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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
A Case of Facial Discoid Lupus Erythematosus (LE) with Oral Lichen Planus (LP): A Dig into Co-existence and LE-LP Overlap
Correspondence Address :
D Manoharan,
Professor, Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical
College and Hospital, #7, C.L.C. Works Road, Shankar Nagar, Chromepet,
Chennai-600044, Tamil Nadu, India.
E-mail: drmanomd@yahoo.co.in
A distinction between ‘co-existence of Lupus Erythematosus (LE) and Lichen Planus (LP)’ and ‘LE-LP overlap’ bears importance as the criterion for true overlap necessitates histological and immunological features of both LE and LP to be found in the same tissue specimen. However, in the present case report the lesions of LE and LP were present in two different sites. A 51-year-old male presented with a large erythematous scaly atrophic plaque on the right cheek with similar lesions on chin and lips for 10 years. He also had violaceous lesions on the bilateral buccal mucosa and a white lesion over the left buccal mucosa for three years. Discoid Lupus Erythematosus (DLE) and Oral Lichen Planus (OLP) were suspected. Dermoscopy of the facial plaque showed features consistent with DLE. Histopathology of the facial plaque confirmed the diagnosis of DLE, whereas the white plaque on the left buccal mucosa showed features of early invasive squamous cell carcinoma. Violaceous lesion over the right buccal mucosa showed features suggesting OLP. A Direct Immunofluorescence (DI) was also performed for the buccal mucosa to rule out the possibility of DLE with oral involvement, which turned out to be negative. Therefore, a diagnosis of synchronous presentation of DLE and OLP along with Squamous Cell Carcinoma (SCC) of the buccal mucosa was made and patient was treated with topical corticosteroids, systemic hydroxychloroquine and surgical intervention for the squamous cell carcinoma. It is also imperative that not only long standing cutaneous lesions, but also oral lesions like LP should be investigated and kept under observation to look for any early malignant changes.
Dermoscopy, Direct immunofluorescence, Follicular plugging, Oral squamous cell carcinoma, White rosettes
A 51-year-old male patient, painter by occupation presented with a red, scaly and atrophic plaque on the right cheek since past 10 years. Patient had similar lesions on the chin and lips as well. The lesions started as mildly erythematous pruritic patches which gradually evolved over years to reach the current state. There was history of photosensitivity as he complained of burning sensation over the lesion on sun exposure. There was no history of chronic drug intake. There were no lesions elsewhere on the body. There was history of similar lesions in the family.
The patient also complained of multiple bilateral oral lesions over the buccal mucosa for three years. He had pain and irritation while chewing and deglutition. He was a chronic smoker (nine pack-years) and also chewed tobacco for 18 years. He also consumed alcohol (30-60 mL of country liquor twice weekly for past 10 years). There was no history of application of dental amalgam. He did not give any history of systemic co-morbidities or loss of weight or appetite.
On examination, the plaque over right cheek measured approximately 10×6 cm and extended from below the zygomatic bone upto the chin. It showed prominent erythema, adherent scaling, atrophy and scarring with few areas showing loss of hair. There was central depigmentation and peripheral hyperpigmentation (Table/Fig 1). The surface was rough and borders were well-defined. No discharge was noted. The lesion did not show warmth or tenderness. Regional lymphnodes were non palpable. There was no growth over the surface. The lesion did not bleed on touch. The lesions on the chin and lips showed similar findings. Based on clinical morphology, a primary diagnosis of DLE was made.
The buccal mucosa showed erythematous and violaceus plaques over bilateral walls. Mild superficial erosions were noted. The tongue, palate and gums were free from involvement. There was poor dental hygiene and tobacco stains on the teeth noted. The plaque on the left buccal mucosa showed development of superficial white adherent patch (Table/Fig 1).
A dermoscopy was performed from the right cheek which was suggestive of DLE, showing the following features: prominent follicular openings with perifollicular scaling and erythema, diffuse superficial scaling, ‘white rosettes’, peppery brown pigmentation, pinkish white background of erythema and white structureless areas (Table/Fig 2). Complete blood counts, erythrocyte sedimentation rate, liver function tests, renal function tests were done for the patient which were normal. Furthermore, to confirm the suspicion of DLE, a skin biopsy was performed two weeks after the first visit, which showed: hyperkeratosis, follicular plugging, moderate acanthosis, basal cell degeneration and patchy lympho-histiocytic infiltrate in the upper dermis (Table/Fig 3)a,b. These features were therefore conclusive of DLE. Antinuclear antibody test was done in view of DLE and it was negative.
The patient was seronegative for Human Immunodeficiency Virus (HIV), Hepatitis B surface antigen (HBsAg) and Hepatitis C Virus (HCV). The lesions over the left buccal mucosa were suspected to be leukoplakia and a biopsy from the patch was performed. It showed features of squamous cell carcinoma: dysplastic epithelium with cellular and nuclear pleomorphism, nuclear hyperchromatism, individual cell keratinisation, loss of cohesion, altered mitotic activity and intra epithelial keratin pearl formation (Table/Fig 4). However, for the violaceous lesions over the bilateral buccal mucosa, it was suspected OLP (erosive type) and a biopsy was performed from the right buccal mucosa which showed following features: hyperkeratosis, parakeratosis, spongiosis with irregular acanthosis, marked basal cell degeneration with a band like lymphocytic infiltrate in the upper dermis (Table/Fig 5). These histopathological findings favoured OLP. A Direct Immunofluorescence (DIF) from the right buccal mucosa for IgG, Immunoglobulin G (IgG) and C3 was negative, which confirmed the oral lesion to be LP and not DLE with oral involvement. With this, it was concluded as a diagnosis of SCC invoving left buccal mucosa, bilateral OLP and DLE on the external skin, i.e., right cheek, lips.
