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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]
  • Effectiveness of a combination of anti-pigmentary products in facial
           post-inflammatory hyperpigmentation

    • Authors: Chitra S. Nayak, Saba M. M. Ansari, Vrushali Salve, Shweta Patil
      Pages: 1 - 8
      Abstract: Background: Post-inflammatory hyperpigmentation (PIH), also has psychosocial implications. Hydroquinone containing preparations though effective, have unacceptable side effects. Molecules like kojic acid, arbutin, vitamins C and E, niacinamide and many others have depigmenting effect, singly or in combination. The objective of this study was to assess the effectiveness and tolerability of a cream containing a combination of niacinamide-4.0%, glycolic acid-2.0%, vitamin E acetate-0.1%, kojic acid dipalmitate-2.0%, soy isoflavones-0.5%, arbutin-2.0%, pterowhite-0.12%, licorice-40% CA-0.12%, ascorbyl glucoside-0.1% (Melaglow-Rich, Abbott Healthcare Pvt. Ltd.) in treatment of PIH. The specific objectives were to evaluate the changes in pigmentation, safety of the cream and patient opinion regarding the cream after 90 days of use.Methods: After IEC approval, adult males and non-pregnant, non-lactating females aged upto 50 years with PIH were included. Those with endocrinopathies who received systemic steroid therapy in the preceding month were excluded. 114 participants who were enrolled in this open-label, non-comparative study, applied study medication (b.i.d) and sunscreen (SPF-30; q.d). Effectiveness was assessed by PIH severity scale, Mexameter assessment, Patients’ and Physicians’ Global Assessment Scale and clinical photographs. Adverse events were documented.Results: Mean PIH score and mean mexameter reading for melanin and erythema in the hyperpigmented and non-hyperpigmented skin reduced by day 90 (p=0.0009, p<0.0001, p<0.001). Significant reduction in physicians’ (p=0.004) and patients’ (p=0.006) global assessment score was evident by day 90. Itching (n=1), burning (n=3) and stinging (n=3) were noted.Conclusions: Melaglow rich cream was found to be effective and well-tolerated in the treatment of PIH.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195199
      Issue No: Vol. 6, No. 1 (2019)
       
  • Relationship of cutaneous manifestations with inflammatory markers in
           diabetic nephropathic patients on haemodialysis

    • Authors: Srinivas Subbaramaiah, Nagendra Subbaramaiah, Anvitha Chidanand, Prashanthkumar Goudappala, Kashinath Rattihalli Thirumala Rao
      Pages: 9 - 13
      Abstract: Background: Diabetic nephropathy is a serious life threatening complication of type-2 diabetes mellitus. Apart from severe kidney dysfunction these patients are prone to various cutaneous complications including psoriasis and eczema due to accumulated nitrogenous waste products. Inflammation is the basic cause of cutaneous complications and many inflammatory markers have been shown elevated in chronic kidney dysfunction. Hence a study has been planned to assess the levels of inflammatory markers such has C-reactive protein (CRP) and interlukin-6 (IL-6) as well as to correlate these markers with creatinine levels along with existing cutaneus complications.Methods: The study included 50 diabetic nephropathic patients undergoing regular heamodialysis. A heparanised blood sample was collected and plasma was employed for estimation of glucose, creatinine, CRP and IL-6. A detailed dermatological examination was done to record the cutaneous complications like pruritis, xerosis, hyper pigmentation and half & half nails.Results: The results show a significant raise in CRP and IL-6 levels in proportion to the severity of kidney dysfunction as reflected by creatinine levels. Also a positive relationship was observed between the inflammatory markers and multiplicity of cutaneous complications.Conclusions: It can be concluded from the present study that evaluation of inflammatory markers, CRP and IL-6 along with creatinine is beneficial in controlling cutanious complications in DN patients undergoing regular heamodialysis.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195176
      Issue No: Vol. 6, No. 1 (2019)
       
  • A study of clinical spectrum of patterns of cutaneous adverse drug
           reactions in a tertiary care hospital

