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Results in Journal International Journal of Research in Dermatology: 881

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Saleena Beevi A. R., George Kurien, Mary Vineetha
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20172019

Abstract:
Background: Urticaria affects up to 20% of the population during their life time. Urticaria occurring on almost all days for more than 6 weeks is classified as chronic urticaria. Chronic urticaria is one of the most vexing management problems the dermatologists face. Chronic urticaria cases in which no etiology can be found are labelled chronic idiopathic urticarial (CIU). In most cases of idiopathic urticaria, autoimmunity may be the initiating factor- chronic autoimmune urticaria. Autologous serum skin test (ASST) is a simple and reliable method to detect autoimmune urticaria.Methods: Among patients with chronic idiopathic urticaria, ASST is done to detect ASST positivity and thereby chronic autoimmune urticaria. Patient’s serum is separated and 0.05 ml injected intradermally on left forearm. Normal saline is injected intradermally at least 5 cm away as control. Wheal and flare at serum site which is 1.5 mm more than that of control is taken as positive. Results were analyzed using Microsoft excel and Epi info7.Results: 49 patients were studied and 34 (69.4%) showed ASST positivity, which is an indicator of autoimmune urticaria. Moreover, it was seen that ASST positive patients had more episodes of urticaria per week, compared to ASST negative patients. Conclusions: ASST is a simple and reliable method to detect chronic autoimmune urticaria. ASST positive patients have more episodes of urticaria compared to ASST negative patients.
, Vikrant Saoji, Adarshlata Singh, Shivani Mane
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20171497

Abstract:
Background: Very little information is available regarding the association of acanthosis nigricans with insulin resistance from rural areas of India. Therefore this study was carried out with the aim and objectives to study the association between acanthosis nigricans and insulin resistance and to evaluate correlation of acanthosis nigricans severity, neck severity and neck texture severity with fasting blood sugar & serum insulin especially in this rural part of central India.Methods: In this cross sectional study with comparative group, total 162 age and sex matched subjects were divided into two groups of cases (81) with acanthosis nigricans and comparative subjects (81) without acanthosis nigricans. The severity acanthosis nigricans was assessed using the Burke’s quantitative scale. Fasting blood sugar and fasting insulin levels were estimated to know the Homeostasis model assessment of insulin resistance (HOMA-IR) values. Data was analyzed by using appropriate statistical tests.Results: The age range was 20 to 55 years with the mean of 32.82 ± 10.19 years for cases and 33.67 ± 8.09 for comparative subjects. Univariate analysis which showed significant association of acanthosis nigricans with fasting insulin and HOMA-IR with significant odds ratios and p value (p =0.0001) respectively. Fasting blood sugar showed greater risk of association in cases but it was statistically insignificant with p-value of (p =0.32). Spearman rank coefficient correlation showed weak correlation of HOMA-IR with acanthosis nigricans severity, neck severity and neck texture severity, but showed positive correlation of fasting insulin with acanthosis nigricans severity, neck severity and neck texture severity, with statistically significant P-value (p <0.05).Conclusions: Acanthosis nigricans was strongly associated with insulin resistance with significant odds ratio and statistical significant p value (P < 0.05). Acanthosis nigricans severity, neck severity and neck texture severity showed positive correlation with fasting serum insulin with statistically significant p value (P <0.05).
Sukumarakurup Sreekanth, Betsy Ambooken, Sarita Sasidharanpillai, Shibili Eranhikkal
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20171470

Abstract:
Background: Herpes genitalis, has assumed greater importance, being the most common genital ulcer disease nowadays. Hence we aimed to study and analyse the epidemiology of herpes genitalis among STI clinic attendees of our institution during the three year study period.Methods: Previous case records of those who attended the STI clinic of our tertiary care institution with herpes genitalis from 2009 January to 2011 December were reviewed, data collected and studied.Results: 87 of the 530 patients (16.4%) who attended our STI clinic during the three year study period were diagnosed to have herpes genitalis. Females (57) outnumbered males (30) and majority of the affected belonged to the 20-39 age group (58/87, 66.7%). The common clinical types noted were primary herpes genitalis in females (38/57, 66.7%) and recurrent herpes genitalis (15/30, 50%) in males. Conclusions: The facts that all female patients except one were married, only 7.7 % of female patients had either EMC or PMC and many had developed symptoms within one year of their marriage, indicated that marital contact is the commonest cause of herpes genitalis in females in this locality. Significant percentage of primary herpes occurring in pregnant females points to the necessity of pre-marital counselling regarding various STIs and their respective modes of transmission. The study also indicated that males tend to get recurrences for a more prolonged period (2 months to 30 years) , compared to females ( 2 months to 5 years).
Neethu Haridas, Kunnummal Muhammed, Sarita S.
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20171469

Abstract:
Background: AIDS is characterized by the waning of body’s immunity leaving the victim to the multitude of life threatening opportunistic infections, neurological disorders or malignancies. Dermatologic manifestations occur in more than 90% of patients with HIV infection most often due to infections. The awareness of the varied patterns of these skin lesions would help in early diagnosis and management of these in HIV infection, which in turn reduce the morbidity and improve quality of life.Methods: Observational study from 1st April 2012 to 31st March 2013 in a tertiary care institution of North Kerala. HIV positive patients attending sexually transmitted infection clinic of Dermato venereology department, anti-retroviral treatment clinic (ART clinic) and infectious diseases ward of Department of Medicine of a tertiary care centre were examined after consent for mucocutaneous infections. Results: The study population comprised of 206 HIV infected patients with mucocutaneous infections. The male to female ratio was 2.07:1. Most of the affected belong to 30-50 years age group. Majority were manual laborers(49.3%) and in stage3 HIV disease. 107 patients had CD4 Count below 350 at the time of study(51.9%) whereas 40 cases (19.4%) had CD4Count above 500. Most common mucocutaneous infection was oral candidiasis (51%), followed by onychomycosis (16.5%). Out of 29 patients with dermatophytosis majority had tinea cruris (18 patients). Bacterial was second commonest infection. Only 3 patients had tuberculoid leprosy, one with type 1 reaction. Common viral infection was herpes zoster followed by herpes genitalis and conyloma accuminata. 11 patients had verruca vulgaris, one with extensive lesions. Out of 206 patients 28 had sexually transmitted infections (STIs) other than HIV, herpes genitalis being the commonest. Syphilis observed in 4 patients (1.9%). 162 patients (78.6%) were on HAART. The response to treatment was better in patients with CD4 Count above 500cells/mm3. Conclusions:Oral candidiasis, onychomycosis, pyoderma and ulcerative STIs were noted in significant number of HIV infected individuals. These were more common in those with CD4Count below 300 cells/ mm3. .Those patients with CD4 Count above 500 cells/ mm3 responded well to treatment.
Abhineetha Hosthota, , Renu K, Swati Braroo
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20171468

Abstract:
Background: Acne is a multifactorial dermatosis which occurs often during early adulthood with different grades of severity. The factors contributing to the formation of acne include genes, hormones, iatrogenic, psychological, and environmental and occupation. Our article presents the findings on a possible impact of smoking on acne.Methods: This study was conducted to evaluate smoking habits in 126 male acne patients in the age group of 15-45 years. Equal number of age and gender matched healthy controls were taken after consent. These subjects were administered a semi structured proforma to collect socio demographic details. Acne was graded taking into account the predominant lesions and smokers were administered Fagerstrom Test for Nicotine Dependence.Results: Among the total subjects, 28.57% of cases and 15.87% of controls were smokers. In acne patients the number of cigarettes smoked was more as compared to controls. There was positive correlation between the number of cigarettes and the grading of the acne(r=0.4515). The risk of acne was 2.12 times more in smokers than in non-smokers.Conclusions: Various studies have reported that smoking may play a role in pathogenesis of acne. Compelling evidence shows that higher nicotine dependence will exacerbate acne. So the association between the two cannot be excluded. The effect of smoking on the course of acne is still inexplicit.
Rahima S., Najeeba Riyaz, Saleem P. M.
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20171027

