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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]
  • A clinico-epidemiological study of psoriasis patients with moderate to
           severe plaque type in tertiary care centre in South India

    • Authors: Suganya Sekar, Samuel J. Daniel
      Pages: 1 - 6
      Abstract: Background: Psoriasis is a chronic disorder with the most common manifestation being the plaque-type. Nearly 20% of the plaque type suffer from a disease of moderate to severe intensity with immense effect on the quality of life. Aim was to study the clinical, socio-economic and demographic characteristics of patients with moderate to severe plaque type of psoriasis.Methods: This was an observational study conducted in about fourty patients diagnosed with moderate to severe plaque type of psoriasis based upon the clinical history, morphology of the lesions and assessed using psoriasis area and severity index (PASI), dermatology life quality index (DLQI) scoring and for comorbidities. Data was compiled and analyzed with statistical package for social science (SPSS) Version 20.0.Results: Mean age was 37.43±10.1 years. 22 were males (55%) and 18 were females (45%). The mean duration was 8.93 years and 15% had family history. The mean age of onset was earlier in the females (20.23 years) with a positive family history, as compared to males (25.36 years). About 62.5% had moderate psoriasis and 37.5% had severe psoriasis. At the baseline the PASI score was 31.98±6.08 and DLQI score was 36. About 67.5% had nail changes and 10% had psoriatic arthritis. Almost in half (47.5%) the duration of the disease was 1 to 5 years and scalp (32.5%) the most common initial site of involvement. Various comorbidities were documented, 72% in moderate psoriasis and 73.33% in severe psoriasis with dyslipidemia (67.5%) being commonest.Conclusions: Patients with moderate to severe psoriasis mostly have a low quality of life with multiple significant co-morbidities that increases the risk for morbidity and mortality.  
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20204934
      Issue No: Vol. 7, No. 1 (2020)
       
  • Open label multi-centre trial on efficacy and tolerability of microionized
           isotretinion therapy in treatment of moderate to severe acne vulgaris

    • Authors: Bela Shah, Neha Jangid, Aswini A. Naidu
      Pages: 7 - 10
      Abstract: Background: Isotretinion was approved by United States Food and Drug Administration (US FDA) in 1982 for the treatment of severe recalcitrant nodulocystic acne. Its conventional recommended dose has been 0.5-1.0 mg/kg body weight per day for 16-32 weeks, with a maximum cumulative dose of 120 mg/kg. Objective of the study was to assess the efficacy and tolerability of 24 week of once daily micronized isotretinoin therapy in the treatment of moderate to severe acne vulgaris was conducted.Methods: Total n=580 of patients were included with 249 (43%) male and 331 (57%) females. Patients were assessed at baseline 6, 12 and 24 weeks and 12 weeks post treatment follow-up based on the assessment of severity of acne vulgaris using global acne grading system (GAGS), assessment of improvement in lesion counts, global assessment of overall efficacy by doctor (based on overall assessment) and by patients (based on overall relief in symptoms) and overall assessment of drug tolerability.Results: In terms of improvement in lesions, excellent results from 4% (22) in week 6th has move to 34% (193) in week 24th. In terms of global efficacy examined by doctors, very effective results i.e. 40% (234) in 12th week has moved to 70% (403) in 24th week. In terms of drug tolerability, excellent results have moved from 119 patients to 190 patients by end of the study.Conclusions: Hence the micronized isotretinoin therapy had overall satisfactory outcome in the treatment of patients with moderate to severe acne vulgaris (grade 2, 3 and 4).
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205463
      Issue No: Vol. 7, No. 1 (2020)
       
  • Skin care physicians insight on epidemiological patterns, diagnosis and
           treatment modalities for female pattern hair loss

    • Authors: Krishna Rajesh Kilaru, Suhasini Attada, Pooja Munnangi, Manogna Chowdary Kilaru
      Pages: 11 - 17
      Abstract: Background: Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. The underlying pathophysiology is multifactorial. There are no universally agreed treatment guidelines available. The objective of the study was to understand the diagnosis and treatment pattern of female pattern hair loss and the role of minoxidil topical formulation and its combination in the management of FPHL.Methods: Predesigned questionnaire on FPHL was prepared based on review of literature and was filled by 80 consultant dermatologists. Recorded data was statistically analyzed.Results: Common age of onset of FPHL was between 20 to 30 years. Majority (96.25%) have reported FPHL in association with psychological morbidity. The most preferred treatment in mild and severe FPHL was minoxidil 5% and platelet rich plasma (PRP) plus minoxidil respectively. Most dermatologists (47.5%) treated with minoxidil for over 6 months. Majority (27.5%) reported flaking as the most common side effect with minoxidil followed by dryness, scalp irritation and itching. Majority (27.5%) observed that long treatment duration was contributing to non-compliance followed by medication cost and side effects. Majority of the dermatologists (90%) felt the need for treatment guidelines in the current Indian scenario.Conclusions: Minoxidil was the most common preferred treatment for mild and severe FPHL. PRP is the most common choice of combination therapy with minoxidil. Minimizing side effects, patient education and universal treatment guidelines can help manage FPHL better.  
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20204997
      Issue No: Vol. 7, No. 1 (2020)
       
  • Real world retrospective analysis of luliconazole 1% and salicylic acid 3%
           as fixed dose combination in the management of hyperkeratotic
           dermatophytosis in India