    • Authors: Narendra Gangaiah, Veena Thimmappa, Harish Kumar Gajam, Naveen Kumar
      Pages: 14 - 19
      Abstract: Background: Adverse drug reactions are unwanted pharmacodynamic effects following administration of a drug. With an increase in number of newer drugs adverse drug reactions have become very common in recent times. Among them cutaneous reactions have been steadily gaining importance and constitute a major proportion of all the adverse drug reactions.Methods: This observational study was conducted at Sri Siddhartha Medical College and Hospital Tumkur, Karnataka, India, involving 73 patients with cutaneous adverse drug reaction (CADR) during November 2016 to May 2018. The aim of the study is to identify the causal drug and categorised into definite/probable/possible Naranjo Algorithm scale was used.Results: The mean age of study participants was 35 years. Majority of cases observed had fixed drug eruptions (FDE: 37%), followed by maculo papular drug reaction (MPDR: 26%). Antimicrobials (42%), non-steroidal anti-inflammatory drugs (NSAIDs: 26%), anticonvulsants (9.5%) were commonly implicated drugs causing CADR. Among those with FDE, definite causality was highest for NSAIDs (9.6%) predominantly paracetamol whereas in MPDR definite causality was noted with anti-tubercular drugs (rifampicin 1.4%) and probable causality was highest for cephalosporins (5.5%) predominantly cefpodoxime. In present study it was observed female patient aged ≥35 years showed statistically significant mucosal involvement and past history of CADRs.Conclusions: A wide range of clinical spectrum of CADRs ranging from FDE to serious toxic epidermal necrolysis was observed. Most of these drug eruptions were caused by antimicrobials. Eliciting past history of CADRs with causal association will help to prevent and manage cases in a better way.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195670
      Issue No: Vol. 6, No. 1 (2019)
       
  • Etiological profile of pyodermas in a tertiary care hospital in North-East
           India and their antibiotic sensitivity pattern

    • Authors: Bijayanti Devi, Kamal Das, Suman Gupta
      Pages: 20 - 24
      Abstract: Background: Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017. Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors.Methods: In this study, a special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.Results: The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.Conclusions: Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195671
      Issue No: Vol. 6, No. 1 (2019)
       
  • Clinico-epidemiological study of facial dermatoses among adolescents

    • Authors: Manjunatha Hemalingaiah, Raghuveer Chekuri, Veeresh .
      Pages: 25 - 30
      Abstract: Background: The obsession of getting a flawless skin is more for adolescents than in any other age group. But these problems are seldom given enough importance. Very common problem like acne vulgaris can cause serious psychological impact in them.Methods: Four hundred consecutive adolescent (10-19 years) patients with facial dermatoses presenting to skin department, VIMS, Ballari were selected for the study. Study design was descriptional and cross sectional, conducted from January 2013 to December 2013.Results: Eighty seven percentage of the study population was students and the rest were either labourers or drivers. Acne vulgaris was the diagnosis in 304 (76%) of cases. Second most common condition was seborrheic dermatitis accounting for 24 (6%) of cases.Conclusions: Facial dermatoses are common among the adolescents. These dermatoses are of a major cosmetic concern in this age group. Early diagnosis and proper management with education of patients is important to prevent late disfiguring complications and psychological sequelae.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195204
      Issue No: Vol. 6, No. 1 (2019)
       
  • A study of clinical course and therapeutic response of sexually
           transmitted infections in people living with HIV/AIDS

    • Authors: Ram Kanta Halder, Pradeep Balasubramanian
      Pages: 31 - 33
      Abstract: Background: Human immunodeficiency virus (HIV) continues to be a major public health problem worldwide. Once a person is infected with HIV, the manifestations of other infections and diseases are altered due to waning of the host immunity.Methods: This study was carried out in HIV reactive patients in Command Hospital, Pune. The types of sexually transmitted infections (STIs) in those patients and the response to therapy were studied in detail. The statistical data was expressed as number and percentages.Results: In this study, 52 people living with HIV/AIDS (PLWHA) who were having various STIs were included. Majority of the patients in this study belonged to the age group of 20-34 years (75%). The most common STIs encountered were condyloma acuminata (38.45%) followed by syphilis (30.77%), lymphogranuloma venereum, herpes genitalis, chancroid, molluscum contagiosum, gonorrhea and granuloma inguinale. Resistance to antimicrobial therapy at the standard dosage, requirement of higher dosage, resistance and relapse of infections were observed in the patients with PLWH.Conclusions: Several STIs coexisted with HIV infected patients. Unusual clinical presentations, clinical course and treatment failure in STI were common in HIV infected individuals. Hence all STI patients should be screened for HIV and vice-versa.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195575
      Issue No: Vol. 6, No. 1 (2019)
       
