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International Journal of Research in Dermatology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2455-4529
Published by Medip Academy Homepage  [12 journals]
  • Clinical and economic burden of psoriasis: a retrospective study of the
           cost implications among cohorts in Abuja, Nigeria

    • Authors: Bob A. Ukonu, Perpetua U. Ibekwe
      Pages: 443 - 449
      Abstract: Background: Psoriasis is a common chronic cutaneous inflammatory disorder of the skin which presents as sharply demarcated scaly erythematous papules or plaques. The level of its clinical severity at presentation largely determines the cost implications and economic burden on the patient. The study aimed to determine the direct cost of treating various clinical severity of psoriasis and its economic consequences to our healthcare system.Methods: This is a retrospective study that was conducted between May 2016 and October 2019 at the Dermatology Unit of University of Abuja Teaching Hospital. Data was retrieved from patient’s folder into a designed proforma, noting their biodata, clinical level of severity using psoriasis area severity index (PASI) score, amount of money spent on drugs, laboratory test, nursing time and consultation fees. Results: Out of 82 psoriasis patients seen during the study period, 66 fulfilled the inclusion criteria. About 51.5% of them had severe psoriasis with a mean PASI score 33.2. The annual cost of treating mild, moderate and severe psoriasis was N198,900.00, N261,633.00 and N323,708.00 respectively. This accounted for 1.77% of the national annual healthcare spending within the years under review.Conclusions: The cost of treating psoriasis and its economic burden is largely determined by the level of its clinical severity.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202646
      Issue No: Vol. 6, No. 4 (2020)
       
  • Assessment of anti-ageing effects of oral choline-stabilized orthosilicic
           acid on hair, skin and nails: an open label, non-randomized interventional
           study

    • Authors: B. S. Chandrashekar, Chaithra Shenoy, Dharmesh Kumar Kheni, Varun Sureja
      Pages: 450 - 455
      Abstract: Background: Ageing is a continuous process and efforts are being made to reverse or rather slow the process. It is evident through changes in the skin, hair and nails. Due to changes in these, aesthetic appearance is compromised. Choline-stabilized orthosilicic acid (ch-OSA®) has shown results in improving skin, hair and nail health. The aim of the present study was to assess these effects in the Indian population taking oral ch-OSA®.Methods: Randomly selected 39 participants were assigned to 4 groups to study alopecia, hair quality, skin health and nail health. Ch-OSA®was administered for 5 months. Assessment was made at baseline, 2, 3 and 5 months. After this ch-OSA®was stopped and further assessment was made at 8 months.Results: There was a significant improvement in terms of all the 11 parameters related to alopecia and hair quality from baseline to 8 months (p<0.001). Most of the participants reported grade-1 skin wrinkling at 5 or 8 months. Skin hydration also improved significantly after the ch-OSA® administration. Greater percentage of participants reported of reduced roughness and dyschromia at the end of the study. Nail parameters were also significantly improved. No side-effect was reported by the participants throughout study.Conclusions: Oral intake of ch-OSA® showed significant beneficial effects on the health of hair, skin and nails with good tolerability.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202444
      Issue No: Vol. 6, No. 4 (2020)
       
  • Clinico-etiological study of pediatric dermatoses in tertiary health care
           hospital in East-coast Andhra Pradesh, India

    • Authors: Indira Bonthu, Suruthi Purushothaman, Nivedita Devi Vukkadala
      Pages: 456 - 462
      Abstract: Background: Pediatric dermatoses vary vastly from adult dermatoses in clinical presentation, treatment and prognosis and are more influenced by socioeconomic status, climatic exposure, dietary habits, external environment, thereby needing a special view in this field. The present study was carried to determine the clinico-epidemiological patterns of pediatric dermatoses.Methods: Consecutive 2581 children aged >1 month to 12 years with 2661 dermatoses attending dermatology OPD in tertiary care hospital, Kakinada (May 2018 to June 2019) with clinical evidence of cutaneous disorder were studied. Complete history and cutaneous examination with necessary investigations are recorded.Results: Infestations disorder in 39.68% followed by eczematous disorder 19.80%, infection in 13.71%, pigmentary disorder in 8.34%, papulosquamous disorder in 5.82%, appendageal disorder in 2.93%, nutritional disorder in 2.21% and drug reactions including toxic epidermal necrolysis in 1.12%, child abuse and sexually transmitted diseases in 0.37% was the pattern in the present study. Rare cases including aplasia cutis, cutis laxa, ectodermal dysplasia, monilethrix and griscelli syndrome, epidermolysis bullosa, ichthyosis, palmoplantar keratoderma and congenital syphilis were also observed. The most common cutaneous dermatoses are infection and infestations followed by eczemas and nutritional disorders. Surprisingly STD and child abuse contributed significantly which cannot be neglected. Genodermatosis were notable in the study probably due to the high incidences of consanguineous marriageConclusions: The study reinforces features of tropical paediatric dermatology especially high prevalence of infections and infestations in school children (5-12 years) which highlights the need of proper counselling of caretaker regarding skin hygiene and establishment of specialized paediatric dermatology clinics.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202647
      Issue No: Vol. 6, No. 4 (2020)
       
  • Topical steroid abuse in commercial workers: a cross-sectional analytical
           study in a tertiary care center