Abstract:
Background: Foot dermatoses are a common malady in children. It has a varied presentation ranging from patchy fissured scaly lesions to disabling highly inflammatory vesicular eruption. A role for foot wear exacerbating these dermatoses is a possibility, which could be confirmed by patch testing.To evaluate the role of patch testing in determining the allergen either causing or exacerbating various foot dermatoses in children.Methods: Patch testing was done in 40 children with various foot dermatoses using the standard footwear series and the results were read after 48 hours, 96 hours and again after 7 days. Also, skin biopsy was done in 10 cases from the representative lesions.Results: Patch test was positive in 24(60%) patients to different antigens. Disperse orange (25%) was found to be the commonest allergen followed by epoxy resin (15%), neomycin sulphate (12.5%) and black rubber mix (10%). Conclusions: Patch testing has a major role in finding out the causative agent or at least the exacerbating footwear in various foot dermatoses. Disperse orange was found to be the most common allergen. The diagnosis of acrodermatitis or JPD should not deter doing a patch testing.
Ramachandran Ramakrishnan, , Soosai Donald Fernandes
International Journal of Research in Dermatology, Volume 3, pp 187-191; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170982

Abstract:
Background: The profile of sexually transmitted infections (STIs) is variable due to changes in socio-economic, cultural, geographic & environmental factors in different parts of the country. However, baseline information about the epidemiology of STIs remains essential for designing, implementing and monitoring of successful targeted interventions. The study was conducted with the aim to study the frequency of various STIs among male patients attending the STI outpatient department (OPD) of our hospital during a period of one year.Methods: This is a retrospective study, wherein data collected from January 2016 to December 2016 regarding male attendees to STI clinic in our hospital was used to assess the occurrence of various STIs among male patients during that period.Results: Among the study group (266), most common STI was scabies (33.83%) followed by balanoposthitis (33.08%) and anogenital warts (10.9%). It was also noted that 71% of scabies occurrence was during Jan to April and then December, compared to other months. Early syphilis (Primary/secondary) was detected in 3 subjects. Syphilis occurrence was lower than data from some previous Indian studies. Conclusions: There is considerable variation in the incidence of STIs among various regions of our country. There is also a change in occurrence of various STIs over last 2 decades. The reasons could include over-the-counter antibiotic use and more frequent use of antibiotics for other diseases than in the past.
, Gita R. Tegta, Vinay Shanker, Ghanshyam K. Verma, Anuj Sharma, Meena Chauhan
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170972

Abstract:
Background: Endogenous eczemas are often complicated by exogenous factors like environment and contact allergens. Nummular eczema, a variant of endogenous eczema is no exception to this. Our study aimed at investigating the incidence of allergic contact dermatitis and finding offending agent responsible for chronicity or relapsing course of nummular eczema in patients from a hilly region with cold and dry environmental conditions.Methods: Forty patients of nummular eczema with a mean age of 39.1±19 years were patch tested with the Indian Standard Patch Test Series. Positive reactions were graded as per recommendations of International contact dermatitis research group.Results: Twenty one out of forty patch tested patients showed positive reactions. The most common allergens were found to be: fragrance mix in seven (17.5%) patients, nickel in five (12.5%) patients, PPD in three (7.5%) patients and gentamicin in two (5%) patients. Sensitivity to thiuram mix, black rubber mix, P. tert. butylphenol formaldehyde, neomycin, benzocaine and chinoform was observed in one patient each (2.5% each). Conclusions: Patients of nummular eczema of a hilly region are at a significant risk of developing allergic contact dermatitis owing to xerosis due to dry environmental conditions. This results in chronic nature of their disease. Patch testing should be considered in such patients and avoidance of offending allergens can improve their quality of life.
Ameesha Mahajan, Jasleen Kaur, Idu Manjari, Saurabh Sharma, Pooja Bains, Guneet Awal, Saurabh Chawla
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170973

Abstract:
Background: The purpose of the study was to evaluate the clinical and histopathological features of oral pemphigus vulgaris.Methods: A prospective study of 35 cases of oral pemphigus vulgaris, over a period of 2.5 years from June 2014 to December 2016 in the Department of Dermatology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar was designed. Complete history and detailed mucocutaneous examination was done. Punch biopsy was performed from the oral mucosa and skin lesions (if present). Specimen was sent for histopathological examination and results analysed.Results: Out of 35 patients, 17 (48.57%) were males and 18 (51.42%) were females. Male to female ratio was 1:1.1. The majority of the patients (12, 34.29%) were in the 40-49 year age group. Multiple sites were involved in all patients with bilateral buccal mucosa being involved in all the cases, followed by tongue (30, 85.71%). Histopathological examination showed presence of suprabasal split and acantholytic cells in all cases. Conclusions: Oral ulcers are a presenting feature of pemphigus vulgaris which commonly precede the skin lesions. Histopathological examination enables early diagnosis of the disease which leads to prompt treatment and decreased morbidity.
Ashish Dalal, Ritambhara Lohan, Muskaan Ahlawat, Ajay Kumar
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170807

Abstract:
A proportion of cases of diffuse hair loss over the scalp mimicking telogen effluvium or androgenetic alopecia are found to have alopecia areata incognita (AAI) on dermascopic examination and histopathology. AAI has commonly been reported in middle aged women who present with a sudden increase in hair shedding with diffuse alopecia developing after several months. Though the typical glabrous patches of hair loss observed in classical alopecia areata are absent, the abrupt and intense hair loss with a positive hair pull test is suggestive of AAI. There are few reports of AAI occurring in children. We are reporting a case of AAI in a 6-year old child.
Ravikanth Punniyakodi, Chandramani Gurumani, Brindha Thangaraj
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 155-157; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170806

Abstract:
Angina bullosa hemorrhagica (ABH) is a term used to describe acute, subepithelial oral mucosal blisters filled with blood without any systemic disorder or hemostatic defect. They rupture spontaneously after short time resulting in painless superficial erosion that heals spontaneously within one week without scarring. We report two cases of ABH to create awareness regarding occurrence of this lesion thus avoiding any misdiagnosis.
Jyoti Rajpoot, , Rashmi Arora
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170805

Abstract:
Cutaneous leiomyosarcomas are uncommon neoplasms, accounting for 1-3% of all the soft tissue sarcomas. They encompass a variety of clinicopathological features that makes their diagnosis difficult. They are divided into various categories, as this division has an important prognostic implication. We describe a rare case of recurrent cutaneous leiomyosarcoma of the anterior abdominal wall in a 50 years old female.
Rahima S., Abdul Latheef E. N., Pavithran K.,
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170802

Abstract:
Background: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered as the severest end of spectrum of erythema multiforme. Various etiologies like infections, drugs and malignancies have been proposed. The aim of the present study was to know the incidence, common causes, clinical course of SJS and TEN and to estimate the morbidity and mortality.Methods: A 2 year study of patients presenting with SJS and TEN was carried out. A detailed examination to know the cutaneous and mucosal involvement was done. Biopsy was done in 3 patients.Results: There were fifty patients of SJS-TEN spectrum. Of which 31 were SJS, 3 had SJS-TEN overlap and 16 had TEN. Anticonvulsants were implicated in causing these reactions in 24 patients (48%) with carbamazepine being the most common i.e. in 16 patients (32%). Sparing of pressure areas like the strap area of brassier and waist was noticed in two patients (4%). The most common complication was due to eye involvement seen in 20 patients (40%). 46 patients were treated with steroids and of the remaining, 3 were children and one was HIV positive. Only three patients with TEN (6%) died. Conclusions: To conclude, TEN was less common than SJS, had more sequelae and more mortality compared to SJS.
, Prabhakar Meti, JagannathKumar V.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170804