    • Authors: R. D. Kharkar, Dhiraj S. Dhoot, Gaurav A. Deshmukh, Hanmant Barkate
      Pages: 18 - 21
      Abstract: Background: In recent times, there is increase in prevalence of hyperkeratotic dermatophytosis in India. These hyperkeratotic lesions usually impede the absorption of topical anti-mycotic agent making infection recalcitrant to topical anti-fungal therapy alone. Hence, many times topical keratolytic are used in combination with topical anti-fungal agents which augment the shedding of scales.Methods: To seek for short period therapy in hyperkeratotic dermatophytosis, we conducted multicentre, retrospective data analysis at 61 dermatology clinics to study effectiveness and safety of Luliconazole 1% and Salicylic acid 3% fixed dose combination (FDC) cream for 2 weeks.Results: A data of 191 patients’ were included in this analysis. All patients have received some of the topicals and switched to FDC. Total symptom score of 7.19±1.91 improved to 3.15±1.12 in just 2 weeks (p<0.05). The clinical improvement rate (percentage of ‘marked improvement’ plus ‘moderate improvement’) was 78% after 2 weeks of treatment. Moreover, 5 patients (2.61%) achieved complete clearance. This FDC was found to be safe in 51.83% (n=99) of the patients whereas 37.7% of the patients (n=72) reported it as almost safe. Minor problems with the safety was found in 9.42% of the patients (n=18). Two patients (1.04%) reported it as not safe and thus shifted to another drug. Irritation and burning were reported as most common adverse events (AE).Conclusions: The short combination therapy with luliconazole and salicylic acid as FDC has been found to be effective and safe. It should be a valuable option for hyperkeratotic dermatophytosis for early achievement of clinical cure and better patient compliance.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205013
      Issue No: Vol. 7, No. 1 (2020)
       
  • The epidemiological investigation of bed bugs, Cimex lectularius in Jeddah
           governorate, Saudi Arabia

    • Authors: Samar A. Khan, Jazem A. Mahyoub, Khalid M. Al-Ghamdi, Fatehia N. Gharsan, Somia A. Mohammed Elhassan, Tariq S. Alghamdi
      Pages: 22 - 27
      Abstract: Background: Bed bugs are small insects that feed on animal blood at all stages of their life cycle, with the most common species, Cimex lectularius, preferring to feed on human blood. In recent years, it has reappeared in many countries around the world.                                                                                                                                  Methods: Samples of bed bugs were collected from Jeddah governorate neighbourhoods from 4th December, 2018, to 1st May, 2019, to determine the infected neighbourhoods and the degree of insect infestation. The study was conducted by random selection of individuals in the Jeddah community; data were collected through the completion of 1000 questionnaires, which were then statistically analysed.                            Results: The current study monitored the presence of bed bugs in many neighbourhoods of Jeddah governorate; their presence percentage varied according to the different neighbourhoods, and they were arranged in descending order according to the percentage of their presence as follows: Al-Safa >Bani-Malik >Al-Sherafiya >Al Jamaa >Al Nuzula. The prevalence of bed bugs related to the population density, random neighbourhoods, low level of hygiene in the neighbourhood, and moving from one residence to another. 98% of the residents of Jeddah in the sample agreed that bed bugs were a disturbing pest and an environmental problem which needs to be researched and studied to reach the best ways to control it, as 99.6% of them agreed the necessity of including bed bugs in the list of disturbing pests and vectors of diseases that must be controlled by the concerned authorities in Jeddah governorate.            Conclusions: The necessity of including bed bugs as one of the pests that need to be considered and must be controlled by the relevant authorities.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205589
      Issue No: Vol. 7, No. 1 (2020)
       
  • Evaluation of anti-dermatophytic activity of medicinal plants derived
           products

    • Authors: Anu Gupta, Alisha ., Sandeep Kaur, Prabhjot Kaur Gill
      Pages: 28 - 32
      Abstract: Background: Dermatophytes are a group of closely related fungi which are able to invade the keratinized tissue skin, hair and nail. In this study different medicinal plants like Melaleuca alternifolia, Zingiber officinale, Allium sativum, Azadirachta indica, Citrus limonum, Curcuma longa, Cocos nucifera were used as antifungal agent against different dermatophyte species.Methods: A hospital-based study consisting of 320 patients clinically diagnosed having dermatophytic infection who reported to the Dermatology outpatient department (OPD), Adesh medical college, Bathinda was conducted for the period of 2 years. Socio-demographic and clinical information was collected and sample was taken from the edge of infected area which was then collected in 2 ml of Eppendorf. Extracts of medicinal plants were then explored against dermatophyte. The data was evaluated using appropriate statistical method.Results: All dermatophyte species were found sensitive for Melaleuca alternifolia, Zingiber officinale and Allium sativum. These medicinal plants showed very good results as antifungal against dermatophytes while Azadirachta indica and Citrus limonum were moderate sensitive and Curcuma longa and Cocos nucifera did not show any zone of inhibition around the well.Conclusions: This research provides a scientific validation for the use of these medicinal plants in the treatment of dermatophytic infection and could be used in future for dermatophytic infection and other skin infection.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205590
      Issue No: Vol. 7, No. 1 (2020)
       
  • Management of dermatophytosis with a novel itraconazole formulation: a
           research survey

    • Authors: Susmit Haldar
      Pages: 33 - 37
      Abstract: Background: Dermatophytic infections are the most prevalent fungal infections, which affect majority of the global population. Indian climate, especially the hot and humid conditions contribute majorly to dermatophytosis. Itraconazole is an orally active triazole antifungal drug, which has demonstrated a broad spectrum of activity and a favourable pharmacokinetic profile. Itraconazole at an appropriate dosage and duration schedule has been reported to be an effective antifungal drug and has achieved optimal results.Methods: The present survey aimed at evaluating the efficacy of the novel itraconazole formulation,I-Tyza 100 [itraconazole 100 mg (Abbott health care pvt ltd)] with multi-particulate in solid dispersion (MPSD) technology in patients with tinea infections. The data collection was based on the proportion of patients presenting in the clinics for tinea infections, the choice and duration of therapy, real life efficacy of the drug, and for understanding the overall antifungal therapy in dermatomycosis.Results: The responses obtained from 177 doctors were evaluated, and statistical analyses were carried out. The results suggested that clinical presentation of patients with tinea infections per week ranged between 30% and 60%. For the management of tinea infections, oral itraconazole was preferred by maximum doctors, followed by terbinafine, griseofulvin and fluconazole. Also, majority of the doctors (83%) opined that MPSD technology could improve therapeutic efficacy of the novel itraconazole formulation.Conclusions: The survey findings indicated that the novel itraconazole formulation is a preferred oral antifungal therapy for the management of tinea infections.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205591
      Issue No: Vol. 7, No. 1 (2020)
       