For the facial plaque, the patient was started on topical clobetasol propionate 0.05% ointment and systemic hydroxychloroquine 200 mg once daily. The OLP lesions were treated with alternate day applications of triamcinolone acetonide and tacrolimus. For the OSCC, patient was referred to the surgical oncologist who performed a wide local excision with split thickness skin graft and sentinel node biopsy followed by supra omohyoid neck dissection. Postoperatively, patient was given adjuvant radiotherapy. Four months after radiotherapy, the patient was comfortable and had a scar over the left buccal mucosa. The patient is still under treatment for DLE and OLP which shows mild improvement.
Discoid lupus erythematosus is the most common subset of chronic cutaneous LE. Photosensitivity, trauma, drugs, infections etc., can exacerbate lesions. Atrophy, scarring and central depigmentation are key diagnostic features (1). OLP presents as whitish streaks forming a lace like network on the buccal mucosa. Several clinical types have been reported viz., reticular, bullous, erosive, atrophic and plaque like (2).
Since the first case reported in 1977, LE-LP overlap syndrome has been a topic of deliberation (3). The histological and immunological features of this entity blend with both diseases involved, thereby creating a quandary. The terms ‘co-existence’ and ‘overlap’ may create confusion and need to be delineated clearly (4). Some reports have suggested a high incidence of Oral Squamous Cell Carcinoma (OSCC) in OLP patients and have implicated OLP as a premalignant lesion (4). Patients with OLP, particularly the erosive type, have an increased incidence of OSCC development and should be monitored closely (5). Lupus Erythematosus-Lichen Planus overlap syndrome (also known as Lupus Planus) was first proposed in 1977 by Romero and later established by Nagao K and Chen KR (6),(7). Current criterion for ‘true overlap’ necessitates histological and immunological features of both LE and LP to be found in conjunction in the same tissue specimen. If not so, the term ‘co-existence’ is more apt (6).
Lupus Erythematosus-Lichen Planus overlap has been reported in approximately 50 cases in the past (7). The DIF shows presence of IgG, granular C3 and IgM deposits (suggestive of LE) and cytoid body staining with shaggy fibrinogen along the basement membrane zone (suggestive of LP) (7). Early DLE dermoscopically presents as erythema, telangiectasias, diffuse white scaling, keratotic follicular plugging, perifollicular halo etc., late lesions present as white structureless areas, blue grey globules, dotted vessels etc. The presence of ‘white rosettes’ under polarised light due to hyperkeratosis of follicular infundibulum is considered as a specific clue to the diagnosis of DLE among all inflammatory dermatoses is also noted in the case being reported (8). OLP can have a benign self-limiting course to more florid manifestations deeply affecting patients’ quality of life. The erosive form of OLP may give rise to malignancies (9).
Kiyani A et al., have reported a case of SLE with OLP (reticular type). The author has mentioned about the ‘co-existence’ of both conditions with negative DIF assay of the oral mucosa for IgG, IgM, IgA or C3. This goes against the criteria of true LE-LP overlap and thereby they have considered it as a synchronous presentation/co-existence (10). This is similar to the present case where the DIF assay was negative with the additional finding of squamous cell carcinoma over the buccal mucosa.
Lupus Erythematosus and Lichen Planus are two distinct clinical entities. The autoimmune aetiopathology triggers the onset in both and thereby forms the link to ‘overlap’ or ‘co-existence’ as seen.
The main aetiological factors of OSCC are tobacco, alcohol, and emotional stress. Out of these factors, the patient described here presented chronic tobacco and alcohol consumption, which possibly influenced the occurrence of LP and the later occurrence of squamous cell carcinoma. Early detection of premalignant lesions and oral cancer is essential for achieving favourable prognosis (11).Tobacco and smoking were found to be confounders in this case.
In conclusion, considering that OLP is a relatively a common disease with malignant potential, the case highlights the need for early treatment and follow-up of precancerous oral lesions. This case of co-existing LE and LP in the same individual is being presented in order to highlight the importance of DIF technique to confirm such an association. Early oral biopsy is advised in all patients presenting with precancerous lesions such as leukoplakia, ulceration, erythroplakia, or LP in order to improve the quality of life.
DOI: 10.7860/JCDR/2022/52554.16050
Date of Submission: Sep 25, 2021
Date of Peer Review: Nov 17, 2021
Date of Acceptance: Dec 01, 2021
Date of Publishing: Mar 01, 2022
AUTHOR DECLARATION:
• Declaration of Financial or other Conflicts Of Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 27, 2021
• Manual Googling: Dec 01, 2021
• iThenticate Software: Jan 12, 2022 (5%)
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