Publications by Dr Ram Malkani

Contribution To A Book:
1) "Psychocutaneous Disorders" a chapter in the IADVL
textbook of Dermatology. Editor Valia R G, Bhalani Publishing House, 1994, Bombay.

List Of Publications:
1) Mycosis Fungoides Bulletin of the Jaslok Hospital & Research Centre, Vol XVI no l July 1991 p. 36.

2) Erythema Necroticans Bulletin of the Jaslok Hospital & Research Centre Vol XII no1 July 1987 p.24

3) Acrodermatitis Enteropathica
Bulletin of the Jaslok Hospital & Research Centre Vol XIII, No.3 January 1989 p.36.

4) Essential Fatty acids and the skin
Bulletin of the Jaslok Hospital & Research Centre Vol XVI No.2 October 1991 p.44.

5) Acyclovir (ACV) - a review
Bulletin of the Jaslok Hospital & Research Centre Vol XVII No. 2 October 1992 p.17.

6) Hypereosinophilic Syndrome - A report of 2 cases .
Bulletin of the Jaslok Hospital & Research Centre Vol XVI No.2 October 1991 p.20

7) Hirsutism and acne in young females
Bulletin of the Jaslok Hospital & Research Centre Vol XVII No.1 July 1992 p. 39.

8) Did you know?
Bulletin of the Jaslok Hospital & Research Centre Vol XVIII No.1 July 1993 p. 46.

9) Venereophobia - a symptom of unresolved idealism.
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No.4 April 1990 p.9.

10) Pseudo-Elephantiasis of the vulva of Tubercoulos etiology, an unsual presentation
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No. 4 April 1990 p.5.

11) IgE - Significance and its Interpretations
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No.4 April 1990 p.15.

12) Management of Pemphigus with Gold Compounds.
Bulletin of the Jaslok Hospital & Research centre Vol XIV No. 4 April 1990 p.28.

13) Refsum's disease - a case report
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No.4 April 1990 p.31.

14) Behcet's disease
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No. 4 April 1990 p. 34.

15) Pyoderma Gangrenosum
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No. 4 April 1990 p.41.

16) Chromomycosis
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No.4 April 1990 p.44.

17) Impetigo Herpetiformis - a case report
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No.p.47.

18) Induction of contact dermatitis as a therapeutic measure in Alopecia areata, warts.
Bulletin of the Jaslok Hospital & Research Centre Vol XIV No. 4 April 1990 p.47.

19) Reiter's Syndrome
Bulletin of the Jaslok Hospital & Research Centre Vol XIII Vol 1 July 1988.

20) Zinc - How useful is it?
The Antiseptic Vol 90 No. 4 April 1993 p. 169.

21) Treating palmo-plantar hyperhidrosis with tap water iontophoresis.
The Bombay Hospital Journal Vol 31. No.2 1989.

22) Chronic renal failure- cutaneous manifestation and a case of Kyrle's disease.
Bombay Hospital Journal, Vol 33.No.4 October 1991.

23) Bullous systemic lupus erythematosus - a case report
The Indian Journal of Dermatology, Venereology and Leprology (IJDVL) 1993, 59 :97-100.

24) Systemic Amyloidosis - a case report
Indian Journal of Dermatology, Venereology and Leprology (IJDVL) 1993, 59, 93-94.

25) Toxicity in a serologically negative SLE
Bulletin of the Jaslok Hospital & Research Centre, Mumbai Vol XIX No.1 July 1991.

26) Efficacy of the short 3 day regimens of Azithromycin (Zithromax) in Acute Pyogenic Skin infection.
Bulletin of the Jaslok Hospital & Research Centre, Mumbai Vol XIX No. 3 Jan 1995.

27) Psychogenic pruritus- an overview
Bulletin of the Jaslok Hospital & Research Centre Vol XXV No.3 Jan 2001.

28) "Dapsone syndrome - a case study"
Bulletin of the Jaslok Hospital & Research Centre, Vo1 XXVI No. 4 April 2002.

29) "Livedoid Vasculitis"
Bulletin of the Jaslok Hospital & Research Centre, Vol XXV No. 4 April 2001.

30) Pilot analysis of a KAP study of patients presenting at the anonymous testing centre-Dadar
Bulletin of the Jaslok Hospital & Research Centre Vol XXV No.4 April 2001.

31) Glucagonoma Syndrome
Indian Journal of Dermatology, Venereology and Leprology Vol 62 No. 4 July-August 1996.

32) Bifonazole : Focus on a Tropical Azole
Clinical review November 2002 p. 433-438 Indian Medical Gazette.

