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Deriving from the Greek word λeιχήν for "tree moss" and the Latin word planus for "planar," lichen planus is a relatively uncommon and heterogeneous cutaneous disorder that typically develops in middle-aged adults. Despite the significant clinical burden associated with the disorder, little well-conducted molecular research has been undertaken, possibly because of heterogeneity impeding consistent and confident phenotyping. The multiple variants of lichenoid disease bear overlapping clinical and pathologic features despite manifesting as distinct clinical disorders. The first article in this 2-part continuing medical education series provides a comprehensive overview of the clinical and pathologic characteristics of cutaneous lichenoid dermatoses and links these manifestations to recent advances in our understanding of the underlying pathobiology of such diseases.

Objective: To estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) patients with or without anemia. Methods: This is a single-center observational study, conducted at a tertiary care hospital of south Rajasthan. Patients admitted to hospital with clinical diagnosis of HF based on validated clinical criteria were included in the study. ID was diagnosed based on complete Iron profile, including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT). Anemia was defined as hemoglobin (Hb)

Aims and objectives: Transradial interventions are gaining popularity in recent years. However the radial artery being small, there is a limitation in using interventional devices through this route. We have measured radial and ulnar arteries size in adult patients at our tertiary care cardiology center in southern Rajasthan. Method: Adult patients >30 years, who came for Echocardiography at a tertiary care center were included. Radial and ulnar arteries inner diameters were measured 2–3 cm above the Styloid process in both forearms with the Ultrasonography. Patient information about weight, height, diabetes and hypertension were collected. Body mass index and Body surface area were calculated. Results: We studied 204 patients, which includes 60.8% males. Mean diameter was 2.325 ± 0.4 mm mm for radial arteries and 2.358 ± 0.39 mm for ulnar arteries (p = 0.24). Hypertensive and male patients had larger mean radial artery diameter than non hypertensive (2.383 mm v/s 2.272 mm, p = 0.006) and female patients (2.37 mm v/s 2.26 mm, p = 0.008) respectively. Diabetic patients (2.305 mm) had nonsignificantly smaller radial arteries diameters than nondiabetics (2.329 mm, p = 0.6). We calculated correlations between radial arteries diameters and Body surface area, Body mass index, height and weight of patients, none of these correlations were statistically significant (r = 0.30, r = 0.28, r = 0.07, r = 0.031 respectively). Conclusion: Mean radial artery diameter (2.325 ± 0.4 mm) in the study was slightly smaller than ulnar artery (2.358 ± 0.39 mm). Males and hypertensives had a larger mean radial artery diameter than females and non hypertensives. Radial artery inner diameter measurement by Ultrasonography may be more helpful than Allen's test for ideal selection of cases.

We were interested to read the article Frontal Fibrosing Alopecia - Possible Association with Leave-on Facial Skin Care Products and Sunscreens; A Questionnaire Study by Aldoori et al1. The authors sought to identify possible causative environmental factors associated with frontal fibrosing alopecia (FFA). One conclusion was that the use of facial products containing sunscreens might be implicated. This article is protected by copyright. All rights reserved.

Ellis-van Creveld (EVC) syndrome is a rare genetic abnormality characterized by a tetrad of chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital heart disease. Common atrium is an uncommon cardiac malformation, and yet it is commonly found in patients with EVC syndrome. This rare condition is inherited as an autosomal recessive trait. This report describes a case of common atrium with unusual electrocardiographic findings in a patient with EVC syndrome. This 17-year-old male of Indian origin born of a consanguineous marriage had short stature, genu valgum, polydactyly, gingival hypertrophy, multiple frenula, common atrium, and right axis deviation of QRS with clockwise depolarization in electrocardiogram.

A 33-year-old woman presented to our department with complaints of bluish discoloration of the body, thickening of the nail beds, and dyspnea on exertion for many years. She had history of repeated respiratory infections during infancy and early childhood. Her physical examination revealed cyanosis and clubbing with a pulse rate of 90 bpm, blood pressure of 128/80 mm Hg, and left parasternal heave. Auscultation demonstrated a loud pulmonary component of the second heart sound and a short ejection systolic murmur over the second left intercostal space. Her arterial oxygen saturation was 82% at room air in all 4 limbs. Her chest radiograph showed a cardiothoracic ratio of 55% with a prominent main pulmonary artery segment (Figure 1A). Two-dimensional transthoracic echocardiography (TTE) revealed a large defect between the ascending aorta and the main pulmonary trunk, suggesting an aortopulmonary window (APW) (Figure 1B and 1C and Movies I and II in the online-only Data Supplement). Color Doppler showed bidirectional flow across this APW (Figure 1D and Movie III in the online-only Data Supplement). The entire aortic arch could not be visualized in the suprasternal view. Three-dimensional (3D) TTE further delineated the spatial geometry of the APW and its proximity to the 2 semilunar …

Cardiac rhabdomyomas are described as sporadic as well as associated with tuberous sclerosis. Association with LVOT obstruction with anorectal malformation or imperforate anus has not been reported so far in published literature. In this case report we describe one such case.

The electronic records of 398 patients with chronic spontaneous urticaria (CSU) who had had a serum basophil histamine release assay (BHRA) performed as a marker of functional autoantibodies were audited. The BHRA was positive in 105 patients (26.4%). Fifty eight were treated with ciclosporin because they were H1 anti-histamine unresponsive. CSU patients with a positive BHRA were more likely to respond clinically (P