 10/14/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND: Porokeratosis is characterised by one or more atrophic patches surrounded by a distinctive peripheral keratotic ridge, typically found on sun-exposed areas, with several clinical variants and typical histological findings. Despite ultraviolet radiation, varies antibody - related autoimmune disease treated with systemic steroids and other immunosuppressive conditions such as chronic liver disease, HIV and organ transplantations have been implicated in its etiopathology. CASE REPORT: We present a case of porokeratosis, associated with idiopathic thrombocytopenia in 74 - year old, otherwise healthy male patient, as we discuss the previously reported associated disorders. CONCLUSION: Regarding all of the polymorphism of clinical presentation, associated disorders and treatment responses, we could conclude that disseminated porokeratosis is still an unknown well disorder, which will continue to surprise the physicians in future. The screening and follow up of the patients is mandatory in all cases because as we see, porokeratosis has multiple unexpected faces, which require circumstantial clinical and paraclinical behaviour.
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Affiliation(s)
| | - Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | | | - Ilia Lozev
- Medical Institute of Ministry of Interior Department of General, Vascular and Abdominal Surgery, Sofia, Bulgaria
| | - Georgi Tchernev
- "Onkoderma"- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.,Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
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16
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Agulló-Pérez AD, Resano-Abarzuza MÁ, Córdoba-Iturriagagoitia A, Yanguas-Bayona JI. Porokeratotic eccrine and hair follicle nevus: a report of two cases and review of the literature. An Bras Dermatol 2017; 92:121-125. [PMID: 29267468 PMCID: PMC5726699 DOI: 10.1590/abd1806-4841.20176536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/25/2016] [Indexed: 12/03/2022] Open
Abstract
Porokeratotic eccrine and hair follicle nevus is a very rare non-hereditary
disorder of keratinization with eccrine and hair follicle involvement with only
9 cases described in the literature. In 2009 the term porokeratotic anexial
ostial nevus was proposed to comprehend porokeratotic eccrine and hair follicle
nevus and a related and more common process without follicular involvement:
porokeratotic eccrine ostial and dermal duct nevus Recent findings suggest that
both entities may be produced by a mutation in GJB2 gene, which is associated to
KID syndrome. Herein we report 2 cases of porokeratotic eccrine and hair
follicle nevus and review the existing cases in the Spanish and English
literature.
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Affiliation(s)
- Alfredo Daniel Agulló-Pérez
- Department of Dermatology, Hospital IMED Levante - Benidorm, Spain.,Department of Dermatology, Complejo Hospitalario de Navarra - Pamplona, Spain
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17
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Adya KA, Inamadar AC, Palit A. "Pitted" lesions in dermatology. Int J Dermatol 2016; 56:3-17. [PMID: 27613605 DOI: 10.1111/ijd.13358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/20/2016] [Accepted: 03/20/2016] [Indexed: 11/29/2022]
Abstract
Cutaneous pitting, dimpling, or depressions are frequently dealt with in clinical practice. Such lesions may be primary manifestations of a disorder or develop as secondary changes during the course of the disease. Cutaneous pitting may be a manifestation of certain genodermatoses and internal disorders when it serves as a marker of such conditions. This article describes various types of pitted lesions affecting the ectodermal structures (skin, nails, and teeth) and their clinical significance along with brief description of the associated conditions.
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Affiliation(s)
- Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, SBMP Medical College, Hospital and Research Center, BLDE University, Vijayapur, Karnataka, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, SBMP Medical College, Hospital and Research Center, BLDE University, Vijayapur, Karnataka, India
| | - Aparna Palit
- Department of Dermatology, Venereology and Leprosy, SBMP Medical College, Hospital and Research Center, BLDE University, Vijayapur, Karnataka, India
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