Publications by authors named "Nidheesh Agarwal"

13 Publications

  • Page 1 of 1

Cutaneous Angiosarcoma Simulating as Pyoderma in a Middle-aged Indian female: A Rare Case Report.

Indian J Dermatol 2016 Nov-Dec;61(6):685-687

Department of Dermatology, Venereology and Leprosy, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India. E-mail:

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http://dx.doi.org/10.4103/0019-5154.193694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122293PMC
December 2016

Guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis: An Indian perspective.

Indian J Dermatol Venereol Leprol 2016 Nov-Dec;82(6):603-625

Department of Dermatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Background: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor-α inhibitors.

Aim: The ideal therapy of Stevens-Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments. The aim of this article is to comprehensively review the published medical literature and frame management guidelines suitable in the Indian perspective.

Methods: The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these guidelines to its special interest group on cutaneous adverse drug reactions. The group performed a comprehensive English language literature search for management options in Stevens-Johnson syndrome/toxic epidermal necrolysis across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for keywords (alone and in combination) and MeSH items such as "guidelines," "Stevens-Johnson syndrome," "toxic epidermal necrolysis," "corticosteroids," "intravenous immunoglobulin," "cyclosporine" and "management." The available evidence was evaluated using the strength of recommendation taxonomy and graded using a three-point scale. A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared.

Results: A total of 104 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], previous guidelines [including Indian guidelines of 2006] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these guidelines.

Recommendations: This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1-2 mg/kg/day or equivalent), tapered rapidly within 7-10 days. Cyclosporine (3-5 mg/kg/day) for 10-14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.
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http://dx.doi.org/10.4103/0378-6323.191134DOI Listing
May 2017

Identification of gene mutation in an Indian man with Clouston syndrome.

Indian J Dermatol Venereol Leprol 2016 Nov-Dec;82(6):697-700

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.4103/0378-6323.190855DOI Listing
May 2017

Dyskeratosis congenita presenting with dysphagia.

Indian Dermatol Online J 2016 Jul-Aug;7(4):275-7

Department of Dermatology, Venereology and Leprosy, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Dyskeratosiscongenita (DKC) is a genetically heterogeneous disease of defective telomere maintenance that may demonstrate different patterns of inheritance. It is characterized by thetriad of dystrophy of the nails, leukokeratosis of the oral mucosa, and extensive net-like pigmentation of the skin. We report a case ofDKC who presented with a chief complaint of dysphagia.
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http://dx.doi.org/10.4103/2229-5178.185461DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976405PMC
August 2016

A Sporadic Case of Ichthyosis Curth Macklin: Rare Presentation of a Rare Disease.

Indian J Dermatol 2015 Sep-Oct;60(5):522

Department of Dermatology, SMS Medical College, Jaipur, Rajasthan, India.

Ichthyosis hystrix is a rare autosomal dominant genodermatosis, characterized by persistent spiny hyperkeratotic scales which cover a significant part of the skin surface. Based on the pattern of distribution, five clinical variants namely Brocq type, Lambert type, Curth-Macklin type, Rheydt type and Bδfverstedt type have been described. We report the case of an 11-year-old male child with spiny, hyperkeratotic scales all over the body since birth with sparing of scalp and central part of the face. Palmoplantar keratoderma was also present. These clinical features are suggestive of Ichthyosis Curth Macklin, which has been typically described in families. However, family history was negative in our patient. The case is being reported on account of rarity of the disease, that too with a very rare sporadic presentation.
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http://dx.doi.org/10.4103/0019-5154.164439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601452PMC
November 2015

Therapeutic response of 70% trichloroacetic acid CROSS in atrophic acne scars.

Dermatol Surg 2015 May;41(5):597-604

*Department of Dermatology, Venereology and Leprosy, Geetanjali Medical College and Hospital, Udaipur, India; †Department of Dermatology, Venereology and Leprosy, RNT Medical College, Udaipur, India; ‡Department of Dermatology, Venereology and Leprosy, SMS Medical College, Jaipur, India.

Background: Acne scarring is a common sequela of acne for which no single treatment method is uniformly effective. The chemical reconstruction of skin scars (CROSS) therapy using high-concentration trichloroacetic acid (TCA) has shown promise as a cheap, safe, and effective modality of treatment in acne scars.

Objective: To assess the therapeutic response of 70% TCA CROSS on atrophic acne scars and to evaluate the adverse effects of this therapy.

Materials And Methods: Fifty-three patients with postacne atrophic scars were treated with 70% of TCA focal application every 2 weeks by the CROSS technique and results evaluated on 3 parameters: physician assessment, patient assessment, and satisfaction level of patients, after a follow-up of 3 months.