  • Clinico-epidemiological study of genodermatoses in pediatric age group

    • Authors: Kalyan Dalave, Mahendra Singh Deora, Sonia Sabhandasani, Pallavi Singh, Alisha Mittal, Bhavika Shah
      Pages: 34 - 42
      Abstract: Background: Genetic diseases causing abnormalities in structure and/or function of skin are termed as genodermatoses. As there is paucity of epidemiological data of genodermatoses from our country, this study was conducted to determine the latest clinical and epidemiological trends of pediatric genodermatoses.Methods: A hospital-based observational study consisting of 35 clinically diagnosed pediatric genodermatoses cases, who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of two years. Socio-demographic and clinical information was collected and clinical examination was performed on all patients to record any cutaneous/extra-cutaneous abnormality. The participants were then subjected to necessary investigations to elucidate the additional disease components. The data was evaluated using appropriate statistical methods.Results: Out of 4032 pediatric patients, 35 were found to have genodermatoses. Majority (57.14%) cases belonged to the first decade of life. There was no sexual predilection (male:female - 0.94:1). The commonest genodermatoses detected were neurofibromatosis and tuberous sclerosis (17.14% each). Most common mode of inheritance seen was autosomal dominant (57.14%). Family history and consanguinity were recorded in 45.71% and 22.86% cases respectively. Café-au-lait macules seen in 22.86% cases and ocular anomalies recorded in 34.38% cases were the commonest cutaneous and extracutaneous manifestations, respectively.Conclusions: Genodermatoses are rare skin disorders with systemic involvement at times, resulting in poorer prognosis. This necessitates more focus on this speciality.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195576
      Issue No: Vol. 6, No. 1 (2019)
       
  • Prospective study on comparison of efficacy of topical anti-fungal agents:
           clotrimazole 1% and sertaconazole 2% in treatment of tinea cruris

    • Authors: Som J. Lakhani, Dhaval B. Joshi, Kalindi R. Kumbhani, Rajesh B. Haldia
      Pages: 43 - 47
      Abstract: Background: Tinea cruris is a common superficial dermatophytic infection of the skin occurring in 20-25% population worldwide. The various types of antifungal agents are available for topical use in treatment of tinea cruris. Clotrimazole is conventional imidazole antifungal drug whereas sertaconazole is newer imidazole antifungal claimed to be superior to clotrimazole in tinea infection. The aim of the study was to determine and compare the efficacy of potent topical azole agents 1% clotrimazole and 2% sertaconazole in patients diagnosed with tinea cruris attending out-patient department of skin and VD of tertiary care hospital in Vadodara.Methods: A total of 71 patients diagnosed with tinea cruris were divided into two groups. Group A received topical clotrimazole (1% cream), and Group B received topical sertaconazole (2% cream). Outcome parameters such as erythema, scaling, itching, margins of lesions and size of lesions were noted atthe time of hospital visit, by 3rd week and by 6th week for the assessment of efficacy. The statistical test used was independent student t-test and software used was SPSS 20.0.Results: At the end of follow-up phase, both the drugs were found to be effective with no recurrence or relapse of tinea cruris. However, compared to clotrimazole 1% cream, sertaconazole 2% cream had statistically significant rapid relief in terms of reduction in clinical parameters such as erythema (p<0.001), scaling (p<0.001), itching (p<0.001), size of lesion (p<0.001) and margin of lesion (p<0.011).Conclusions: Topical sertaconazole 2% cream was found to be highly efficacious and superior to clotrimazole 1% cream in improvement of clinical parameters of tinea cruris.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195672
      Issue No: Vol. 6, No. 1 (2019)
       
  • Clinico-epidemiological study of facial hyper-melanoses among patients
           attending dermatology outpatient department at a tertiary care hospital at
           Pondicherry

    • Authors: Chitralekhya Rao, Oudeacoumar Paqurissamy, Govardhan J., Varsha Medasani
      Pages: 48 - 56
      Abstract: Background: Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study titled “Clinico-epidemiological study of facial hyperpigmentation” was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017.Methods: Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors. A special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.Results: The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.Conclusions: Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195673
      Issue No: Vol. 6, No. 1 (2019)
       
