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   2003| March-April  | Volume 69 | Issue 2  
 
 
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ORIGINAL ARTICLE
A new focus of cutaneous leishmaniasis in Himachal Pradesh (India)
RC Sharma, VK Mahajan, NL Sharma, A Sharma
March-April 2003, 69(2):170-172
PMID:17642870
This paper highlights anew focus of cutaneous leishmaniasis (CL) in the temperate area of Himachal Pradesh (India), a previously non-endemic area. In this hospital-based study, 38 new cases of CL, acquired indigenously have been detected from 1988 - 2000. Of these, 26 were from Kinnaur district and 12 from adjoining areas of bordering districts situated along the river: Satluj. There were 18 males and 20 females. They were between 4-75 years of age and had the disease for one month to 2 years at the time of presentation. Face involvement was seen in majority of the patients. Nodulo-ulcerative plaque was the commonest lesion. Muco-cutaneous lesions were seen in four cases. Tissue smears and biopsies were positive for LD bodies in 61.7% and 29.4% cases respectively. Intralesional sodium stibogluconate produced a consistent therapeutic response. The possible mode of its introduction in the region is postulated. The reservoir of infection, identity of the vector at this altitude (9002900 meters above sea level) and the strain of leishmania, remain to be identified.
  13 6,648 0
Cutaneous manifestation of diabetes melitus
S Mahajan, RV Koranne, SK Sharma
March-April 2003, 69(2):105-108
PMID:17642848
One hundred consecutive diabetes mellitus patients attending the diabetic clinic of the hospital constituted the study group. One hundred age and sex matched non-diabetics were taken as controls. The majority, 63%, belonged to the 41-60 years age group and 98% had non-insulin dependent diabetes. Among the study group, 64% had one or more cutaneous manifestations as compared to 22% in the controls. This was statistically highly significant (p<0,001). Infections comprised the largest group affecting 35 of the 64 cases. Among the bacterial infections, pyodermas were observed in 11 and erythrasma in one. Fungal infections were seen in 21, dermatophytoses in 11, and candidiasis in 10. Herpes zoster was seen in 2 cases. Pruritus was observed in 10, neurological abnormalities in the form of paresthesias was seen in 6, mal perforans in one, and meralgia paresthetica in one. Diabetic dermopathy was seen in 6 and rubeosis in 4. Six dermatoses strongly associated with DM were seen, namely one each of waxy skin syndrome, granuloma annulare, eruptive xanthoma, scleredema adultorum, and 2 cases of diabetic bulla.Ten patients exhibited other dermotoses less associated with diabetics: xanthelasmo palpebrarum in 5 patients, acrochordi in 4, and pigmented purpuric dermatoses in one. Likewise syndromes of insulin resistance were seen in 4 patients of whom 3 had aconthosis nigricans and one had congenital lipodystrophy. Forthermore,9 patients had dermatoses known to be associated with an increased incidence of diabetes; vitiligo in 4, acquired perforating dermatoses in 3, and lichen planus in 2. Four patients hod dermatoses known to be associated with diabetes: psoriasis in 3 and diffuse alopecia in one. Three had adverse drug reactions to anti-diabetic therapy.
  9 22,367 0
The therapeutic value of glycolic acid peels in dermatology
C Grover, BS Reddu
March-April 2003, 69(2):148-150
PMID:17642863
Chemical peeling or chemexfoliation has become increasingly popular in recent years for treatment of a number of cosmetic skin problems. Topical glycolic acid in the concentration of 10-30% for 3-5 minutes at fortnightly intervals was investigated as a therapeutic peeling agent in 41 patients having acne (39%), melasma (36.5%), post inflammatory hyperpigmentation (12%) and superficial scarring of varied etiology (12%). A final evaluation done at 16 weeks revealed that this modality is useful especially in superficial scarring and melasma, moderately successful in acne patients with no response in dermal pigmentation. No significant untoward effects were seen.
  7 26,451 0
Drugs causing fixed drug eruptions: Confirmed by provocation tests
R Gupta
March-April 2003, 69(2):120-121
PMID:17642852
Drug reactions ore very frequently seen by dermatologists in day to day practice. Fixed drug eruption though usually not fatal, can cause enough cosmetic embarrassment if present on the exposed part due to recurrence of the reaction on the previously affected site and residual hyperpigmeniation. 40 patients of fixed drug eruption were subjected to oral provocation test with all possible drug to find out the exact causative drug(s). Co-trimoxazole was the most common cause of the fixed reaction (21). Other drug found to cause reaction include oxyphenbutazone(9). Metamezole(3), tetracycline hydrocholoride (3) and pi roxicam (1). Lips were most commonly involved (14). Other frequently involved sites were genitals (6), arms (5), obdomen (4), hand(4), foce (4) and leg (3). To avoid false incrimination of the drugs, provocation test is the only reliable method to confirm the causative drug.
