Ratnakar Shukla

Abstract

Spitz nevi is a very rare and an acquired lesion 1 described by Sophie Spitz in 1948. Spitz nevus is a melanocytic lesion composed of epithelioid and spindled cells, with a remarkable histological resemblance to malignant melanoma, first interpreted as juvenile melanoma, these lesions were later characterized as benign and were observed to affect all age groups. Its incidence is less than 1% of all nevi. Clinically it appears as a solitary, dome shaped, firm, red or brown papule or nodule located most commonly over the face or leg. We report a case of 15 year old female patient who visited us with an asymptomatic lesion on her right knee of 1month duration. On examination it was found to be a single well-defined round to oval dome shaped skin colored to reddish papule, probable diagnosis of adnexal tumor was made, and excisional biopsy was planned, on histopathological examination it was confirmed to be a case of compound spitz nevi.   Keywords: Spitz nevi, Melanocytic lesion, Malignant melanoma, Adnexal tumo

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Abstract

Trichofolliculoma represents an uncommon hamartoma of hair follicle tissue typically occurring on face of adults. Trichofolliculoma represents abortive differentiation of pluripotent skin cells toward hair Follicles. Trichofolliculoma although classified under hair follicle tumors, essentially are benign hamartomas of the hair follicle. They are rare and usually present as solitary lesions on the face often with a tiny tuft of fine white hairs arising from the surface.We present a case of 40 year old female with a small growth on face from last 6 year, it is asymptomatic and non progressive in nature, on local examination the papule was skin colored, firm , non-tender, the systemic examination was noncontributory and radiological examination revealed no bony destruction or formation of sinus tract clinical diagnosis is thought to be benign adnexal lesion, excisional biopsy was done for the lesion, On histopathological examination it was confirmed as trichofolliculoma, so, the final diagnosis of trichofolliculoma was made, and no recurrence was noted during the follow?up of 1 year.   Keywords: Trichofolliculoma, Hamartoma, Pluripotent, Hair follicle tumors Introduction

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Objective: To examine nail changes with capillaroscopy in patients with collagen vascular diseases. Materials and Methods: In this prospective observational study, patients with collagen vascular diseases presented to dermatology outpatient department of a tertiary care center were subjected to capillaroscopy. Structural and morphological abnormalities in these patients were noted. Results: Fifty patients (Mean age 38.2 years; 86% females) with mean disease duration of 1.96 years were included. Patients with systemic sclerosis and systemic lupus erythematosus constituted 34% and 32% patients respectively. Twenty two (44%) patients had presence of dilated nail fold capillary loops. Out of 17 patients with systemic sclerosis, 15(88.23%) and 14(87.5%) showed dilated nail fold capillary loops and capillary drop-pouts respectively. Capillary dropouts were observed in 14(82.35%) patients. Raynaud’s phenomenon, splinter hemorrhage and fingertip scarring was observed in 11(64.71%), six (35.29%) and 33(17.65%) patients respectively. Ragged cuticle was observed in four (25%) patients with systemic lupus erythematosus. Conclusion: In our study, systemic sclerosis and systemic lupus erythematosus were two most common disorders. Dilated nail fold capillary loops/giant capillaries were the most common observation in overall population. Dilated nail fold capillary loops, capillary dropouts, Raynaud’s phenomenon, splinter hemorrhage and fingertip scarring were common in patients with systemic sclerosis.   Keywords: Microangiopathy, Nail fold capillaroscopy, Systemic sclerosis

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