  • Effectiveness and safety of ciclopirox olamine in patients with
           dermatophytosis: a retrospective cohort analysis

    • Authors: Vinay Saraf, Satyaprakash Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Hanmant Barkate
      Pages: 38 - 43
      Abstract: Background: The current scenario of dermatophytosis is alarming, despite the availability of multiple antifungal agents the management of dermatophytosis is still challenging. Hence there is a need for a different antifungal with a novel mechanism of action for the management of dermatophytosis.Methods: It was retrospective cohort study where in record of patients with dermatophytosis who were candidates for topical therapy only were analysed. All the patients were treated with Ciclopirox olamine 1% twice daily for 6 weeks. The efficacy end points were complete cure rate, mycological cure rate and clinical cure rate.Results: 613 patients were included in the final analysis. At the end of study period the complete, mycological and clinical cure rates were 73.89%, 75.37% and 77.65% respectively. Out of 613 patients included 528 patients showed treatment failure to previous topical antifungal agents while 84 patients were treatment naïve. In treatment failure patients the complete, mycological and clinical cure rates were 72.15%, 73.48, and 75.56% respectively. In treatment naïve patients the complete, mycological and clinical cure rates were 84.70%, 87.05% and 90.58% respectively. 5.70% reported adverse events. The most common adverse event was pruritus followed erythema, dryness and rash.Conclusions: Results of this study proves that ciclopirox is efficacious and safe in the management of dermatophytosis. This study also proves that ciclopirox is useful in those patients who failed to respond to other topical antifungal agents. 
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205592
      Issue No: Vol. 7, No. 1 (2020)
       
  • An unprecedent prevalence of palmoplantar warts among nursing students

    • Authors: M. Vijaya Bharathi, Neetha L., S. Murugan, S. Rajagopal, J. Nivin Simon
      Pages: 44 - 47
      Abstract: Background: Skin diseases are common contributors to disease morbidity worldwide, particularly among adolescents. Although skin diseases are rarely lethal, they can have a significant impact in terms of treatment cost, absence from school, and psychological distress. Verruca vulgaris (cutaneous warts) is a common skin problem in adolescents that commonly affects the hands and feet. The aim of the study was to determine the prevalence of warts among nursing students.Methods: Three hundred and twenty eight undergraduate degree students of nursing college were examined for skin conditions after an unprecedented sporadic visitors form the nursing college with palmo-plantar warts. The study was conducted at Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari district during the period of 20 March 2019 to 25 March 2019.Results: Among the 328 students, 102 students (31%) remained healthy dermatologically. Seborrheic dermatitis was found among 145 students (4.4%), pediculosis was found in 40 students (12%). 34 students were having palmoplantar warts (10.4%). Among these, nearly 30 were having palmar warts and only 4 were having plantar and palmar warts. 83 first year students were not having any warts in their hands or foot, whereas 11 among 2nd year, 16 among 3rd year students and 7 among 4th year students were having viral warts. Prevalence was more among 2nd and 3rd year students.Conclusions: Screening of hostel students should also include for the presence of viral skin disease like herpes simplex, Herpes zoster and HPV infections and they should be treated then and there to break the chain of transmission.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205593
      Issue No: Vol. 7, No. 1 (2020)
       
  • Clinico-epidemiological study of mask induced acne due to increased mask
           use among health care workers during COVID pandemic in a tertiary care
           institute

    • Authors: Ramesh Aravamuthan, Shabari Arumugam
      Pages: 48 - 52
      Abstract: Background: Acne vulgaris is a self-limiting, multifactorial disorder affecting the sebaceous glands and pilosebaceous follicles. Regular wearing of mask during this COVID-19 pandemic has resulted in increased incidence of acne flare. The objective is to study the incidence and the clinic-epidemiological factors associated with mask induced acne.Methods: This is a cross sectional web-based survey conducted at Madras medical college and Rajiv Gandhi government general hospital during August 2020. The clinic-epidemiological details were collected from the 215 post-graduates of Madras medical college and Rajiv Gandhi government general hospital in a pre-set questionnaire.Results: Among 215 study participants, 134 (62.3%) reported mask induced acne. Female gender has a statistically significant association. Itching was the most common complaint. Cheeks, chin and bridge of the nose were the common site of lesions. Comedone and papules were the common presenting lesions. Premenstrual flare and psychological stress had a statistically significant association.Conclusion: Mask induced acne has various factors like micro-climate theory, hydration of keratin, mechanical occlusion of pilosebaceous unit pores, seborrhoea, ambient high humidity due to sweating involved in its pathogenesis. Although wearing a mask is extremely important to our fight against COVID-19, the general public should be aware of proper and rational mask wearing.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205594
      Issue No: Vol. 7, No. 1 (2020)
       
