Ravindranath Brahmadeo Chavan; Vasudha A Belgaumkar; Nitika Deshmukh; Balakrishna Nikam; Vijay Deepak Joshi
Abstract
Proliferating trichilemmal tumors are rare, generally solitary, benign tumors arising from the hair’s outer root sheath with trichilemmal keratinization. These tumors are predominantly found on the head, neck, and face of elderly females; the inguinal region is a highly unusual site of involvement. ...
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Proliferating trichilemmal tumors are rare, generally solitary, benign tumors arising from the hair’s outer root sheath with trichilemmal keratinization. These tumors are predominantly found on the head, neck, and face of elderly females; the inguinal region is a highly unusual site of involvement. Malignant change in this tumor is rare, histologically mimicking squamous cell carcinoma. Metastatic malignant proliferating trichilemmal tumor requires a high index of suspicion for diagnosis and accurate histopathological reporting for timely intervention. Here, we report the case of a 65-yearold man presenting with nodular-ulcerative lesions in the groin, clinically confused with hidradenitis suppurativa and histologically with squamous cell carcinoma. He was finally diagnosed with an inoperable metastatic stage of malignant proliferating trichilemmal tumor and was treated with palliative care. This case highlights the innocuous clinical appearance of such lesions that might delay the management of this fulminant tumor.
Balakrishna P Nikam; Mohan Kale; Varsha Jamale; Tunika Arora; Asma Hussain; Nishchhal Shrivastav
Abstract
Background: Self-inflicted acne excoriée is often observed in patients with compulsive skin picking, posing a challenge for diagnosis and treatment as the exact psychiatric cause remains unknown. Studies have suggested that serotonin reuptake inhibitors such as fluoxetine may help in the management ...
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Background: Self-inflicted acne excoriée is often observed in patients with compulsive skin picking, posing a challenge for diagnosis and treatment as the exact psychiatric cause remains unknown. Studies have suggested that serotonin reuptake inhibitors such as fluoxetine may help in the management of this condition. To determine the efficacy and safety profile of fluoxetine in the treatment of acne excoriée and to study the psychological profiles of patients. Methods: Sixty patients of either sex aged ≥16 years with acne excoriée were assigned to either Group A (n=30), which received oral fluoxetine (F) (20 mg/day) and oral doxycycline (D) (100 mg/day) with topical clindamycin (1%), or Group B (n=30), which received a placebo (P), oral doxycycline (100 mg/day), and topical clindamycin (1%). Patients were evaluated for standardized rating scales and followed up every two weeks for 12 weeks. Results: Female gender predominance was observed in both groups, with most patients exhibiting anxiety and depression. With each follow-up visit (2nd, 3rd, 4th, and 5th) in both groups (A and B), the mean AESI (91.4% vs. 26.7%), HAM-A (80% vs. 27.7%), MADRS (68.1% vs. 28.2%), YBOCS (98.27% vs. 15.63%), PGA (88.47% vs. 31.38%), and VAS (99.17% vs. 37.67%) scores decreased from baseline by the final visit, indicating improved patient conditions. Significant differences were observed between the two groups (p <0.001) in the overall response, indicating that fluoxetine was more efficacious than the control. No remarkable side effects were noted. Conclusion: Fluoxetine efficiently managed acne excoriée without remarkable side effects. Background: Self-inflicted acne excoriée is often observed in patients with compulsive skin picking, posing a challenge for diagnosis and treatment as the exact psychiatric cause remains unknown. Studies have suggested that serotonin reuptake inhibitors such as fluoxetine may help in the management of this condition. To determine the efficacy and safety profile of fluoxetine in the treatment of acne excoriée and to study the psychological profiles of patients. Methods: Sixty patients of either sex aged ≥16 years with acne excoriée were assigned to either Group A (n=30), which received oral fluoxetine (F) (20 mg/day) and oral doxycycline (D) (100 mg/day) with topical clindamycin (1%), or Group B (n=30), which received a placebo (P), oral doxycycline (100 mg/day), and topical clindamycin (1%). Patients were evaluated for standardized rating scales and followed up every two weeks for 12 weeks. Results: Female gender predominance was observed in both groups, with most patients exhibiting anxiety and depression. With each follow-up visit (2nd, 3rd, 4th, and 5th) in both groups (A and B), the mean AESI (91.4% vs. 26.7%), HAM-A (80% vs. 27.7%), MADRS (68.1% vs. 28.2%), YBOCS (98.27% vs. 15.63%), PGA (88.47% vs. 31.38%), and VAS (99.17% vs. 37.67%) scores decreased from baseline by the final visit, indicating improved patient conditions. Significant differences were observed between the two groups (p <0.001) in the overall response, indicating that fluoxetine was more efficacious than the control. No remarkable side effects were noted. Conclusion: Fluoxetine efficiently managed acne excoriée without remarkable side effects. Keywords: acnevulgaris,fluoxetine, doxycycline