Meera Thomas - Academia.edu (original) (raw)

Papers by Meera Thomas

Research paper thumbnail of Congenital epulides: A rare case report

Indian journal of dental research : official publication of Indian Society for Dental Research

Congenital epulis (CE) or "Granular cell epulis" also previously termed as "Neuman... more Congenital epulis (CE) or "Granular cell epulis" also previously termed as "Neumann's tumor" is a benign growth arising from the mucosa of the gingiva, typically seen as a mass protruding from the infant's mouth, often interfering with respiration and feeding. These tumors generally present as a single mass arising from the upper alveolus. We report a rare case of two congenital epulides arising from the maxillary and mandibular alveolus in a day old female infant, which was surgically excised, allowing for early initiation of breast feeding. The tumor cells stained negative for S100 protein hence differentiating from other granular cell tumors. The clinical presentation, differential diagnosis in regard to the various neonatal oral swellings and the management of CE has been discussed.

Research paper thumbnail of Rare Manifestation of Sarcoidosis as Endobronchial Mass

Journal of Bronchology, 2008

Abstract Sarcoidosis is a systemic granulomatous disorder of unknown origin that most frequently ... more Abstract Sarcoidosis is a systemic granulomatous disorder of unknown origin that most frequently involves the hilar lymph nodes and lungs. Although granulomatous inflammation of the bronchial wall is not uncommon and may appear as nodules along the bronchial ...

Research paper thumbnail of Malignant tumours of the hand and wrist

Indian Journal of Plastic Surgery, 2011

Research paper thumbnail of Primary conjunctival tuberculosis in a 14 year old girl

The Indian Journal of Tuberculosis, 2011

Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjucti... more Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjuctiva is a rare entity. We report a 14-year-old girl who presented with unilateral eye discharge, watering, redness and itching for two weeks. Giant papillae were present on the upper tarsal conjunctiva. A provisional diagnosis of allergic conjunctivitis was made. Topical therapy with 1% Prednisolone acetate and 2% Sodium cromoglycate was commenced. The patient returned six months later with no improvement in the symptoms. The tarsal conjunctiva had a polypoidal, velvety appearance with giant papillae. A fibrinous membrane was seen over the tarsal conjunctiva and a preauricular node was found. Excision biopsy and histopathologic examination revealed necrotizing granulomatous inflammation suggestive of tuberculosis. Systemic examination and investigations were normal. She was started on anti-tuberculous therapy. In two months she showed complete resolution of symptoms and marked reduction in papillae and conjunctival thickening. Symptoms and signs of unilateral conjunctivitis may masquerade as primary conjunctival tuberculosis. In an endemic country like India, laterality, chronicity and non-resolution of symptoms with steroids are indications for pursuing a biopsy earlier than later. In our patient, the histopathology clinched the diagnosis of conjunctival tuberculosis resulting in a faster and complete resolution of the disease condition.

Research paper thumbnail of Clinical course of disseminated Kaposi sarcoma in a HIV and hepatitis B co-infected heterosexual male

Indian dermatology online journal

AIDS associated Kaposi sarcoma (AIDS-KS) was first reported from India in 1993. Since then only 1... more AIDS associated Kaposi sarcoma (AIDS-KS) was first reported from India in 1993. Since then only 16 cases have been reported. Three of them had proven Human Herpesvirus 8 (HHV-8) infection. We report a case of disseminated KS in a heterosexual male from India with HIV, hepatitis B and HHV-8 infection. He was given six cycles of chemotherapy with liposomal doxorubicin over three months to which he showed a good response. The case highlights the clinical course and management of a HHV-8 positive disseminated KS in a patient co-infected with Hepatitis B and HIV.

Research paper thumbnail of Oncogenic osteomalacia

The Journal of the Association of Physicians of India, 2007

A 59-year-old gentleman presented with symptoms of progressively worsening low back pain associat... more A 59-year-old gentleman presented with symptoms of progressively worsening low back pain associated with difficulty in rising from a squat over a period of two years. Biochemical tests confirmed the initial clinical diagnosis of osteomalacia. Blood pool scanning revealed a focal hot spot on the site of the clinically visible swelling close to the metacarpo-phalangeal joint of the left index finger. The biopsy of the specimen obtained by excision was reported to be consistent with a phosphaturic mesenchymal tumour. The patient had complete resolution of symptoms six months following excision of the lesion.