Abstract:
Background: Pyoderma is defined as a skin infection mainly caused by Staphylococcus aureus, Streptococcus pyogenes or both. Pyoderma is a common skin infection in India and constitutes major portion of patients in dermatological clinics. Many cases nowadays do not respond to the antibiotics that were previously sensitive. In order to successfully treat cases of pyodermas, sound knowledge is necessary regarding the etiology and their sensitivity patterns. Objectives of this study were to determine clinico-epidemiological and etiological factors associated in patients with pyoderma and to find sensitivity pattern of isolated organisms to various antibiotics commonly used.Methods: A hospital based cross sectional study was performed on 100 patients presenting with bacterial skin infections to the Dermatology out-patient department of a tertiary care centre in Central Karnataka. Clinical and epidemiological features were recorded on a predefined proforma. Sterile swabs were used to collect the pus from the lesions under aseptic precaution. Antimicrobial susceptibility testing of the isolated strains to different groups of drugs was tested on Muller Hinton agar by the Kirby Bauer disc diffusion method.Results: Primary pyodermas was seen more in the age group of 21-30 years (21%), followed by 31-40 years (19%). Folliculitis (32%) was the commonest clinical type followed by furuncles (28%). Among the gram positive isolates, Vancomycin (88.24%), Linezolid (86.67%) and Cefoxitin (71%) were the most susceptible drugs, whereas Amoxicillin (92.86%) and penicillin G (88.37%) were the most resistant drugs. Conclusions: Pyodermas have been the major cause of morbidity since long. Even though pyoderma is a common condition, emerging multidrug resistant strains is of major concern to treat these conditions. Suitable and judicious selection of antibiotics by using antibiotic sensitivity data would limit the emerging drug resistant strains in the future to treat these clinical conditions successfully.
Jishna P., M. P. Binitha, Abdul Latheef E. N., V. P. Anilakumari
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170803

Abstract:
Background: Vitiligo is associated with various autoimmune diseases, including autoimmune thyroid disease. The objectives of the present study was to determine the prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in patients with vitiligo, and to compare the clinical profile of anti-thyroid peroxidase positive and anti-thyroid peroxidase negative patients.Methods: A cross-sectional comparative study was conducted in 100 patients with vitiligo and 100 controls. After dermatologic and systemic evaluation, serum thyroid hormones and anti-thyroid peroxidase antibody levels were measured in all the subjects.Results: Thyroid dysfunction was more common in the vitiligo group (27%) than in the controls. Serum thyroid stimulating hormone abnormalities were more common in the vitiligo group (27%) than in the controls (6%). The most common thyroid dysfunction was subclinical hypothyroidism. Anti-thyroid peroxidase antibody positivity was higher in the vitiligo group (36%) when compared to the controls (24%), and the most common type of vitiligo was vitiligo vulgaris (18%) in this group. Thyroid dysfunction and anti-thyroid peroxidase positivity were more common in women (58%) when compared to men (42%). There was a significantly higher prevalence of other autoimmune diseases in the vitiligo group (20%) compared to the controls (6%). Conclusions: This study shows a significant association between vitiligo and thyroid dysfunction, anti-thyroid peroxidase antibodies and other autoimmune diseases. We recommend that thyroid evaluation and regular follow-up should be done in patients with vitiligo for prompt detection of thyroid dysfunction.
Vijaya Anand M., Parimalam Kumar, Nandagopal K.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170800

Abstract:
Background: Mucocutaneous manifestations in patients positive for HIV are helpful in the diagnosis as well as treatment of the disease. Consequent to the introduction of Highly Active Anti-Retroviral Therapy (HAART), there seems to be an increase in the presentation of non-infective diseases. It was aimed to analyse the mucocutaneous manifestations in HIV infected patients taking HAART and correlate with age and CD4 lymphocyte count.Methods: A retrospective analysis of 125 People Living With HIV (PLWH) having mucocutaneous manifestations receiving HAART who attended a tertiary care city hospital over a period of ten months from January 2016 to October 2016 was carried out. The findings were correlated with CD4 count and age. The data were collected from the patient follow up cards maintained by qualified Dermatovenereologist.Results: There was no major gender difference in our study. The trans genders presented with only non-infectious skin diseases. Younger patients had a higher CD4 count (p=0.01%) which was statistically significant. Candidiasis and pruritic papular eruption were the commonest infective and non-infective diseases observed respectively. The mean CD4 count comparison was statistically significant (p=0.04). The count was highest for insect bite allergy and lowest for oral hairy leukoplakia. The mean age of disease manifestation was highest for Herpes zoster and lowest for aphthous ulcers 45 and 29 years respectively. All the adverse reactions observed were to efavirenz. Conclusions: With the improvement of CD4 count in PLWH receiving HAART, the proportion of non-infectious inflammatory disease manifestations are on the rise. Awareness about this fact is very important for effective management.
, K. Karthikeyan
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170796

Abstract:
Background: Vitiligo is fairly commonly encountered disorder of pigmentation resulting in the presence of numerous depigmented macules and patches over the body. Vitamin D is an essential hormone synthesized in the skin. Levels of vitamin D have been found to be low in patients with vitiligo. The purpose of this study is to evaluate if vitamin D levels have any association with vitiligo, by estimating the levels of vitamin D in patients with vitiligo, and correlating type of vitiligo with vitamin D levels.Methods: A hospital based case control study was done in the Dermatology outpatient department of a tertiary center in South India from October 2014 to May 2016. About 45 consenting patients who fulfilled the inclusion criteria were chosen for the study. About 45 age and sex matched consenting individuals without vitiligo were chosen as controls from the Dermatology outpatient department. A detailed history and clinical examination of all the consenting subjects was done. Blood samples were collected from both the cases and controls by venepuncture and sera separated. The levels of Vitamin D were estimated using a vitamin D ELISA kit.Results: There was no statistically significant difference in vitamin D levels between patients and controls. There was no correlation between type of vitiligo and vitamin D value. Conclusions: Vitamin D does not appear to have any role in vitiligo patients in this study.
Ashok S. Hogade, Saranya D.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170801

Abstract:
Background: Various cutaneous manifestations are common in the neonatal period. Transient and pathological neonatal dermatoses should be differentiated to avoid unnecessary treatment and to relieve parent’s stress. The present study is being carried out to study the clinical pattern of cutaneous lesion during the neonatal period, to determine the frequency of various dermatoses i.e. physiological and pathological lesions in neonate along with appropriate management of cases.Methods: A total of 100 neonates from labour rooms and pediatric nursery of Basaveshwara general hospital, Kalaburagi were evaluated for cutaneous manifestations. All the relevant data regarding history, clinical examination and investigations were recorded and analyzed.Results: Of the 100 neonates, 56 (56%) were males and 44 (44%) were females, 72 (72%) were full term, 23 (23%) were pre-term and 5% were post term. Of these 78% newborns were born to multigravidae mothers, while 24% newborns born of consanguineous marriage had cutaneous lesions. The majority of newborns 54% were born through normal delivery. The largest number of babies with cutaneous lesions (72%) was seen in newborns of mothers in the age group of 20-29 years. The most common dermatoses were physiological scaling (18%) and Mongolian spots (20%) followed by milia (13%), miliaria (14%).Conclusions: The present study helps to understand the type and distribution of cutaneous lesions presenting in the early neonatal period in newborns. Majority of skin lesions were transient and did not need any medical treatment. Counselling the parents helped alleviate their significant psychological stress as well as play a role in creating awareness in the community and benefit the people at large.
Eby Chacko, Seethalakshmi Ganga Vellaisamy, Kannan Gopalan, Govindarajan Nanjappachetty
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170798

Abstract:
Introduction: Polymorphic light eruption (PMLE) is an acquired photodermatosis characterized by a polymorphic eruption ranging from papulovesicular lesions to large plaques. The prevalence of PMLE varies from 5% to 15% in various studies across the world and in India it is 0.56%.Objective: The present study was conducted to study the clinical pattern and to assess the epidemiological aspects of polymorphic light eruption.Material and Method: A cross sectional prospective study was conducted in Dermatology OPD between April 2015 and June 2016. A total of 100 patients with symptoms and signs of PMLE were included in the study. Data were coded and analyzed.Results: Majority of the cases in our study were in the age group of 21 - 30 years (36%). It was more common in females (82%) when compared with males (18%). Occupation of most of the patients (29%) was farmers in our study population. Positive family history of PMLE was seen in 11% of the study population. The commonest form was the papular type (46%) and the second most common type was plaque type (17%). Regarding the distribution of lesions, about 51% of our study subjects had polymorphic lesions confined to only one area of their body mostly forearm (25%) followed by face (12%).Conclusion: The prevalence of PMLE was 1.34% in our study population. Pruritus was the presenting complaint in most of the cases and the rash was mainly seen in areas exposed to sunlight.
, Kaliaperumal Karthikeyan
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170799