    • Authors: Sarankumar Sudhakar, Kayalvizhi V. A., Syediqbal Sikkanthar, Madhanchand Muthukrishnan
      Pages: 463 - 467
      Abstract: Background: Abuse of topical corticosteroids (TCs), especially over the face, is prevalent worldwide with India as no exception. Lack of adequate specialist services, the practice of self-medication and easy access over the counter (OTC) has resulted in widespread abuse. Aim of this study was to assess the magnitude of topical steroid abuse and its diverse cutaneous side effects in commercial sex workers.Methods: A cross-sectional analytical study was conducted among commercial sex workers (both females and transgender) attending the STI clinic in the study institution for 6 months. A semi-structured questionnaire was given and type of steroid cream used, frequency, duration, the reason for application and source of information for its use were recorded. Clinical patterns of side-effects were noted. Clinical photographs were taken. Descriptive statistical analysis was done, (SPSS 21.0).Results: Out of the total 180 commercial sex workers (CSWs), 80 were transgender and 100 were females. The most common steroid used was betamethasone valerate followed by the triple regimen containing mometasone. The reasons for TCs use were fairness (72%) followed by melasma (18%) and acne (10%). Side effects were seen in 77.5% of transgender and 66% of female CSWs. Common side effects noted were erythema (40%), acne (26%) and, pigmentation (18%).Conclusions: The main reason for TCs abuse in our country as a fairness agent is obsessiveness with fair skin colour. Various studies on TCs abuse were done in the general population but none of the studies focuses on a particular group as in this study.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202648
      Issue No: Vol. 6, No. 4 (2020)
       
  • A clinic epidemiological study of cutaneous markers of internal malignancy

    • Authors: Jyothi Sri Teki, Satya Sri Teki
      Pages: 468 - 473
      Abstract: Background: The skin provides important clues to many systemic diseases. Changes in the skin can be a marker for internal malignancies. If any cutaneous disorder associated with malignancy can be recognized early, it paves way to rapid diagnosis and treatment of the underlying malignancy. we made such an attempt to recognize cutaneous disorders in 40 patients suffering with internal malignancies at government general hospital, Guntur attending dermatology and radiology departments.Methods: Patients with internal malignancy having specific features were included in our study. Biopsy was done in every patient. The present study lasted for 21 months i.e., from January 2008 to September 2009.Results: We found that carcinoma cervix was the most common malignancy in females and bronchogenic carcinoma in males associated with cutaneous markers. The markers observed were pruritus, acquired lymphorroids, para neoplastic pemphigus, acquired icthyosis and disseminated granuloma annulare. Cutaneous markers were observed within 6 months from onset of internal malignancies.Conclusions: Recognition of any para-neoplastic skin disorders should raise suspicion for an internal malignancy which helps in rapid diagnosis and treatment of underlying malignancy.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202649
      Issue No: Vol. 6, No. 4 (2020)
       
  • Clinico-pathological study of cases of histoid leprosy

    • Authors: Kaveri M., Vishal V. Wali
      Pages: 474 - 478
      Abstract: Background: Rare variants of leprosy pose a diagnostic challenge and histoid leprosy is one such form of disease with unique clinical and histopathological features. The objective of the study was to study clinical and histopathological features of histoid leprosy.Methods: A prospective observational study was conducted at M. R. Medical College and Basveshwar teaching and general hospital, Kalaburagi from July 2018 to October 2019. Newly diagnosed and histologically proven cases were included.Results: Histologically confirmed histoid leprosy accounted for 8 cases (7 males and 1 female). Mean age of the patients was 44.5 years. Patients presented with papules, plaques and nodules over an apparently normal skin. Bacterial index ranged from 4+ to 6+ according to Ridley index. Histopathology showed circumscribed lesion with free sub-epidermal grenz zone and spindle shaped cells.Conclusions: As bacillary load is very high in these patients, they can form a potential reservoir of infection in the community especially in post leprosy elimination era.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202650
      Issue No: Vol. 6, No. 4 (2020)
       
  • A clinical study of geriatric dermatoses in Dharmapuri district, Tamil
           Nadu, India

    • Authors: S. Anitha
      Pages: 479 - 483
      Abstract: Background: Geriatric dermatoses are one of the most common reasons for day-to-day consultation in the elderly. Over the past few years, understanding of the pathophysiology of skin changes in the geriatric age group has improved and has paved the way for better therapeutic options. This article reviews the various physiological and pathological changes of aging, dwelling on the role of intrinsic and extrinsic factors in the pathogenesis of aging skin. To describe the clinical pattern of various dermatological disorders in the elderly.Methods: The study was conducted in the department of Dermatology, Venereology, Leprosy, at Dharmapuri Medical College, Dharmapuri. Totally 150 members were included in the study, who are above the age of 60 years. Thorough systemic and dermatological examination done. Investigations like complete blood count, liver function test, renal function test, random blood sugar were done.Results: Xerosis was seen most commonly in this study in 96 cases (33.2%), followed by wrinkling in 84 cases (29.1%), immunoglobulin heavy in 72 cases (25.0%), senile comedones 25 cases (8.6%), and senile lentigines in 12 case (4.1%). In some of these cases, a combination of the above findings was seen.Conclusions: In this study, various physiological signs of aging were studied, which is an inescapable process along with the pathological changes. These changes in photoaging were superimposed with intrinsic aging. Although most of the changes studied were harmless to the elderly, few have an adverse impact on the lives, which included chronic actinic dermatitis and conditions such as malignancy.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202651
      Issue No: Vol. 6, No. 4 (2020)
       