  • Topical steroids more abused than used! A cross-sectional study in the
           outpatient department of dermatology in a tertiary care centre in coastal
           Karnataka

    • Authors: Rashmitha Nagaraj, Shruthi Hassan Nagaraj
      Pages: 57 - 61
      Abstract: Background: Topical corticosteroids (TCS) are one among the most commonly prescribed medications in the ambulatory setting. They exhibit anti-inflammatory effects, immunosuppressive effect, antiproliferative effects and vasoconstriction.Methods: A total of 400 patients who had visited the outpatient department or was admitted in the department of dermatology and had applied topical corticosteroids for a duration of 2 or more weeks were included for the study over a period of 2 months in June and July 2018. This study is clinical and observational, to evaluate the topical corticosteroids abuse cases.Results: Out of 400 people 304 [76%] patients were either recommended or prescribed TCS by a non-physician source. And the rest 96 [24%] patients were been prescribed by the medical fraternity. Majority of patients have applied TCS belonging to super potent class [294/400] duration of usage varied from 2 weeks to 2 years and amount from 10 to 240 g. The most common consequences of TCS abuse was rebound phenomenon followed by hypopigmentation, striae.Conclusions: Prolonged and continuous use of TCS can cause many adverse effects with varying clinical presentation. Treatment is difficult as there is rebound phenomenon with discontinuation of TCS. Gradual withdrawals of TCS with supplementation of adequate treatment to the present clinical issue are usually recommended to get good clinical results.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195674
      Issue No: Vol. 6, No. 1 (2019)
       
  • Chronic kidney disease and its reflections on skin: a study from
           North-East India

    • Authors: Bijayanti Devi, Ranjit Chandra Das, Suchanda Das, Anup Goswami
      Pages: 62 - 69
      Abstract: Background: Chronic kidney disease is associated with a variety of cutaneous manifestations as a result of underlying etiology as well as the various treatment modalities.Methods: A hospital based cross sectional study was carried out for two year among 100 diagnosed cases of chronic kidney disease admitted in the Department of General Medicine, Regional Institute of Medical Sciences, Manipur, India having at least one mucocutaneous manifestation. Complete clinical and dermatogical evaluation and relevant investigations were done in all patients.Results: There were 57% male and 43% female patients. The maximum number of study subjects belonged to the age range of 41 to 60 years. Diabetes mellitus was the commonest (39%) cause of chronic kidney disease in this study, followed by hypertension (32%), chronic interstitial nephritis and chronic glomerulonephritis (9%) each, other diseases (7%) and obstructive uropathy (4%). Sixty three percent of the patients were managed under conservative therapy and rest (37%) was on dialysis. Xerosis (72%) was the most common cutaneous manifestation followed by pallor (64%), pruritis (56%), hyperpigmentation (51%), yellowish hue (21%), dermatitis (10%) and others (24%). Infectious skin manifestations were present in 43% of study population, among which fungal, bacterial, viral disease constituted 19%, 17% and 7% respectively. Mucosal changes, hair changes and nail changes were reported in 77%, 68%, 119% cases respectively.Conclusions: Early recognition and management of the dermatological manifestations vastly reduce the morbidity and improve the quality of life in chronic kidney disease patients.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195675
      Issue No: Vol. 6, No. 1 (2019)
       
  • Evaluation of vitamin D status, selenium and C-reactive protein level in
           psoriasis

    • Authors: S. Sumathi, S. Vinod Babu, K. Karthikeyan
      Pages: 70 - 74
      Abstract: Background: Psoriasis is an inflammatory skin disease associated with a variety of clinical conditions. Study aim to evaluate the association of vitamin D, selenium and C-reactive protein (CRP) levels in psoriasis.Methods: This hospital-based case-control study involved 50 psoriasis cases and 47 healthy individuals. Serum vitamin D, selenium and CRP levels were measured, and the general demographic values were also recorded.Results: Statistical analysis revealed that vitamin D levels are significantly lower in psoriasis (p<0.005). Among the demographic parameters, obesity was found more common among psoriasis cases than controls. Serum selenium and CRP levels were not significantly different between the two groups.Conclusions: Vitamin D deficiency is strongly associated with psoriasis. Vitamin D supplementation can be useful in psoriasis management and also in the reduction of obesity. Serum selenium and CRP levels aren’t significant markers to demonstrate psoriasis.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195681
      Issue No: Vol. 6, No. 1 (2019)
       