Abstract:
Background: Chronic kidney disease is defined as presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR) that persists for more than 3 months.Chronic kidney disease is major health problem. Chronic kidney failure presents with an array of cutaneous manifestations. The objective of the present study was to determine the pattern of muco-cutaneous manifestations of chronic renal failure on hemodialysis.Methods: A cross sectional study done in the Dermatology & Nephrology OPD of Sri Manakula Vinayagar Medical College and Hospital from October 2014 to May 2016. About 38 consenting patients who fulfilled the inclusion criteria were chosen for the study. The demographic characteristics were included in the study and the clinical profile of the patient such as hematological investigation and renal function tests were assessed. KOH mount, skin biopsy, Woods lamp, Grams stain and culture & sensitivity were done if needed after getting informed consent from the patients.Results: The most common cutaneous manifestations in haemodialysis patients were xerosis and uraemic pruritus. Conclusions: Cutaneous manifestations like uraemic pruritus, Xerosis, Kyrle’s disease, infections, icthyosis & other lesions were seen with Xerosis beimg the most common feature. At least one cutaneous manifestation is found in all CRF patients.
, Asha Bullappa, Shruti Kakar, Prakash Kengnal
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 107-112; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170797

Abstract:
Background: Acne is a chronic inflammatory disease known to occur in adolescent age group. There are many myths and misconceptions in patients as well as health physicians regarding the causes and treatment of acne. Objective of the study was to assess the knowledge, attitude and practice towards acne vulgaris among acne patients attending skin outpatient department in a private medical college.Methods: This is a cross sectional, questionnaire based study conducted between January - April 2016. 100 patients having acne lesions were included in the study.Results: Majority of the study subjects belonged to the age group 15-24. The study showed that 72% had good knowledge. More than half of the study subjects had wrong belief that eating oily foods, chocolates, spicy food caused acne but more than 40% of the study subjects had good knowledge about the causes and aggravating factors like it worsens by squeezing/picking/rubbing (83%), commonly found in oily skin (67%), has seasonal occurrence (54%), associated with premenstrual flare (42%), aggravated with use of cosmetics (41%). Conclusions: The acne patients had poor practice and unfavorable attitude in spite of good knowledge. Many myths exist among patients. Despite being so common and very well responsive to treatment, it is a major cause of depression among patients.
Girish V. Nagaral
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 94-96; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170794

Abstract:
Background: Vitiligo is considered to be symptom less and its presentation is boundless varying from isolated focal lesion to bizarre generalized lesions. The present study was undertaken to study the histopathological changes in lesions of vitiligo in south Indian population.Methods: 150 patients with mild to moderate vitiligo features attending the outpatient department of Dermatology, Venereology and Leprology at Chitageri General Hospital and Bapuji Hospital attached to J.J.M Medical College, Davengere were utilized to study the histopathological features in vitiligo and its association with other diseases.Results: Destruction of melanocytes at dermo-epidermal junction was noted. We have observed presence of melanocytes in the basal layer of the epidermis on left side of the lesion, whereas decreased melanocytes in the basal layer of the epidermis on the right side of the same lesion in the present study. Dermis with mild perivascular lymphocytic infiltration and acanthosis along with mono nuclear cell infiltration in the upper dermis was observed. Conclusions: The present study gives better knowledge to the clinicians about the lesions of vitiligo and its pathogenesis.
Dharmambal C., Somasundaram A., Balachander J., Vasanthmoorthy R.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170795

Abstract:
Background: TGs are considered to constitute an important risk group for the transmission of Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus. High levels of STIs are predominant among TG sex workers due to unsafe sex practices. A study was conducted to describe the prevalence of sexually transmitted infection among Transgender who attended the outpatient clinic of Dermatoveneroleprology department for over 7 years and describe the contributing factors associated with sexually transmitted infections among transgender as there is a scarce data available about it.Methods: Retrospective study carried out on 123 transgender who attended the sexually transmitted disease clinic at Government Vellore Medical College and Hospital during the period 2008-2015.Results: Most of the transgender have active sexual life. 44% of them were having unprotected sex. Anal sex practice is more prevalent (88%). 25% reported one or other symptoms of sexually transmitted infection. 10.5% were reactive for syphilis and 11% reactive for HIV. Conclusions: A high reported prevalence of sexually transmitted infection exists despite many intervention policies adopted by the health system time to time. Implementation strategies to promote awareness among Transgender to access health care at the earliest time of appearance of symptoms and also periodical check-up may help to diagnose sexually transmitted infections at the early stage. Awareness and behavioral change on safe sex practices are the important needs in preventing sexually transmitted infections.
Mounika K., K. N. Shivaswamy
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170611

Abstract:
Background: The urticaria lasting for more than 6 weeks is termed chronic urticaria. The etiology of chronic urticaria and angioedema remains uncertain in most of the patients. Aeroallergens can induce or exacerbates chronic urticaria. The common aeroallergens are house dust mites (HDM), pollens, moulds, etc. House dust mites can trigger immunological process through ingestion, inhalation or inoculation. These mite allergens are resistant to high temperatures, and do not lose their antigenic property even on cooking. HDMs can also cause worsening of existing atopic dermatitis. Skin test with HDMs is well known to cause irritation due to their proteolytic enzymes.The study was undertaken with the objective to study the skin prick test positivity to house dust mites in patients with chronic urticaria.Methods: The study was done on 56 consecutive patients of clinically diagnosed cases of chronic urticaria attending the OPD. The skin prick test was done according to the standard protocol.Results: We had a total of 56 patients with chronic urticaria, of which males were 30 and females were 26 with a male to female ratio of 1:0.8. Of the 56 patients with chronic urticaria skin prick test to HDM was seen in 8 (14.2%) patients. D. pteronysinnus 6 (10.7%) constituted the majority among the HDM positivity followed by D. farinae 2(3.5%). We also found skin prick test positivity to pollens, moulds and animal dander in 5, 4 and 2 patients respectively. Conclusions: House dust mites can cause or trigger the urticarial symptoms and one should consider to do skin prick test to HDM in identifying the cause and thereby reliving the symptoms of urticaria on its avoidance.
Parimalam Kumar, Suguna K., Lavanya P.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 83-87; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170502

Abstract:
Background: Vaginal discharge [VD] is the most common gynecologic complaint in children. The causes vary from being physiological to sexually transmitted diseases. The anatomy and physiology of the vulva and vagina and the vaginal flora influence the causes to some extent. As the above factors vary as the child grows, the etiology varies too. At any age, VD is responsible for a significant morbidity. Hence enumerating the causes and identifying the common causes in specific age groups will help in development of preventive measures and early appropriate treatment. The aim of the study was to enumerate the cause of VD in children attending the OPD at Government Royapettah Hospital and to find out the causes of VD in specific age groups less than 2 year, 2-9 years and 9-14 years.Methods: A retrospective analysis of twenty girls less than 14 years of age with VD details were collected from the STI cards of twenty children in the age group upto 14 years, with vaginal discharge, who attended the STI clinic at GRH, KMC will be selected and their symptoms, clinical examination findings, results of relevant investigations noted from their hospital records. Children with HIV infection, immunosuppression due to juvenile diabetes mellitus/ malignancy and history of sexual abuse will be excluded. The results tabulated and a descriptive analysis done to find out the most common aetiology in different age groups in children. Descriptive analysis was applied to analyse the results.Results: Out of the twenty children studied 40, 10, 50 percent of the girls were in group A, B and C respectively. Youngest child was 6 months old and oldest was 14 years. In 10% of girls the incidence of VD was physiological and in 90% it was due to pathological causes. In 50% of children the causative agent could be demonstrated by laboratory investigations. Candida was the commonest agent demonstrated in 25% of girls studied. In 35% cases the cause was unidentifiable. Bacterial, parasitic and dermatological causes constituted to 10%, 15%, 10% of aetiology of VD respectively. In one child [5%] who had genital psoriasis, the clinical features of candidal infection was negative.Conclusions: Aetiological diagnosis was very important in children with VD. Not all VD in children are infective and hence anti-fungal and anti-bacterial agents should not be prescribed without adequate clinical and or microbiological evidence. Pin worm infestation should be considered as a cause of VD in girls with perianal excoriation and nocturnal worsening of symptoms.
Rachana R., Shivaswamy K. N., Anuradha H. V.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170081

