Raj Kubba

Boston University | BU · Department of Dermatology

Insulin Resistance Associated Acne alludes to a subset of acne vulgaris that is driven by exaggerated insulin/IGF-1 signalling. It has a distinctive clinical profile defined by attendant companion morphologies, notably, acanthosis nigricans and benign cutaneous hyperplasias. It has comorbidities derived from hormonal disturbances (PCOS), immune dys...

Acne vulgaris is a chronic, inflammatory disease of the sebaceous follicle characterized by increased sebum secretion and formation of follicle-associated closed and open comedones, papules, pustules and nodules; pseudocysts and several types of scars are sequelae of the primary lesions [1]. Acne is a most common skin disease seen worldwide. Howeve...

Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne res...

Extracellular Ca and Vit. D on sebocytes

Calcium and 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) are promoters of epithelial cell functions; however their effects on sebaceous glands are unknown. In this study, morphology, ultrastructure, cell numbers, lipid synthesis and apoptosis of SZ95 sebocytes were assessed in vitro under different concentrations of extracellular calcium with or without...

Cutaneous ulceration as the primary manifestation of chronic cutaneous lupus erythematosus (CCLE) and lichen planus (LP) is uncommon. In the absence of typical lesions, clinical diagnosis is challenging. We report six cases, three each of, CCLE and LP that presented with cutaneous ulcers. A detailed comparison of clinical and histopathological feat...

Conventional acne treatment presents several challenges such as intolerable side effects and antibiotic resistance. Dermocosmetic products may be used to reduce these unwanted effects. Dermocosmetics include skin cleansers, topical sebum-controllers, skin antimicrobial/anti-inflammatory agents, moisturizers, sunscreens, and camouflage products. App...

In patients with darker skin types (Fitzpatrick phototypes III-VI), acne is often accompanied by post-inflammatory hyperpigmentation (PIH). Further, acne-related pigmentation can pose a greater concern for the patient than the acne lesions. There has been little formal study of this acne-related PIH. Recently, the Asian Acne Board - an internationa...

Background: Calcium and 1,25-dihydroxyvitamin D3 are well-known promoters of epithelial cell functions; however their effects on the sebaceous gland and its diseases are not clearly elucidated. Objective: The in vitro part of our study was performed in order to evaluate extracellular calcium and 1,25-dihydroxyvitamin D3 effects onhuman sebocytes. I...

Post-inflammatory hyperpigmentation (PIH) is a problematic and distressing acne sequela. The difficulty of clinically assessing and managing post-inflammatory hyperpigmentation is especially prevalent in Asian populations. The Asian Acne Board conducted a study to evaluate concordance in diagnosis of post-inflammatory hyperpigmentation in patients...

Argyria is an uncommon grey-blue pigmentation of skin and mucous membranes caused by prolonged silver exposure. The impetus behind this review is our experience with cases of generalized argyria resulting from a uniquely Indian socio-cultural practice and belief that it is under reported. Our objective is to increase the awareness for this esoteric...

Acquired pigmentary disorders are group of heterogenous entities that share single, most significant, clinical feature, that is, dyspigmentation. Asians and Indians, in particular, are mostly affected. Although the classic morphologies and common treatment options of these conditions have been reviewed in the global dermatology literature, the valu...

Acquired hypopigmentary disorders comprise a significant group of disorders that affect Indians and Asians. The pigment disturbance in darker skin individuals can be very distressing to the patient and the family. These disorders cover a wide array of pathologies including infections, autoimmune processes, lymphoproliferative disorders, and scleros...

Acne vulgaris is common throughout the world and often perceived by both patients and clinicians as an inconsequential disease of adolescence. In reality, however, acne is a chronic medical disease that lasts for years and causes a considerable impact on quality of life. Many patients with acne experience emotional problems due to their disease, wh...

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare variant of porokeratosis with characteristic histological feature of cornoid lamella involving the acrosyringium. We report a classic case of a 20-year-old male, who clinically presented to us with keratotic papules and plaque with pits, few having comedo like plugs, on right pal...

The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update review...

cosmetic is defined as an "article intended to be rubbed, poured, sprinkled, or sprayed on the human body for the purpose of cleaning, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or function." [1] Appropriate skin care contributes to successful management of acne. Skin care needs to be ra...

A case of a 35-year-old lady with scleromyxoedema is reported. The lesions were initially urticarial plaques and nodules. Which evolved into a generalized lichenoid papular eruption. Bone marrow was normal.