  • Dermoscopic evaluation of nail psoriasis: a cross-sectional study

    • Authors: Krishnendra Varma, Ujjwal Kumar, Praneeta Jain
      Pages: 53 - 57
      Abstract: Background: Psoriasis is a chronic inflammatory immune mediated disease that can involve skin, nails, scalp, etc. Nails can be involved in up to 90% of psoriatic patients in their lifetime. Also, psoriatic arthritis is commonly found in patients having nail involvement. Nail changes in psoriasis can be imperceptible to the unaided eye and easily missed on clinical examination. Onychoscopy has helped in improving diagnosing these subtle clinical features. Aim of the research was to study dermoscopic features in nails involved in psoriasis.Methods: 50 patients having clinically evident nail psoriasis, of which 2 were excluded due to positive KOH examination were recruited in the cross-sectional descriptive study. After clinical examination, all the nails were subjected to dermoscopic examination. The findings were tabulated in Excel and comparisons were made.Results: The common dermoscopic findings were pits (79.2%), splinter haemorrhage (72.9%), onycholysis (68.8%), subungual hyperkeratosis (50%), nail plate scales (50%), dilated PNF/LNF capillaries (20.8%), ridges (18.8%), leukonychia (14.5%), salmon spots (10.4%), fuzzy lunula (8.3%), and dilated hyponychial capillaries (6.3%).Conclusions: Dermoscopy is a simple, easy, rapid and an office-based technique. It helps in picking up subtle nail changes not visible to the naked eye. It also precludes from doing painful nail biopsy in nail disease without its skin manifestation. Onychoscopy helps in picking up early nail findings in psoriasis and thereby warning the patients against impending disease severity.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205595
      Issue No: Vol. 7, No. 1 (2020)
       
  • Pediatric dermatological emergencies in tertiary health care

    • Authors: Vrutika H. Shah, Vidya D. Kharkar
      Pages: 58 - 63
      Abstract: Background: In recent years, the demand for dermatological consultations in the emergency department has increased. However, most of the publications of dermatological emergencies deal with the general population, without taking into account the changes in frequencies found in young children (ages 0-14 years). Dermatological emergencies in pediatric age group are not uncommon. The aim of our study was to analyse the spectrum of dermatological emergencies in the pediatric age group.Methods: A hospital‑based observational study was conducted at the Department of Dermatology of tertiary care centre, between September 2019 and February 2020. Thirty pediatric patients (age ≤16 years) who had visited Dermatology Outpatient Department (OPD) and emergency department were included in this study.Results: Total thirty patients were included in this study. The male to female ratio was 2:1. The average age of the study was 7.6 years. Maximum cases were in school-aged children (6 to 12 years), which were 12 (40%). The average duration of illness was 36.04 days. The most common condition was inherited conditions (23%) followed by primary cutaneous infections (20%). The cases were divided as 7 (23%) inherited conditions, 6 (20%) cases of infections, 5 (17%) cases each of vasculitis and cutaneous adverse drug reaction and 7 (23%) miscellaneous cases.Conclusions: Pediatric dermatological emergencies require an interdisciplinary approach for timely intervention. Standardised protocol should be followed in their management to prevent complications like acute skin failure. Early referral of these patients with primary skin conditions to the dermatologists might result in better clinical outcome and decreased mortality.  
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205596
      Issue No: Vol. 7, No. 1 (2020)
       
  • A clinicoepidemiological study of herpes zoster in a tertiary care
           institute

    • Authors: Ramesh A., Yuva Priya B.
      Pages: 64 - 68
      Abstract: Background: Herpes zoster which is also known as shingles, caused by reactivation of latent Varicella-zoster virus from the dorsal root ganglion. Although it is usually self-limiting in healthy adults, immunocompromised individuals are at higher risk of developing severe or visceral or disseminated cutaneous involvement. The study aimed to analyse the clinical patterns and epidemiological factors of herpes zoster.Methods: This was a cross-sectional study and conducted for 1 year. A total number of 100 patients with herpes zoster attending our dermatology outpatient department (OPD) were included in this study. A detailed epidemiological, clinical history and a complete dermatological examination were performed. Tzanck smear was done whenever necessary.Results: Out of 100 patients with herpes zoster, 64% were males and 36% were females. The age group varied from 20-80 years. The most commonly affected age group was 41-50 years. Thoracic dermatome was most commonly affected by 48%, followed by lumbar dermatome. In the total study population, left side dermatomal affection (55%) was more than the right side. Most of the patients presented with pricking type of pain.Conclusions: Herpes zoster can affect any age group with a higher incidence in elderly patients and immunocompromised individuals. Early recognition and treatment with antivirals within 72 hours of rash onset has shown a reduction in severity, complications, and postherpetic neuralgia.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205597
      Issue No: Vol. 7, No. 1 (2020)
       
  • Autologous serum therapy: a viable option for chronic spontaneous
           urticaria

    • Authors: Darshana Sundaresh, S. Kumaravel, M. Anbumalar
      Pages: 69 - 72
      Abstract: Background: Chronic urticaria (CU) is a common disorder causing decrease in quality of life of patients with associated morbidity, chronic dependence on medications and a huge pill burden. CU is multifactorial and a subset of patients have an autoimmune background for their condition which is confirmed by a positive skin reaction to ASST. This study compared the efficacy of Autologous serum therapy in both ASST positive and ASST negative patients by evaluating total severity score (TSS).Methods: This quasi experimental study was conducted on fifty patients were selected randomly and withdrawn from antihistaminic use. ASST was done for all patients and AST was administered to all patients in both groups for 9 weeks. The patients were followed up at 4 weeks and 12 weeks after completion of AST. TSS measurements were used as baseline and recorded weekly after each injections till 9 weeks then 4th and 12th week after completion of therapy.Results: 50 patients were the study population. The median age was 34.7 years with a female predominance. 23 patients were ASST positive and the rest were negative. Following treatment, ASST positive group had 69% improvement in TSS and ASST negative group had 61.5% improvement in TSS. There was statistically significant differences following treatment compared to baseline and between the two groups.Conclusions: AST as an adjunctive treatment for chronic urticaria shows promise for patients irrespective of ASST positivity and is more effective for ASST positive patients.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205598
      Issue No: Vol. 7, No. 1 (2020)
       