Abstract:
Background: Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.Methods: A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.Results: Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least. Conclusions: Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.
Sumyuktha J., , Parveen Basher Ahamed
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 59-63; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170082

Abstract:
Background: Skin infections caused by dermatophyte fungi account for 6% of dermatology consultations at our hospital and 3 to 4% worldwide. A variety of antifungal agents are available for topical use. Terbinafine 1% cream is considered the first line topical medication in the treatment of dermatophytosis. Sertaconazole 2% cream is a relatively new drug having antifungal as well as antiflammatory property. In this prospective study we sought to compare the safety and efficacy of topical 2% Sertaconazole and 1% Terbinafine creams in the treatment of localized tinea cruris and/or tinea corporis.Methods: In this study, 80 patients were randomized into two groups of 40 each. Group A received 2% Sertaconazole cream while group B received Terbinafine 1% cream topical application twice daily for 4 weeks. Patients were followed up at the end of 2nd and 4th weeks for clinical, mycological (KOH mount and fungal culture) and complete cure (both clinical and mycological).Results: The mean age of the patients studied was 27.97 years. Complete cure was achieved in 59.5% and 80% in group A and 71.4% and 90.9% in group B at the end of 2nd and 4th weeks respectively. Significant P values were observed if the results were compared within the group, between baseline and 2 weeks, baseline and 4th week and also 2nd and 4th week. Clinically significant side effects were not observed in both the groups. Conclusions: Although higher cure rates were observed in the Terbinafine treated group, the results were not statistically significant. It can be concluded from our study that Sertaconazole 2% cream is similar in efficacy to Terbinafine 1% cream in the treatment of localized tinea cruris and corporis.
Chintaginjala Aruna, Senthil Kumar A. L., Sridevi K., Ramamurthy D. V. S. B.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170454

Abstract:
Background: Cutaneous tuberculosis constitutes 1.5% of extra pulmonary tuberculosis and the disease continues to be a challenging one because of its multifaceted presentation. The present study was done to document the most common type of cutaneous tuberculosis, atypical presentations if any and response to directly observed therapy short course (DOTS).Methods: All patients with clinically suspected cutaneous tuberculosis attending outpatient department of dermatology in our hospital from October 2012 to April 2016 were included in the study. A detailed history of presenting illness and thorough general, systemic and cutaneous examination was carried out along with documentation of demographic details. Routine blood invetigations, biopsy and mantoux test were done. Diagnosed cases were treated with DOTS.Results: A total of 25 cases of cutaneous tuberculosis were included in the study. Most common type of cutaneous tuberculosis was lupus vulgaris. Atypical presentations noted during the study were multifocal lupus vulgaris (LV), co-existence of tuberculosis verrucosa cutis (TVC) and LV, TVC of lower lip, erythema induratum of bazin presenting as annular plaque in one case and as erythema nodosum in another case. DOTS were effective in majority of the patients. Conclusions: Cutaneous tuberculosis is multifaceted. High clinical suspicion is necessary in rare presentations. Coexistence of two or more morphological patterns can occur. Doubtful cases, 5-6weeks of therapeutic trail helps. Adequate dose is essential for good response. Second line drugs are to be considered in case of failure /clinical resistance.
Senthil Asokan, , Rajagopalan V.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170432

Abstract:
Background: Over the past few decades, the developments in the field of Nephrology have improved the life expectancy of patients with chronic kidney disease (CKD). This situation provides more time for the dermatological conditions to manifest. The objective of the present study was to evaluate the different clinical patterns of cutaneous manifestations in chronic kidney disease and also to compare the cutaneous manifestations in CKD patients on dialysis and medical management.Methods:. 120 consecutive cases of chronic kidney disease were included in the study. This included inpatients and outpatients, patients on medical management as well as those undergoing hemodialysis. A detailed history was taken and complete dermatological examination was performed. Digital photographs of skin lesions were taken. Relevant investigations like complete blood counts, blood urea, serum creatinine, serum electrolytes were performed routinely. Special investigations like KOH mount for fungus, Tzanck smear and skin biopsies were performed when clinically indicated.Results: The number of cutaneous manifestations present in each patient is compared based on severity and duration of CKD. 82.8% of patients with severe CKD had more than one dermatoses compared to 60% of patients with mild CKD. So, multiple cutaneous manifestations could be found in the same patient, as the severity of CKD increases. Xerosis and hyperpigmentation were more prevalent in patients undergoing dialysis than those on medical management alone.Conclusion: In patients with CKD xerosis, pruritus, pigmentation, nail changes and cutaneous infections were the predominant cutaneous manifestations. The prevalence of xerosis and hyperpigmentation were higher in patients with longer duration of disease and increased as the severity of CKD increased. The prevalence of pruritus was independent of the duration and severity of CKD.
, Divya K. G., Rajagopalan V., Parveen B.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170433

Abstract:
Background: Melasma is an acquired hypermelanosis characterized by light-to-deep brown pigmentation over cheeks, forehead, upper lip, and nose. Treatment of this condition is difficult and associated with high recurrence rates. Among newer therapies, there is interest in the use of glycolic acid peels and Q-switched Nd:YAG laser (QSNYL). The aim of the present study was to compare the therapeutic efficacy and in melasma. Methods: 60 patients of melasma were included. They were randomly divided in two groups (Group A = 30 patients treated with glycolic acid and Group B = 30 patients treated with QSNYL). Out of the 60 patients included, 26 patients in Group A, 24 patients in Group B completed the study. Response to treatment was assessed using MASI scores. Results: The peak incidence of melasma was seen in the age group 31-40 years. Female preponderance was seen in the study (F: M-6.6:1). Sunlight was the common aggravating factor in both the groups (30%). Malar type was the most common (51.7%) observed in both the groups. MASI scores improved from 7.14 to 4.99 with glycolic acid peel and from 6.17 to 4.67 in the laser group at the end of the study. The common adverse effect observed in the study was erythema in both the groups. Postinflammatory hyperpigmentation was frequent in laser treated patients.Conclusion: 70% Glycolic peels were better than Q switched Nd:YAG laser for the treatment of melasma. Among patients treated with laser postinflammatory hyperpigmentation was a significant side effect especially in darker skin types.
Olasseri K. Reena Mariyath, Manikoth P. Binitha, Vadakke P. Anilakumari, George Biju, Pappinisseri K. Nikhila, Mann Pradeep
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170362

Abstract:
Background: The exact etiology of chronic spontaneous urticaria is unknown in the majority of patients. A subset of chronic spontaneous urticaria can be autoimmune and may be associated with thyroid autoimmunity.Methods: Serum anti thyroid peroxidase (anti-TPO) antibody level and thyroid function tests (TFT) including triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) levels were estimated in 100patients with chronic spontaneous urticaria and 50 controls. Autologous serum skin test (ASST) was done in 84 chronic urticaria patients and 21 patients with high anti-TPO antibody.Results: High anti-TPO antibodies and abnormal thyroid function were seen in 24 (24%) patients each. High anti-TPO antibody levels were seen in nine (18%) and abnormal TFT in 11 (22%) controls. Abnormal TSH was seen in 22 patients (22%) and 6 (12%) controls. Autologous serum skin test was positive in 53 patients with chronic spontaneous urticaria. It was positive in 16 and negative in five out of 21 patients with high anti-TPO antibody levels. Conclusions: Though there was a slight increase in abnormal anti-TPO antibody level and thyroid dysfunction in patients with chronic spontaneous urticaria compared to controls, it was not statistically significant.
Mounika K., Shivaswamy K. N.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164519

