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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
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International Journal of Research in Dermatology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2455-4529
Published by Medip Academy Homepage  [12 journals]
  • Clinical evaluation and role of patch testing in identifying the exogenous
           causes in patients presenting with hand eczema

    • Authors: S. Jyothi Lakshmi, K. Gopalakrishnan
      Pages: 1 - 7
      Abstract: Background: Hand eczema is a common dermatological problem resulting from both allergic and irritant contactants. Patch testing helps in both diagnosing and identifying allergens.Methods: A cross sectional study wherein 110 patients with hand eczema attending Dermatology OPD were included and patch testing was done. Data was collected from April 2015 to July 2016 and was analysed for clinical and epidemiological characteristics.Results: The mean age of the patients studied was 40.27 years with male preponderance. Housewives were the major occupational group comprising 25.5% followed by masons 21.8% and farmers 10.9%. The commonest morphological type was hyperkeratotic type constituting 51.85%, followed by fingertip eczema 19.1%, discoid eczema 11.8%, wear and tear dermatitis 8.2%, recurrent focal palmar peeling 4.5% and pompholyx 4.5%. In the study group 60% of patients showed positive patch test result. A total 66 patients showed patch test positivity to a total of 69 allergens. Nickel was the most common allergen 27.3% identified followed by potassium dichromate 10.9%. Among female patients with positive patch test 70% reacted to nickel and similarly 83.5% of male patients reacted to potassium dichromate. Parthenium allergy was seen in 41.5% of farmers studied.Conclusions: Patch testing has a definitive role in diagnosing hand eczema caused by allergens. Identifying the allergen involved helps the clinician in advising the patient regarding further avoidance of contactants.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185081
      Issue No: Vol. 5, No. 1 (2019)
  • A clinical study of various cutaneous manifestations in neonates

    • Authors: Shams Zia Usmani, Kshitij Saxena, Venkatarao Koti, Shrish Bhatnagar, Gaurav Paliwal, Shivani Yadav, Anukriti Singh
      Pages: 8 - 12
      Abstract: Background: Cutaneous manifestations are common in neonates. Transient and pathological neonatal dermatoses should be differentiated to avoid unnecessary treatment and thus considering the variable nature and severity of neonatal skin lesions, it is important to be aware of the transient skin lesions in newborn and to differentiate these from other serious conditions which will avoid unnecessary therapy to the neonates and the parents can be assured of good prognosis of these skin manifestations. The present study has been carried out to study the clinical pattern of cutaneous lesion in neonatal period.Methods: A total of 255 neonates from Department of Dermatology in collaboration of Department of Pediatrics, Era’s Lucknow Medical College and Hospital were evaluated for cutaneous manifestations. A detailed assessment regarding history, clinical examination and investigations were recorded and analyzed.Results: Out of 255 neonates, 138 (54.1%) were males and 117 (45.9%) were females. The sex ratio (M:F) was 1.18. The most common dermatoses were physiological desquamation (54.1%) and mongolian spots (37.6%) followed by milia (19.6%), miliaria (14%), epstein pearls (10.2%).Conclusions: The physiological and transient cutaneous lesions are common are in neonates. Physiological cutaneous manifestations were quite frequent apart from birthmarks/congenital cutaneous manifestations. An understanding of these manifestations helps in managing and deciding the appropriate manifestation.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185513
      Issue No: Vol. 5, No. 1 (2019)
  • Hair loss in children in rural population

    • Authors: Vimala Manne, D. Subhash Reddy
      Pages: 13 - 16
      Abstract: Background: Among children worldwide, dermatophyte infections are most common constituting a public health problem. The aim of the study is to determine the prevalence and causative agents of tinea capitis in school children attending primary school located in Hyderabad and to perform an analysis of risk factors associated with tinea capitis as the etiological factor.Methods: This is a school based, cross sectional, prospective study which was conducted in July 2015. This study was conducted in a school located near Hyderabad.Results: Out of 600 school children, 298 boys and 302 girls, 100 were diagnosed with a tinea capitis infection after clinical and microbiological examination, with an estimated prevalence rate of 15.0%. The most prevalent dermatophytes isolation in tinea capitis in children were Trichophyton verucosum (90), Trichophyton tonsurans (30), Trichophyton mentagrophytes (28), Microsporum audiouium (15), Trichophyton soudanese (9), Trichophyton violaceum (5), Microsporum ferrugineum (3), Trichophyton schoenleineii (3), Microsporum gallinae (2) and culture negative and KOH positive (10).Conclusions: This study concluded that the findings suggest that the practices resulting in entrenchment of dermatophyte infections and fungal infection. The promotion of public health action plan based on self hygiene education, which aimed to counteract the epidemiological burden specifically, and it should play an pivotal role in reduction of the prevalence in future of this common infection.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20184771
      Issue No: Vol. 5, No. 1 (2019)
  • Clinico-epidemiological study of iatrogenic cutaneous manifestations in
           neonates in intensive care unit in a tertiary care hospital

    • Authors: E. S. Sushmitha, D. Manoj, K. Ravindra, G. Guruprasad
      Pages: 17 - 22
      Abstract: Background: Neonatal dermatology, by definition, encompasses the spectrum of cutaneous disorders that arise during the first four weeks of life ranging from from physiological and transient to grossly pathological lesions in the skin of a neonate. The aim and objectives of the study were to determine the quantum of iatrogenic problems which can be minimized and prevented.Methods: A total of 1000 neonates admitted in the tertiary care NICU of JJM Medical College were examined and spectrums of pathological cutaneous lesions noted.Results: Among 1000 neonates examined, 101 had iatrogenic cutaneous conditions which were commonly seen in day one of life in 48 neonates and least in newborns between 15-21 days. Skin lesions were commonly seen in full term neonates (59), followed by preterm (39) and post term (3) neonates.Among the iatrogenic injuries needle prick injury (83), thermal burns (12) and bronze baby syndrome (11) were most commonly were noted in LBW and the normal for weight neonates. A variety of other conditions which could not be categorized into any of the above categories accounted for 5 cases. These included albinism, Waardenburg syndrome, TORCH complex and Down’s syndrome and Goltz syndrome.Conclusions: Iatrogenic cutaneous abnormalities among neonates are under reported, with no detailed studies on these variants. Genetic, neonatal, maternal, social and geographic factors seen to influence the patterns of neonatal dermatoses. Hence, it is important for a dermatologist and paediatrician to have a thorough knowledge and to distinguish various iatrogenic manifestations and to minimize the outcomes during their stay in NICU.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20184710
      Issue No: Vol. 5, No. 1 (2019)
  • Sexually transmitted infections among HIV positive patients: a five year
           retrospective study

    • Authors: N. Saravanan, Murugan Swamiappan, Rajkumar Kannan, G. Arul Raja
      Pages: 23 - 26
      Abstract: Background: Sexually transmitted infections (STIs) are the most well established risk factors for the spread of HIV infection. STIs act as cofactors and facilitators for HIV transmission. The effects of HIV infection on immunity can increase susceptibility to other STIs. The aims and objectives of the study were to determine the prevalence of co-infection of sexually transmitted infections among people living with HIV and AIDS.Methods: A retrospective chart review of the data collected from the clinical records of all HIV patients who had attended the STI clinic of Chengalpattu Medical College, Chengalpattu, Tamil Nadu during the five years period, from January 2013 to December 2017, was carried out. Demographic data, clinical manifestations, co-infection of STIs among HIV patients, laboratory investigations and treatment were collected. The data collected were computed and analyzed statistically.Results: During the study period of 5 years from 2013 to 2017 the total number of patients attended the STI clinic were 10825, among that males were 4534 (41.88%) and females were 6291 (58.12%). STIs/RTIs were seen in 2560 (23.65%) cases among the total number of patients attended. HIV was found to be positive in 294 cases, in that 168 (57.15%) were males and 126 (42.85%) were females. In male HIV patients, 51 (30.36%) had co-infection with other STIs/RTIs. In female HIV patients, 57 (45.24) % had co-infection with other STIs/RTIs. Viral STIs was the common co-infection seen in males and vaginal cervical discharge was common in females.Conclusions: STI/RTI co-infection, both symptomatic and asymptomatic are common among PLHIV. Hence they should be regularly counselled regarding the significance of periodic screening for STI/RTIs avoidance of high risk sexual behaviour.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20184724
      Issue No: Vol. 5, No. 1 (2019)
  • Serum 25-hydroxyvitamin D level in psoriasis patients: a case-control