  • Erythroderma: a clinico etiological study of 77 patients in a tertiary
           care centre in Kerala

    • Authors: Abin Abraham Itty, Rajiv Sridharan, Anoop Thyvalappil, Bindurani Sudhamani
      Pages: 73 - 77
      Abstract: Background: Erythroderma is defined as generalized erythema and scaling of the skin affecting more than 90% of body surface area. Identification of the underlying disease process represents one of the most complex challenges in proper patient care.Methods: A retrospective study was done in Department of Dermatology in a Tertiary Care Centre. History, clinical findings and investigations of erythroderma patients were recorded and clinic-histopathological correlation was analyzed by kappa coefficient (К).Results: Erythroderma was more prevalent in elderly males with a mean age of 64.56 years and a male to female ratio of 3:1. A clinical evidence of pre-existing dermatoses was found in 65 patients, commonest being eczema (41.3%) followed by psoriasis (40.3%). Evidence of a trigger was seen in 54.54% patients, commonest being the use of ayurvedic medications (42.8%). Clinico-histopathological correlation was seen in 53.9% cases.Conclusions: Although the clinical presentation of erythroderma is similar, etiological factors are varied and it depends largely on the population studied. Most commonly, erythroderma is due to generalization of pre-existing dermatoses as seen in our study. Hence careful evaluation of clinical clues and histopathological correlation plays a pivotal role in diagnosis of the primary cause and the effective management of erythroderma.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205599
      Issue No: Vol. 7, No. 1 (2020)
       
  • Efficacy of platelet rich plasma in chronic leg ulcers: a prospective
           randomized controlled study

    • Authors: Naphisabet Wanniang, Pankaj Shukla, Varadraj V. Pai
      Pages: 78 - 84
      Abstract: Background: Chronic wounds affect approximately 1-2% of the population in Europe and the United States. Platelet rich plasma (PRP) has emerged as an effective, inexpensive, minimally invasive treatment modality for chronic leg ulcers. Objective of the study was to evaluate the efficacy of PRP, and to compare the effectiveness of PRP to regular antiseptic dressing in the management of chronic leg ulcers.Methods: A hundred patients with chronic leg ulcers of more than 6 weeks duration were randomized into two groups (PRP and conventional dressing group). Patients in the PRP group received weekly intradermal injections of PRP to the wound in addition to conventional daily dressings till complete healing of the ulcers or up to a maximum of 6 weekly PRP sessions. Percentage of improvement in the area and volume of the ulcers were recorded. Patients were followed up at 1 month post PRP treatment.Results: The mean reduction in the area of the ulcers at the end of 6 weeks was 66.39% in the PRP group and 28.6% in the control group. The mean reduction in volume of the ulcers at the end of 6 weeks was 71.80% and 37.88% in the case and control group respectively. At the end of 1 month post treatment follow-up, 74% and 10% of the ulcers treated with PRP and with conventional dressing respectively showed complete healing.Conclusions: Leg ulcers treated with PRP showed a significantly higher reduction in the area and volume of the ulcers compared to ulcers treated with conventional moist dressing.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205600
      Issue No: Vol. 7, No. 1 (2020)
       
  • Muco-cutaneous manifestations of chronic kidney disease with or without
           hemodialysis

    • Authors: Titiksha Hans, Devendra Kumar, Soumya Agarwal, Aliza Shoeb Zaidi, Swosti Mohanty, Aditi Wadhwa
      Pages: 85 - 90
      Abstract: Background: Mucocutaneous manifestations significantly impair the quality of life of patients with chronic kidney disease (CKD) but are usually understudied. Our objective was to study the patterns and prevalence of mucocutaneous and nail involvement in CKD patients and to compare those in patients with or without haemodialysis.Methods: Ninety patients aged 18-80 years having CKD (M: F=1.64:1) since mean duration of 4.43±9.9 months were studied in an observational cross-sectional study. Sixty-two (68.9%) patients were on hemodialysis since 42.64±63.14 months. Detailed history and examination, and relevant investigations like KOH mount, skin biopsy, gram stain and culture were done when required. Data was analyzed using SPSS version 21 software. Relevant tests were applied, p<0.05 was considered statistically significant.Results: Xerosis in 43 (47.7%), pruritus in 26 (28.9%), ichthyosis in 11 (12.2%), and skin pallor in 7 (7.8%) patients were major dermatoses. Xerosis was more commonly found in patients on haemodialysis (37.8%) as compared to those without dialysis (9.9%) (p-0.046). Bullous lesions, perforating folliculitis and foot ulcers occurred in 1 (1.1%) patient each. Common nail abnormalities were longitudinal ridging (21.1%), leukonychia (13.3%), Lindsay’s half‐and‐half nails (4.4%) and dystrophic nails (4.4%). Mucosal manifestations were coated tongue (2.2%%), angular cheilitis (2.2%), and pigmented tongue (1.1%).Conclusions: Xerosis, pruritus, ichthyosis skin pallor, longitudinal ridging, leukonychia, coated tongue, and angular cheilitis were the common mucocutaneous manifestations in our study. Early recognition and management of these dermatoses plays a crucial role in a holistic patient treatment, reduce disease morbidity and improve their quality of lives.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205601
      Issue No: Vol. 7, No. 1 (2020)
       
  • Clinical patterns and epidemiological characteristics of dermatophyte
           infection in Malwa region of Punjab