33) The hypereosinophilic Syndrome
Bulletin of the Jaslok Hospital & Research Centre Vol XXVI No.3 January 2002.

34) 'Dapsone induced hemolysis in Glucose -6- Phosphate Dehydrogenase (G6PD) deficient individual'
Bulletin of the Jaslok Hospital & Research Centre, Vol XXVII No. October 2002.

35) Review article on Drug Update "Bifonazole, Focus on Topical Azole"
Bulletin of the Jaslok Hospital & Research Centre, Vol XXVII NO.2 October 2002.

36) 13th International AIDS Conference - a commentary.
Bulletin of the Jaslok Hospital & Research Centre 2003.

37) "Disseminated Mycobacterium Bovis infection from BCG vaccination of a patient with combined immunodeficiency" Bulletin of the Jaslok Hospital & Research Centre Vol XXVII No.4 April 2003 p.8.

38) "Acute Graft versus host disease manifesting as skin lesions in a post allogenic stem cell transplantation in chronic Myeloid Leukemia"
Bulletin of the Jaslok Hospital & Research Centre Vol XXVII No. 4 p.12 April 2003.

39) Sarcoidosis
Indian Journal of Dermatology 2004 (under publication).

40) Aquagenic Pruritis
Indian Journal of Dermatology 2004.(under publication).

41) Lasers in Dermatology
Bulletin of the Jaslok Hospital & Research Centre Vol XXV No. 2 October 2003.p.15

42) Treating Palmo-plantar hyperhidrosis with Tap water Ionlophoresis.
The Bombay Hospital Journal Vol. 31 No. 2 1989.

43) Keloids with Hypertrophoic Scars.A therapeutic enigma
The Bombay Hospital Journal Vol. 39 No. 3 July 1997 p.548.

44) Pseudo-Kaposi's Sarcoma (Acroangiodermatitis) a case report.
Bulletin of the Jaslok Hospital & Research Centre Vol.XXV No.1 July 2000 p.11.

45) Health risks associates with case of HIV infection, Hepatitis B or C Virus infected patients.
Bulletin of the Jaslok Hospital & Research Centre Vol.XXV No.2 Oct. 2000 p.9.

46) Perforating Granuloma Annulare - a case report.
Indian Journal of Dermatology, Venereology and Leprology.

47) Disseminated Mycobacterium Bovis Infection from BCG Vaccination of patient with combined Immunodeficiency. Bulletin of the Jaslok Hospital & Research Centre Vol.XXVII No.4 Apr..2003 p.8 -11.

48) Acute Graft - Versus Host disease manifesting as skin lesions in a post allogenic stem cell transplantation in Chronic Myeloid Leukemia. Bulletin of the Jaslok Hospital & Research Centre Vol.XXVII No.4 Apr. 2003 p.12 -16.

Other Publications:
1) Wrote a treatise on 'Cetirizine' in urticaria and Atopic Dermatitis
In the Medifacts Vol. 12 1994 - an in house publication of Alkem Laboratories, Mumbai.
2) Wrote an article in the newspaper MIDDAY on 'The world and AIDS'in the issue of Sunday July 26 1998.
3) "Don't just look beautiful but 'Be' Beautiful" in the Beauty is only skin deep Myth or truth?
Debate in the Thursday supplement of the Times of Oman June 27-July 3 2002.
4) Angiolymphoid hyperplasia with eosinophilia
Skin sight issue 3 1999 p. 10-11. The publication made with educational grant from Books Piramal Health Care Ltd.
5) Contributed clinical photographs in What's new? in Dermatology, sexually transmitted diseases leprosy issue in Jan 2000. A publication of Fulford (India).
6) 'Selected Abstracts' (in the conference news) on the 20th World Congress of Dermatology 1st to 5th July 2002, Paris, France .
In the What's new? in Dermatology, sexually transmitted diseases and Leprosy issue No. 33 October 2002 p. 47.
7) Writing a column in a newsletter "Intelligent Beautician" 1999 to 2001.

ARTICLES PUBLISHED IN JOURNALS BY THE DNB RESIDENTS IN DERMATOLOGY FROM JASLOK HOSPITAL AND RESEARCH CENTRE,MUMBAI.