    • Authors: Surinder Gupta, Preeti Garg, Nakul Gupta
      Pages: 27 - 31
      Abstract: Background: Sufficient level of vitamin D in blood is required for proper regulation of cell differentiation and proliferation. Unchecked proliferation of cells leads to various disease states. Vitamin D also has immunomodulatory effects in the body. Psoriasis is a chronic inflammatory and hyperproliferative disease with vitamin D having an impact on it. This case – control study was done to judge the levels of vitamin D in patients of psoriasis compared to age and sex matched controls.Methods: A case control study was conducted including 50 patients (35 females and 15 males) of chronic plaque psoriasis from dermatology outpatient department of Maharaja Agrasen Medical College (MAMC), Agroha, Haryana, representing patients from north India and 50 healthy controls. Both urban and rural background patients were included.Results: The mean serum 25-hydroxyvitamin D (25-OHD) level in psoriasis patients was 22.865±11.386 ng/ml, whereas in controls it was 35.116±11.048 ng/ml (p<0.001). Serum level of 25-OHD in psoriatic patients was deficient (<20 ng/ml) in 26 (52%), insufficient (20-30 ng/ml) in 8 (16%) psoriatic patients.Conclusions: High prevalence of low vitamin D level was found in this study. We infer that vitamin D does play a role in the pathogenesis, precipitation, exacerbation, or treatment resistance of psoriasis. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185500
      Issue No: Vol. 5, No. 1 (2019)
  • Comparative therapeutic evaluation of 308 nm monochromatic excimer light
           in combination with calcipotriol ointment vs 308 nm monochromatic excimer
           light alone in palmoplantar psoriasis

    • Authors: Chandrakant B. Poulkar, Nitin D. Chaudhari, Swapna S. Khatu, Shilpa L. Patwekar
      Pages: 32 - 36
      Abstract: Background: Palmoplantar psoriasis is difficult to treat and often recalcitrant to traditional treatment modalities like topical steroids, anthralin, calcipotriol, methotrexate, cyclosporine, NB-UVB and PUVA. This study was aimed to compare efficacy of 308 nm monochromatic excimer light (MEL) in combination with calcipotriol ointment to 308 nm MEL alone in treatment of palmoplantar psoriasis.Methods: This self-control study was conducted in 30 patients of palmoplantar psoriasis. Right side was treated with 308 nm MEL, 2 times/week, at meantime calcipotriol ointment was applied externally, 2 times/day (treatment group); the left side was treated with 308 nm MEL alone, 2 times/week (control group). Erythema, scaling, induration and fissuring (ESIF) score and cumulative doses of 308 nm MEL were assessed before treatment and on weeks 2, 4 and 6 after initiation of treatment.Results: All 30 patients completed the treatment. ESIF scores on week 2, week 4, and week 6 in treatment group were significantly lower than control group (p<0.01). The average cumulative MEL dose in treatment group at the end of trial was 8.12±1.72 J/cm2, which was significantly lower than in control group 12.76±1.92 J/cm2 (p<0.01).Conclusions: Treatment of palmoplantar psoriasis with 308 nm MEL in combination with external application of calcipotriol ointment can improve long-term treatment efficacy, decrease cumulative doses, and adverse effects induced by MEL irradiations.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190038
      Issue No: Vol. 5, No. 1 (2019)
  • Analysis of response of vitiligo to treatment with NBUVB

    • Authors: J. Madhava Praveen, Jatin Sidhwa
      Pages: 37 - 39
      Abstract: Background: Vitiligo is an acquired skin disorder characterised by white (depigmented) patches in the skin, due to the loss of functioning melanocytes. The disease can have devastating consequences on an individual’s relationships with others and internal feelings of self-worth. Vitiligo is caused by a dynamic interplay between genetic and environmental risks that initiates an autoimmune attack on melanocytes in the skin. Long term phototherapy has shown good response in the management of vitiligo. In this study we explore the efficacy of phototherapy in management of our vitiligo patients.Methods: 30 subjects were included in the study. Subjects were started on NBUVB at 300mj/cm2. Weekly 3 doses were given. Doses were increased after every 3rd sitting by 10%. In case of adverse effects treatment is withheld till resolution of symptoms following which NBUVB is given at 50% of the last dose and patient managed based on the response.Results: A majority of the subjects showed significant and persistent improvement within the first 3 months of initiation of treatment. The proportion of the patients showing improvement increased with duration of treatment.Conclusions: Our study has revealed the standard and significant role the phototherapy plays in the treatment of vitiligo as a monotherapy or as an adjuvant with other treatment modalities. With good treatment response and minimal side effect incidence, phototherapy is an important treatment modality in the management of vitiligo. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185105
      Issue No: Vol. 5, No. 1 (2019)
  • A clinical study of facial dermatoses

    • Authors: Pradeep Vittal Bhagwat, Mary Zothanpuii Chhangte, Chandramohan Kudligi
      Pages: 40 - 44
      Abstract: Background: The attractiveness of the human body has always been an important issue in the fields of sociology, psychology, psychiatry and also in the field of dermatology. Because in most societies the face is usually a body part that is visible, imperfections of its skin is also visible, therefore its flawed appearance bears the potential to become a source of misery to some. The objective of the study was to study the various dermatological conditions affecting the face.Methods: A cross-sectional study was conducted among 200 patients with facial dermatoses during the period Dec-2014 to May-2016. Patients belonging to age group 12 years and above and both sexes were randomly selected and included in the study after taking their consent.Results: Out of the facial dermatoses, 75 patients had infections of the face comprising 37% of the total facial dermatoses with tinea faciei being the most common individual facial skin condition comprising 18%. Skin tumors and cysts and miscellaneous conditions of the face comprised 15% each of the total facial dermatoses. This was followed by contact dermatitis (9%), photodermatoses (8.5%), Rosacea in 5.5% of patients, Nevi in 5% of patients and pigmentary disorders being the least common facial dermatoses comprising 4.5%.Conclusions: It is worthwhile to take note of the special nature of facial skin and the disorders that affect it.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190052
      Issue No: Vol. 5, No. 1 (2019)
  • Study of clinical patterns and frequency of cutaneous manifestations in
           the elderly

    • Authors: Gaurav Paliwal, Kshitij Saxena, Venkatarao Koti, Priyanka Shukla, Shobhit Dutt, Shams Zia Usmani, Chandni Jain, Ayesha Khalid
      Pages: 45 - 51
      Abstract: Background: Cutaneous manifestations are common in elderly. The elderly population is composed of persons over 60 years of age and very few studies are available on the dermatologic diseases in this group. This study was done to study the clinical pattern and frequency of cutaneous manifestations in the elderly.Methods: A cross sectional observational study was conducted on 540 patients, aged 60 years and above, who attended the out-patient department and admitted as inpatients having cutaneous manifestations were included, in the department of dermatology Era’s Lucknow Medical College And Hospital, Lucknow.  A detailed history was taken regarding the onset and duration of cutaneous manifestations. Thorough dermatological examination was carried out on all study patients. Relevant investigations which included haemogram, biochemical tests and a skin biopsy were performed, wherever needed. Skin changes in all the patients were recorded and were classified into physiological and pathological changes. Data were entered in an Excel sheet and were analyzed using descriptive statistics.Results: Out of 540 patients studied, 55.7% were males and 44.3% were females. Pruritus was the single most common complaint elicited (90.6%). Among the physiological changes, wrinkling was the commonest (80.9%). Among the pathological changes skin tumours, eczemas, infections were the common findings.Conclusions: The geriatric dermatoses are different in different populations, as there is significant number of geriatric population, the increased emphasis on geriatric medicine is   inevitable.  This    present study helps in providing greater understanding of pattern of geriatric dermatoses that aids in early diagnosis and management.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190065
      Issue No: Vol. 5, No. 1 (2019)
  • Effectiveness, safety and tolerability of botulinum toxin in focal
           hyperhidrosis and dynamic facial wrinkles