In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients...

Leishmaniasis is a parasitic infection caused by many species of the protozoa Leishmania. It occurs in endemic foci scattered throughout Asia, Africa, the Americas, and the Mediterranean countries. The disease is complex and may simulate many skin and systemic diseases. With awareness and suspicion, however, leishmaniasis is relatively easy to diag...

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment...

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment...

A review of 288 skin biopsy specimens from cutaneous leishmaniasis lesions caused by Leishmania major showed assorted nerve changes in 14 biopsy specimens (5%). Ten patients had perineural inflammatory cell infiltrate consisting of either lymphocytes or a mixture of lymphocytes, plasma cells, and macrophages. Four patients had inflammatory cell inv...

In a study of cutaneous leishmaniasis (CL) caused by Leishmania major in Saudi Arabia, 10% of the patients were found to have subcutaneous nodules (SCN). The SCNs were usually inconspicuous, painless, and proximal to the primary skin lesions; when multiple, they showed a "sporotrichoid" configuration or appeared as "beaded cords." Their number rang...

Cutaneous leishmaniasis (oriental sore) is characterized by slowly evolving inflammatory lesion(s) that are nodular, noduloulcerative, or ulcerative and that heal spontaneously with scar(s) in 3 to 12 months. In the course of a comprehensive study of cutaneous leishmaniasis due to Leishmania major in an endemic focus in Saudi Arabia, seven clinical...

Thirteen patients with CL were studied. Their demographic and clinical information is recorded in Table 3. Two patients were children, and the rest were adults. Their mean age was 29 years (range 4 months to 62 years). Nine patients were males. Three patients were native Saudis, and the others included four Egyptians, two Indians, two Bangladeshis,...

The distribution and numbers of IgG-, IgA-, IgM-, and lysozyme-positive cells were investigated by the immunoperoxidase method in paraffin-sections of 13 cases of chronic cutaneous leishmaniasis of low parasite load from Saudi Arabia. The majority of the peroxidase-positive plasma cells contained IgG, whereas the numbers of IgA+ and IgM+ plasma cel...

Cutaneous leishmaniasis of the classical noduloulcerative variety is endemic in Al-Hassa, Saudi Arabia. In a clinical study in which 56 Saudi patients and 66 non-Saudi patients were examined, it was found that the Saudi patients were considerably younger and had significantly milder disease compared with the non-Saudi patients.

• In a two-year prospective study of cutaneous problems in orthopedic implant recipients, cutaneous eruptions of unknown cause that bore good temporal relationships with implant surgery occurred in 19 patients. Two clinical patterns were observed. A transient "exanthematic" dermatitis was seen in six patients; in two of them, it recurred after each...

Sequential testing for antinuclear antibody (ANA) in a group of 99 patients receiving long-term methoxsalen (PUVA [methoxsalen plus ultraviolet light]) therapy showed positive tests for ANA in the serum samples of 42 patients. In 22 patients, the ANA was persistent; in seven patients, it was transient; and in the other 13 patients, it developed nea...

In a two-year prospective study of cutaneous problems in orthopedic implant recipients, cutaneous eruptions of unknown cause that bore good temporal relationships with implant surgery occurred in 19 patients. Two clinical patterns were observed. A transient "exanthematic" dermatitis was seen in six patients; in two of them, it recurred after each s...

• Sequential testing for antinuclear antibody (ANA) in a group of 99 patients receiving long-term methoxsalen (PUVA [methoxsalen plus ultraviolet light]) therapy showed positive tests for ANA in the serum samples of 42 patients. In 22 patients, the ANA was persistent; in seven patients, it was transient; and in the other 13 patients, it developed n...

Scalp biopsies showed the well-known histology of alopecia areata and there were no obvious differences between the 10 biopsies. Direct immunofluorescence examination of biopsies was uniformly negative; so immunoglobulin, complement or fibrin were detected. Gastric parietal cell antibodies were present in one patient, and rheumatoid factor in anoth...

• Eight patients with mycosis fungoides (seven in plaque stage and one with tumors) were successfully treated with methoxsalen-ultraviolet-A (PUVA) photochemotherapy. A selective immunity evaluation had been carried out prior to starting treatment and was repeated seven to 33 months (mean, 22 months) later. The results of pre-PUVA and post-PUVA the...

Three new cases of congenital triangular alopecia are reported and the differential diagnosis of this rare developmental defect is discussed.