Abstract:
Background: Urticaria is an allergic skin disorder characterized by wheals. Though the diagnosis is easy, it is difficult to identify the cause for the episodes. Autologous serum skin test (ASST) and skin prick test (SPT) help in the identification of the cause. The objective of the study was to determine the frequency of ASST and SPT positivity in patients with chronic idiopathic urticaria (CIU).Methods: Fifty-six patients attending the dermatology OPD with chronic idiopathic urticaria were evaluated and taken up for the study. ASST and SPT were performed on all the patients and the obtained results were documented. Data was analyzed using Chi square test.Results: Among the 56 patients studied, males (53.57%) outnumbered females and the majority was in the age group 21 to 30 years (33.9%). One third of the study patients gave history of known food allergy and 10.7% gave history of dust allergy. ASST positivity was seen in 30.3% and SPT positivity was seen in 64.3%. Ten of our patients (17.8%) were positive to both ASST and SPT. Amongst the SPT positives 33.3% showed positivity to food allergens, 19.4% showed positivity to aeroallergens and 47.2% showed positivity to both. Conclusions: ASST and SPT are two reliable tools in identifying the cause for urticaria and this in turn helps in avoidance of possible causes and providing proper treatment.
, Arakali Lakshminarayana Shyam Prasad, Tharayil Kunneth Sumathy, Rakesh Vibhakar Reddy
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 49-54; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20164785

Abstract:
Background: Anti-cancer chemotherapy is associated with a myriad nail changes ranging from cosmetic disfigurement to severe changes which may require an alteration in the cancer chemotherapeutic regimens. The objective of the study was to analyse the nail changes in patients undergoing cancer chemotherapy.Methods: Screening was done for all in-patients undergoing cancer chemotherapy and out-patients referred to Dermatology from Oncology. All nail changes were documented according to a proforma and an attempt was made to establish a relation, if any, with a chemotherapeutic agent group.Results: A total of consecutive 150 patients undergoing cancer chemotherapy were screened, out of which nail changes were observed in 50 patients. The age group of patients ranged from 12yrs to 73yrs. The Male: Female ratio was 2.7:1. Following platinum based agents, the nail changes were seen in 54% of patients. There was a significant association of nail changes following chemotherapy with a p value of 0.00001%. Pigmentary changes were the most common nail plate changes. Longitudinal pigmentary bands were the most common pigmentary nail plate changes seen in 67.7% of patients following chemotherapy with platinum based agents, and 16.1% of patients following CHOP regimen. Diffuse pigmentation of nail plate was most common nail plate change (16.1%) following chemotherapy with taxanes. Muehrcke’s lines were the most common nail bed changes seen in 57.1% of patients following treatment with platins. Half and half nails and onycholysis were seen in 42.85% of patients following CHOP chemotherapy. Pigmentation of the nail folds were the most common changes seen in 40% of patients following platinum based agents and CHOP chemotherapy.Conclusions: A variety of nail changes can be associated with cancer chemotherapy. A knowledge about the various changes ranging from those of cosmetic concern to serious changes in patients who are undergoing chemotherapy is vital for the successful management of the patient.
Shashikant Balkrishna Dhumale, Shimpa R. Sharma,
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 37-45; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20164433

Abstract:
Background: Genital herpes (GH) is a sexually transmitted infection (STI) increases risk of human immunodeficiency virus (HIV) infection. Some risk factors like age, sex, previous genital ulcerative disease (GUD), number of sex partners and clinical presentations like number and size of erosions, number of episodes, inter-episode duration, healing period with acyclovir & co-STDs are studied with reference to HIV status.Methods: This is a longitudinal, observational study comparing 25 patients each in HIV positive and negative groups of GH between 15-60 years of age in both genders. Chi square test (or Fisher’s exact test) for nominal data and ‘t’ test for continuous data was used in case of association. Mann Whitney U test was used for comparison of mean ranks and median.Results: Adolescents were 18%. HIV positivity was significantly associated with age group above 45 years, multiple sex partners, average number of episodes & the duration between them and number of erosions (p <0.05). Healing period with acyclovir in HIV positive patients was significantly longer than in HIV negative patients. Secondary syphilis a co-STD had significant association with HIV positivity. Though previous GUD alone was not associated with HIV positivity significantly; however GUD in patients with multiple sexual partners showed significant association with HIV. Conclusions: High proportion of adolescents amongst GH patients is notable. Adolescents & older patients above 45 years should not be neglected in STD & HIV awareness. Risk factors must be interviewed with patients. Clinical parameters & risk factors, differs with HIV status.
B. Janardhan, D. Shailendra
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164248

Abstract:
Background: An adverse cutaneous drug reaction (ACDR) is defined as an undesirable clinical manifestation resulting from administration of a particular drug. With an ever increasing number of drugs and varied formulations being continuously made available it is important that a close watch on the risks of adverse drug reactions is looked for, to ensure safe use of medicines in the interest of the patient. In the present study our aim is to study the prevalence & pattern of cutaneous adverse drug reactions reported to department of dermatology at MediCiti Institute of Medical Sciences, Hyderabad, India.Methods: All suspected cutaneous adverse drug reactions reported to the department of dermatology at MediCiti Institute of Medical Sciences during the two year period from January 2013 to December 2014 were included in this study. A thorough clinical examination of all these cases & details related to the drug use and clinical manifestations of the cutaneous adverse drug reaction were documented using a structured proforma. Naranjo scale was used to assess causality in all the causes of cutaneous adverse drug reactions.Results: The mean age of the patients was 42 years (age range: 1-64 years). Most of them were in the age group of 30-39 years. The male to female ratio was 1.78:1. The most common type of skin eruptions observed were maculopapular rash (35.55%), urticaria (26.19%) and fixed drug eruption (17.87%). The mean duration between drug intake and appearance of rash was 4 days (range: 1-120 days). Conclusions: The pattern of ACDRs and the drugs causing them in this study were similar to that reported in other studies both in terms of disease burden and clinical pattern. Knowledge of adverse cutaneous drug reactions will help to identify common medications contributing to dermatological reactions, so as to anticipate, prevent and limit their undue consequences.
M. Sandeepthi, G. K. Prasad, B. Narayan Reddy
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164305

Abstract:
Background: Diabetes mellitus is very common metabolic disorder seen in our developing world. Skin is affected by both acute metabolic derangements and the chronic degenerative complications of diabetes. It is suggested that these skin changes may eventually be used as a reflection of the patient’s current as well as the past metabolic status.Methods: 200 diabetic patients were examined and their various cutaneous manifestations were analysed with parameters like age, sex, type of infection, HbA1c etc.Results: A total of 200 diabetic patients with cutaneous manifestations were enrolled in our study. Majority were in 6th decade (34.5%) and 7th decade (30%) respectively. Males constituted 66% of the cases with a male to female ratio was 1.89:1 Among the cutaneous infections, out of the 132 cases with cutaneous infections, fungal infections (46%) were most frequent, followed by bacterial infections (16.5%) and viral infections (3.5%). Conclusions: This study showed demographic, social factors & prevalence of dermatological manifestations in type 2 DM patients. It is suggested that the various skin changes may eventually be used as a reflection of the patient’s current as well as the past metabolic status.
Arakali Lakshminarayana Shyam Prasad, Praveen Kumar Shanmugam Reddy
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164398

Abstract:
Background: Skin problems constitute a significant percentage of all medical problems, despite which training in recognition and treatment of dermatological disorders during the MBBS course remains abysmal. The situation is compounded due to non-inclusion of dermatology in the final examinations, which results in students having little motivation to learn about this important subject. This study was designed to test whether the present internship training offered in dermatology succeeds in imparting cognitive skills related to common skin problems.Methods: This was done by means of a pre- and post-test administered before and after their posting. A set of 20 questions were administered to all interns on the first day of their postings as a pre-test and the post-test was given on the last day, after completion of their two week posting.Results: The results of this preliminary study suggest that there is considerable improvement after their training. The paired t test, the t value was found to be -16.13 with a p value of <0.001, which was statistically significant.Conclusions: It is possible that use of a pre- and post-test focuses their attention on common entities and thus could be used to improve cognitive skills. To the best of our knowledge a similar study has not been reported from the Indian subcontinent.
E. N. Abdul Latheef, Najeeba Riyaz, M. P. Binitha, K. Muhammed
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164405