Research paper thumbnail of Proptosis and polyuria

Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2009

Research paper thumbnail of Novel multidrug therapy for disseminated rhinosporidiosis, refractory to dapsone – case report

Tropical doctor, 2013

Rhinosporidiosis is a chronic granulomatous disorder, caused by Rhinosporidium seeberi endemic in... more Rhinosporidiosis is a chronic granulomatous disorder, caused by Rhinosporidium seeberi endemic in India and Sri Lanka. The most common sites are the nasal mucosa and the nasopharynx and cutaneous lesions usually occur as a part of disseminated rhinosporidiosis. Dapsone has been frequently used in treating disseminated disease in immunocompetent individuals. Here we report a case of disseminated rhinosporidiosis in an immunocompromised individual on antiretroviral drugs, non-responsive to Dapsone and therefore treated with a multidrug therapy of Cycloserine, Dapsone and Ketoconazole with good response.

Research paper thumbnail of Primary conjunctival tuberculosis in a 14 year old girl

The Indian journal of tuberculosis, 2011

Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjucti... more Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjuctiva is a rare entity. We report a 14-year-old girl who presented with unilateral eye discharge, watering, redness and itching for two weeks. Giant papillae were present on the upper tarsal conjunctiva. A provisional diagnosis of allergic conjunctivitis was made. Topical therapy with 1% Prednisolone acetate and 2% Sodium cromoglycate was commenced. The patient returned six months later with no improvement in the symptoms. The tarsal conjunctiva had a polypoidal, velvety appearance with giant papillae. A fibrinous membrane was seen over the tarsal conjunctiva and a preauricular node was found. Excision biopsy and histopathologic examination revealed necrotizing granulomatous inflammation suggestive of tuberculosis. Systemic examination and investigations were normal. She was started on anti-tuberculous therapy. In two months she showed complete resolution of symptoms and marked reduction in...

Research paper thumbnail of Disseminated protothecosis

The Indian Journal of Pediatrics, 2009

Here is presented, a rare case of disseminated protothecosis in a 10-year-old boy with combined i... more Here is presented, a rare case of disseminated protothecosis in a 10-year-old boy with combined immunodeficiency, hitherto unreported from India. Even though it is difficult to diagnose clinically, observation of the sporangiospores within the sporangium in culture gives the accurate laboratory identification of Prototheca spp. In this patient, failure to eradicate the infection with amphotericin B and recurrence with olecranon bursitis along with skin lesions and splenomegaly was observed. Disseminated protothecosis in a child with combined immunodeficiency and failure to eradicate the infection with amphotericin B is reported.

Research paper thumbnail of Metachronous bilateral mucoepidermoid carcinoma of the parotid gland

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

We report a very rare case of bilateral muco-epidermoid carcinoma of the parotid gland that under... more We report a very rare case of bilateral muco-epidermoid carcinoma of the parotid gland that underwent bilateral parotidectomy with neck dissections and radiotherapy. This case has done well for three years and suggests that metachronous bilateral mucoepidermoid carcinoma of the parotid gland, if treated as per the merits of each side, has a reasonable survival.

Research paper thumbnail of Pediatric Onset Keratosis Lichenoides Chronica: A Case Report

Pediatric Dermatology, 2012

Keratosis lichenoides chronica (KLC) is an acquired keratinization disorder that is rare in child... more Keratosis lichenoides chronica (KLC) is an acquired keratinization disorder that is rare in childhood. We report a case of sporadic pediatric-onset KLC with seborrheic dermatitis-like lesions on the forehead, papules in a retiform pattern in the axillae and mons pubis, and eye and oral mucosal involvement,with additional features of premature canities and a transient photosensitive eruption.

Research paper thumbnail of A Novel X-Chromosomal Microdeletion Encompassing Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects

Pediatric Dermatology, 2013

We report an unusual phenotype of congenital hemidysplasia with ichthyosiform erythroderma and li... more We report an unusual phenotype of congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome most likely resulting from a novel X-chromosomal microdeletion encompassing the promoter region and exon 1 of the nicotinamide adenine dinucleotide phosphate steroid dehydrogenase-like protein gene, the neighboring gene CETN2, and more than 10 kb of noncoding deoxyribonucleic acid.