  • Overview of exanthems: a case series in a tertiary care hospital

    • Authors: Ramesh A., Thamizhinian K.
      Pages: 484 - 492
      Abstract: Background: Generalized rashes are the most common conditions seen by primary care physician and the most common reason for new patient visit to dermatologists. There is often difficulty in diagnosing a generalized rash because many conditions produce similar rashes and a single condition can result in rashes with varied appearance. Accurate diagnosis is important because treatment varies depending on the cause. Hence, we decided to undertake a steady on the various presentations of exanthems in Madras medical college Chennai. To find out the incidence of exanthems in the OPD of Department of Dermatology, Venerology and Leprosy (DVL) in Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai to help in early diagnosis and treatment of the diseases.  Methods: The study included all the newly diagnosed cases attending to the OPD of DVL, Madras Medical College, Chennai for a period of three months. Diagnosis was done based on clinical grounds and lab investigations were done whenever required.Results: An analytical study of the medical records of patients attending the OPD of DVL, Madras Medical College, Chennai shows that maculopapular rash is the most common presentation of exanthems followed by papules, vesiculobullous, pustular, nodules, verrucous lesions.Conclusions: The present study includes exanthems as a whole on contrary to many such studies performed in other parts of India which included rashes caused by viral infections and drugs. Our study included generalized skin eruptions due to infections, drugs, specific dermatoses, allergy.   
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202652
      Issue No: Vol. 6, No. 4 (2020)
       
  • A clinico-epidemiological study of various keratinization disorders

    • Authors: Bharti K. Patel, Nilam K. Selot, Neela V. Bhuptani, Pooja R. Raja
      Pages: 493 - 498
      Abstract: Background: There is a vast spectrum of disorders with basic defect in the process of keratinization. There are various associations (genetic, autoimmune and environmental) with different keratinization disorders. The aims and objectives of this study to study the epidemiology, clinical features and associations in various keratinization disorders.   Methods: A retrospective observational study of 500 patients was done in a tertiary care center. Detailed history was taken and clinical examination was done. Investigations and skin biopsy were performed when needed.Results: In our study of 500 cases of keratinizing disorders, there were 269 (53.8%) cases of psoriasis, 132 (26.4%) cases of  palmoplantar keratoderma, 22 (4%) cases of phrynoderma, 19 (3.8%) cases of ichthyosis, 13 (2.6%) cases of acanthosis nigricans, 11 (2.2%) cases of porokeratosis, 7 (1.4%) cases of Darier’s disease, 3 (0.6%) Cases of pityriasis rubra pilaris, 2 (0.4%) cases each of pachyonychia congenita and erythron keratoderma. The most common age group affected was 51-60 years (19.6%). Males to female ratio was 1.13:1. Chronic plaque psoriasis (43.51%) was the most common variant of psoriasis. Psoriasis vulgaris (75%) was the most common cause of erythroderma. Histopathological findings in all patients whose biopsy was taken was consistent with clinical diagnosis. Non trans gradient (97.75%) was the most common type of palmoplantar keratoderma. Ichthyosis vulgaris (47.38%) was the most common type of ichthyosis.Conclusions: Heredity plays an important role in keratinization disorders. Also, various comorbidities have been associated with different keratinization disorders. Hence, we need to look for these factors while evaluating the patients of keratinization disorders.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202653
      Issue No: Vol. 6, No. 4 (2020)
       
  • A study of cutaneous morphological patterns of adverse drug reactions in
           tertiary care center, Chitradurga, Karnataka, India

    • Authors: Nikitha Babu, Yogendra M., Raghu M. T., Virupakshappa H. E., Ashwini S., Purva Kunda
      Pages: 499 - 501
      Abstract: Background: An adverse cutaneous drug reaction is an undesirable change in structure and function of skin, its appendages or mucous membrane due to drugs. The main aim of this study is to detect the pattern of adverse cutaneous drug reaction in a tertiary care hospital of Chitradurga district, Karnataka, India.Methods: A Hospital based cross sectional study was performed in a tertiary care hospital, Chitradurga for 6 months from January 2019 to June 2019. For each case, data regarding age, sex of the patient, clinical history, past history and comorbidities, name of suspected drugs, duration between drug intake and onset of reaction, morphology of drug eruption, associated mucosal or systemic involvement were analyzed.Results: During the 8 months study period, 30 patients have attended the dermatology outpatient department with cutaneous adverse drug reaction. Majority of the patients were in the age group 20-39 years and the male to female ratio was 1.1:1. The commonest drug reaction pattern observed was the maculopapular rash (40%), urticaria (20%), fixed drug eruption (5%), Stevens Johnson syndrome (10%), toxic epidermal necrolysis (6.7%) and exfoliative dermatitis (6.7%). Commonest drugs producing reactions were diclofenac (30%), amoxycillin (23.3%), carbamazepine (20%), anti-tubercular drugs (16.7%), phenytoin (6.7%) and dapsone (3.3%).Conclusions: Knowledge of the pattern and the offending drug helps in better management and reduced complications in these patients and also help in preventing recurrences.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202654
      Issue No: Vol. 6, No. 4 (2020)
       
  • Clinico-etiological study of erythroderma cases from tertiary care
           hospital, Chitradurga, Karnataka, India

    • Authors: Harish Gangaraju, Raghu M. T., Yogendra M., Virupakshappa H. E., Ashwini S., Rakesh Y. R.
      Pages: 502 - 504
      Abstract: Background: Erythroderma is a cutaneous morphological reaction pattern of skin having many underlying causes and finding the etiology helps in the proper management of erythroderma cases.Methods: A cross sectional study was performed at the department of dermatology, Basaveshwara Medical College, Hospital and Research center, Chitradurga.
      Authors studied 30 consecutive cases of erythroderma from July 2017 to June 2019 with respect to the epidemiological, clinical and histological data. Clinico-histological correlation was analyzed for etiology of erythroderma.Results: The mean age of onset was 35.03 years with a male to female ratio of 3:2. In addition to erythrema and scaling that were present in all patinets, other co-existent features included were pruritus (43.3%), fever (23.3%), and edema (16.7%). Of the pre-existing dermatoses, psoriasis was the most common (36.6%) disease followed by eczema (26.7%), drug-induced erythroderma (16.7%), colloidan baby (3.3%), pityriasisrubrapilaris (3.3%) and in 13.3% of cases, etiology could not be ascertained. Clinico-histopathological correlation could be established in 73.3% of cases.Conclusions: In all erythroderma cases cutaneous features were identical irrespective of etiology. Detailed history, clinico-histopathological examination and other necessary haematological investigations helps to establish the etiology of erythroderma which helps in further management.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202655
      Issue No: Vol. 6, No. 4 (2020)
       