    • Authors: K. Gopalakrishnan
      Pages: 52 - 56
      Abstract: Background: Botulinum toxin is a potent neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction thereby causing localized muscle relaxation which smoothen the overlying skin and reduces dynamic facial wrinkles. Also clinical studies suggest that intra dermal injections of botulinum toxin are effective in the treatment of palmar hyperhidrosis by blocking the excessive sympathetic cholinergic sudomotor nerve traffic to the palmar surface of the hands.Methods: We treated twenty patients with palmar hyperhidrosis and fifteen patients with dynamic facial wrinkles with intra dermal botulinum toxin type A.Results: Among patients treated, complete response was seen in 90% of patients with hyperhidrosis and 70% for patients with facial wrinkles. The relapse of symptoms was highly variable among patients and the average relapse was seen at 14 weeks for both the indications. No major side effects noted.Conclusions: Botox is an effective and highly tolerable treatment for both hyperhidrosis and facial wrinkles.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185139
      Issue No: Vol. 5, No. 1 (2019)
  • Cutaneous manifestations of underlying malignancies presenting to a
           tertiary care teaching hospital

    • Authors: Krishna Rajesh Kilaru, Keerthana Kaja, Venkateswara Rao Garimella
      Pages: 57 - 62
      Abstract: Background: The skin is the largest organ in the human body. Many types of cancers can cause lesions to appear on the skin. An association between systemic malignancy and cutaneous manifestations has long been recognized. Recognition of these lesions is important for diagnosis at early stages and hence we analyzed the presentation of various skin manifestations in relation to various malignancies.Methods: We did a prospective study from June 2016 to November 2017 on 50 confirmed cases of internal malignancy with skin manifestations attending the DVL and Oncology OPD of NRI Medical College and General Hospital and Cancer Institute. Detailed history, cutaneous examination, and investigations were done.Results: Study population included 23 males and 27 females. The majority of cases (34%) were aged above 60 years. In females, reproductive tract malignancies were the highest (37%). In males, Non-Hodgkin's lymphoma (17.3%) and carcinoma rectum (17.3%) were commonly seen. Generalized pruritus was the major presenting cutaneous manifestation (16.4%). Paraneoplastic dermatoses were the most frequent cutaneous markers (67.2%).Conclusions: Cutaneous manifestation from an internal malignancy is a relatively uncommon phenomenon. But at times, they may be the only presenting feature. Cutaneous paraneoplastic syndromes are important clinical markers that may precede or occur simultaneously or after the diagnosis of a given neoplasm and recognizing them may lead to a higher chance of cure and better prognosis for the patient.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185512
      Issue No: Vol. 5, No. 1 (2019)
  • Diabetes mellitus and hepatitis c in generalised lichen planus: a case
           control study

    • Authors: K. Parimalam, R. Sowmiya, S. Mithra
      Pages: 63 - 66
      Abstract: Background: Prevalence of lichen planus (LP) and generalised lichen planus (GLP) is about 2.6% and 1% respectively. Various studies have shown higher prevalence of Diabetes Mellitus (DM) and stronger association between Hepatitis-C virus (HCV) and LP. The main objective of this study was to predict the prevalence of DM and HCV in patients with GLP before starting steroids.Methods: A case-control study was conducted with 33 patients in each group for one year period. Case group included patients with GLP excluding oral LP and drug induced lichenoid dermatitis. Control group included patients with other skin conditions and not on steroids. Preliminary details and history of DM and HCV were collected. Random blood sugar and Anti-HCV were done.Results: The proportion of patients with GLP was higher in women compared to men (63.6% vs. 36.3%). Highest prevalence was observed in the age group 35-45 years for both genders. On stratification by sex, odds of having GLP in women are 0.76 times lower among diabetics compared to non-diabetics whereas no association in males. There was no association between GLP and HCV in both sexes.Conclusions: There is no significant association between Diabetes mellitus and Hepatitis-C infection with GLP. Future study is planned with larger sample size for a definite conclusion.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190237
      Issue No: Vol. 5, No. 1 (2019)
  • A study of topical steroid induced facial dermatosis in Andaman and
           Nicobar Islands and to analyse the role of Demodex mite in its

    • Authors: Mansi Srivastava, Pradeep Balasubramanian, Anjali J. Anil
      Pages: 67 - 71
      Abstract: Background: Topical corticosteroids (TCs) are widely abused all over our country due to its short term benefits and effortless over the counter availability. The rate of its abuse is more so in Andaman & Nicobar Islands (A&N). Henceforth we conducted a study to evaluate the topical steroid induced facial dermatosis (TSFD) in A&N and to analyse the role of demodex mite in its pathogenicity.Methods: 58 patients with TSFD participated in this study. Details such as demography of patient, topical steroid used, duration of usage, reason behind its usage and facial dermatosis of the TSDF developed were collected. Following this, standardized surface skin biopsy (SSSB) was performed to assess the density of demodex mite. The details were statistically analysed.Results: TSFD were predominantly seen in female of age group between 20 and 30 years. It was commonly misused to get rid of acne, pigmentation, tinea faciei and as a fairness cream. The commonly misused TCs were betamethasone cream followed by mometasone. It was commonly advised by pharmacists, friends, relatives, beauticians and GPs. Papules, pustules, photosensitivity and erythema were the commonly encountered adverse events. Microscopic examination of SSSB was negative in all the patients.Conclusions: The study depicts rampant and irrational use of TCs in our population. Though the demodex mites were absent in the patients studied, further studies with larger sample size and in different ethnicity needs to be done to affirm its role in the pathogenicity of TSFD.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185508
      Issue No: Vol. 5, No. 1 (2019)
  • A clinico-epidemiological study of HIV seroconcordant and serodiscordant

    • Authors: K. Radha Raja Prabha, A. Sathish Selvakumar
      Pages: 72 - 77
      Abstract: Background: The aim of the present study was to assess the epidemiological and risk factors that are likely to influence HIV transmission among married couples and to study the pattern of sexually transmitted infections among both concordant and discordant HIV infected couples..Methods: This cross-sectional study was done on 100 HIV patients and their married partners attending to Institute of Venereology, Madras Medical College, Tamil Nadu. Detailed history of their high risk sexual behaviour, previous veneral diseases (PVDs) was noted and physical and genital examination was done. All the partners of HIV cases were examined for HIV to know the serostatus (seroconcordant and serodiscordant).Results: Among the 100 married couples, 65 couples were seroconcordant for HIV and 35 couples were serodiscordant. Of them, 94 males and 71 females were positive for HIV. History of PVDs was found in 34 patients (28 were seroconcordants and 6 were serodiscordants). The most common STD in the males noticed was ano-genital warts (n=11) and genital ulceration (n=11) is associated with maximum seroconcordance rates. Whereas in the females it was bacterial vaginosis (n=11).Conclusions: The findings suggest that risk factors such as STDs, PVDs in males, anal intercourse, sexual contact during menstruation, avoidance of condom during sexual act and lack of circumcision was significantly associated with presence of HIV concordance in the study population. Duration and frequency of sexual contact with partner, previous venereal diseases in females and ART were found not to influence the transmission of HIV.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185129
      Issue No: Vol. 5, No. 1 (2019)
  • Common allergens in patients with contact dermatitis identified using
           patch test in a tertiary care centre in North Kerala