Research paper thumbnail of Role of imatinib in the treatment of pediatric onset indolent systemic mastocytosis: a case report

Journal of Dermatological Treatment, 2013

Mastocytosis is a sporadic disease characterized by an abnormal accumulation of mast cells (MCs) ... more Mastocytosis is a sporadic disease characterized by an abnormal accumulation of mast cells (MCs) in single or multiple organs. It has a heterogeneous clinical picture which is a reflection of underlying tissue MC burden, mediators released and the organs involved. Here, the authors report significant symptomatic, cutaneous and systemic response to imatinib in a case of childhood onset indolent D816V KIT unmutated systemic mastocytosis (SM). A 19-year-old female presented with a history of itchy skin lesions over the face, trunk and extremities since 6 months of age associated with recurrent bouts of angioedema. The skin and bone marrow examination were consistent with mastocytosis. No pathogenic mutations were detected in exons 8 and 17. In view of the severity of cutaneous symptoms and evidence of bone marrow involvement, she was treated with imatinib which resulted in marked improvement. Imatinib has a therapeutic role in the presence of an imatinib-sensitive KIT mutation or in KIT816-unmutated patients with aggressive SM. Its role in the treatment of indolent and cutaneous mastocytosis is less well established. However, the authors have demonstrated the usefulness of imatinib in the treatment of c-KIT-negative indolent SM with extensive cutaneous involvement.

Research paper thumbnail of Linear epidermolytic acanthoma of vulva: An unusual presentation

Indian Journal of Dermatology, Venereology and Leprology, 2010

Epidermolytic acanthoma (EA) is a rare benign tumor that shows epidermolytic hyperkeratosis (EH) ... more Epidermolytic acanthoma (EA) is a rare benign tumor that shows epidermolytic hyperkeratosis (EH) on histopathology. It can occur in a solitary or disseminated form. This condition needs to be distinguished from other hereditary or acquired conditions that may show EH. We diagnosed an unusual case of EA of the vulva presenting in a linear pattern in a 50-year-old lady based on the clinical features and typical histopathological findings and stress the importance of considering epidermolytic acanthoma in the differential diagnosis of verrucous lesions of the genitalia.

Research paper thumbnail of Different types of fungal sinusitis occurring concurrently: implications for therapy

European Archives of Oto-Rhino-Laryngology, 2013

Research paper thumbnail of Plasmacytoma Mimicking Mediastinal Parathyroid Tumour in a Patient with Primary Hyperparathyroidism

Asian Journal of Surgery, 2007

Research paper thumbnail of An Unusual Mediastinal Mass

The Annals of Thoracic Surgery, 2011

Research paper thumbnail of Acral pigmentation in alkaptonuria resembling degenerative collagenous plaques of the hands: A report of five cases

Journal of the American Academy of Dermatology, 2011

Research paper thumbnail of Congenital epulides: A rare case report

Indian journal of dental research : official publication of Indian Society for Dental Research

Congenital epulis (CE) or "Granular cell epulis" also previously termed as "Neuman... more Congenital epulis (CE) or "Granular cell epulis" also previously termed as "Neumann's tumor" is a benign growth arising from the mucosa of the gingiva, typically seen as a mass protruding from the infant's mouth, often interfering with respiration and feeding. These tumors generally present as a single mass arising from the upper alveolus. We report a rare case of two congenital epulides arising from the maxillary and mandibular alveolus in a day old female infant, which was surgically excised, allowing for early initiation of breast feeding. The tumor cells stained negative for S100 protein hence differentiating from other granular cell tumors. The clinical presentation, differential diagnosis in regard to the various neonatal oral swellings and the management of CE has been discussed.

Research paper thumbnail of Rare Manifestation of Sarcoidosis as Endobronchial Mass

Journal of Bronchology, 2008

Abstract Sarcoidosis is a systemic granulomatous disorder of unknown origin that most frequently ... more Abstract Sarcoidosis is a systemic granulomatous disorder of unknown origin that most frequently involves the hilar lymph nodes and lungs. Although granulomatous inflammation of the bronchial wall is not uncommon and may appear as nodules along the bronchial ...

Research paper thumbnail of Malignant tumours of the hand and wrist

Indian Journal of Plastic Surgery, 2011

Research paper thumbnail of Primary conjunctival tuberculosis in a 14 year old girl

The Indian Journal of Tuberculosis, 2011

Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjucti... more Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjuctiva is a rare entity. We report a 14-year-old girl who presented with unilateral eye discharge, watering, redness and itching for two weeks. Giant papillae were present on the upper tarsal conjunctiva. A provisional diagnosis of allergic conjunctivitis was made. Topical therapy with 1% Prednisolone acetate and 2% Sodium cromoglycate was commenced. The patient returned six months later with no improvement in the symptoms. The tarsal conjunctiva had a polypoidal, velvety appearance with giant papillae. A fibrinous membrane was seen over the tarsal conjunctiva and a preauricular node was found. Excision biopsy and histopathologic examination revealed necrotizing granulomatous inflammation suggestive of tuberculosis. Systemic examination and investigations were normal. She was started on anti-tuberculous therapy. In two months she showed complete resolution of symptoms and marked reduction in papillae and conjunctival thickening. Symptoms and signs of unilateral conjunctivitis may masquerade as primary conjunctival tuberculosis. In an endemic country like India, laterality, chronicity and non-resolution of symptoms with steroids are indications for pursuing a biopsy earlier than later. In our patient, the histopathology clinched the diagnosis of conjunctival tuberculosis resulting in a faster and complete resolution of the disease condition.