    • Authors: Anu Gupta, Alisha ., Ramgopal Saini, Sandeep Kaur
      Pages: 91 - 95
      Abstract: Background: Although dermatophytes are found throughout the world, the most prevalent strains and the most common sites of infection vary by region. Hot, humid climates and overcrowding predispose populations to skin diseases; including tinea infections. This study highlights the clinical pattern and epidemiological characteristics of dermatophyte infection in the Malwa region of Punjab.Methods: A cross sectional prospective study was carried out over a period of two years depending on pre-structured questionnaire on a total of 272 patients clinically suspected cases with dermatophyte infection. Socio-demographic and clinical information was collected and sample was taken. The collected samples were subjected to direct microscopy with potassium hydroxide and cultured on Sabourauds dextrose agar to identify the fungal speciesResults: A total of 272 patients were included in the study in which 147 were males and 125 were females. Occupation wise housewives were the most affected group constituting 114 cases. Tinea corporis was the most common type found in 159 cases and Trichophyton mentagrophytes was the most common isolated fungi. Maximum number of dermatophyte cases was in the age group of 21-30 years with 69 cases.Conclusions: In current research we observed that hot and humid environment of Malwa region of Punjab increases the prevalence of fungal infection especially in the month of June to September and the occupation of people also plays an important role in prevalence of infection. We also observed that dermatophyte fungal infection is more common in adult males as compare to females.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205602
      Issue No: Vol. 7, No. 1 (2020)
       
  • Effectiveness and safety of eberconazole 1% cream in Indian patients with
           Tinea corporis and Tinea cruris: a prospective real-world study

    • Authors: Jayakar Thomas, Siddhartha Das, Sunil Ghate, Manas Chatterjee, Sharad Teltumde, Sujeet Narayan Charugulla, Suyog Mehta, Amey Mane, Rahul Rathod, Ravindra Kale
      Pages: 96 - 107
      Abstract: Background: Tinea corporis and cruris are estimated to affect 22% to 55% of the Indian population. This real-world study was conducted to evaluate the effectiveness and safety of eberconazole 1% cream among Indian patients.Methods: In this prospective, single-arm, observational study, patients with Tinea corporis and cruris aged ≥18 years were prescribed eberconazole 1% cream (Ebernet®, Dr. Reddy’s Laboratory, India) for up to 3 weeks. The primary endpoint was proportion of patients with improvement in total signs and symptoms score with 2 weeks of treatment. The key secondary endpoint was mean percent reduction in individual signs and symptoms score (erythema, itching, scaling) from baseline to the end of the 1st, 2nd, and 3rd week. A post-hoc analysis was performed on a subgroup of patients (completer set [CS]) who reported application of eberconazole 1% cream for 3 weeks in the study. There were no adverse effects reported.Results: Of 120 enrolled patients;104 (86.7%) were included in the full analysis set (FAS) and 76 (63.3%) patients were included in the CS. After 2 weeks of treatment, total signs and symptoms score<2 was achieved by 25% of patients in the FAS and 28.9% in the CS. After 3 weeks of treatment, mean percent reduction in total sign and symptom score was 60.3% for erythema, 61.2% for itching, and 76.8% for scaling.Conclusions: The evidence from this real-world observational study and a post-hoc analysis suggests that eberconazole 1% cream is effective and safe treatment option in the management of Tinea corporis and cruris in Indian patients.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205603
      Issue No: Vol. 7, No. 1 (2020)
       
  • Cutaneous manifestations among health-care workers caring for COVID
           patients

    • Authors: Krishna Rajesh Kilaru, Kavya Chekuru, Pooja Munnangi, Mallesari Chennur, Babitha Sukhavasi, Manogna Chowdary Kilaru
      Pages: 108 - 112
      Abstract: Background: Due to the high transmission ability of the SARS-CoV-2 virus, front-line healthcare workers (HCWs) are at a greater risk of contracting the infection during the management of COVID patients. As a result, prevention measures against COVID-19 disease transmission like personal protective equipment (PPE) and frequent hand washing have become a necessity. While these measures are effective against COVID-19 transmission, they have negative implications as well, one of which is their detrimental effects on the skin. The objective of the study was to understand the prevalence and pattern of cutaneous manifestations among HCWs caring for COVID patients.Methods: A descriptive study on HCWs caring for COVID-19 patients was conducted at a designated COVID hospital from September to October 2020. Data on protective measures taken and cutaneous examination findings were recorded and analyzed.Results: Among 310 HCWs in this study, 137 HCWs (44.19%) had skin rash. The highest incidence of cutaneous manifestations was seen among nurses (48.33%), followed by doctors (42.29%) and support staff (33.33%). Hand eczema (43.80%) was the most common manifestation, followed by acne (22.63%), hair fall (18.98%), sweat dermatitis (11.68%), pressure dermatitis (10.22%), irritant contact dermatitis (7.30%). Seborrhea capitis, pruritus, xerosis, hyperpigmentation, urticaria, tinea corporis, and eczema over legs were the other cutaneous manifestations seen in this study.Conclusions: Nearly half of the HCWs in this study had cutaneous manifestations. Hence, there is a need to educate the HCWs regarding best practices for the prevention of skin damage caused by PPE and frequent hand wash.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205604
      Issue No: Vol. 7, No. 1 (2020)
       
  • Resurfacing of facial acne scars with pulsed carbon dioxide laser: a case
           series of 10 patients