    • Authors: V. P. K. Gopinath, V. M. Simi, K. Basheer Ahammed, C. M. Ali Rishad, P. M. Farisa
      Pages: 78 - 87
      Abstract: Background: Allergic contact dermatitis (ACD) is a disease characterised by an immune mediated response to a substance. The primary prevention remains avoidance of the implicated allergen. This is done with the help of patch test using the Indian Standard series (ISS).Methods: Out of the 246 cases of ACD that came to our Dermatology department, 92 patients were selected and subjected to patch testing using the ISS. Results were read after 48 and 96 hours, interpreted as per ICDRG criteria and were analysed.Results: From 92 patients 59.8% were males and 40.2% were females. Majority of the individuals with ACD who were patch tested belonged to the age range of 21-60 years accounting to 72.8%. The most affected site was the foot. 26.7% showed positivity to Black rubber mix, followed by potassium dichromate 20% and nickel 14.4%. 7.8% produced delayed reactions with positivity revealed at the final reading. One patient gave multiple positive reactions to paraben, PPD and chlorocresol.Conclusions: In the study middle aged males were mostly affected which may be influenced by the sample selected. Black rubber mix was identified as the most frequent sensitizer followed by potassium dichromate which was also implicated as the sensitizer most seen in the unskilled generally. Fragrance mix was responsible for all delayed responses yielding positivity in the second reading. When not considering the negligible left, patch tests’ results could be correlated with the clinical presentations. Patients were treated, educated on ACD and advised to refrain from exposure with suggestions of possible alternatives.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185054
      Issue No: Vol. 5, No. 1 (2019)
  • Clinico-mycological study and comparison of efficacy of three different
           techniques of sample collection from skin lesions for potassium hydroxide
           mount preparation in dermatophytoses

    • Authors: Veena Thimmappa, Veeranna Shastry, Jayadev Betkerur
      Pages: 88 - 93
      Abstract: Background: Dermatophytoses are superficial fungal infections which invade and multiply within keratinized tissue. The KOH mount is one of the useful procedures and believed to be more reliable than culture for demonstrating dermatophytes. A few studies in the past have demonstrated the usefulness of alternative methods of sample collection for KOH preparation, but data on sensitivity and specificity of these methods is lacking. The aim of the study was to study the clinic-mycological aspects of dermatophytoses and to compare the efficacy of three different sampling techniques from skin lesions and correlating KOH mount with culture results.Methods: 210 clinically diagnosed patients with dermatophytic infection attending outpatient department of Dermatology of a tertiary care hospital for duration of 2 years (September 2015 to October 2017) were included. The samples were collected from skin, hair and nail. These samples were used for direct microscopy by KOH mount and fungal cultures by Sabouraud dextrose agar media.Results: Of the total of 210 patients, maximum were in age group of <10 years (74 cases), male: female - 1.2:1. Tinea corporis was commonest presentation (40.5%). Overall direct microscopy positivity was 81% while three different techniques from the glabrous skin and groins lesions was scraping method (97%), cellophane tape method (96%), skin surface biopsy (SSB) (98%) and culture in (89%). T. rubrum was commonest species isolate (37.7%).Conclusions: Tinea corporis was the commonest clinical type followed tinea capitis. T. rubrum were commonest dermatophytes isolated. All three methods of sampling were suitable for routine sample collection. The KOH mount helped rapid confirmation of clinical diagnosis.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185515
      Issue No: Vol. 5, No. 1 (2019)
  • Prevalence and risk factors of hyperpigmentation induced by
           hydroxychloroquine in lupus patients

    • Authors: Nouf T. Mleeh
      Pages: 94 - 100
      Abstract: Background: Antimalarials including hydroxychloroquine (HCQ) have been used in the treatment of systemic lupus erythematosus (SLE) for more than 50 years. Few cases of hyperpigmentation attributed to HCQ have been reported in the literature from different geographical areas. However, no case reports or local studies from Saudi Arabia estimated the magnitude of HCQ adverse effect. This study aimed to estimate the prevalence of HCQ-induced hyperpigmentation and to investigate the possible risk factors related to this condition.Methods: This retrospective study was conducted at King Abdulaziz University Hospital. All SLE patients on HCQ treatment, aged 18 years or above who visited Rheumatology and Dermatology Clinics were included. Those with the previous history of hyperpigmentation before starting HCQ treatment, or on chloroquine or quinacrine therapy were excluded. Medical records from September 2005 until June 2016 were reviewed.Results: Out of 199 cases, 98 (49.2%) cases had hyperpigmentation, only 13 (13.3%) cases reported resolution. The main sites affected were the hands 46 (23.1%), followed by face 45 (22.6%), then feet 18 (9.0%), leg and whole body equally 12 (6.0%). There was a significant association between hyperpigmentation and receiving medications, history of ecchymosis, sun exposure, the presence of mucous membrane pigmentations (p<0.0001, p=0.012, p<0.0001, p=0.022 respectively).Conclusions: HCQ-induced pigmentation is considered uncommon adverse effect of HCQ, with a prevalence rate of 49.2% indicated in this study. Furthermore, history of bruising, sun exposure, and the presence of mucous membrane pigmentation are possible predisposing factors.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190229
      Issue No: Vol. 5, No. 1 (2019)
  • Dyslipidemia in psoriasis patients: a case-control study

    • Authors: Surinder Gupta, Preeti Garg, Nakul Gupta
      Pages: 101 - 105
      Abstract: Background: Psoriasis is a chronic inflammatory disorder with defective proliferation and differentiation of keratinocytes. It is associated with metabolic syndrome i.e. dyslipidemia, hypertension, obesity, cardiovascular diseases and insulin resistance. The high incidence of cardiovascular events in psoriasis is highly associated with abnormal lipid metabolism. This case-control study was done in North Indian medical institute to investigate the levels of serum lipids in psoriasis patients taking in account various parameters like weight, height, body mass index, blood pressure and diabetes.Methods: We assessed the fasting lipid profile in 48 psoriasis patients and 48 healthy, age and sex matched controls.Results: The study found significant elevation (p<0.05) of serum total cholesterol, triglycerides, low density lipoproteins (LDL) and very low density lipoproteins (VLDL) in psoriasis patients compared to controls. The levels of high density lipoproteins (HDL) were also significantly lower (p<0.05) in psoriasis patients.Conclusions: This study suggests that psoriasis is a high risk disorder for cardiovascular mortality and morbidity because of its association with dyslipidemia. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190039
      Issue No: Vol. 5, No. 1 (2019)
  • Clinico-epidemiological study of dermatophytosis in teaching hospital of
           North Karnataka

    • Authors: K. Y. Guruprasad, Mohammed Waseem Javed, C. Roopa, Humera Ansari, A. A. Takalkar
      Pages: 106 - 109
      Abstract: Background: Although fungi are worldwide, only few of them are considered pathogenic. The pathogenic fungi may give rise to infections in animals and human beings. Skin infection due to dermatophytes has become a significant health problem of late equally affecting children, adolescents and adults. Depending on the climate and culture, the clinical picture can vary enormously. The objective of the study was to study the clinical and diagnostic spectrum of dermatophytosis at Dermatology OPD of KBNIMS, Kalaburagi.Methods: The present descriptive study was conducted in Dermatology OPD in teaching Hospital of North Karnataka.Results: Majority of the subjects were from 21 to 40 years age group i.e. 44.58% followed by 36.4% from 0 to 20 years age group. Out of 250 patients, majority were males i.e. 70.4% whereas 29.6% were females. More than half i.e. 174 (69.6%) out of 250 patients were KOH positive. Prevalence of culture positive specimen was found to be 40%. T. cruris (35%) and corporis (32%) were most common infections in our study. 31% of cases T. mentagrophyte was observed as most common isolate on culture..Conclusions: In our study, most common dermatophytic infection was T. cruris (35%). Only 40% were culture positive and among which Trichophton mentagrophyte was commonly seen isolate. Low socioeconomic status, overcrowding and compromised personal hygiene with tropical climate are prevalent factors in our study. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190100
      Issue No: Vol. 5, No. 1 (2019)
  • Effect of clofazimine on nerve function impairment in pauci-bacillary
           leprosy patients

    • Authors: Chandrakant B. Poulkar, Nitin D. Chaudhari, Swapna S. Khatu
      Pages: 110 - 115
      Abstract: Background: Clofazimine is a riminophenazine derivative which is useful both for treating the leprosy and managing reactive episodes. Previous studies demonstrated that clofazimine may have a useful prophylactic role against neuritis/type 1 reaction and nerve damage. The WHO Technical Advisory Group (TAG), in its Third meeting in 2002, proposed that uniform MDT regimen (U-MDT) of 6 months duration should be considered to treat all types of leprosy. This study was aimed to determine any additional beneficial effects of clofazimine as part of UMDT in the prevention of nerve function impairment (NFI) in paucibacillary (PB) leprosy patients.Methods: Sixty paucibacillary leprosy patients were randomized into two groups, A and B consisting of 30 patients each. Group A received U-MDT for 6 months and group B received MDT-PB for 6 months. Nerve function assessment (NFA) using various modalities was done at the beginning (0 month) and at the completion of MDT (6 months) and results were compared.Results: No statistically significant difference in improvement or deterioration of NFI was found in two groups.Conclusions: On the basis of present study, we found that addition of clofazimine in standard dose as part of U-MDT has no beneficial role in prevention or improvement of NFI in PB leprosy patients. However, a larger longitudinal study taking substantial number of population in both groups might be helpful to derive any conclusion.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185499
      Issue No: Vol. 5, No. 1 (2019)
  • Intralesional autologous platelet rich plasma therapy in chronic
           nonhealing cutaneous ulcers: an interventional study from a tertiary care
           centre in North Kerala