  5 22,453 4
Pattern of dermatoses in diabetics
PK Nigam, S Pande
March-April 2003, 69(2):83-85
PMID:17642840
Two hundred diabetics comprising of 125 males and 75 females were, studied for the presence of cutaneous lesions and type of infective organism, if any, in them. 70.2% of patients with uncontrolled diabetes mellitus showed some form of cutaneour involvement while only 51 % of the patients with controlled diabetes had it. Infections with bacterial (16%) and fungal (10.5%) agents were the most common manifestation. Among bacterial infections, Staph. aureus was the most frequent causative agent in 65.6% cases. Pruritus was present in 4.5% of cases only.
  5 7,077 0
CASE REPORT
Systemic sclerosis treated with dexamethasone pulse
R Gupta
March-April 2003, 69(2):191-192
PMID:17642879
A 52-year-old women had systemic sclerosis of 8 years duration. The disease was progressive inspite of all available methods of treatment. Treatment with 100 mg dexamethasone given intravenously in 500 ml of 5% glucose on 3 consecutive days every month led to remarkable reversal of all the clinical manifestations over a period of 21 months.
  4 5,406 0
ORIGINAL ARTICLE
Adverse reactions to cosmetics
A Dogra, YC Minocha, S Kaur
March-April 2003, 69(2):165-167
PMID:17642868
Adverse reaction to cosmetics constitute a small but significant number of cases of contact dermatitis with varied appearances. These can present as contact allergic dermatitis, photodermatitis, contact irritant dermatitis, contact urticaria, hypopigmentation, hyperpigmentotion or depigmentation, hair and nail breakage. Fifty patients were included for the study to assess the role of commonly used cosmetics in causing adverse reactions. It was found that hair dyes, lipsticks and surprisingly shaving creams caused more reaction as compared to other cosmetics. Overall incidence of contact allergic dermatitis seen was 3.3% with patients own cosmetics. Patch testing was also done with the basic ingredients and showed positive results in few cases where casual link could be established. It is recommended that labeling of the cosmetics should be done to help the dermatologists and the patients to identify the causative allergen in cosmetic preparation.
  4 9,410 8
Role of modified rapid AFB method in histopathological sections of hansen's disease
SV Nayak, AS Shivarudrappa, AH Nagarajappa, S Sacchidanand, SM Ahmed
March-April 2003, 69(2):173-174
PMID:17642871
Leprosy is a chronic debilitating disease. A reliable diagnosis hinges around a good histopothological diagnosis and demonstration of the bacilli in the histopathological section. The usual method performed Modified Fite Faraco Method is time consuming, laborious and less sensitive. It has been our endeavor to devise a more rapid and sensitive method for the diagnosis and bacillary load detection in histopathological sections. The Modified Rapid AFB devised by us is sensitive and time saving which is essential for the pathologist and for the treatment by the Dermatologist. We hove studied about 53 cases of different types of Hansens disease and compared with both Modified Fite Faraco method and Modified Rapid AFB method. The results were found to be very encouraging with the Modified Rapid AFB method.
  4 8,229 0
Psoriasis and helicobacter pylori
S Qayoom, QM Ahmad
March-April 2003, 69(2):133-134
PMID:17642857
Recently, several reports have been pointing to a possible relationship between Helicobacter pylori infection of gastric mucosa and dermatological diseases. Association has been reported for urticaria, rosacea, sjogrens syndrome and Henoch-Schonlein purpura. It has also been suggested that Helicobacter pylori may be one of the organisms capable of triggering psoriasis. We did Helicobacter pylori serology in 50 clinically typical psoriatic patients presenting to the Department of Dermatology, SMHS Hospital, Srinagar to determine if antibodies to Helicobacterpylori could be found in them. These psoriatic patients were without any known gastrointestinal complaints. An equal number of healthy individuals constituted the control group. The prevalence of Helicobacterpylori sero-positivity in psoriatic patients was significantly higher (P<0.05) than in control group.