Research paper thumbnail of Clinical course of disseminated Kaposi sarcoma in a HIV and hepatitis B co-infected heterosexual male

Indian dermatology online journal

AIDS associated Kaposi sarcoma (AIDS-KS) was first reported from India in 1993. Since then only 1... more AIDS associated Kaposi sarcoma (AIDS-KS) was first reported from India in 1993. Since then only 16 cases have been reported. Three of them had proven Human Herpesvirus 8 (HHV-8) infection. We report a case of disseminated KS in a heterosexual male from India with HIV, hepatitis B and HHV-8 infection. He was given six cycles of chemotherapy with liposomal doxorubicin over three months to which he showed a good response. The case highlights the clinical course and management of a HHV-8 positive disseminated KS in a patient co-infected with Hepatitis B and HIV.

Research paper thumbnail of Oncogenic osteomalacia

The Journal of the Association of Physicians of India, 2007

A 59-year-old gentleman presented with symptoms of progressively worsening low back pain associat... more A 59-year-old gentleman presented with symptoms of progressively worsening low back pain associated with difficulty in rising from a squat over a period of two years. Biochemical tests confirmed the initial clinical diagnosis of osteomalacia. Blood pool scanning revealed a focal hot spot on the site of the clinically visible swelling close to the metacarpo-phalangeal joint of the left index finger. The biopsy of the specimen obtained by excision was reported to be consistent with a phosphaturic mesenchymal tumour. The patient had complete resolution of symptoms six months following excision of the lesion.

Research paper thumbnail of Proptosis and polyuria

Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2009

Research paper thumbnail of Novel multidrug therapy for disseminated rhinosporidiosis, refractory to dapsone – case report

Tropical doctor, 2013

Rhinosporidiosis is a chronic granulomatous disorder, caused by Rhinosporidium seeberi endemic in... more Rhinosporidiosis is a chronic granulomatous disorder, caused by Rhinosporidium seeberi endemic in India and Sri Lanka. The most common sites are the nasal mucosa and the nasopharynx and cutaneous lesions usually occur as a part of disseminated rhinosporidiosis. Dapsone has been frequently used in treating disseminated disease in immunocompetent individuals. Here we report a case of disseminated rhinosporidiosis in an immunocompromised individual on antiretroviral drugs, non-responsive to Dapsone and therefore treated with a multidrug therapy of Cycloserine, Dapsone and Ketoconazole with good response.

Research paper thumbnail of Primary conjunctival tuberculosis in a 14 year old girl

The Indian journal of tuberculosis, 2011

Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjucti... more Tuberculosis is a common disease in India. However, tuberculosis primarily affecting the conjuctiva is a rare entity. We report a 14-year-old girl who presented with unilateral eye discharge, watering, redness and itching for two weeks. Giant papillae were present on the upper tarsal conjunctiva. A provisional diagnosis of allergic conjunctivitis was made. Topical therapy with 1% Prednisolone acetate and 2% Sodium cromoglycate was commenced. The patient returned six months later with no improvement in the symptoms. The tarsal conjunctiva had a polypoidal, velvety appearance with giant papillae. A fibrinous membrane was seen over the tarsal conjunctiva and a preauricular node was found. Excision biopsy and histopathologic examination revealed necrotizing granulomatous inflammation suggestive of tuberculosis. Systemic examination and investigations were normal. She was started on anti-tuberculous therapy. In two months she showed complete resolution of symptoms and marked reduction in...

Research paper thumbnail of Disseminated protothecosis

The Indian Journal of Pediatrics, 2009

Here is presented, a rare case of disseminated protothecosis in a 10-year-old boy with combined i... more Here is presented, a rare case of disseminated protothecosis in a 10-year-old boy with combined immunodeficiency, hitherto unreported from India. Even though it is difficult to diagnose clinically, observation of the sporangiospores within the sporangium in culture gives the accurate laboratory identification of Prototheca spp. In this patient, failure to eradicate the infection with amphotericin B and recurrence with olecranon bursitis along with skin lesions and splenomegaly was observed. Disseminated protothecosis in a child with combined immunodeficiency and failure to eradicate the infection with amphotericin B is reported.