    • Authors: V. P. K. Gopinath, V. M. Simi, K. Basheer Ahammed, P. M. Farisa, C. M. Ali Rishad
      Pages: 116 - 122
      Abstract: Background: Treatment of chronic nonhealing cutaneous ulcers is a challenge to clinicians. When wounds fail to achieve sufficient healing after 4 weeks of conventional therapy reassess the underlying pathology and consider advanced therapeutic options. Autologous platelet rich plasma is a novel treatment for nonhealing cutaneous ulcers, which can provide growth factors directly onto the wound.Methods: 34 patients with non-healing cutaneous ulcers satisfying inclusion and exclusion criteria were included in the study. All patients were treated with PRP therapy weekly for 6 weeks. Every week ulcer area and volume was measured and outcome expressed as improvement in area and volume of ulcers before and after PRP therapy.Results: In our study majority were males (64%) and the mean age of population was 51.0±10.4 years. Of 34 patients 18 had venous ulcers. All ulcers healed within 12 weeks and mean duration of healing was 7.51±2.9 weeks. 8 (24.24%) patients had their ulcer completely healed within 6 weeks. Larger ulcers took long duration to heal and smaller ones healed within short duration. The total improvement in area and volume of ulcers was 85.7% and 90.7% (median) respectively at the end of 6 weeks.Conclusions: PRP is an effective, safe, readily available and cheap outpatient procedure which can be widely used for the treatment of chronic recalcitrant ulcers which improves the quality of life and reduces the financial burden of patients. Further research and controlled, randomized prospective clinical trials on larger population are necessary to validate the results.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185080
      Issue No: Vol. 5, No. 1 (2019)
  • A clinico etiological study of balanoposthitisin male patients attending
           the sexual transmitted diseases outpatient department

    • Authors: K. Deepa, C. L. Chitra, R. Manipriya
      Pages: 123 - 127
      Abstract: Background: The term balanoposthitis refers to inflammation of the glans and the prepuce. It is a widespread condition in male patients attending the genitor-urinary clinic. It may be acute or chronic, occurring most commonly in the uncircumcised men. The aim of the study was to study the incidence of balanoposthitis in all male, to identify the etiological agents by microbiological investigations and the risk factors and the complications associated with balanoposthitis.Methods: Study group consists of 100 male patients presenting with the complaints of pain, pruritus, fissuring of the prepuce and subpreputial discharge attending the STD department were chosen. The detailed history was taken, and clinical examination was done. The subpreputial discharge was collected, and wet mounts, cultures, and subcultures were done.Results: All the patients in the study group with balanoposthitis were uncircumcised. 55% of the patients had some associated systemic disease. Out of the 55 patients, diabetes was present in 45 patients. Of the 51 patients of diabetics, 77.77% were in the recently diagnosed group within the past 5 years. Phimosis and preputial adhesions were the most common complications. The Sensitivity of the KOH wet mount in detecting yeast cells was around 93%. Candida albicans was grown by 56%. In our study, S. aureus (24%) was the most common bacterium isolated.Conclusions: The most common systemic association and the predisposing factor was diabetes mellitus. The infective etiological agents were associated with the majority of balanoposthitis. The most common complication associated with balanoposthitis was phimosis.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190236
      Issue No: Vol. 5, No. 1 (2019)
  • Clinical study of geriatric dermatoses

    • Authors: M. Vairaprabha Devi, N. C. Manikandan
      Pages: 128 - 133
      Abstract: Background: Diagnosis of geriatric dermatoses is a challenging job for the Physician due to the involvement of many intrinsic and extrinsic ageing factors. The present study was done with the aim to determine the clinical profile and pattern of dermatological manifestations in elderly people aged 60 and above and to analyze the correlation of various geriatric dermatoses with systemic diseases.Methods: This was a prospective study done on 200 elderly individuals aged 60 years and above attending the outpatient clinic of Department of Dermatology, RGGGH and the outpatient clinic of Department of Geriatrics, RGGGH during the study period from October 2015 to September 2016. Detailed history of cutaneous complaints, present and past medical complaints were taken. A complete general, physical, systemic and dermatological examination was done in all patients and the findings were noted and analysed.Results: Male preponderance was observed (M:F-1.8:1). Maximum number of patients (n=166) belonged to the age group of 60-69 years. Wrinkling of the skin is the commonest physiological geriatric dermatoses. Among the pathological changes, infections and infestations were observed in 27.5% of the study population. Fungal infection was the commonest among them (20%) followed by bacterial (18%) and viral (12%). Diabetes Mellitus was the commonest associated systemic ailment and was observed in about 31.5% of the study population.Conclusions: Geriatric dermatoses occur in the elders due to extrinsic and intrinsic ageing factors. Crinkles were the commonest physiological geriatric dermatoses and benign tumours were the commonest pathological ones. Educating the elders about proper skin care along with the early diagnosis and treatment of their cutaneous ailments would help them to lead a productive and healthy life.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190231
      Issue No: Vol. 5, No. 1 (2019)
  • A study of pattern of non-venereal genital dermatoses in female patients
           at a tertiary care center

    • Authors: P. Sivayadevi, Heber Anandan
      Pages: 134 - 138
      Abstract: Background: Nonvenereal genital dermatoses are responsible for considerable concern for the patients as any genital lesion, or related-symptom is often misinterpreted as being sexually transmitted. To the physician, it may create confusion from venereal dermatoses and cause diagnostic challenge. The study is aimed to determine the clinical pattern and relative frequency of nonvenereal genital dermatoses in sexually active female patients.Methods: The study was conducted as a prospective, observational study in sexually active female patients who presented with genital lesions, after excluding venereal diseases. A detailed history and dermatological examination along with skin biopsy in selected cases to aid in diagnosis was done, and the results were tabulated and analysed.Results: This study included 100 female patients with nonvenereal genital lesions. A total of 23 genital dermatoses were noted. Most of the patients belonged to 25-40 years of age group. Infections and infestations were responsible for 39% of cases of which vulval candidiasis was the most common disorder. Other dermatoses noted include lichen sclerosus et atrophicus, lichen simplex chronicus, psoriasis, lymphangioma circumscriptum, epidermoid cyst, seborrheic keratosis, vulval intraepithelial neoplasia, vitiligo, angioedema of vulva and vestibular papillomatosis.Conclusions: This study underscores the importance of considering non-venereal dermatoses in the differential diagnosis of genital lesions, thus avoiding the misbelief that all genital lesions are sexually transmitted.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190232
      Issue No: Vol. 5, No. 1 (2019)
  • Dermatology life quality index in patients with persisting and recurrent

    • Authors: T. S. Rajashekar, Shruti Nandigonnanavar, Suresh Kumar Kuppuswamy, G. Shruthi Madhavi
      Pages: 139 - 143
      Abstract: Background: Dermatophytosis is the most common fungal infection, which has recurrent and persisting course because of topical steroid abuse, irregular treatment and poor hygiene. Dermatology life quality index (DLQI) is a questionnaire based survey method to assess the impact and severity of many dermatology specific diseases and infections. There is paucity in the literature on the impact of dermatophytosis on the quality of life (Qol). The aim of the study was to assess the impact of dermatophytosis and its sequelae on quality of life.Methods: A total of 186 patients with recurrent and persistent dermatophytosis were selected for Qol questionnaire for a period of six months and statistical analysis was performed using t test to determine the impact of dermatophytosis on Qol.Results: Male to female ratio was 2.7:1, most cases were between 25 to 45 years age group. Thigh fold and gluteal region were the most common sites involved. Mean DLQI score was 12.7. The DLQI scores were statistically influenced by age of the patient, duration of the infection and site of involvement.Conclusions: This study revealed significant impairment of Qol in dermatophytosis patients. Assurance and counselling along with early and prompt treatment plays a significant role in reducing disease related psychosocial sequelae and increase the efficacy of treatment.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190233
      Issue No: Vol. 5, No. 1 (2019)
  • Clinico-microbiological aspects of tinea corporis in North India:
           emergence of Trichophyton tonsurans