  • Evaluation of newer imidazoles in dermatophytosis

    • Authors: Annie Ratnam Nakka, Janardhan Bommakanti, Siva Rami R. Karumuri, Naresh B. Thambisetti
      Pages: 75 - 79
      Abstract: Background: Eberconazole, a newer Imidazole derivative, antimycotic drug. Similarly, sertaconazole and luliconazole are also newer antifungal which all exhibit fungicidal, fungistatic and anti-inflammatory actions. But, sertaconazole in addition have antipruritic effect also.Methods: Randomized, open-labelled, prospective study comprising of 75 patients divided into three equal groups A, B, C of 25 patients each. Group A received eberconazole 1%, Group B received sertaconazole 2% and Group C received luliconazole 1% for twice daily topical application for 4 weeks. Patients were asked to review at 2nd and 4th week to record clinical and mycological cure.Results: In this study out of 75, seventy patients completed the complete course of treatment whereas, five patients were not reported for review citing personal reasons. Parameters included are pruritus, erythema, scaling and vesicles in all three groups. In this study, marked relief of pruritus was achieved clinically with eberconazole (72.7%) followed by luliconazole and sertaconazole with 50.0% and 33.3% respectively at 4th week of treatment phase and reduction of scaling was achieved more with eberconazole (90.9%), sertaconazole (87.5%) and luliconazole (83.3%). All three groups of patients showed successful mycological cure by confirming with negative 10% potassium hydroxide examination at the end of treatment course.Conclusions: Eberconazole 1% cream was better than sertaconazole 2% cream and luliconazole 1% cream in relieving symptoms like pruritus and scaling at the end of treatment phase and follow up.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195677
      Issue No: Vol. 6, No. 1 (2019)
       
  • A study on prevalence of depression in patients of vitiligo in tertiary
           care centre in South India

    • Authors: Sneha R. Rathi, Ambresh S. Badad, Ashok S. Hogade
      Pages: 80 - 83
      Abstract: Background: Skin is an organ that has a primary function in tactile receptivity and reacts directly upon emotional stimuli. The effects on the quality of life as a result of acquiring vitiligo is highlighted.Methods: 100 patients with vitiligo were included in this study. A survey was done on the basis of Hamilton score of depression (HAM-D) having 17 different points that were supposed to be asked.Results: The majority of the patients in this study were in 3rd to 5th decade. Mean age is 42 years. Of these, males were 44 and females were 56. Of these, 25 (25%) patients did not show any signs of depression, 45 (45%) patients showed mild depression, 20 (20%) patients showed moderate depression and 10 (10%) patients showed severe depression on HAM-D scale.Conclusions: Vitiligo is a secondary psychocutaneous disorder which definitely has psychiatric co morbidity inthe form of depression. Treatment of vitiligo should include psychiatric counselling along with specific treatment.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195678
      Issue No: Vol. 6, No. 1 (2019)
       
  • A clinicoepidemiological study of adult acne

    • Authors: Aneesa Sajeed, Yogesh Devaraj, Belagola D. Sathyanarayana, Mukunda Ranga Swaroop, Shruti Bidarkar
      Pages: 84 - 88
      Abstract: Background: Acne vulgaris is a chronic inflammatory dermatosis of pilosebaceous unit. Adult acne is defined as presence of acne after the age of 25 years. Though acne vulgaris has been studied extensively, there is paucity of literature on adult acne.Methods: A total of 150 patients with adult acne were enrolled in the study. A detailed history was taken followed by detailed dermatological examination. Ultrasonography abdomen and pelvis, hormonal evaluation was done in case of women with symptoms and signs of hyperandrogenism.Results: Out of 150 patients studied, majority (61.3%) were in the age group of 26-30 years. The mean age of patients with adult acne was 30.1 years. Females (86%) outnumbered males. Majority of the patients (53.3%) had persistent adult acne and 46.7% had late onset acne. Exposure to sunlight (24%) was the most common aggravating factor followed by use of cosmetics in 19.3%. Menstruation was causing flare up of acne in 72 (55.8%) female patients. Face was involved in all the patients. Cheek was the most common site involved followed by forehead. Post acne scarring was present in 46.6% of the patients. Majority of the patients (67.3%) had grade 2 acne. Symptoms and signs of hyperandrogenism were present in 14 female patients.Conclusions: Adult acne is more common in females. Persistent acne is more common than late onset acne. Patients with persistent adult acne are more prone to develop nodulocystic acne and acne scars.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195679
      Issue No: Vol. 6, No. 1 (2019)
       