Abstract:
Background: Vitiligo is a common skin disease affecting 1%-2% of general population. Even though different modalities of treatment available, it remains as a difficult disease to treat. Many cases remain stable after a period of medical therapy without any further response. Surgical techniques are the only hope in such patients. The aim of this study was to evaluate the response of autologous, noncultured melanocyte keratinocyte cell transplantation in patients with stable focal vitiligo.Methods: A retrospective study of 100 cases focal vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation. Serial of photographs were taken on each visit. The patents were followed for a period of 5 years. The results were analyzed on a visual analogue scale.Results: Out of total 100 patients, 44 had excellent (90 to 100%) response, 18 had good (60 to 89%) response, 12 had fair (25 to 59%) response and 26 had poor response (0 to 24%). Age and sex of the patients and size and duration of lesions, did not show significant influence on results of transplantation. Conclusions: This is a simple, safe, and effective surgical therapy for replenishing the missing melanocytes in resistant cases of vitiligo. Repigmentation lasts long with very good cosmetic acceptability.
Meera G., Thilak S., Jefferson Joshua
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 20-23; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164404

Abstract:
Background: Pityriasis versicolor is a Malassezia-associated opportunistic skin infection prevalent in tropical and sub-tropical regions like India. This study describes the distribution of age, gender, blood group, lesion morphology, hemoglobin levels, cholesterol levels and diabetic status in pityriasis versicolor subjects. Methods: 200 subjects confirmed to have pityriasis versicolor by KOH mounts were assessed and the results tabulated.Results: Subjects in the 2nd and 3rd decade of life were most commonly infected with cases also showing a female preponderance. Most subjects with pityriasis versicolor were found to be Rh positive. Achromic lesions were most common, and anaemia was common among the pityriasis versicolor positive subjects. Diabetes and hypercholesterolemia weren’t particularly common in subjects with pityriasis versicolor. Conclusions: The study elucidates the behaviour of tinea versicolor in a clinical setting by describing its basic demographic data, clinical presentation, and association with some common co-morbidities relevant to an Indian clinical setting.
Thilak Sundararaj, Meera Govindaraju, Brindha Thangaraj
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3, pp 13-19; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20164409

Abstract:
Background: Allergic contact dermatitis (ACD) is a delayed type of hypersensitivity from contact with a specific allergen. The aim of the study was to study age, sex incidence of allergic contact dermatitis and incidence of various allergen in patch test positive cases for that allergen in patients presenting to dermatology department in Meenakshi Medical College & Research institute, Kanchipuram.Methods: Diagnosis of allergic contact dermatitis was made by patch testing.Results: Most cases of allergic contact dermatitis fall in the age group of 41-50 years. More common in males than females. Allergic contact dermatitis to cement was found to be the commonest cause in our study. Conclusions: Allergic contact dermatitis is common in middle age and incidence of disease is common in males than females. The higher incidence of allergic contact dermatitis to cement is due to more people being employed in construction working in this part of the world.
Thilak S., Anbumalar M.
Published: 23 February 2017
International Journal of Research in Dermatology, Volume 3; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20164412

Abstract:
Background: Diabetes mellitus is a chronic non-communicable disease causing an increase in blood glucose levels due to an ineffectiveness or insufficiency of secreted insulin. Infections have also been shown to be the most common skin changes in diabetics. In our study we aim to assess the susceptibility of diabetics to various superficial fungal infections. We will study candidiasis, tinea versicolor and dermatophytic infections in diabetics.Methods: 400 diabetic individuals who gave consent were chosen at random from the patients attending the OPD. They were subjected to thorough clinical evaluation. Routine hematological investigations were done. FBS, PPBS, and HBA1C were done to assess diabetic control. Fungal infections were confirmed by KOH mounts.Results: Of the 400 subjects 220 were male and 180 were female. 52.5% of the subjects had some fungal infections. 55.2% of the fungal infections were candidiasis. 27.6% of the fungal infections were dermatophytic infections. 17.1% of the fungal infections were tinea versicolor infections. Conclusions: The study has analysed the epidemiology of cutaneous fungal infections in diabetics. A little over half the diabetics studied proved to have cutaneous fungal infections. Candidiasis was the most frequent form of cutaneous fungal infections accounting for 57% of the fungal infections. Dermatophytic infections were seen in 28% of infections and pityriasis versicolor for 17% of the infections. This high prevalence of cutaneous fungal infections among diabetics merits systematic screening for the same among this target group.
Pooja Bains
Published: 10 September 2016
International Journal of Research in Dermatology, Volume 2; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20163105

Abstract:
Background: Prolonged and uninterrupted use of topical corticosteroids on face is globally prevalant and this misuse has reached monstrous proportion in India. The topical corticosteroid abuse leads to various local adverse effects on face which are difficult to treat. The aim of this study was to ascertain the magnitude, demographics, cause and adverse effects of TC abuse on the face in the dermatology out-patient department.Methods: A total of 100 patients with history of topical corticosteroid abuse on face for a minimum period of one month were enrolled in this study.Results: In our study, majority of the patients were females (76%) and the most common age group was 21-30 years with 49% patients. The duration of application was <6 months (45%) in majority of patients. Most common topical corticosteroids abused were betamethasone valerate in 49% and clobetasol propionate in 40% cases.Conclusions: Topical corticosteroid abuse on face is quite common with varied presentation. There is need to take urgent remedial steps and increase awareness about this problem in general population.
Dhanalakshmi Kathirvel, Vaishnavi Dhandapani, Baskaran R., Gladius Jennifer H.
Published: 10 September 2016
International Journal of Research in Dermatology, Volume 2; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20163150

Abstract:
Background: Psoriasis is a chronic inflammatory skin disease that affects 1-3% of the population. Recent studies have reported that psoriasis is associated with metabolic disorders, including obesity, dyslipidaemia and diabetes. The aim of the present study was to investigate the prevalence of metabolic syndrome (MS) in psoriasis and to evaluate the association with severity and duration of psoriasisMethods: This was a hospital based cross sectional study that involved 60 patients with psoriasis evaluated for MS. Statistical analysis was done by SPSS version 16.0 software. Percentages, mean, standard deviation, correlation, chi-square test, t test were calculated at 5% level of significance.Results: 20% of patients had MS which is comparable to the normal population. 60% of the patients in our study are obese which is directly correlating with MS. There is significant increase in MS as age (p =0.01), duration of psoriasis (p =0.03), BMI (p =0.0001), waist circumference (p =0.0001) increases.Conclusions: There is 20% association of psoriasis with MS. There is no gender predisposition and no association between the severity of psoriasis and metabolic syndrome. There is minimal relationship between the duration of psoriasis and metabolic syndrome. Obesity is the commonest factor related to psoriasis, diabetes and MS which should be taken care of by diet, exercise and lifestyle modification.
Suma Patil, S. K. Patil
Published: 10 September 2016
International Journal of Research in Dermatology, Volume 2; https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20163149

Abstract:
Background: Scarring is particularly a distressing phenomenon. The micro-needling is a minimally invasive procedure which has recently attained popularity because of the fact that it can be used safely with minimal training.Methods: The present study was performed on 30 patients suffering from facial scarring of acne vulgaris. The patients were photographed and assessed clinically at the time of enrolment to grade the severity of scarring as per the grading system proposed by Goodman and Baron.Results: A total of 30 patients were included in the study of which females were 18 and males 12. The age of the patients ranged from 18 to 30 years with the mean age of 24 years. Overall, 20 out of the total of 28 patients (71.4%) showed an excellent response to dermaroller treatment while 7 others achieved a good response (25%). Only 1 patient (3.6%) out of the total of 28 failed to show a significant response to treatment.Conclusions: Dermaroller is a safe and effective treatment option for grade 2 and grade 3 acne scars.
, Surinder Pal Singh, Saurabh Sharma, Jasleen Kaur
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 69-76; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163508