    • Authors: Isampreet Kaur, Anuradha Chaudhary, Harshvardhan Singh
      Pages: 144 - 149
      Abstract: Background: Tinea corporis is a superficial fungal infection of the glabrous skin of the trunk and extremities caused by closely related organisms of the three genera of dermatophytes– Trichophyton, Microsporum and Epidermophyton. The prevalence of the different species varies according to geographic and climatic regions. This study was an attempt to find out the causative fungal agents in clinically suspected cases of tinea corporis.Methods: During a period of six months from June 2017 to November 2017, various skin samples from clinically suspected cases of dermatophytosis were examined for presence of fungal elements using KOH preparation and culture on Sabouraud’s dextrose agar. The causative organisms were identified using conventional methods.Results: A total of 157 skin samples were obtained and processed. The most common age group involved was 21 to 30 years of age with male to female ratio of 1.5:1. The patients of rural area (67%) predominated over urban (33%) with most of the patients presenting in the monsoon season (43%). The KOH positivity was seen in 51% and culture positivity in 50% of samples. The dermatophytes (62.9%) predominate over non-dermatophytes (37.1%) with Trichophyton tonsurans isolated as the commonest causative fungal agent.Conclusions: Due to the great variation in the presence of fungal species in different places and at different times, mycological examination is necessary to diagnose, differentiate and treat dermatophytosis.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190234
      Issue No: Vol. 5, No. 1 (2019)
  • Modifications of pulse therapy in pemphigus: a retrospective study of 72

    • Authors: Neela V. Bhuptani, Khushbu P. Chauhan, Monal M. Jadwani, Pooja Raja
      Pages: 150 - 154
      Abstract: Background: Pulse therapy defines as the administration of supra-pharmacologic doses of drugs in an intermittent manner to enhance the therapeutic effects and reduce the side effects. Dexamethasone-Cyclophosphamide pulse (DCP) therapy is known since 1986 but there are certain limitations due to side effects of cyclophosphamide.Methods: A retrospective study was carried out where 72 patients of pemphigus were treated with modified pulse therapy like DCP, DAP, DMP from 2006-2016. Modifications were made in DCP therapy protocol and substitution of cyclophosphamide with either azathioprine or methotrexate in few patients.Results: Male to female ratio observed was 1:0.7. Majority of them belonged to age group of 31-40 years (41.66%) followed by 41-50 years (33.3%). Maximum number of patients had pemphigus vulgaris (86.1%) followed by pemphigus foliaceous (12.5%) and IgA pemphigus (1.38%). Good response was observed in patients who took pulse therapy regularly.Conclusions: Modifications to the original DCP therapy protocol were found to be very effective, useful and it shortened the duration of phase I. Side effects were minimal and manageable.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190235
      Issue No: Vol. 5, No. 1 (2019)
  • Quality of life of adolescents with facial acne vulgaris before and after
           treatment in Ibadan, Nigeria

    • Authors: Ehiaghe L. Anaba, O. O. Adebola
      Pages: 155 - 159
      Abstract: Background: Adolescent facial acne vulgaris impairs their quality of life (QOL). This impairment of QOL in has been documented to improve with treatment. In Nigerian adolescents who have facial acne vulgaris, it is not known if QOL improves with treatment. The aim was to assess QOL improvement with in adolescents who have facial acne vulgaris. To identify the socio-demographic, CADI QOL items and clinical characteristics related to this QOL improvement.Methods: This was a cross-sectional comparative study. One hundred and nine adolescents aged 15-20 years clinically examined for facial acne vulgaris. Quality of life before and after 6 weeks of treatment with 10% benzoyl peroxide was assessed using the Cardiff acne disability index. Data was analyzed using SPSS 16. The differences in quality of life scores were tested using non-parametric tests. Level of significance of all tests was p<0.05.Results: Post-treatment, the median CADI score improved to 2 from a pre-interventional score of 4, p<0.001. Improvement was observed in all the components of the CADI especially with the question, “how bad do you think your acne is now” with a percentage reduction from 81.4% to 54.6% and this improvement was in more males with improvement from 92% to 65%. Also, post-treatment, moderate to severe clinical severity of acne improved from 49.1% to 10.3%, p<0.001.Conclusions: Treatment of adolescent facial acne leads to improvement of QOL especially in the perception of facial skin appearance and the severity of acne.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190230
      Issue No: Vol. 5, No. 1 (2019)
  • A clinical study of cutaneous manifestations in renal transplant

    • Authors: Pradeep Vittal Bhagwat, R. Rajagopal, P. S. Murthy, R. S. V. Kumar
      Pages: 160 - 163
      Abstract: Background: Chronic renal failure is becoming common entity with increased incidence of diabetes mellitus and resulting diabetic nephropathy. With the availability of renal transplantation services in many centers, increased availability of donors, improved surgical technique and availability of better drugs, the survival of renal transplant recipients has increased. The objective of the study was to study the cutaneous manifestations in renal transplant recipients.Methods: Fifty consenting, consecutive renal transplant recipients attending the OPD and in-patients at Command Hospital Air Force, Bangalore during July 2001 to March 2003 were included in the study. Detailed history was taken and clinical examination was carried out with special emphasis on the Dermatological examination. Relevant investigations were carried out.Results: A total of 50 renal transplant recipients were studied of which 42 (84%) were males and 8 (16%) were females. The age of patients ranged from 16 years to 60 years. Infections were the most common finding, encountered in 38 (76%) patients, followed by drug induced manifestations in 24 (48%) patients. Cellulitis was noted in 1 (2%) patient, viral infections were seen in 18 (36%) patients, fungal infection was the commonest in this study, encountered in 38 (76%) patients. Monomorphic acne was seen in 13 (26%) patients. Hypertrichosis/hirsutism were the commonest drug induced manifestation in this study, seen in 16 (32%) patients.Conclusions: In patients with renal transplantation, superficial fungal infections and viral infections of the skin are seen more commonly. Monomorphic acne and hypertrichosis due to immunosuppressive are also seen frequently. These changes are moderately influenced by the immunosuppressive regimen used.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190053
      Issue No: Vol. 5, No. 1 (2019)
  • Haematological profile of human immunodeficiency virus infected patients

    • Authors: C. L. Chitra, R. Manipriya, K. Deepa
      Pages: 164 - 169
      Abstract: Background: In India, approximately 6 million populations are affected by human immunodeficiency virus (HIV). Anemia and leukopenia, especially thrombocytopenia is seen commonly in HIV infections. Low CD4+ count and increased viral load are some of the factors associated with increased risk of thrombocytopenia. The aim of the study was to study the hematological changes that occur in HIV infected patients who attend the Institute of Venereology, before starting HAART.Methods: This cross-sectional study was conducted in the Institute of Venereology, Madras Medical College/Rajiv Gandhi Government General Hospital, Chennai in 100 treatment-naive HIV infected patients. Detailed history and clinical examination was done. Blood samples were collected. Complete blood count, CD4 count, prothrombin time, activated plasma thromboplastin time, peripheral smear etc., were done. Results were collected and analysed.Results: Out of 100 patients, 56% were males and 43% females and one transgender. Anaemia was detected in 72%patients. 73.5% males and 76.2% females with CD4 count <350/μl were anemic. The commonest anaemia was normochromic normocytic, seen in 65% patients. 7 male and 7 female patients had leukopenia. 81.25%patients with lymphocytopenia had CD4 count <350/μl. 12% males and 4% females had neutropenia. 17% had neutrophilia. Patients in WHO stage I did not have neutropenia. 23% patients had thrombocytopenia. 47% patients with thrombocytopenia were in stage IV. Maximum number of patients with normal platelet count was in stage I.Conclusions: Haematological abnormalities are a common occurrence during the course of HIV infection. Identifying and treating the haematological changes have great impact on both the morbidity and mortality of HIV infected patients.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190238
      Issue No: Vol. 5, No. 1 (2019)
  • Dermatological life quality index in psoriasis out patients: the changing