  • Clinico-mycological study of onychomycosis

    • Authors: Sumedha Ballal, Ishwara Bhat P., Anil Abraham, Jayanthi Savio
      Pages: 89 - 94
      Abstract: Background: Onychomycosis is the most common infective nail disorder accounting for 30% of cutaneous mycoses. Though predominantly caused by dermatophytes, yeast and non-dermatophyte moulds have also been implicated. Aim of this study was to describe and analyse clinical and mycological pattern of onychomycosis.Methods: One hundred patients with onychomycosis diagnosed by direct potassium hydroxide microscopy and culture were included. Nail specimens were collected for fungal culture as per standard procedure. An analysis of demographic data, clinical features and mycological results was made.Results: Majority of the affected cases were between 19 to 85 years of age. Fingernail onychomycosis was seen in 41 patients, toenail was seen in 46 patients, concurrent involvement was seen in 13 patients. The predominant clinical pattern seen was distal lateral subungual type (70%). Culture was positive among 49% patients. Among these patients non dermatophyte growth was predominant (72%) showing. Aspergillus species (31%) and Fusarium species (31%), Cladosporium species (4%) and Scytalidium species (2%). Trichophyton species (16%) and Candida species (16%) were also isolated. The clinico-etiological correlation revealed that a single pathogen could give rise to more than one clinical type of onychomycosis. Non-Dermatophyte moulds were the most common isolate followed by yeasts and dermatophytes. This is in contrast to earlier studies from a similar geographical region where dermatophytes were the commonest pathogen.Conclusions: Non-dermatophyte moulds are emerging as the predominant isolate in onychomycosis. The clinical pattern of nail involvement showed no correlation with the fungal isolate.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195680
      Issue No: Vol. 6, No. 1 (2019)
       
  • Rosacea: do microbes have some role in its causation' A
           cross-sectional study from North-East India

    • Authors: Bijayanti Devi, Jantu Kumar Bhaumik, Nandita Bhattacharjee
      Pages: 95 - 99
      Abstract: Background: Rosacea is a common inflammatory disease affecting the centrofacial skin. The etiopathogenesis is unknown and the disease follows a chronic course. It causes great social discomfort and reduces quality of life.Methods: A cross sectional study was conducted from October 2011 to September 2013 in the Department of Dermatology, Venereology and Leprology of Regional Institute of Medical Sciences in Imphal, Manipur and all the patients diagnosed with rosacea were included. A detailed history and clinical examination were done and recorded in a preset proforma. Potassium hydroxide mount of skin scrapings and Gram stain as well as culture from lesion and control were performed.Results: A total of 72 patients were included with female predominance. The mean age of the patients was 31.64±9.623 years. Sun exposure (70.8%) was the commonest exacerbating factor followed by fried spicy food (69.4%). Persistent erythema was seen in most of the patients (97.2%) and ETR was the commonest subtype (65.3%). Associated ocular manifestations were present in 4.2% of patients. The prevalence of Demodex mite was found to be higher in lesional skin as compared to the control. Culture from both lesion and control showed predominant growth of coagulase-negative staphylococcus (87% and 78.3% respectively).Conclusions: Rosacea is a multifactorial disorder with diverse clinical spectrum. Elimination of the triggering factors may help in controlling the flares and improve the quality of life.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195676
      Issue No: Vol. 6, No. 1 (2019)
       
  • Clinicoepidemiological study of chronic urticaria in a government tertiary
           care centre in South India