  4 8,575 4
Dexamethasone cyclophosphamide pulse therapy in pemphigus: experience in Kashmir valley
Q Masood, I Hassan, I Majid, D Khan, S Manzooi, S Qayoom, G Singh, F Sameem
March-April 2003, 69(2):97-99
PMID:17642846
Thirty patients of pemphigus have been treated with Dexamethasone Cyclophosphamide Pulse (DCP) in our hospital in the past three years. Of these twelve patients are off all treatment and are in complete remissin while the rest are in different phases of the treatment and responding quite well to the pulse therapy. Only one case of relapse has been experienced till date.
  4 5,633 0
Palmar dermatoglyphics as diagnostic tool: Mayer-rokintansky-kuster-hauser syndrome
A Kumar, SJ Manou
March-April 2003, 69(2):95-96
PMID:17642845
The congential anomalies involving Mullerian duct dysgenesis, the MRKH (Mayer-Rokitansky-Kuster-Hauser) syndrome overlaps a 'community of syndromes' which share, apart from a complete absence of uterus and vagina, associated presentations that include developmental abnormalities of skeletal, renal, dental and other dysmorphias. First described more than 400 years ago, this complement of anomalies now rechristened, the MRKH syndrome has been extensively studied. Found to occur once in every 4000 females; estimated on its incidence vary from 1/5000 to 1/20,000. Despite its fairly wide prevalence, this syndrome has remained largely underdiagnosed or cryptic. Social and cultural perceptions have perforce driven, the wide existence of the very personal handicap underground and unacceptable. Accidentally discovered during routine examination, during secondarily associated medical problems, the mullerian agenecies syndrome has been subject of a wide range of clinical and laboratory investigations. The oddity in the syndrome is that the patient appears absolutely normal and that it presents with no genetic marker. We herein report the palmar dermatoglyphic and doctylographic features of a patient with MRKH syndrome. However interpretation, show conclusively, at least in this single case that the MRKH syndrome can be diagnosed through its characteristic dermatography patterns. In our view, routine dermatographic study of all live females births may lead to not only an early but also a cost effective diagnostic method.
  3 7,632 0
Nail changes in alopecia areata: Incidence and pattern
V Gandhi, MC Baruah, SN Bhattacharaya
March-April 2003, 69(2):114-115
PMID:17642850
One hundred consecutive patients with alopecia areata were examined for presence of nail abnormalities. Nail changes were seen in 44/100 (44%) of patients with most frequent occurrence in multifocal variety (30/44=68%). The commonest abnormality observed was superficial pits seen in 28(64%) patients. Presence and severity of nail changes may indicate a more severe and recalcitrant disease.
  3 13,529 8
CASE REPORT
Lupus vulgaris causing nasal perforation: Not a thing of the past
S Kaur, GP Thami, SK Singhal
March-April 2003, 69(2):182-183
PMID:17642875
  2 6,448 0
CONTINUING MEDICAL EDUCATION
Dry skin conditions, eczema and emollients in their management
K Siddappa
March-April 2003, 69(2):69-75
PMID:17642836
Dry skin, which refers to roughened, flaky, or scaly skin that is less flexible than normal and dry to feel, is relatively common problem in all age groups, but is more common in elderly individuals. The water content of the stratum corneum is of paramount importance in maintaining the normal appearance and texture of human skin. The relative hydration of the stratum corneum is a composite of 3 factors viz. the rate of water transport from dermis to stratum corneum, the rate of surface loss of water and the rate of water binding ability of stratum corneum. Loss of integrity of the barrier function is a central factor in the development of dry skin conditions and eczema. The various factors involved in producing dry skin, various causes of dry skin and the role of emollients in the management of these conditions are discussed.
  2 22,809 4
LETTER TO EDITOR
Data sharing using internet: A suggestion
BR Eapen
March-April 2003, 69(2):194-194
PMID:17642881
  2 4,744 0
ORIGINAL ARTICLE
Topical 20% KOH-An effective therapeutic modality for moluscum contagiosum in children
BB Mahajan, A Pall, RR Gupta
March-April 2003, 69(2):175-177
PMID:17642872
Senior Lecturer, Dermatology Department,224 - Medical Campus Faridkot-151 203 (Punjab) India. Phone: 01639-5213, Fax: 01639-51070Topically 20% KOH aqueous solution once doily at bedtime was applied in 27 children having molluscum contagiosum by their parents, till lesions showed signs of inflammation or superficial ulceration. 24 children (88.9%) completed the trial and complete clearance was achieved after a mean period of 17 days. No recurrence was observed during follow up period. Thus in this open trial topical 20% KOH aqueous solution has proved to be convenient, easy to apply at home, safe and inexpensive alternative therapeutic modality for the treatment of molluscum contogiosum in children.