    • Authors: K. Parimalam, S. Sanjeetha Fathima
      Pages: 170 - 174
      Abstract: Background: Psoriasis is a chronic inflammatory disease characterized by remissions and exacerbations, having great impact on social and psychological aspects. From mild plaque psoriasis to more severe pustular and erythrodermic forms with or without joint involvement, is known to have a negative impact on QOL (Quality of Life). Appropriate treatment will improve both disease outcome and QOL in patients. The objective of the study was to assess QOL in psoriasis patient of different age group, type, duration and severity of disease, and their response to this assessment.Methods: A cross sectional study was done with pretested DLQI questionnaire on 101 psoriasis patients, in a government hospital. Interpretation of score and impact on QOL was done and graded as mild, moderate, considerable, severe and very severe.Results: In our study, females outnumbered males with male female ratio of 1:1.5. The mean age 39.56±16.029 years. No significant association was noted between grade of affection and demographic variants. Most of them had moderate impact on QOL. QOL was worst affected in patients <5 years of disease duration. 85% of the patients felt happy & 15% felt neutral on being evaluated by this questionnaire.Conclusions: It is suggested that DLQI is assessed in all new/patients with less than 5 years of disease. Appropriate systemic/photo therapy to be initiated even in mild disease if there is negative impact on the QOL. Assessment of QOL strengthens the doctor-patient rapport and improves better patient adherence to therapy and achieves faster and better control of the disease.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190239
      Issue No: Vol. 5, No. 1 (2019)
  • A retrospective study of systemic manifestations in systemic lupus
           erythematosus in a tertiary care centre

    • Authors: Deepmala Budhrani, Pooja Raja, Monal Jadwani, Khushbu Chauhan, Bharti Patel, Neela V. Bhuptani
      Pages: 175 - 178
      Abstract: Background: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. Other than cutaneous manifestations, thorough examination and investigations for systemic involvement should also be done. The objective is to study the prevalence of various systemic manifestations in SLE patients in a tertiary care hospital.Methods: A retrospective study was conducted from April 2009 to August 2018 on the patients who fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria for SLE. A total of 63 cases of SLE were extracted from the case record for the study. Each case was subjected to detailed history, examination, investigations including complete blood count, liver function test, renal function test, blood sugar, urine routine examination, ECG, X-ray of chest and involved joints, USG abdomen, pulmonary function test. Ours being a resource limited set-up, ANA, ENA profile and echocardiography were done whenever patient could afford.Results: In present study of 63 cases of SLE 94% were females. Mean age was 30 years. Various systemic involvement was present, amongst them musculoskeletal system was the most common system involved with 60 (95%) patients, followed by hematological system 48 (76%), renal system 37 (59%), neuropsychiatric system 29 (46%), gastrointestinal system 28 (44%), reproductive system 27 (43%), cardiovascular system 25 (40%). Other systems with ophthalmic involvement 23 (21%), hepatobiliary system 22 (35%), respiratory system 17 (27%), endocrine involvement 13 (28%) and malignanacy was present in 2 (3%) cases.Conclusions: SLE is protean in its manifestations. Thorough knowledge about the systemic involvement will help in tailoring the treatment in case of SLE.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190240
      Issue No: Vol. 5, No. 1 (2019)
  • Cutaneous manifestations of diabetes mellius: a clinico epidemiological

    • Authors: S. Venkatesh, S. Thamizhselvi, Tharini .
      Pages: 179 - 182
      Abstract: Background: Diabetes mellitus is one of the commonest non communicable diseases seen all over the world, constituting 49% from India, i.e., 72 million patients according to the Indian Council of Medical Research. The aim of the study was to study the various skin manifestations in diabetic patients and to correlate them with glycemic levels.Methods: Patients for the study were chosen among those who were on treatment for diabetes mellitus and presented to the skin department with various cutaneous manifestations.Results: Infections were commonest cutaneous manifestations in both type 1 and type 2. Among infections, fungal infections were commoner followed by bacterial infections. Among house wives, the commoner was candidal dermatosis intertrigo-toe/finger cleft followed by chronic paronychia. Among bacterial infections, erythrasma was commonly followed by pyoderma. Among pyodermas, furunculosis was common. Most common associated dermatoses were acanthosis nigricans and acrochordons. Treatment-related manifestations were not found.Conclusions: In type 2 diabetic patients, infections were commonly followed by acanthosis nigricans, acrochordons, and generalized pruritus. Glycemic levels were higher in those with candidiasis and also with pyodermas. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190241
      Issue No: Vol. 5, No. 1 (2019)
  • The role of topical tacrolimus in adherence to antifungal therapy in
           recalcitrant tinea incognito: a preliminary non randomised controlled

    • Authors: Ajay Kumar, Kalyani Deshmukh, Mahendra Singh Deora
      Pages: 183 - 186
      Abstract: Background: The dropout of outpatients on antifungal therapy for recalcitrant tinea incognito is attributable to the flare on withdrawal of topical corticosteroids and the virulence of pathogens. The objective of the study was to evaluate the role of topical tacrolimus in adherence to antifungal therapy in recalcitrant tinea incognito.Methods: 28 cases of topical corticosteroid induced tinea incognito of more than 6 months duration were enrolled and topical and systemic antifungal therapy instituted for 8 weeks. Topical tacrolimus was also instituted in the test cohort. The end point for resolution was the absence of raised margins, erythema, induration and scaling.Results: 17 patients were male while 11 were female and their age ranged from 16-45 years (mean 26.5). Two patients were from upper-middle; 5 from lower-middle and 21 from upper-lower socioeconomic class. Their occupations included shop assistants, security guards, drivers and labourers and the duration of illness ranged from 7-36 months. Topical corticosteroids were obtained on prescription by 5 and over the counter by 23 patients. Out of the test cohort of 14, all lesions had resolved in 10 patients who had adhered to therapy and were reviewed at the end of 8 and 10 weeks. While 5 reported burning on application of tacrolimus 1 developed folliculitis. Out of the control cohort of 14, though 5 had adhered to therapy all lesions had resolved only in 3 patients at the end of 8 and 10 weeks.Conclusions: Topical tacrolimus facilitates adherence to antifungal therapy in recalcitrant tinea incognito.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190242
      Issue No: Vol. 5, No. 1 (2019)
  • Efficacy of apremilast in psoriasis: a cross sectional study

    • Authors: Jayakar Thomas, Shreya Srinivasan
      Pages: 187 - 191
      Abstract: Background: This study was done to evaluate the efficacy of apremilast in patients with psoriasis.Methods: A total of 20 patients clinically diagnosed with different forms of psoriasis were prescribed apremilast 30 mg twice a day. A psoriasis area severity index (PASI) scoring was done every 4 weeks with a final score taken at the end of 12 weeks.Results: Of the 20 (eight female and 12 male) patients prescribed apremilast 30 mg, 8 patients achieved 75% and more PASI reduction, 10 patients achieved 50% and more PASI reduction at the end of 12 weeks. One patient did not show any significant PASI reduction, while another patient dropped out from the study after 3 weeks of apremilast due to intolerable vomiting and diarrhoea.Conclusions: Apremilast, a relatively safe drug, has no effect on the haematological, renal, hepatic systems as well as no major immunological effects like other drugs used in the treatment of psoriasis, making monitoring of laboratory parameters inconsequential. It is also well tolerated with very few side effects in comparison, making it a welcome drug in the long run.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190243
      Issue No: Vol. 5, No. 1 (2019)
  • Prevalence of non-infectious dermatoses in patients attending a tertiary
           care center in Rajasthan