Results: Good or excellent improvement (>50%) was seen in 66% of patients on physician and patient assessments. The patients were either very satisfied or satisfied in 81.1% of cases. Patients with predominantly boxcar scars and higher pretreatment scar severity were associated with better treatment outcomes. Age, sex, duration of scars, or type of skin did not significantly influence the treatment outcome and adverse effects.

Conclusion: The study showed that 70% of TCA is a safe and effective treatment option in all types of atrophic acne scars, especially in severe boxcar scars.
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http://dx.doi.org/10.1097/DSS.0000000000000355DOI Listing
May 2015

A curious case of hourly attacks of disabling episodic spontaneous hypothermia with hyperhidrosis.

Indian J Dermatol Venereol Leprol 2015 Mar-Apr;81(2):185-6

Department of Dermatology, Venereology and Leprosy and Department of Neurology, R. N. T. Medical College, Udaipur, Rajasthan, India.

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http://dx.doi.org/10.4103/0378-6323.152292DOI Listing
December 2015

Outbreak of hand, foot, and mouth disease in udaipur.

Indian J Dermatol 2015 Jan-Feb;60(1):108

Department of Dermatology, RNT Medical College, Udaipur, India House No. 62, Road No. 2, Ashok Nagar, Udaipur, India. E-mail:

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http://dx.doi.org/10.4103/0019-5154.147896DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318054PMC
February 2015

Chromoblastomycosis from a Non-endemic Area and Response to Itraconazole.

Indian J Dermatol 2014 Nov;59(6):606-8

Department of Dermatology, RNT Medical College, Udaipur, Rajashtan, India.

Chromoblastomycosis belongs to the heterogeneous group of subcutaneous mycoses. It is caused by various pigmented (dematiaceous) fungi, which gain entry into the skin via traumatic implantation. We would like to share a case report of chromoblastomycosis in a 32-year-old male, who presented to us with 3 years history of slowly progressive, itchy, verrucous, crusted lesions over right forearm and arm. He is being treated with itraconazole 100 mg twice daily. The case is of interest because it has so far not been reported from our region- the northwest arid zone of India. The patient showed favorable response to itraconazole.
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http://dx.doi.org/10.4103/0019-5154.143537DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248502PMC
November 2014

Hypohidrotic ectodermal dysplasia in association with milia.

Indian J Dermatol Venereol Leprol 2014 Sep-Oct;80(5):483

Department of Dermatology, Rabindra Nath Tagore Medical College, Udaipur, Rajasthan, India.

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http://dx.doi.org/10.4103/0378-6323.140348DOI Listing
May 2015

Fixed drug eruption to levocetirizine and cetirizine.

Indian J Dermatol 2014 Jul;59(4):411-3

Department of Dermatology, Rabindra Nath Tagore Medical College, Udaipur, Rajasthan, India. E-mail:

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http://dx.doi.org/10.4103/0019-5154.135507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103287PMC
July 2014

Chemical reconstruction of skin scars therapy using 100% trichloroacetic Acid in the treatment of atrophic facial post varicella scars: a pilot study.

J Cutan Aesthet Surg 2013 Jul;6(3):144-7

Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India.

Context: Chickenpox (varicella) is a common viral disease caused by Varicella zoster virus. Facial atrophic scars after varicella infection are not uncommon and pose a cosmetic problem. Like atrophic scars of other aetiologies, they are a difficult condition to treat. There are not enough references in the literature regarding efficient treatment of post varicella scars. High strength Trichloroacetic acid (TCA), which is known to cause dermal collagen remodelling, was used to treat varicella scars in the present study.

Aims: The study was undertaken to assess the efficiency of Chemical Reconstruction of Skin Scars (CROSS) technique using 100% TCA in the treatment of atrophic facial post varicella scars.

Settings And Design: Open label, pilot study.

Materials And Methods: A total of 16 patients with atrophic facial post varicella scars were treated by focal application of 100% TCA solution by pressing down upon the scar surface by a toothpick (CROSS technique). Total 4 sittings were given at 2 weekly intervals and the results evaluated after 3 months of follow-up. Statistical analysis was carried out using Fischer's exact t-test.

Results: All of the 13 patients who completed the study showed good clinical improvement, with 69% patients grading the response as excellent (>75%) improvement, whereas the rest 31% patients reporting good (51-75%) improvement. No significant complications were seen in any patient.

Conclusions: CROSS technique using 100% TCA is a safe, cheap and effective therapy for the treatment of post varicella scars.
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http://dx.doi.org/10.4103/0974-2077.118408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800288PMC
July 2013

Treatment of nodular scabies with topical tacrolimus.

Indian Dermatol Online J 2013 Jan;4(1):52-3

Department of Dermatology, RNT Medical College, Udaipur, Rajasthan, India.

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http://dx.doi.org/10.4103/2229-5178.105486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573456PMC
January 2013