Abstract:
Background: Pediatric dermatoses vary vastly from adult dermatoses in terms of clinical presentation, treatment and prognosis, thereby generating special interest in this field. The present study was carried to find out the spectrum, pattern and incidence of various skin disorders in infants and preschool children (upto 5 years), to correlate their prevalence with age, sex and rural/urban residential status.Methods: 1000 children under five years age , were evaluated for the presence of skin disease to study the pattern and incidence of these disorders and establish their relationship with age, sex and residential status (rural/urban).Skin disorders were described in detail and classified into groups like bacterial, fungal, parasitic, viral, eczematous, allergic, papulosquamous, pigmentary, miscellaneous.Results: Maximum number of children belonged to age group of less than 1 year (31.6%). Male patients (56.6%) out-numbered female patients (43.4%). 56.8% children belonged to urban area while 43.2% children were from rural area. Maximum incidence was of infections (41.1%). Of these infections, bacterial infections (14.5%) were the predominant followed by parasitic infections (10.9%). Eczematous skin disorders were the next common entity after infections seen in 35.1 % children followed by that of allergic disorders seen in 5.9% children. Conclusions: There is preponderance of infectious dermatoses among the under five population followed by eczematous and hypersensitivity disorders. The role of poverty, overcrowding, poor personal hygiene and low level of health education, undernutrition and consequent poor immunity are emphasized by these preventable diseases.
, Adarshlata Singh
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 77-81; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163502

Abstract:
Background: Acne vulgaris is chronic inflammatory disorder of pilosebaceous unit mainly characterized by comedones, papules and nodulocystic lesions affecting face and upper trunk. Topical dapsone 5% gel is approved to treat acne vulgaris because of its anti-inflammatory and anti-bacterial activities.Methods: A single center, open label interventional study was conducted during 1 year period in dermatology OPD of Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra. Patients were enrolled in the study considering inclusion criteria. Patients were asked to apply dapsone 5% gel twice daily on face for 12 week. Efficacy was evaluated by mean percent reduction in total, inflammatory and non-inflammatory lesions and success rate on change in investigator global acne severity assessment scale while tolerability was assessed by evaluating skin dryness, erythema, stinging or burning sensation and scaling at baseline, 1, 2, 4, 8 and 12 week.Results: At end of 12 week, success rate reached to 31.54%. Dapsone 5% gel was effective in reduction of total, non-inflammatory and inflammatory lesions by 57.75%, 52% and 63.1% respectively. Side effects with dapsone gel were tolerable, mild and transient.Conclusions: Dapsone 5% gel was efficacious and well tolerated in non-inflammatory as well as inflammatory acne lesions.
Kumaresan Muthuvel, , Deepa M. S.
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 91-94; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163981

Abstract:
Background: The aim of the present study was to assess the efficacy of 100% trichloroacetic acid (TCA) for the incomplete ear lobe cleft repair.Methods: A total of 30 females with bilateral incomplete ear lobe cleft were included in the study group. Under local anaesthesia, 100% TCA was applied to the abraded surface with the help of toothpick till frosting was achieved and the wound was closed with a micropore tape. Patients were reviewed weekly and 100% TCA was applied until frosting was achieved, without abrasion on the edges of cleft once a week till complete closure of the ear lobe cleft.Results: Out of 30 patients 28 (93.33 %) had complete closure of cleft. Two patients (6.66%) had incomplete closure even after four application of TCA. Temporary post inflammatory pigmentation was seen in 22 (73.33%) patients which subsided one week after the last TCA application. Minimum number of sittings required was one and maximum required for complete closure was 3 sessions.Conclusions: Multiple applications, temporary post inflammatory pigmentation, inward rolling of edges, mild scarring as a result of secondary healing of the wound and failure to repair the bigger clefts were the disadvantages of this technique.
Dharmendra Kumar,
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 64-68; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163756

Abstract:
Background: Endocrine diseases may induce manifestation through the skin. Hypothyroidism is known to cause a wide range of general and skin manifestations. Dermatologists may commonly see skin disorders that reflect an underlying hypothyroid state. The objective of the study was to evaluate varied general and cutaneous manifestations of hypothyroidism.Methods: A hospital based descriptive clinical study was conducted in the department of Dermatology, Venerology and Leprosy, MKCG Medical College, Berhampur, Odisha. Diagnosed cases of hypothyroidism were included as the study subjects. An informed consent was taken from each patient. Institutional ethics committee of the college approved the Study.Results: 320 patients of hypothyroidism were evaluated. Maximum patients 115 (35.9%) were among 31-40 years of age group. Male to female ratio was 1:5.7. The percentage of hypothyroid patients who complained of constipation, fatigue, Cold intolerance, weight gain and neck swelling was 75.0%, 57.2%, 50.9%, 35.9% and 31.9% respectively. Among females, 54.5% were having irregular menses. The most common cutaneous symptom was dry course skin (75.9%), followed by diffuse hair loss (50.9%), puffy oedema (48.1%), decreased sweating (11.9%) and yellow skin (9.1%). The most observed cutaneous sign was xerosis (66.9%), followed by alteration in skin texture (55.0%). Some patients showed more than one cutaneous signs. The most common hair changes in our patients were diffuse hair loss (55.9%), followed by course scalp hair (29.4%).Conclusions: The interaction between hypothyroidism and skin is of profound clinical importance. So, dermatologists need to be alert of the ways in which these two organ systems interact, so that early diagnosis and management of hypothyroidism may ensue.
Kumara Lakshmanan Sengotuven, , Karthikeyan Kaliaperumal
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 55-63; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163510

Abstract:
Background: Alcoholism is a chronic fatal disease of worldwide concern. Alcohol abuse can present in a variety of ways, and dermatological disease is emerging as an important marker of alcohol misuse. The aim is to find out the various skin manifestations associated in chronic alcoholics, to find out the most common skin manifestations among chronic alcoholics and to identify the early skin changes in chronic alcoholics.Methods: A cross sectional study conducted in patients attending medicine, psychiatry and dermatology clinics at a tertiary care centre, Puducherry. Inclusion criteria were patients with history of chronic alcoholism, aged above 18 years. After obtaining history, cutaneous examination was done including skin, mucosa, hairs, and nails. Alcohol dependency pattern was calculated using short alcohol dependency score (SADD).Results: A total of 130 patients were included. All were male and 59.2% of them belonged to high dependency pattern. About 128 of them had dermatological manifestations pityriasis versicolor was the most common dermatoses followed by psoriasis. Alcohol specific dermatoses were not seen in our study.Conclusions: In our study, 98.4% of alcoholics had skin manifestations, of which cutaneous infections were the most common.
Published: 18 November 2016
International Journal of Research in Dermatology, Volume 2, pp 86-90; https://doi.org/10.18203/issn.2455-4529.intjresdermatol20163976

Abstract:
Background: Childhood vitiligo is a special subtype and is seen in significant proportion of vitiligo patients. There are only a few clinical studies in the past which address the clinical spectrum of vitiligo in children. This study on eighty cases of childhood vitiligo will cover the epidemiology and clinical spectrum.Methods: To study the epidemiology, clinical spectrum and associations in childhood vitiligo. Inclusion criteria: all new cases of vitiligo in children under 12 years attending the outpatient department of Dermatology, exclusion criteria: old treated cases of vitiligo and age more than 12 years. Statistical analysis was done using mean and percentage of means.Results: Most common age group affected includes 4-6 years. Most common site of initial lesion was head and neck followed by upper limb, lower limb and trunk. Most common clinical type was vitiligo vulgaris followed by focal type then segmental. Lip tip type was least common type. Conclusions: Childhood vitiligo is a serious issue and the knowledge of its various patterns and associations needs to be updated at regular intervals.
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