  • Evaluation of ustekinumab treatment in psoriasis and the potential effect
           of metabolic syndrome on treatment response: a single center retrospective
           study

    • Authors: Ömer Kutlu, Hatice M. Eksioglu
      Pages: 505 - 510
      Abstract: Background: Ustekinumab is a biological agent used in the treatment of psoriasis. This study evaluated the treatment response of psoriasis patients who received ustekinumab.Methods: The study included nine patients with plaque-type psoriasis who received ustekinumab treatment. Clinical response of all patients was evaluated with psoriasis area and severity index (PASI), dermatology life quality index (DLQI), and psoriasis disability index (PDI) at 0, 4, 16 and 28 weeks. The patients were also evaluated for metabolic syndrome and its effect on treatment response.Results: A total of five male and four female patients with psoriasis vulgaris were included in the study. At the end of 28th weeks, 55% of the patients reached PASI 75 score. The mean PASI scores of the patients at weeks 0, 4, 16, 26 and 28 were 36.98±12.28, 8.86±9.06, 9.52±11.55, 3.55±3.61 and 6.98±6.40, respectively. Although not statistically significant, at the 28th weeks, the mean PASI, DLQI and PDI values of the patients with metabolic syndrome were higher than those without metabolic syndrome (p=0.505, p=0.314, p=0.786, respectively).Conclusions: Ustekinumab is an effective treatment option for patients with psoriasis who resistant to conventional and biological treatments. In resistant cases to the ustekinumab, the routine treatment interval should be reduced. Psoriasis patients with accompanying metabolic syndrome may have a lower response rate than those without metabolic syndrome to biological agents.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202656
      Issue No: Vol. 6, No. 4 (2020)
       
  • Pattern of skin disorders among pediatric age group cases attending a
           tertiary health care center

    • Authors: Shahul Hameed G., Karthik Raja S.
      Pages: 511 - 514
      Abstract: Background: Skin diseases among the pediatric age group people are more common and it contributes to significant burden to health sectors. Also, the pattern of skin diseases changes consistently with reference to place and time. Hence the present study was conducted to assess the pattern of skin diseases in pediatric age group patients attending a tertiary care hospital.Methods: The cross-sectional study was conducted by the department of Dermatology, Venereology and Leprosy at Sri Muthukumaran Medical College Hospital and Research Institute, among the pediatric age group patients attending the outpatient department, during the month of October to December 2019. A total of 412 pediatric age group patients with skin disorder were included in the study. The study was conducted using a proforma with the clinical history and diagnosis of the participants. Data was entered in Microsoft excel and data analysis was done using SPSS version 17.Results: The common skin disorders reported in this study includes infections (34.7%) followed by dermatitis (32.3%), infestations (11.4%), miliaria (8.3%), popular urticaria (7.5%) and urticaria (6.1%). Among the infections fungal, bacterial and viral pathogens contributes to 16.3%, 10.9% and 7.5% of cases, respectively. Also 11.2% of cases were found to be infested with scabies (9.2%) and pediculosis (2.2%).Conclusions: Skin disorders in the pediatric age group are common and showing increasing trend. Hence health education of the parents and the school children about good nutrition, hygiene practices, and proper hydration of skin can be promoting in order to reduce the burden of skin disorders.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202023
      Issue No: Vol. 6, No. 4 (2020)
       
  • Correlation of clinical and histopathological diagnoses of oral mucosal
           lesions at tertiary care centre: a retrospective study

    • Authors: Ankita M. Maheshwari, Vidya D. Kharkar
      Pages: 515 - 519
      Abstract: Background: The objective of the study was to study the correlation between clinical and histopathological diagnoses of oral lesions.Methods: Data of all patients attending the department of Dermatology KEM Hospital, Mumbai with oral mucosal lesions who underwent biopsy for histopathological examination in a duration of one year was included in this retrospective study. Their clinical and histopathological diagnoses were correlated and data was analysed.Results: A data of total of 164 patients was included in study. Out of the clinically diagnosed, histopathological correlation was found to be 66.66% for oral leucoplakia, 81.25% for lichen planus, 72% for squamous cell carcinoma, 88% for pemphigus vulgaris and 75% for submucosal fibrosis. Overall correlation found was 75.60%.Conclusions: Histopathological examination of oral mucosal lesion is very important to arrive at the accurate diagnosis and to plan definitive treatment. Histopathological examination of oral mucosal lesions must be done routinely because wide variety of conditions present with similar morphologic features and can be the initial signs of many skin disorders.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202657
      Issue No: Vol. 6, No. 4 (2020)
       
  • A comparative study between micro needling with modified Kligman regimen
           versus micro needling with tranexamic acid in melasma patients