    • Authors: Bhagirath Singh, Indira Subhadarshini Paul
      Pages: 192 - 196
      Abstract: Background: Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. There is very little epidemiological study available on non-infectious childhood dermatoses in India. The aims of the study were to find the prevalence, clinical profile and various etiological factors associated with childhood non-infectious dermatoses and to determine the prevalence of most common non-infectious childhood dermatoses.Methods: This cross-sectional observational study conducted at tertiary care centre in Rajasthan, India. Children with age 13 years and below with clinical evidence of cutaneous disorders were studied. Parents who have not given consent for the study, acutely ill children, Children having infectious dermatoses (bacterial, fungal, viral, arthropods, parasitic and protozoal infection) were excluded from the study.Results: A total of 232 cases were studied which showed a female preponderance of 55.60%. Most of the skin diseases were seen in the 5 to 13 years (school children) age group. The most common dermatoses was eczematous (36.63%), among eczema atopic diathesis was the commonest (17;20%) followed by hypersensitivity dermatoses (21.12%), genetic disorders (13.36%), disorders of genetic disorders (7.4%), sweat gland disorders (8.18%), pigmentary disorders (4.31%), papulo squamous disorders (4.74%), Nevi (6.46%).Conclusions: Eczematous dermatoses were the most commonly noted in the study, followed by hypersensitivity dermatoses. Atopic diathesis was the commonest endogenous eczemas. Acne, insect bite reaction and miliaria were the other common dermatoses. There was no significant association of various dermatoses with systemic diseases in the study.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190244
      Issue No: Vol. 5, No. 1 (2019)
  • A retrospective study of mucocutaneous lesions of SLE patients and their
           systemic implications

    • Authors: Rekha Gurunatham Ponnurangam, Rajkumar Kannan, Kamalanathan Nallu, Muthusubramanian Chandrasekar
      Pages: 197 - 202
      Abstract: Background: SLE is a systemic disease with multiorgan involvement occuring very rarely, if so, it has a very grave prognosis if not detected early. Our study enlightens about the evolution of mucocutaneous lesions which can serve as an eye opener for early detection of systemic involvement.Methods: A descriptive study was conducted in the Department of Dermatology at a tertiary care centre from May 2017 to April 2018 retrospectively. From 15 confirmed cases of SLE a critical retrospective analysis of symptom complex evolution was done and thus a clinical correlation of evolution of mucocutaneous lesions and systemic involvement was attempted.Results: Out of the fifteen patients in our study comprising various age groups (4-51 years), mean age group was 29.76 years. 14 (93%) were female patients and 1 (6.6%) male patient. Oral ulcerations, Non-scarring alopecia and vasculitic lesions were predominant (3 patients-80%) followed by photosensitivity and cheilitis (9 patients- 60%). Systemic involvement was present in 9 (60%), out of which one (6%) patient had lupus nephritis and 3 patients (20%) had CNS lupus, 2 (13%) had chronic unilateral scleritis, 2 (13%) had interstitial lung disease, one (6%) had coronary heart disease. Mucocutaneous lesions preceded the systemic involvement in 88.8% of cases, with mean duration being 3 years (4 months – 10 years).Conclusions: Mucocutaneous lesions could serve as an eye opener for diagnosis of SLE, which is always a diagnosis made out of high degree of suspicion apart from certain mucocutaneous lesions serving as an ominous sign of system involvement in SLE. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190245
      Issue No: Vol. 5, No. 1 (2019)
  • The study on association of co-morbidities in female patients with

    • Authors: Athilakshmi Sivasubramanian, Suchithra Ganapathi
      Pages: 203 - 205
      Abstract: Background: Vitiligo is an acquired pigmentary disorder of skin characterized by the presence of depigmented patches and macules. Vitiligo has been found to be associated with certain autoimmune diseases like diabetes and hypothyroidism. This study is done to evaluate the association of certain co-morbidities with vitiligo in female patients. The aim of the study was to assess the association of vitiligo with co-morbidities in female vitiligo patients and to find the familial association.Methods: Retrospective hospital-based study done over a period of 6 months.Results: In this study series of 75 cases, 19% of cases were associated with hypertension, 25% were associated with diabetes mellitus, 15% were associated with hypothyroidism and positive family history was noted in 17% patients. The mean age of presentation was 43.18.Conclusions: We found a high association of co-morbidities among female patients with vitiligo. In our study, diabetes has been found to be more commonly associated with vitiligo than other comorbidities. Hence screening for co-morbidities should be considered in vitiligo patients.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190246
      Issue No: Vol. 5, No. 1 (2019)
  • Case report of middle aged male patient with extra digital glomus tumor
           visiting dermatology clinic of King Abdul-Aziz Medical City, National
           Guard Health Affairs, Jeddah, Saudi Arabia, 2018

    • Authors: Awadh Alamri, Marwan Alahmadi, Mohamed B. Satti, Amaal F. Alruwaili, Homaid Alotaibi, Hani Saad Al-Mugti
      Pages: 206 - 209
      Abstract: Glomus tumors are rare, benign and vascular neoplasm of the glomus body, account for less than 2% of all soft tissue tumors. The most common site is the subungual region of the fingers and toes. Extra digital sites including the forearm are uncommon and usually misdiagnosed as other conditions. Usually the glomus tumors present with the classical triad of severe pain, pinpoint tenderness and clod hypersensitivity. This is a case report study design with detailed history, examination of 54-years-old male patient with a painful nodular lesion in the left forearm, which is misdiagnosed as foreign body granuloma. Elliptical excision relieved the symptoms and histopathologic examination confirmed the diagnosis of glomus tumor.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190247
      Issue No: Vol. 5, No. 1 (2019)
  • Cutaneous horn arising from a basal cell carcinoma of forehead: a case

    • Authors: S. Sivaramakrishnan, Jayakar Thomas
      Pages: 210 - 211
      Abstract: The term cutaneous horn or “cornu cutaneum” is used to describe a well circumscribed usually conical hyperkeratotic mass arising from another cutaneous lesion. Several lesions have been reported to occur at the base of the keratin mass. Here we report a rare case of cutaneous horn arising from a basal cell carcinoma (BCC) over the forehead of a 52 year old female patient. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190248
      Issue No: Vol. 5, No. 1 (2019)
  • Rituximab as first line: an advent in pemphigus

    • Authors: V. P. K. Gopinath, Basheer Ahammed Kolaparambath, V. M. Simi, C. M. Ali Rishad, P. M. Farisa, Tresy Jose
      Pages: 212 - 216
      Abstract: Rituximab is a newly approved biological wonder drug in pemphigus vulgaris -an autoimmune mucocutaneous blistering disease due to antibodies produced against the epidermal adhesion molecules dsg 1 and dsg 2. The conventional therapy included high dose steroids or immunosuppressants that though effective had significant adverse effects that necessitated an alternate path in treatment. We present a case series of five patients in different clinical scenarios diagnosed with pemphigus vulgaris and treated with Rituximab by RA protocol either sole or in combination with other treatment strategies. Our experience with this drug has paved way to immense possibilities and outcomes that are in favour of using Rituximab as first line option. We have encountered prolonged remission in cases that were treated with Rituximab by Rheumatoid arthritis (RA) protocol. The sustained response has helped in reducing the dose of steroids and other immunosuppressants substantially. These facts are reinforced through our observations. But there is need to standardize the dosage of Rituximab in pemphigus.
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20190249
      Issue No: Vol. 5, No. 1 (2019)
  • Advanced treatment in basal cell carcinoma of skin

    • Authors: Pankaj Kumar Gupta, Xuefeng Wan, Hari Krishna Kanduri, Kurelli Sai Charan Goud, Paride Abliz, Akebaier Sulaiman
      Pages: 217 - 223
      Abstract: In the past ten years, the occurrence of basal cell carcinoma (BCC) has amplified manifold. There are many treatment procedures to cure BCC, which includes micrographic surgery by means of surgical margins of 3-5mm based on size of tumor, intrusion and location. The normally used method for treatment of basal cell carcinoma is excision by surgery. The most commonly used advanced method of excision in the treatment of bcc is Mohs’ micrographic surgery (MMS). There is no proper guideline, which mentions surgery as the treatment of choice as there are no controlled randomized studies matching surgery with nonsurgical treatment options in BCC. Excision is a competent and meticulous technique as there is a low recurrence of tumor following the histological examination of tumor margins. 
      PubDate: 2019-01-25
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20185514
      Issue No: Vol. 5, No. 1 (2019)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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