The

Introduction: This case report highlighting the presence of keratoacanthoma and verruca vulgaris over the lesion of porokeratosis of mibelli. Case Report: In this case a 50-year-old housewife came with large well-defined asymptomatic plaque over the upper part of back of the trunk for last 10 years. After evaluation we got the presence of keratoacanthoma and verruca vulgaris on the plaque of porokeratosis of mibelli. Discussion: Porokeratosis is a clonal expansion of keratinocytes. Among the neoplasm squmous cell carcinoma (SCC) is the most commonly reported malignancy in porokeratosis. But in our case we didn’t find lesion of SCC. Porokeratosis of Mibelli, Keratoacanthoma and Verruca vulgaris have an association with human papilloma virus(HPV). This eithopathogenesis may be related to our clinical finding. Conclusion: There were reporting of squmous cell carcinoma or keratoacanthoma on Porokeratosis of Mibelli. But in our case we found both Keratoacanthoma and Verruca Vulgaris over Porokeratosis of Mibelli. Medicine Today 2021 Vol.33(2): 172-175

Introduction: Red blood cell distribution width (RDW) has been considered as an inflammatory marker in various disorders. Evaluation of RDW value can also be used as a novel and additional marker for differentiating systemic vasculitis from primary cutaneous vasculitis. Objective: To compare RDW value between patients with cutaneous vasculitis with systemic vasculitis, thereafter to find out it's role as an effective indicator to distinguish both forms of vasculitis. Materials and Methods: This cross sectional observational study was conduct between from July 2016 to December 2017. Total of 48 patients were divided into primary cutaneous vasculitis and systemic vasculitis. Blood was collected in EDTA tube to measure RDW value. Patient’s disease activity also scored and plotted according to Birmingham vasculitis activity score. Statistical analysis was performed by using SPSS. Results: Significantly high mean RDW were found in patients with systemic vasculitis compared to primary cutaneous vasculitis (15.09±0.92 vs. 13.48±1.1, p = 0.000). BVAS was significantly greater (13.93±5.10 vs. 4.87±2.69, p = < 0.001) in systemic vasculitis as well as in patients with high RDW group (11.73±5.71 vs. 5.37±3.96, p = < 0.001). Optimal RDW cut off point for differentiating systemic vasculitis from cutaneous vasculitis was 14.2 with 81.3% sensitivity and 81.2% specificity.  Conclusion: Present study revealed importance of RDW monitoring along with disease activity in patients with any form of vasculitis. Systemic vasculitis had higher level of RDW. So RDW can be considered as a marker to discriminate systemic vasculitis from primary cutaneous vasculitis. Medicine Today 2021 Vol.33(2): 84-89