    • Authors: Anjum M. Momin, Ankita A. Mistry, Jignesh B. Vaishnani
      Pages: 520 - 525
      Abstract: Background: Melasma is common, acquired disorder of hyperpigmentation, with female predominance and occurrence of facial involvement mostly. Various modalities of treatment are available including topical, oral and procedural therapies.Methods: Total 46 patients of melasma were studied. They were divided in two groups A and B. Micro needling with derma roller 1.5mm was done once in a month for 3 months. Group A patients received topical Modified Kligman regimen daily at night, while group B patients were advised topical tranexamic acid daily. Topical sunscreen was advised in both group patients. Patients were evaluated clinically and by Modified MASI score, and followed up for 3 more months after completion of treatment.Results: Female predominance was noted with most common age group being 25-40 years. Epidermal type of melasma was common. Centro-facial type of distribution was found mostly in patients. Significant decrease was noted in modified MASI score (p<0.05) which was more and rapid in group A patients.Conclusions: Modified Kligman regimen has better efficacy but tranexamic acid is safer with lesser side effects. Inspite of various treatment arms, melasma is still challenging.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202658
      Issue No: Vol. 6, No. 4 (2020)
       
  • Pattern of dermatological involvement in early postmenopausal period: a
           cross sectional study

    • Authors: Bhavika Shah, M. A. Patvekar, Pallavi Singh, M. S. Deora, Alisha .
      Pages: 526 - 531
      Abstract: Background: The high burden of menopausal symptoms notwithstanding, there is a paucity of published work evaluating its impact specifically on the skin and mucosa. With high incidence of underreported cases in developing countries, active screening of all women is essential for accurate assessment of prevalence of cutaneous features, as highlighted by this study. The objective of this study is to assess clinical patterns of dermatosis in menopausal women.Methods: A cross‑sectional study conducted in the dermatology department conducted on postmenopausal patients below 65 years having dermatoses after taking their written consent. Data analysis using SPSS 20.0.Results: Of 350 postmenopausal women, 165 had genital involvement, atrophic vaginitis (41.21%) being the most common manifesting typically as vaginal dryness. Of 82 women having oral complaints, 42.7% women had complaints of pain or difficulty swallowing in the absence of mucosal lesions. Of the total sample size, 34% women had had female pattern hair loss, maximum women with grade I-2 (45.4%) and I-3 (36.13%). Two key findings which we did not find previous records of included incidence of keratoderma climactericum (2.29%) and hirsutism in early menopause which we found to be 8%. It is important to note that only 28% of women were aware that their complaints were related to menopause or chose to seek active treatment for existing complaints.Conclusions: This study highlights the various clinical patterns of postmenopausal dermatoses to raise awareness in dermatologists and gynecologists for prompt diagnosis, treatment and patient education. 
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202659
      Issue No: Vol. 6, No. 4 (2020)
       
  • A study of respiratory system involvement in autoimmune connective tissue
           diseases: a marker of morbidity

    • Authors: Neha T. Solanki, Sahana P. Raju, Deepmala Budhrani, Bharti K. Patel
      Pages: 532 - 536
      Abstract: Background: The auto-immune connective tissue diseases (AICTD) are polygenic clinical disorders having heterogeneous overlapping clinical features. Certain features like autoimmunity, vascular abnormalities, arthritis/arthralgia and cutaneous manifestations are common to them. Lung involvement can present in AICTDs in form of: pleurisy, acute/ chronic pneumonitis, pulmonary artery hypertension (PAH), shrinking lung syndrome, diffuse alveolar damage, pulmonary embolism (PE), bronchiolitis obliterans organizing pneumonia, pulmonary infections, cardiogenic pulmonary edema, etc. High-resolution computed tomography (HRCT) plays an important role in identifying patients with respiratory involvement. Pulmonary function tests are a sensitive tool detecting interstitial lung disease.Methods: The present study is an observational study carried out on 170 patients of AICTD in department of Dermatology, Venereology and Leprosy at a tertiary care centre during a period of 2 years from October 2017 to August 2019. Detailed history, examination and relevant investigations like chest X-ray, pulmonary function test (PFT), HRCT thorax were done as indicated.Results: The overall incidence of respiratory involvement was 56.7% with maximum involvement in systemic sclerosis cases (82.8% of cases). 45.7% of patients of systemic lupus erythematosus had respiratory involvement, most common being pleural effusion in 11.5%. Impaired PFT’s were seen in 82.8% cases of systemic sclerosis (SSc)  and all cases of UCTD. Interstitial lung disease was seen in 34.7% and 25% cases of SSc and DM respectively. PAH was found in 15.2% cases of SSc and 9.8% cases of mixed connective tissue diseases.Conclusions: AICTD are multisystem disorders in which pulmonary involvement can be an important cause of morbidity to the patient and early detection is necessary for prevention of long-term respiratory complications.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202660
      Issue No: Vol. 6, No. 4 (2020)
       
  • Role of autoinoculation in the management of cutaneous warts: a comparison
           study with 100% tricholoroacetic acid application