1) Acta Medica (Hradec Kralove). 2012;55(2):104-6.
Recalcitrant pruritus as primary manifestation of synchronous Hodgkins lymphoma and Langerhans cell histiocytosis.
Topal AA, Malkani RH, Bhat G, Vishnani RT.
Source
Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, India. afshatopal_11@yahoo.co.in

Abstract
We present a 73 year old female with intractable pruritus and nonspecific cutaneous rash for a period of 9 months. She had recieved symptomatic therapy with no improvement. A complete examination revealed axillary and abdominal lymphadenopathy. A biopsy confirmed the diagnosis of Hodgkins lymphoma with Langerhans cell histiocytosis. She received 5 cycles of chemotherapy with resolution of pruritus and reduction in axillary and abdominal lymphadenopathy. The patient presented 6 months later with relapse and succumbed to the illness. Simultaneous occurrence of Langerhans cell histiocytosis and Hodgkins lymphoma may lead to misdiagnosis. The awareness of such an association is important to make an accurate diagnosis and guide appropriate therapy.

2) Indian J Gastroenterol. 2009 Jul-Aug;28(4):154-6. Epub 2009 Nov 24.
Reversal of nail changes after liver transplantation in a child.
Gandhi V, Nagral A, Philip S, Malkani RH, Pimputkar R.
Source
Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai 400 026, India.

Abstract
We report a 6-year-old girl who received a left-lobe live-related liver transplant for decompensated liver disease after a failed Kasai's surgery for biliary atresia. Preoperatively, her nails were white, dystrophic, brittle with severe onycholysis, clubbing and watch-glass deformities. Nail scrapings were negative for fungus. Five months after transplantation, her nails had become near normal. There is only one such documented case in literature on reversal of nail changes in an adult.
PMID:
19937415
[PubMed - indexed for MEDLINE]

3) INFECTIOUS MONONUCLEOSIS LIKE DRUG RASH AND DAPSONE HYPERSENSITIVITY
Dr. Reshma T. Vishnani, Dr. Ram Malkani, Dr. H. G. Desai
Submitted for publication in Indian Journal Of Dermatology, Venerology and Leprosy

4) CUTANEOUS PRESENTATION OF ATYPICAL MYCOBACTERIAL INFECTION – AN INTERESTING CASE
Dr Sneh L Thadani*
Dr Om Shrivastava**
Dr. Ram H Malkani*†
*Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, India
** Consultant Infectious Diseases, Jaslok Hospital and Research Centre, Mumbai, India
published in the journal of Saifee Hospital, Mumbai.

5)Abstract

Stressful life events and diffuse unexplained hair-loss in women

N. S. Atefi, R. Soltani-Arabshahi & A. Afkham Ebrahimi Iran University of Medical Sciences, Tehran, Iran Acute psychological stress has long been noted as a cause of hair loss especially in women, but the role of ordinary stressful life events in causing dif-fuse hair loss is less identified. (1). Recent research has shed light on the molecular basis for the effect of stress on hair follicle, involving mast cells, lymphocyte and various neurotransmitters (2). We designed a case-control study to examine the relationship between stressful life events and diffuse hair loss in women. All 18–50 year old women attending our dermatology clinic with the chief complaint of recent (<1 year) unexplained diffuse hair-loss between november 2003 and december 2004 were studied.

Forty women with diffuse non-cicatricial hair loss who had normal laboratory screening tests and no organic cause for their alopecia were selected. Forty controls were also selected from patients at the same clinic who did not experience hair loss and did not have any condition known to be associated with stress. All participants filled the standard ‘Social Readjustment Rating Scale’ (Holmes and Rahe). The mean total stress score was compared between two groups. The mean age of the case and control group was 32.10 and 34.80, respectively. Mean stress score was significantly higher in women with hair loss compared to controls (181.98 vs. 103.33, p < 0.05). In addition, women with hair loss experienced significantly more stressful life events than the control group (mean number of stressful life events was 6.28 in cases and 4.30 in controls, p < 0.05). We concluded that stressful life events might be a contributing factorin unexplained diffuse hair loss in adult women.
Reference
1. York J, Nicholson T, Minors P, Duncan DF. Stressful
life events and loss of hair among adult women, a case
-control study. Psychol Rep 1998; 82(3 Pt
1): 1044–1046.
2. Arck PC, Handjiski B, Hagen E, Joachim R, Klapp BF,
Paus R. Indications for a ‘brain-hair follicle axis
(BHA)’: inhibition of keratinocyte proliferation
and up-regulation of keratinocyte apoptosis in telogen
hair follicles by stress and substance P. FASEB J
2001; 15: 2536–2538.
1
2005 Journal of the European Academy of Dermatology
and Venereology, volume 19, supplement 2
ISSN: 0929-0168

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Stress and cutaneous neuroimmunology
C. E. Kleyn,* R. Saraceno,  G. Terenghi  & C. E. M.

