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Ganiger V, Srinivas SM, Kalegowda IY. Localized Scleromyxedema Masquerading as Angioedema. Indian Dermatol Online J 2024; 15:660-662. [PMID: 39050048 PMCID: PMC11265756 DOI: 10.4103/idoj.idoj_476_23] [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: 06/21/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 07/27/2024] Open
Affiliation(s)
- Veena Ganiger
- Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Sahana M. Srinivas
- Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Inchara Y. Kalegowda
- Department of Pathology, St. John’s Medical College, Bengaluru, Karnataka, India
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Adya KA, Inamadar AC, Palit A, Shivanna R. Knuckle lesions in inherited and acquired disorders. Indian Dermatol Online J 2021; 12:805-819. [PMID: 34934715 PMCID: PMC8653727 DOI: 10.4103/idoj.idoj_416_21] [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: 06/27/2021] [Revised: 07/05/2021] [Accepted: 07/29/2021] [Indexed: 11/04/2022] Open
Abstract
Skin lesions occurring over the knuckles can be a primary or characteristic manifestation of a disorder. Characteristic knuckle lesions may also be important cutaneous features of various internal disorders when they serve as useful clinical pointers, as well as may speak of the disease severity in certain instances. Furthermore, knuckle lesions also speak of various external factors as the underlying cause of the disease/lesions, such as trauma - occupational or otherwise, and contact dermatitis. Although knuckles essentially imply dorsal aspect of the metacarpophalangeal joints, many of the lesions described as those 'involving the knuckles' are seen over the proximal and/or less frequently, the distal interphalangel joints as well. This review presents a compilation of various inherited and acquired dermatoses and dermatological manifestations of various internal disorders associated with different forms of knuckle lesions.
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Affiliation(s)
- Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Aparna Palit
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Ragunatha Shivanna
- Department of Dermatology, Venereology and Leprosy, ESIC Medical College and PGIMSR, Rajaji Nagar, Bengaluru, Karnataka, India
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Nofal A, Amer H, Alakad R, Nofal E, Desouky FE, Yosef A, Albalat W, Gharib K, Mostafa I, Fathy S, Waked M, Ragheb E, Gammaz H. Lichen myxedematosus: diagnostic criteria, classification, and severity grading. Int J Dermatol 2016; 56:284-290. [PMID: 27667657 DOI: 10.1111/ijd.13437] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/28/2016] [Accepted: 07/09/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Lichen myxedematosus (LM) is a rare, chronic idiopathic disorder characterized clinically by waxy, closely set papules and histopathologically by diffuse dermal mucin deposition and fibroblast proliferation. The most recent classification of LM was proposed in 2001; however, it seems to be complex, confusing, and imprecise. Herein, we present seven cases of LM to evaluate the validity of the current classification, to propose new diagnostic criteria and classification, and to suggest a clinically relevant severity grading system for this rare disorder. MATERIALS AND METHODS The study included seven patients with different presentations and severities of LM. All patients were subjected to thorough dermatological and systemic examination, routine laboratory tests, evaluation of thyroid function, protein electrophoresis, and detailed investigations to detect systemic involvement. RESULTS The current classification does not meet the requirements of proper diagnosis of different presentations of LM. Subtyping of the studied patients differs greatly according to the old classification and the newly proposed one. New diagnostic criteria, classification, and grading are consequently suggested. CONCLUSIONS We propose two sets of diagnostic criteria to define the disease more precisely and to avoid confusion associated with the other classification. The first set comprises constant clinical and histopathological features that are always present in every case, and the second set includes associated features that were variably reported in some patients. LM is then subclassified according to the presence or absence of systemic manifestations into a systemic severe form (scleromyxedema) and a non-disabling, pure cutaneous form.
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Affiliation(s)
- Ahmad Nofal
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hala Amer
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
| | - Rania Alakad
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Nofal
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Fatma El Desouky
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ayman Yosef
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Waleed Albalat
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Khaled Gharib
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Inass Mostafa
- Department of Dermatology and Andrology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Sahar Fathy
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
| | - Monira Waked
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
| | - Eman Ragheb
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
| | - Hanan Gammaz
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
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Nofal A, Alakad R, Amer H, Nofal E. Lichen Myxedematosus: Strict Classification and Diagnostic Criteria are Still Lacking. Indian J Dermatol 2016; 61:92-3. [PMID: 26955106 PMCID: PMC4763707 DOI: 10.4103/0019-5154.174040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ahmad Nofal
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E-mail:
| | - Rania Alakad
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E-mail:
| | - Hala Amer
- Al-Haud Al-Marsoud Dermatology Hospital, Cairo, Egypt
| | - Eman Nofal
- Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E-mail:
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Thomas E, George A, Deodhar D, John M. Authors' Reply. Indian J Dermatol 2016; 61:93-4. [PMID: 26951072 PMCID: PMC4763708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Emy Thomas
- From the Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India
| | - Anisha George
- From the Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India
| | - Divya Deodhar
- Department of Medicine, Christian Medical College, Ludhiana, Punjab, India. E-mail:
| | - Mary John
- Department of Medicine, Christian Medical College, Ludhiana, Punjab, India. E-mail:
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