    • Authors: Karla N. Faleiro, Pankaj Shukla
      Pages: 537 - 543
      Abstract: Background: Persistent and recurrent warts pose a challenge to physicians despite the availability of multiple treatment options. Autoinoculation exposes HPV antigens to the dermis and vasculature thereby activating a delayed hypersensitivity response, facilitating clearance of both local and distant warts. The aim of this study was to assess the efficacy of autoinoculation and compare it with chemical cautery using 100% trichloroacetic acid.Methods: A non-blinded interventional study was conducted at Goa Medical College, a tertiary care centre. Non-immunocompromised patients with 5 or more non-genital warts were included. Group 1: a wart was removed by punch biopsy, minced and implanted in the dermis. The procedure was repeated at 4 and 8 weeks. Group 2: weekly trichloroacetic acid (100%) application. Response was assessed at 4, 8 and 12 weeks in terms of percentage reduction in the number of warts. Statistical correlation with respect to age, sex, duration, number and type of warts was assessed using Welch ANOVA.Results: In group 1, 63 patients and in group 2, 54 patients completed the study. Post autoinoculation, complete clearance was seen in 46.0% and 3.2% had partial clearance. With TCA application, 33.3% patients had complete and 13% had partial clearance. Response differed with the type of warts. Palmoplantar, periungual warts and verruca vulgaris showed better response to autoinoculation. Filiform and plane warts showed better response to TCA.Conclusions: Autoinoculation is an efficacious treatment modality which can be performed routinely especially for palmoplantar and periungual warts which are particularly challenging to treat with other modalities.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202661
      Issue No: Vol. 6, No. 4 (2020)
       
  • Clinico-epidemiological study of melasma in tertiary care centre

    • Authors: Nishtha H. Patel, Narendra Gangaiah, Veena Thimappa, Pavithra Gundappa
      Pages: 544 - 547
      Abstract: Background: Melasma is common pigmentary disorder and affect patient quality of life due to its presentation over the face. It mostly affects sun exposed area and present as grey-brown pigmentation over the face.Methods: In this observational or descriptive study, total 110 patients were enrolled which was carried out in the Department of Dermatology from February 2019 to January 2020 at Sri Siddhartha Medical College and Sciences, Tumkur, Karnataka.Results: Mean age group affected was 31-40 years of age (41.8%). Out of 110 patients 18 patients were male and 92 patients were females. Total 15 patients had positive family history (13.6%). 30 patients had history of taking oral contraceptive pills (27.3%). 22 patients had sun exposure history (20%). 59 patients had epidermal pigmentation (53.6%) and 62 patients had malar region distribution (56.4%).Conclusions: During third decade of life, females were more commonly affected. Pathogenesis of melasma is multifactorial. In our study, we found that oral contraceptive pills and sun exposure may predispose or trigger the melasma. Most common area affected was malar. Epidermal pigmentation was more common.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202662
      Issue No: Vol. 6, No. 4 (2020)
       
  • Boosting effect of cyclosporine on corticosteroids in the acute management
           of toxic epidermal necrolysis

    • Authors: Nageswaramma Sidhabathuni, Sahitya Tadi, Rakesh Darla, Premsagar Gomukonda
      Pages: 548 - 552
      Abstract: Toxic epidermal necrolysis (TEN) is a life-threatening dermatological emergencies. It is a rare, acute mucocutaneous disorder that usually occur secondarily as an idiosyncratic reaction to certain drugs. Prompt identification and discontinuation of the causative drug is mandatory along with adequate supportive care like proper hydration, minimize the number of skin manipulation, prevention of secondary infections. Many immunosuppressive modalities have been tried with variable results. In this manuscript, we reported 12 consecutive cases of TEN presented to our hospital over a period of 2 years from 2017 to 2019. All the cases presented with varying percentage of skin blistering and mucosal involvement secondary to an offending drug. The incriminated drug was discontinued, supportive care was initiated along with combination therapy of cyclosporine and corticosteroids as immunosuppressants. The clinical presentation, etiological drugs and treatment protocol followed and its efficacy will be described in details.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202663
      Issue No: Vol. 6, No. 4 (2020)
       
  • Therapeutic vanish in pyogenic granuloma: a case series

    • Authors: Deepthi Ravishankar, Mamatha S. Kusagur
      Pages: 553 - 555
      Abstract: Pyogenic granuloma (PG) is a common benign vascular tumour which affect both skin and mucous membranes, occurring commonly on the face, oral mucosa, or a site of previous injury in all ages. Though some PGs resolve spontaneously, most requires treatment to prevent bleeding, ulceration, and scarring. We presented a case report of 4 patients who developed PG on index finger, forehead and nose. Our findings demonstrated the use of sclerotherapy using 3% sodium tetradecyl sulphate which is a safe and economical therapy for adult patients.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202664
      Issue No: Vol. 6, No. 4 (2020)
       
  • Refractory interstitial granulomatous dermatitis in the setting of
           underlying diffuse large B-cell lymphoma

    • Authors: Trevor A. Nessel, Jeffrey B. Morris, German Treyger, Connor C. Kerndt, Bryan Sofen
      Pages: 556 - 559
      Abstract: Interstitial granulomatous dermatitis is a rare dermatologic condition characterized by erythematous papules, nodules, and plaques, most commonly on the trunk and limbs. It is commonly associated with comorbidities such as arthritis, autoimmune disease, lymphoproliferative disorders, and malignancies. In addition, the rash can be medication-induced, which is differentiated by histopathologic results. Diagnosis is confirmed with skin biopsy, and treatment is individualized to each patient. Here we report an 89-year-old man with sudden onset lower extremity interstitial granulomatous dermatitis with the concurrent diagnosis of diffuse large B-cell lymphoma. Treatment of the skin lesions was attempted with a combination of steroids, antibiotics, antifungals, and disease-modifying anti-rheumatic drugs, without complete resolution.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202665
      Issue No: Vol. 6, No. 4 (2020)
       
  • Unilateral nevus comedonicus associated with epidermoid cyst

    • Authors: Umadevi Vallabhareddy, Venkateswara Rao G., Thanuja Bikkireddy, Hyndavi Madala
      Pages: 560 - 562
      Abstract: Nevus comedonicus (NC) is a type of an epidermal nevus which was first described in 1895 by Kofmann. Clinically, it is characterized by linear lesion comprising numerous dilated follicular openings with keratinous plugs resembling classical comedones, seen mainly on the head and neck area followed by trunk and upper arm. Treatment options of NC include topical therapy, laser, and surgery. NC associated with epidermoid cyst is rare. We report here a case of NC affecting left side of trunk, left lower limb with epidermoid cysts.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202666
      Issue No: Vol. 6, No. 4 (2020)
       