    • Authors: C. Vijayabhaskar, S. Venkatesan
      Pages: 100 - 103
      Abstract: Background: According to the consensus statement 2017, urticaria is a common skin condition with a lifetime prevalence of 22% and point prevalence of 1%. This study aims to study the clinico epidemiological presentation of chronic urticaria in patients attending a govt. tertiary care center and to assess absolute eosinophil count.Methods: This observational study was conducted in patients with chronic urticaria presenting to the outpatient clinic of Dermatology department. Patients details including demographics, clinical manifestations, investigations, associated comorbidities, and therapeutic were collected.Results: Chronic urticaria is commonly present in females-appears commonly in 4th decade but patients present to tertiary care center only in 5th decade-duration was less than 1 year in males, but it was equally between 1-2 and 2-4 years in females. Ear, nose, throat and dental involvement are negligible and common comorbidities are diabetes mellitus, hypertension and hypothyroidism. 42% of patients present with more than normal absolute eosinophil count.Conclusions: Chronic urticaria was common in females with 5th decade being the common age of presentation to the tertiary care center and 4th decade being the common age of disease onset. Paediatric population is less affected. Common comorbidities like diabetes mellitus, hypertension and hypothyroidism are to be ruled out. Raised absolute eosinophil count has to be looked for.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195682
      Issue No: Vol. 6, No. 1 (2019)
       
  • Post biologic scenario in pemphigus patients at a tertiary care
           institution

    • Authors: Ramesh A., Sampath V., Shabari A.
      Pages: 104 - 110
      Abstract: Background: Rituximab is increasingly used for the treatment of pemphigus. Data derived from single center studies following a uniform treatment protocol are limited. The effect of demography and disease type on treatment response is poorly characterized. Aim of this study was to assess the efficacy, adverse effects of rituximab, adjuvants and follow up in pemphigus patients.Methods: Author undertook a retrospective review of records of 26 pemphigus patients (pemphigus vulgaris 25 and pemphigus foliaceus 1) who had received rituximab infusion. Oral prednisolone was administered in doses up to 0.5 mg/kg of body weight after infusion and tapered over the next 3-4 months according to the disease activity. However, other immunosuppressive agents such as cyclophosphamide and AZT were continued for one year after clinical remission was achieved.Results: Complete remission was observed in 23 (88.5%) patients. The mean time to disease control and complete remission was 1.10 and 4.36 months, respectively. Three patients experienced relapse after a mean duration of 26 months. Infectious complications like candidiasis and furunculosis developed in two patients. Two patients had hypotension during infusion.Conclusions: Rituximab is an effective agent in the treatment of pemphigus and also for a long duration of remission with a lower initial dose of oral prednisolone. Severe side effects were rare.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195683
      Issue No: Vol. 6, No. 1 (2019)
       
  • A comparative study of the outcomes of potent topical steroids versus
           topical tretinoin in patchy alopecia areata of scalp

    • Authors: Asma Arif Hussain
      Pages: 111 - 114
      Abstract: Background: Alopecia areata (AA) is a common condition causing patchy alopecia of scalp. It can follow an unpredictable course with spontaneous exacerbations and remissions. Various therapeutic options have been tried to alleviate the cosmetic concern of the patient. The objective of this study is to compare the efficacy and safety of potent topical steroid versus topical 0.05% tretinoin in limited patchy alopecia areata of scalp.Methods: In this study 50 patients of age group above 5 years and of both sexes having localized alopecia areata of scalp (<5 patches and <25% scalp involvement) were included in the study after taking an informed consent. It was a randomized prospective study done for a period of 12 weeks. Excluding the age and sex bias, patients were distributed into two treatment groups A and B.  Group A was treated with 0.05% betamethasone dipropionate (BMD) cream applied twice daily. Group B was treated with topical 0.05% tretinoin cream applied twice daily. The response was assessed in every patient subjectively as well as objectively by alopecia grading scale and regrowth score (RGS) at the end of 12 weeks.Results: We found that 72% of patients in Group A showed statistically significant clinical improvement (RGS 3 and 4) when compared to 36% patients in Group B.Conclusions: It can be concluded that 0.05% BMD is still the most effective and economical topical treatment in less extensive forms of AA. However topical 0.05% tretinoin also gives a fairly  good response. But further studies with tretinoin are needed to establish its role in limited alopecia areata.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195684
      Issue No: Vol. 6, No. 1 (2019)
       
  • Oral lichenoid contact reaction to amalgam occurring as a leukoplakia-like
           lesion: a case report