    • Authors: Anil P. Gosavi, Ravindranath B. Chavan, Darshana R. Kundale, Neelam Bhatt
      Pages: 113 - 117
      Abstract: Acne vulgaris is a common skin disorder affecting 80% of people between 11-30 years of age with many experiencing some degree of scarring. Pulsed wave carbon dioxide (CO2) laser resurfacing is a recent addition in armamentarium of treatment options for acne scars. This study focuses on one of the most common type of acne complication - atrophic scars treated with pulsed wave carbon dioxide laser. To evaluate efficacy of pulsed carbon dioxide laser for treatment of mild to moderate atrophic facial acne scars. 10 subjects (6 male and 4 females, aged 22-35 years) with skin type III-V and atrophic acne scars were treated with 4 sessions of carbon dioxide non-ablative laser resurfacing on 6 weeks interval. 7 out of 10 subjects in our study perceived an excellent to good improvement with 2 patients showing fair improvement and 1 patient with no improvement. Adverse effects were limited to prolonged erythema (two patients), and post-inflammatory hyperpigmentation (three patient). Excellent to good clinical improvement observed in 70% of patients with acne scars. This underscore pulsed carbon dioxide laser’s effectiveness in the treatment of mild to moderate atrophic acne scars.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205605
      Issue No: Vol. 7, No. 1 (2020)
       
  • Cutaneous manifestations of COVID-19: experience from a tertiary care
           center for COVID-19 management in South India

    • Authors: Olasseri K. R. Mariyath, Sreekanth Sukumarakurup, Koyakutty A. Samad, Keerankulangara Devi, George Nikhil, Ulpurath Minu, Premachandran Mekha, Mohamed Shaan
      Pages: 118 - 122
      Abstract: Cutaneous manifestations observed in COVID-19 include maculopapular rash, urticaria, pseudo chilblain, vesicles, livedo reticularis, petechiae, erythema multiforme-like, symmetric drug related intertriginous and flexural exanthem (SDRIFE)-like and pityriasis rosea-like lesions. Maculopapular rash involving the trunk and sparing palms and soles is the most common cutaneous manifestation reported in COVID-19 patients. We report cutaneous manifestations in six COVID-19 patients from the corona isolation ward and intensive care unit of a tertiary care center for COVID-19 management in Kerala, South India. The skin lesions observed were urticaria (two patients), atypical maculopapular rash with urticarial and erythema multiforme-like lesions, eruptive pseudoangiomatosis, exaggerated insect bite reaction and acute localized exanthematous pustulosis (ALEP)-like lesions. To the best of our knowledge atypical maculopapular rash with urticarial and erythema multiforme-like lesions, eruptive pseudoangiomatosis and acute localized exanthematous pustulosis-like lesions are not reported in COVID-19.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205606
      Issue No: Vol. 7, No. 1 (2020)
       
  • A report of seronegative clinically amyopathic dermatomyositis

    • Authors: Milad Heydari-Kamjani, Jessica Forbes, Lailah Issac, Michelle Demory Beckler, Marc M. Kesselman
      Pages: 123 - 125
      Abstract: Clinical amyopathic dermatomyositis is a rare idiopathic inflammatory disease within the spectrum of dermatomyositis. This disease entity presents with similar cutaneous findings as dermatomyositis, but the clinical manifestation of myositis is absent. Given the increased risk also associated with clinical amyopathic dermatomyositis, a high index of suspicion is imperative to minimize rheumatologic and dermatologic misdiagnoses. Here we report a case of seronegative CADM in a young female athlete.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205607
      Issue No: Vol. 7, No. 1 (2020)
       
  • Persistence pays: a case of primary cutaneous B-cell lymphoma masked by
           granulomas

    • Authors: Ruple Jairath, Neil K. Jairath, Timothy Vandenboom, Michael T. Goldfarb
      Pages: 126 - 128
      Abstract: Primary cutaneous diffuse large B cell lymphoma is a form of cutaneous lymphoma characterized by a clonal proliferation of B cells that is often presents with a delayed diagnosis, and therefore often carries poor prognosis. We report a 77-year-old female presenting with a shin lesion resembling a deep dermal or fungal process. Initial biopsy revealed superficial and deep mixed granulomatous inflammatory infiltrate, which suggested an initial diagnosis of Majocchi’s granuloma, despite negative fungal cultures. Despite treatment, the progressive worsening of the skin lesions prompted multiple repeat biopsies, which eventually revealed CD20, Bcl-2, and Bcl-6 staining, loss of CD3 and CD30, and high Ki67, compatible with a cutaneous high-grade B-cell lymphoma. Clinical presentations of primary cutaneous diffuse large B cell lymphoma can mimic several different clinical entities, rarely including granulomatous disease, such as a fungal pathology. This report highlights the importance of persistence and a multimodal approach to the diagnosis of unidentified skin lesions, especially in the setting of failure to respond to standard therapies.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205608
      Issue No: Vol. 7, No. 1 (2020)
       
  • Successful treatment of granuloma faciale

    • Authors: Sahar H. Alsharif, Reda H. Saifaldeen, Logain G. Alghanemi
      Pages: 129 - 131
      Abstract: Granuloma faciale (GF) is a chronic condition characterized by asymptomatic erythematous plaque with prominent telangiectasia presenting usually over the face. Although the condition is benign, its treatment is often unsatisfactory. Therapeutic modalities that have been tried include topical steroids and topical tacrolimus sometimes enhanced with topical dapsone. Others include intralesional corticosteroids, antimalarials, isoniazid and pulsed-dye laser. We report a case of a 58 years old female with a 1 year history of a solitary slowly progressive plaque over the nose. Diagnosis of GF was made based on the histopathological findings. The patient was started on the combination of topical tacrolimus, intralesional corticosteroids injection and oral doxycycline for 3 months. The patient showed gradual improvement in 3 months without any side effects. This case supports previous papers of successful treatment of GF with topical tacrolimus. There was no recurrence at follow-up 18 months later. It also supports the use of combination therapy especially in resistant cases.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205609
      Issue No: Vol. 7, No. 1 (2020)
       