Research paper thumbnail of Metachronous bilateral mucoepidermoid carcinoma of the parotid gland

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

We report a very rare case of bilateral muco-epidermoid carcinoma of the parotid gland that under... more We report a very rare case of bilateral muco-epidermoid carcinoma of the parotid gland that underwent bilateral parotidectomy with neck dissections and radiotherapy. This case has done well for three years and suggests that metachronous bilateral mucoepidermoid carcinoma of the parotid gland, if treated as per the merits of each side, has a reasonable survival.

Research paper thumbnail of Pediatric Onset Keratosis Lichenoides Chronica: A Case Report

Pediatric Dermatology, 2012

Keratosis lichenoides chronica (KLC) is an acquired keratinization disorder that is rare in child... more Keratosis lichenoides chronica (KLC) is an acquired keratinization disorder that is rare in childhood. We report a case of sporadic pediatric-onset KLC with seborrheic dermatitis-like lesions on the forehead, papules in a retiform pattern in the axillae and mons pubis, and eye and oral mucosal involvement,with additional features of premature canities and a transient photosensitive eruption.

Research paper thumbnail of A Novel X-Chromosomal Microdeletion Encompassing Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects

Pediatric Dermatology, 2013

We report an unusual phenotype of congenital hemidysplasia with ichthyosiform erythroderma and li... more We report an unusual phenotype of congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome most likely resulting from a novel X-chromosomal microdeletion encompassing the promoter region and exon 1 of the nicotinamide adenine dinucleotide phosphate steroid dehydrogenase-like protein gene, the neighboring gene CETN2, and more than 10 kb of noncoding deoxyribonucleic acid.

Research paper thumbnail of Role of imatinib in the treatment of pediatric onset indolent systemic mastocytosis: a case report

Journal of Dermatological Treatment, 2013

Mastocytosis is a sporadic disease characterized by an abnormal accumulation of mast cells (MCs) ... more Mastocytosis is a sporadic disease characterized by an abnormal accumulation of mast cells (MCs) in single or multiple organs. It has a heterogeneous clinical picture which is a reflection of underlying tissue MC burden, mediators released and the organs involved. Here, the authors report significant symptomatic, cutaneous and systemic response to imatinib in a case of childhood onset indolent D816V KIT unmutated systemic mastocytosis (SM). A 19-year-old female presented with a history of itchy skin lesions over the face, trunk and extremities since 6 months of age associated with recurrent bouts of angioedema. The skin and bone marrow examination were consistent with mastocytosis. No pathogenic mutations were detected in exons 8 and 17. In view of the severity of cutaneous symptoms and evidence of bone marrow involvement, she was treated with imatinib which resulted in marked improvement. Imatinib has a therapeutic role in the presence of an imatinib-sensitive KIT mutation or in KIT816-unmutated patients with aggressive SM. Its role in the treatment of indolent and cutaneous mastocytosis is less well established. However, the authors have demonstrated the usefulness of imatinib in the treatment of c-KIT-negative indolent SM with extensive cutaneous involvement.

Research paper thumbnail of Linear epidermolytic acanthoma of vulva: An unusual presentation

Indian Journal of Dermatology, Venereology and Leprology, 2010

Epidermolytic acanthoma (EA) is a rare benign tumor that shows epidermolytic hyperkeratosis (EH) ... more Epidermolytic acanthoma (EA) is a rare benign tumor that shows epidermolytic hyperkeratosis (EH) on histopathology. It can occur in a solitary or disseminated form. This condition needs to be distinguished from other hereditary or acquired conditions that may show EH. We diagnosed an unusual case of EA of the vulva presenting in a linear pattern in a 50-year-old lady based on the clinical features and typical histopathological findings and stress the importance of considering epidermolytic acanthoma in the differential diagnosis of verrucous lesions of the genitalia.

Research paper thumbnail of Different types of fungal sinusitis occurring concurrently: implications for therapy

European Archives of Oto-Rhino-Laryngology, 2013

Research paper thumbnail of Plasmacytoma Mimicking Mediastinal Parathyroid Tumour in a Patient with Primary Hyperparathyroidism

Asian Journal of Surgery, 2007

Research paper thumbnail of An Unusual Mediastinal Mass

The Annals of Thoracic Surgery, 2011

Research paper thumbnail of Acral pigmentation in alkaptonuria resembling degenerative collagenous plaques of the hands: A report of five cases

Journal of the American Academy of Dermatology, 2011