Griffiths* *The Dermatology Centre, The University of Manchester, Manchester, UK  The University of Rome ‘Tor Vorgata’, Rome, Italy,  The University of Manchester, Manchester, UK The detrimental effect of psychological stress on inflammatory skin disease including psoriasis, atopic dermatitis and acne has been recognized by dermatologists for many years, however, the underlying mechanisms whereby psychological factors might trigger and/or exacerbate skin diseases are poorly understood. Physiologic response to stress occurs via two main pathways: stressors either activate the hypothalamus–pituitary–adrenal (HPA) axis or may also activate the locus ceruleus adrenergic system. The study of stress, particularly in humans, is complex as many variables may influence the interpretation of data. Emerging evidence indicates that the skin has an important immunological function and that cutaneous inflammation is, in part, controlled by close apposition of components of the nervous and immune systems.

Immunohistological studies have demonstrated that epidermal nerve fibres connect to epidermal Langerhans’ cells and that neuropeptides such as calcitonin gene-related peptide (CGRP) control immune cell activity within the skin. Furthermore, work in mice has demonstrated that stress – in the form of overcrowding – produces a significant reduction in the number of epidermal Langerhans’ cells. Clinical correlates of these observations may include: (i) Patients with psoriasis frequently report that stress or stressful life events may trigger and/or exacerbate flares of their disease; (ii) a significant stress-induced delay of skin barrier function repair in response to tape-stripping in students during examination periods; (iii) resolution of psoriasis plaques in areas of denervation secondary to cutaneous nerve damage; and (iv) patients with stress-reactive psoriasis have a relatively hypo-cortisolic response to emotional stress. More studies to elucidate the ‘brain-skin axis’ are central to our understanding of the role that stress plays in the
neuroimmunology of skin disease.
1
  2005 Journal of the European Academy of Dermatology
and Venereology, volume 19, supplement 2
ISSN: 09290168

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FC01 ATOPY, ATOPIC ECZEMA, URTICARIA AND OTHER INFLAMMATORY SKIN DISEASES
FC01.12

Stress involvement in atopic dermatitis and urticaria patients L. Manolache* & V. Benea *Cetatea Histria Polyclinic,  Scarlat Longhin Clinic of Dermatology, Bucharest, Romania Two groups of patients were compared (one with atopic dermatitis, the other with urticaria) regarding stress involvement as precipitating or aggravating factor. 173 patients with atopic dermatitis-(AD), 195 patients with urticaria-U (both groups matched with control-groups with skin diseases not related to stressful events: impetigo, different types of tinea). Life Events and Difficulties Scale (Holmes and Rahe) was used. Mean age for AD group was 6.96 years old and for U group was 24.52 years old. 12% of AD patients had stressful events before the onset (5.8% in control group), with a difference between men (5.8%) and women (18%). Stress influences were more often related to aggravation of skin condition. Stress involvement in U group was in 38% of cases (control-group 20%); in 55% of physical urticaria cases, in 30% of acute urticaria cases. Women were more reactive to stress. Odds ratio was 2.26 in AD group and 2.44 in U group.

Most of the patients with AD were children, so the stressful events were related to school (beginning/ ending school, examination periods). In 40% of U cases there were also involved these times of beginning or ending of school with increased solicitations. In U group other potential stressful events were: financial problems, changing job conditions, divorce or other personal illnesses. We have used in 60% of cases of urticaria, psychotropic drugs as adjutants (40% anxiolytics, 20% antidepressants) with good results in 85 % of treated cases. Stress seems to play an important role, mostly as aggravating factor, both in AD and U (double risk than control-group). School events and over-solicitation could be vulnerable times for children and adolescents. Psychotropic drugs could be helpful as adjutants in urticaria patients.
References
1. Koblenzer CS, Psychologic aspects of skin disease. In: Fitzpatrick TB, Eisen AZ, Wolf K, Dermatology in General Medicine, New York: McGraw-Hill,
1993: 14
2. Gupta MA, Gupta AK, Psychodermatology: an update, J Am Acad Dermatol 34 (6): 1030� 1996.
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 2005 Journal of the European Academy of Dermatology and Venereology, volume 19, supplement 2
ISSN: 0929-0168

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Psychogenic factors in lichen planus