  • Toxic epidermal necrolysis like acute cutaneous lupus erythematous or drug
           induced toxic epidermal necrolysis: case report of a diagnostic dilemma

    • Authors: R. B. Chavan, V. A. Belgaumkar, N. S. Deshmukh, A. M. Pawar
      Pages: 563 - 566
      Abstract: Systemic lupus erythematosus (SLE) is an autoimmune disorder causing microvascular inflammation with generation of antinuclear auto-antibodies. It can have varied presentations and its coexistence with other disorders makes diagnosis and management all the more challenging. We describe a young male, known case of SLE and pulmonary tuberculosis on anti-tubercular treatment presenting with sudden onset diffuse maculopapular dusky rash, oral lesions, fever, joint pain and photosensitivity. Positive Nikolsky’s sign on clinical examination, epidermal necrosis on histopathology, negative direct immunofluorescence and Naranjo’s causality assessment clinched the diagnosis of streptomycin-induced toxic epidermal necrolysis (TEN) in SLE. Rash responded rapidly to systemic steroids and discontinuation of anti-tubercular drugs. Rifampicin, ethambutol and isoniazid have been previously incriminated in TEN but streptomycin- induced toxic epidermal necrolysis remains an extremely rare event. TEN like rash of lupus is a rare entity clinically indistinguishable from drug induced TEN. Moreover, TEN is known to occur with increased frequency in connective tissue disorders.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202667
      Issue No: Vol. 6, No. 4 (2020)
       
  • Human infestation with pubic lice

    • Authors: Ankush Maheshwary
      Pages: 567 - 569
      Abstract: Pediculosis pubis is caused by Phthirus pubis (diptera: anoplura) commonly known as crab louse, an obligatory ectoparasite, found on human hair and requires human blood to survive. Pubic lice can be found on pubic hair, underarms, thigh and leg hair, beard and rarely on eyebrows and eyelashes. They are rarely found on scalp hair. Spread of lice occurs mostly by sexual contact but spread via non-sexual contact although rare has also been reported. I present the case of a middle-aged woman with pubic lice. No lice/nits were found in underarm hair, eyebrows or eyelashes. A review of literature is enclosed.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202668
      Issue No: Vol. 6, No. 4 (2020)
       
  • Skin manifestation of angioimmunoblastic T-cell lymphoma mimicking
           Hansen’s disease on histology

    • Authors: Anju Shukla, Sunil Sharad Dabadghao, Surbhi Gupta, Priyanka Jain
      Pages: 570 - 572
      Abstract: Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon form of peripheral T-cell lymphoma now put under the category of nodal T-cell lymphoma with follicular T helper phenotype. 50% cases of AITL have varied cutaneous manifestations including macules, papules, petechiae, purpura, nodules, non-specific rash and urticaria. Herein we present a case of AITL initially presented as maculopapular rash which on histology was mimicking as Hansen’s disease with perineural and perivascular inflammation; however, an infective organism could not be demonstrated. Later on, a delayed diagnosis was made on lymph node biopsy and immunohistochemistry and patient responded well with chemotherapy.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202669
      Issue No: Vol. 6, No. 4 (2020)
       
  • Hemmorhagic chickenpox

    • Authors: Sonu Suman
      Pages: 573 - 575
      Abstract: Chickenpox (varicella) is self-limited disease caused by Varicella-Zoster virus (VZV). Hemorrhagic manifestation is rare complication in immunocompromised patient. Here we report a case of rare form of hemorrhagic chickenpox due to chronic alcohol intake. The course of illness was very fulminant and rapid.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202670
      Issue No: Vol. 6, No. 4 (2020)
       
  • Acute methotrexate toxicity with severe cutaneous ulcerations in a patient
           of chronic plaque psoriasis

    • Authors: Anil P. Gosavi, Rahul N. Jaiswal, Ravindranath B. Chavan, Sanjay N. Gaidhani
      Pages: 576 - 578
      Abstract: Methotrexate continues to be one of the most widely used systemic immunosuppressive agents in chronic plaque psoriasis. In addition to the important well characterized adverse effects such as hepatotoxicity and myelosuppression, methotrexate may induce a number of mucocutaneous adverse events including methotrexate induced mucocutaneous ulcerations. We present a case of methotrexate induced severe cutaneous ulcerations in patient with chronic plaque psoriasis. 45 year old male known case of chronic plaque psoriasis on methotrexate therapy manifested as methotrexate toxicity leading to acute kidney injury with painful ulcerated plaques with active bleeding over previously psoriatic plaques over extremities and trunk with mucosal ulcerations responding effectively to leucovorin therapy. Dermatologists need to be alert to the possibility of cutaneous adverse events associated with methotrexate therapy especially ulcerations of psoriatic plaques. 
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202671
      Issue No: Vol. 6, No. 4 (2020)
       