    • Authors: Silvio Hirota, Norberto Sugaya, Dante Migliari
      Pages: 115 - 117
      Abstract: This article reports a case of oral lichenoid contact reaction (OLCR) in which a bilateral lesion involving the buccal mucosa was observed. Its relevance lies on that the lesions could be misdiagnosed as an oral leukoplakia, since they showed a typical feature of a homogeneous white plaque; however, fortunately, this misjudgement was spared because one of the lesions, on the right-buccal side, was in direct contact with an amalgam filling. Hence, the suspicion of mucosal contact reaction was made and the patient successfully treated by amalgam replacement. Comments on diagnosing of OLCR is also included is this report.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195685
      Issue No: Vol. 6, No. 1 (2019)
       
  • Verrucous lesion over the foot: a diagnostic challenge

    • Authors: Anil P. Gosavi, Ravindranath B. Chavan, Nitika S. Deshmukh, Shishir Khose, Darshana R. Kundale, Vijay V. Raut
      Pages: 118 - 120
      Abstract: Infection with Mycobacterium tuberculosis or other very closely related strains, as well as the inflammatory reaction of the host, define the disease tuberculosis. Cutaneous tuberculosis constitutes a small proportion of extrapulmonary tuberculosis. Extensive, multifocal involvement of cutaneous tuberculosis is a rare manifestation. We report one such case of tuberculosis verrucosa cutis in a 24 year old immunocompetent male patient.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195686
      Issue No: Vol. 6, No. 1 (2019)
       
  • Generalized pigmentation with nutritional deficiency

    • Authors: Snahasish Naskar, Vidya Kharkar
      Pages: 121 - 124
      Abstract: Vitamin B12 deficiency is one of the most underdiagnosed causes of hyperpigmentation. It is known to cause Addisonian pigmentation. We describe a case where a patient presented with hyperpigmentation on the aesthetically significant areas of the body for which he presented to the clinic. Diagnosis was confirmed on histopathology and serum vitamin B12 levels. The hyperpigmentation reversed significantly on treatment.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195687
      Issue No: Vol. 6, No. 1 (2019)
       
  • An unusual case of bullae and scars

    • Authors: Tanvi P. Vaidya, Ramesh M. Bhat, Sukumar Dandekeri
      Pages: 125 - 128
      Abstract: The term epidermolysis bullosa (EB) encompasses a group of inherited mechano-bullous disorders, clinically characterized by blisters over skin and mucosae following minor frictional trauma. The diagnosis is predominantly clinical, but further classification is carried out by defining the histological level of the split. Histopathology tends to be ambiguous, as it was in this case. Our case is of a twelve-year-old male child who came with complaints of recurrent painful fluid filled lesions all over the body since 10 days of birth, aggravated by trauma, with exacerbations in the summer, and with a history of similar lesions in the mother and maternal uncle. On examination, there were multiple flaccid bullae, crusted erosions, scars and milia over trauma prone sites, such as the elbows, back, knees, shins and knuckles, with nail dystrophy and pitting of the teeth. The clinical impression as well as histopathology suggested a dominant dystrophic or a junctional EB, but immunofluorescence antigen mapping revealed it to be a case of EB simplex. We must thus bear in mind that histopathology is not definitive in EB, and immunofluorescence antigen mapping or transmission electron microscopy is imperative to correctly diagnose it.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195688
      Issue No: Vol. 6, No. 1 (2019)
       
  • Borderline tuberculoid hansens with type 1 reaction in a HIV patient: an
           IRIS phenomenon over an unusual site

    • Authors: Chitralekhya Rao, Parthasaradhi Anchala
      Pages: 129 - 131
      Abstract: Immune reconstitution inflammatory syndrome (IRIS) is an acute symptomatic expression of a latent infection during the recovery of the immune system and it occurs as a response to antiretroviral therapy. Opportunistic infections can act as a trigger for IRIS. Hansens disease is an infection caused by Mycobacterium leprae. There are very few case reports reporting the development of borderline tuberculoid hansens with type 1 reaction as IRIS. We here report a unique case of IRIS in a HIV patient who presented with borderline tuberculoid leprosy with type 1 lepra reaction presenting over unusual site following highly active antiretroviral therapy administration.
      PubDate: 2019-12-23
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20195689
      Issue No: Vol. 6, No. 1 (2019)
       
 
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