  • Double trouble-pulmonary tuberculosis in a patient of lepromatous leprosy

    • Authors: Avinash Pravin, Geo Danny Celestin, Ashok Kumar, D. Manoharan
      Pages: 132 - 134
      Abstract: The association of two of the oldest diseases of mankind, leprosy and tuberculosis (TB) has been uncommonly reported within the literature. Herein, we report a known case of leprosy subsequently related to sputum positive TB complicated by a type-II lepra reaction. there's a requirement for screening of patients for TB in patients diagnosed with leprosy to stop the accidental misuse of a crucial drug, rifampicin to stop the likelihood of drug-resistant TB.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205610
      Issue No: Vol. 7, No. 1 (2020)
       
  • Dyssebacea: a feature that points to an underlying pellagra

    • Authors: Neethu Mary George, Amruthavalli Potlapati
      Pages: 135 - 137
      Abstract: Niacin (vitamin B3) is a B complex vitamin whose deficiency leads to pellagra, a condition with characteristic cutaneous, gastrointestinal and neurological features. In the western world, it is almost eradicated due to fortification of flour with niacin. In developing countries, it is commonly seen in low socioeconomic group of population or in areas where corn or maize is a staple diet and it generally affect adults. The role of niacin has also been detected in various non dermatological conditions like hypertension apart from its dermatological uses. Its deficiency can easily be missed unless the patient presents with the characteristic photosensitive rash. “Dyssebacia” is the name coined to describe numerous plugs of inspissated sebum projecting from dilated orifices of sebaceous gland. It is occasionally found to precede other dermatological findings in pellagra. Hence it is important for a clinician to know this unusual finding, dyssebacea, which helps in early detection and treatment of the deficiency.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205611
      Issue No: Vol. 7, No. 1 (2020)
       
  • Genital vesicobullous disease-not herpes genitalis!

    • Authors: Sachin Dhawan, Naina Jain, Meenakshi Batrani
      Pages: 138 - 140
      Abstract: Genital bullous pemphigoid (BP), a localized subset of bullous pemphigoid, has been identified in children and women in the past. However, we report an adult male presenting with blisters confined to glans and shaft of penis, mimicking herpes genitalis, failing antiviral therapy. The patient responded to treatment with dapsone.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205612
      Issue No: Vol. 7, No. 1 (2020)
       
  • Expert consensus on management of dermatophytosis in elderly patients,
           patients with comorbidities, and immunocompromised status: an Indian
           perspective

    • Authors: Jayakar Thomas, Anchala Parthasaradhi, A. K. Bajaj, Mukesh Girdhar, Asok Ghoshal, Rizwan Haq, Maleeka Sachdev, Anil Ganjoo, Bikash R. Kar
      Pages: 141 - 149
      Abstract: Dermatophytosis is a common fungal infection of skin contributing to increasing disease burden worldwide. Increasing age, presence of comorbid conditions and immunity have a profound impact on the manifestation of dermatophyte infections. Treatment of dermatophytosis includes monotherapy, combination therapy, or sequential therapy of antifungal drugs. However, specific patient populations such as the elderly, people with comorbid conditions, immunocompromised patients, etc. are subjected to inappropriate adverse events due to highly interacting host and drug factors. Thus, the management of dermatophytosis in special populations is a challenge, and it demands a change in the regular treatment plan. A group of Indian experts reviewed the evidence available on different antifungal agents for the management of dermatophytosis and provided their expert opinion on safe and effective management of the condition in special clinical scenarios. This article summarizes the consensus clinical viewpoint of the entire expert panel for a choice of the antifungal drug, factors to be assessed, and treatment considerations in special populations with dermatophytosis. The panel emphasized that complete knowledge of patient's clinical history, presence of comorbid conditions, and pharmacokinetic and pharmacodynamic characteristics of antifungal agents and associated potential drug interactions are essential for the successful management of dermatophytosis in these patients. Also, regular monitoring of drug toxicity is important during antifungal therapy in special population.
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205613
      Issue No: Vol. 7, No. 1 (2020)
       
  • Practice pattern and use of serum peptide formulation in patients with
           alopecia: results of an opinion survey among dermatologists in India

    • Authors: Rekha Lanjekar
      Pages: 150 - 154
      Abstract: To evaluate practice pattern and preference for use of serum peptide formulation by dermatologists for the treatment of alopecia. Dermatologists in India were administered a questionnaire consisting of questions related to number of patients with alopecia seen every week, investigations, prevalence of nutritional deficiencies and use of serum peptide formulation in telogen effluvium (TE) and androgenetic alopecia (AGA). The responses were analysed as number and percentages. Out of 124 dermatologists, 38 (31%) reported that they see 11-15 patients with TE every week and 31 (25%) reported seeing 11-15 patients of AGA per week. According to 51 (41%) dermatologists, 40-60% patients with hair loss have some nutritional deficiency and 95 (77%) reported that iron deficiency profile, thyroid stimulating hormone (TSH), vitamin B1 and vitamin D level estimation is necessary in patients with TE. A total of 86 (69%) dermatologists preferred serum peptide formulation in patients with TE and AGA. Ninety nine (80%) and 75 (60%) dermatologists reported “very good” or “good” efficacy of serum peptide in TE and AGA respectively. Ninety nine (80%) dermatologists said, gender is not an important criterion for choosing a serum peptide in hair fall. For aesthetics related parameters, Folliserum (Abbott Health care Pvt Ltd) was rated as “Very good” and “Good” by 66 (53%) and 38 (31%) dermatologists respectively. According to dermatologists in India, nutritional deficiency is common in patients with alopecia. Majority of the survey participants rated Folliserum as “Very good” or “Good” for its efficacy and aesthetic parameters. 
      PubDate: 2020-12-24
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20205614
      Issue No: Vol. 7, No. 1 (2020)
       
 
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