E. Topcuoglu, B. Yalcin, A. Pelitli & N. Alli Ankara Numune Training and Research Hospital, Ankara, Turkey Lichen planus (LP) is a chronic, inflammatory dermatosis involving the skin, mucosa and nails. Infections, contact allergens, psychogenic and immunologic factors may trigger the development of this disease in genetically susceptible individuals. It has been reported that anxiety and depression may provoke and exacerbate miscellaneous dermatologic diseases. LP has been reported more commonly encountered in nervous personalities. We included 46 patients with LP and 24 healthy controls that have attended our outpatient clinic. The patients were given the psychogenic tests: the Beck depression inventory (BDI), State-trait anxiety inventory (STAI) 1 and 2. Also, a stressful life event in relationship to their disease was questioned. In 89.1% of LP patients a stressful life event was detected before the development of the disease. The interval between the stressful event and the beginning of the LP was as follows: in 43.9% of the patients that interval was 1–4 weeks, and 34.2% of the patient it was 4–12 weeks. According to the results of the tests, statistically significant difference between study and control groups was detected in BDE and STAI-2 tests, however not in STAI-1 test. Our study suggests that psychological factors do play an important role in the pathogenesis of LP.
1
  2005 Journal of the European Academy of Dermatology
and Venereology, volume 19, supplement 2
ISSN: 09290168

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To link systemic inflammation and metabolic syndrome using lipids and waist circumference measurements in psoriasis,acne,melasma,urticaria, alopecia areata,cicatricial alopecia and chronic venous insufficiency

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LIST OF POSTERS AND PAPERS PRESENTED BY DERMATOLOGY RESIDENTS OF JASLOK HOSPITAL AND RESEARCH CENTRE,MUMBAI, TO THE STATE AND NATIONAL CONFERENCES IN THE LAST TWO YEARS.

1) CUTANEOUS MYIASIS : CUTICON 2011,DERMACON 2012
Authors: Reshma .T. Vishnani, Venisha. B. Shah, Ram. H. Malkani

2) DAPSONE – INFECTIOUS MONONUCLEOSIS LIKE DRUG RASH : CUTICON 2010, DERMACON 2011
Authors: Reshma .T. Vishnani, R.H.Malkani,H.G.Desai

3) LYMPOHMATOID DRUG ERUPTION: CUTICON 2011, DERMACON 2013 ; RECEIVED AWARD.
Authors: Reshma .T. Vishnani, Ram. H. Malkani

4) EPIDERMOLYSIS BULLOSA AQUISITA AND SERONEGATIVE ARTHRITIS: DERMACON 2013
Authors: Venisha B. Shah, Ram H. Malkani

5) ERYTHROMELALGIA: DERMACON 2013
Authors:- Dr. Venisha B Shah, Dr. Chandni N Merchant, Dr. Ram H Malkani

6) ATYPICAL MYCOBACTERIA: DERMACON 2013
Author : Dr Sneh Thadani, Dr Om Shrivastava, Dr. Ram H Malkani,

7) HANSENS: PAPULES OF LEPROSY : DERMACON 2011, CUTICON 2010
Authors: Reshma .T. Vishnani, Ram. H. Malkani

8) HODGKINS LYMPHOMA: DERMACON 2011
Authors: Reshma .T. Vishnani, Ram. H. Malkani

9) KINDLER SYNDROME: CUTICON 2012
Authors: Priyanka Ghuge, Rahul Bade, R. H. Malkani

10) DRUG HYPERSENSITIVITY TO ALLOPURINOL: CUTICON 2012
Authors: Rahul dixit ,R.H.Malkani

11) ACTINOMYCETOMA: DERMACON 2013,CUTICON 2012
Authors:Priyanka Ghuge,Rahul Bade, Ram Malkani

12) PEMPHIGUS VEGETANS: DERMACON 2013
Authors: Rahul Dixit, Anshu Agarwal, I.K.Ramchandani

13) SKIN – A MIRROR OF INTERNAL DISEASE: CUTICON 2011
Authors: Dr. Reshma T. Vishnani, Dr. Ram Malkani

14) SARCOID: CUTICON 2012
Authors: Priyanka Ghuge, Anshu Agarwal,I.K.Ramchandani

15) PIGMENTARY PURPURIC DERMATOSIS AS A MANIFESTATION OF CHRONIC VENOUS INSUFFICIENCY: DERMACON 2012
Authors; Sneh Thadani, R.H.Malkani

16) RECALCITRANT PRURITIS AS A PRIMARY MANIFESTATION OF SYNCHRONOUS HODGKINS LYMPHOMA AND LANGERHANS CELL HISTIOCYTOSIS : DERMACON 2012
Authors: Afsha Topal, Reshma Vishnani, R.H.Malkani

17) PYODERMA GANGRENOSUM: CUTICON 2011
Authors : venisha shah,I.K.Ramchandani

18) A RARE COMPLICATION OF RITUXIMAB THERAPY IN PEMPHIGUS VULGARIS: DERMACON 2013, CUTICON 2012
Authors :Deepak Devkar , R.H.Malkani

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