  • Eruptive xanthomas: a warning sign of future hyperlipidemia complications

    • Authors: Trevor A. Nessel, Connor C. Kerndt, John A. Bills, Lynn Sikorski
      Pages: 579 - 583
      Abstract: Eruptive xanthomas are localized lipid deposits in the skin or subcutaneous tissue that are associated with both primary and secondary hyperlipidemia. Typical presentation manifests as small yellow papules on the buttocks or extensor surfaces. Xanthomas can be diagnosed clinically with an extensive history and physical examination, however, can be confirmed via biopsy and histological findings. It is essential to identify the underlying cause of the skin lesions and take appropriate measures to prevent future hyperlipidemia-induced consequences. Here we report a 42-year-old female with eruptive xanthomas on her trunk and extremities. Previous visits to the primary care provider and emergency department resulted in diagnoses of viral exanthems. The consulted dermatologist ordered laboratory tests remarkable for extreme hypertriglyceridemia, hypercholesterolemia, and hyperglycemia. Lifestyle modification in conjunction with cholesterol and triglyceride lowering medications led to the resolution of abnormal laboratory findings and remission of eruptive xanthoma lesions.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202672
      Issue No: Vol. 6, No. 4 (2020)
       
  • Classification and pathophysiology of cutaneous manifestations of COVID-19

    • Authors: Surinder Gupta, Nikita Gupta, Nakul Gupta
      Pages: 584 - 588
      Abstract: Cutaneous manifestation of in COVID-19 patients are varied and needs proper categorization and classification. Various morphological manifestation on skin are seen. The pathophysiology of this virus is not well understood because of it being a novel virus. This disease involves all organs of the body, primarily the respiratory system, heart, kidneys, liver, spleen and the skin as well. In addition to pneumonia which is a hall mark feature of this virus, multiorgan failure occurs as a result of its cascading pathological pathways. Another fatal feature of this virus is hyperimmune response (because of IL-6), known as, ‘cytokine storm’. The pathophysiological changes in skin leading to different kinds of rashes range from vasculitis changes to formation of microthrombi obliterating the dermal vessels. After reviewing current literature, we have proposed a simplified classification of cutaneous manifestations of COVID-19 is proposed based on morphological features, relation with severity of disease and histopathological changes. Pathophysiology of cutaneous changes is also being described.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202443
      Issue No: Vol. 6, No. 4 (2020)
       
  • Unani and modern aspects of psoriasis (Da’u-us-Sadaf) treatment: a
           review

    • Authors: Abdul Nasir, Gazala Fatma, Waris Ali, M. Aftab Ahmad
      Pages: 589 - 596
      Abstract: Psoriasis (Da’u-us-Sadaf) is a common, disfiguring, inflammatory, and chronic autoimmune skin disorder with a worldwide distribution, highest incidence is in Europeans, and the lowest in Asians from the East. The prevalence of psoriasis in adults varies from 0.44 to 2.8%, in India. The word psoriasis is derived from Greek word ‘psora’ meaning ‘itch’ ‘iasis’ meaning ‘action, condition’. Da’u-us-Sadaf is derived from Arabic words ‘daun’ means ‘disease’ and ‘Sadaf’ means ‘oyster shell’. Psoriasis or Da’u-us-Sadaf are not mentioned in any classic literature since ancient times. It was considered in the context of Taqashur-e-Jild and Qashaf-e-Jild by famous Unani physicians; Razi, Majoosi, Ahmad Bin Mohd Tabari, Ibn-e-Zohr, Akbar Arzani, Azam Khan, because of dryness of the skin and scale formation, which clinically resembles very much with psoriasis (Da’u-us-Sadaf). According to Ali Ibn-e-Abbas Al-Majoosi has described that Tabiyat expels the Khilt-e-Ghaleez from internal organs towards skin resulting in the dryness and itching of the skin, but in this condition skin is unable to remove Khilt-e-Ghaleez leading to accumulation of sauda in skin and produce Taqashur-e-Jild. Unani scholars has emphasized the Usool-e-Ilaj (principle of treatment) such as evacuations of black bile (Istifragh or Tanqiyahe Sauda), use of blood purifier (Tasfeeh-e-Dam), Munzijate Sauda (Melancholic concoctives), Mushilate Sauda (Melancholic purgatives), Tabreed Badan (genesis of ratoobat or fluids in the body), try to restore normal temperament (Tadeele Mizaj), topical application of jali (detergent), murakhi (emollient), murattib and mohallil (anti-inflammatory) advia. In this review we have tried to discuss about Unani and modern aspects of psoriasis (Da’u-us-Sadaf).
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202673
      Issue No: Vol. 6, No. 4 (2020)
       
  • Unveiling the dermatological manifestations of nCOVID-19

    • Authors: Dheemant M., Sushmitha E. S., Madhan Jeyaraman, Ajay S. S., Rashmi Jain
      Pages: 597 - 603
      Abstract: Coronaviruses are RNA viruses that have become a major public health concern since the severe acute respiratory syndrome CoV (SARS-CoV-2) outbreak in 2002. The continuous evolution of coronaviruses was further highlighted with the emergence of the middle east respiratory syndrome CoV (MERS-CoV) outbreak in 2012. The spike glycoprotein of SARS-CoV-2 plays a pivotal role in the entry of virus into the cell and it further interacts with ACE-II receptors which are widely distributed on the human cell surface especially on alveolar type II cells (AT-2) and endothelium. Currently, the world is concerned about the 2019 novel CoV (SARS-CoV-2) that was initially identified in the city of Wuhan, China in December 2019. Patients presented with severe viral pneumonia and respiratory illness. Despite the virus not being dermatotropic, several skin conditions have emerged mainly as a result of prolonged contact with personal protective equipment and excessive personal hygiene. In this review, we discuss structure, genome organisation, entry of CoVs into target cells, probable cutaneous manifestation that dermatologists may be aware of skin complications and the preventive measures, outcome of the disease and the management.
      PubDate: 2020-06-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20202024
      Issue No: Vol. 6, No. 4 (2020)
       
 
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