  2 16,309 0
STD trends in regional institute of medical sciences, Manipur
G Zamzachin, NB Singh, TB Devi
March-April 2003, 69(2):151-153
PMID:17642864
A study carried out among the 2230 STD patients during 1996-2000 shows the types, distribution and trends of the various STDs seen in our hospital. STDs contribute 3.30% of the total skin OPD cases. Males dominate with 89.3% of STD cases. Bolanoposthitis (22%) was the commonest STD, followed by gonorrhoea (11.8 %) and nongonococcal urethritis(NGU) being 11.2%. Syphilis was seen in 6.2% of the cases. The prevalence of VDRL reactivity and HIV reactivity remains almost the some being 8.49% and 8.21 % respectively. There is increased occurrence of various psychosexual disorders among the affected patients.
  2 7,600 0
A clinical and investigational study of donovanosis
S Veeranna, TY Raghu
March-April 2003, 69(2):159-162
PMID:17642866
A clinical and investigational study of 25 cases of Donovanosis was undertaken. The incidence was found to be 1.53% of all STD cases and 2.9% of GUD. M:F ratio was 2.12:1. Incidence was more in unmarried people. Fleshy exuberant type was seen in 88% of cases. Two patients (8%) had extragenital ulcers. Donovan bodies were found in 88%. Pseudo elephantiasis was seen in 8 patients. Biopsy was done in 8 cases and showed ocanthosis, plasma cell infiltration and pseudo epitheliomatous hyperplasia. One patient developed squamous cell carcinoma of vulva.
  2 8,662 0
Clinico-epidemiological study of HIV patients in Trivandrum
SP Nair, KP Moorty, S Suprakasan
March-April 2003, 69(2):100-103
PMID:17642847
A retrospective descriptive study of 121 HIV patients in the Department was carried out. The male/female ratio was 2.3:1. The maximum number of patients were seen in age group 21 - 40(77.68%). Skilled workes constituted the maximum (13.2%). Sexual route was the commonest mode of transmission (78.5%). Cutaneous manifestations were present in 57% of patients, oral condidiasis being the commonest (16.5%). Pulmonary tuberculosis was the commonest systemic manifestation (13.2%). 37 patients (30.57%) had other STD's, syphilis being the commonest (12.39%). 22 patients had AIDS defining conditions.
  2 8,821 0
CASE REPORT
Clinicohistological disparity in leprosy
S Majumdar, G Srivastava, P Kumar
March-April 2003, 69(2):178-179
PMID:17642873
A healthy elderly man presented with localized isolated erythematous tender, anesthetic, oval plaque with little scaling near the medial angle of right eye, of 3 years' duration without any obvious nerve thickening, treated irregularly with WHO MDT for 3 months, clinically simulating BT leprosy with downgrading reversal reaction. Histology showed a BL granuloma with plenty of solid staining AFB within the foamy macrophages. Lepromin test was very weakly positive. The case is discussed in the light of clinicohistological disparity in leprosy cases with review of relevant literatures. A stress is laid on the importance of newer MDT in such cases to prevent drug-resistance, relapse and recurrence.
  1 4,825 0
Passwell syndrome
K Muhammed, B Safia
March-April 2003, 69(2):180-181
PMID:17642874
There is an expanding list of syndromes that combine ichthyosis with neuroectodermal and mesodermal defects. We report a syndrome of congenital ichthyosis with atrophy, mental retardation, dwarfism, aminoaciduria, primary amenorrhoea and underdeveloped secondary sexual characters in a 38-year-old woman of non consanguinous parentage.
  1 5,211 0
CONTINUING MEDICAL EDUCATION
Trichotillomania
K Siddappa
March-April 2003, 69(2):63-68
PMID:17642835
Trichotillomania is one of the types of traumatic alopecia and is defined as the irresistible urge to pull out the hair, accompanied by a sense of relief after the hair has been plucked. In trichotillomania alopecia results from deliberate efforts of the patients who is under tension or is psychologically disturbed. The condition maybe episodic and the chronic type is difficult to treat. The prevalence of the condition appears to be more common than previously believed. The purpose of this article is to discuss the various aspects of the condition including the available treatments.
  1 15,147 0
LETTER TO EDITOR
Diet in dermatology
CS Sirka, Bornali Dulte
March-April 2003, 69(2):196-197
PMID:17642884
  1 9,904 0
ORIGINAL ARTICLE
Comparative study of ketoconazole versus selenium sulphide shampoo in pityriasis versicolor
K Aggarwal, VK Jain, S Sangwan
March-April 2003, 69(2):86-87
PMID:17642841
Forty patients suffering from pityriasis versicolor were treated with either 2% ketoconazole shampoo (20 patients) or 2.5% selenium sulphide shampoo (20 patients), once a week for three weeks. On global assessment after one month of start of therapy, 19 (95%) out of 20 patients treated with ketoconazole shampoo were cured while one case had mild residual disease. In selenium sulphide shampoo group, 17 (85%) out of 20 patients were cured, one had mild residual disease and two had considerable residual disease. No significant difference was observed in the response rates in the two groups. Relapse occurred in one patient of ketoconazole group and two patients of selenium sulphide group during the follow - up period of three months.
  1 25,894 0
Treatment of primary localised cutaneous amyloidosis with cyclophosphamide
J Das, RK Gogoi
March-April 2003, 69(2):163-164
PMID:17642867
The study was undertaken to evaluate the efficacy of cyclophosphamide in primary localised cutaneous amyloidosis. Thirty-six patients of primary localised cutaneous amyloidosis were treated with cyclophosphomide 50 mg. tablets orally daily for a period of six months. Most of the patients following the therapy showed marked improvement in respect of itching, pigmentation and sizes of the popular lesions. Side effects of cyclophosphamide were very low.
  1 15,707 0
Randomised controlled trial of topical butenafine in tinea cruris and tinea corporis
M Ramam, HR Prasad, Y Manchanda, BK Khaitan, U Banerjee, A Mukhopadhyaya, R Shetty, JA Gogtay
March-April 2003, 69(2):154-158
PMID:17642865
Butenafine is a new antifungal agent similar to allyl amine antifungals. A randomized controlled trial was conducted in 75 patients to compare its efficacy with clotrimazole in tinea cruris and corporis that was diagnosed on clinical features and demonstration of hyphae in a potassium hydroxide (KOH) preparation. Twenty patients treated with butenafine once daily for 2 weeks and 20 treated with clotrimazole twice daily for 4 weeks were analysed. At the end of treatment, 2 weeks and 4 weeks later, the KOH preparation was negative in 90.9%, 95.5% and 90.9% of patients respectively in the butenafine group and 100%, 96.4% and 92.85% respectively in the clotrimazole group. There was a reduction of 81.5% in the sign and symptom score at 4 weeks following treatment in the butenafine group and 85.93% in the clotrimazole group. There was no statistically significant difference between the two groups. Adverse effects were mild in both groups and did not require discontinuation of therapy except one patient treated with clotrimazole who developed dermatitis at the site of application. Butenafine appears to be as effective as clotrimazole in the treatment of tines cruris and corporis while requiring a single daily application for a shorter of 2 weeks.
  1 12,086 0
Hair loss in cancer chemotherapeutic patients
V Chadha, SD Shenoi
March-April 2003, 69(2):131-132
PMID:17642856
The hair loss in 8 cancer patients aged between 18 and 60 years on chemotherapy was studied. All had diffuce moderate alopecio within 1 month of starting treatment. Of the 8, 3 had only telogen hairs and 3 had high dystrophic hair count. Both anagen and telogen effluvium are implicated.
  1 7,330 16
Ketoconazole 2% shampoo in pityriasis versicolor: An open trial
SK Rathi
March-April 2003, 69(2):142-143
PMID:17642861
Pityriasis versicolor is a common superficial fungal infection caused by a lipophilic yeast. The aim of the study was to evaluate the efficacy of ketoconazole 2% shampoo in the treatment of pityriasis versicolor, for which thirty patients were included. The shampoo was applied daily for 3 days and found to be very effective in clearing the signs and symptoms of the disease. There was no serious adverse effects.
  1 11,816 0
The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patient
K Banerjee, JN Barbhuiya, AP Ghosh, SK Dey, PR Karmakar
March-April 2003, 69(2):135-137
PMID:17642858
Autoimmunity is one of the most probable pathogenesis of vitiligo. Systemic corticosteroids may arrest the progression of vitiligo and lead to repigmentation by suppressing immunity. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients. One hundred (100) patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3mg/kg body weight) initially as a single oral dose after breakfast for the first 2 months. The dosage was then reduced to half the initial dose during the 3rd month and was halved again for the 4th and final month. After 4 months of treatment, 76% showed repigmentation while the arrest of progression (both repigmentation and stationary) was noted in 90% of patients. Male sex, and patients under 15 years of age showed pronounced repigmentation with statistical significance. According to this study low-dose oral prednisolone is an effective method in preventing progression and inducing repigmentation of fast-spreading vitiligo without the associated serious side-effects.
  1 20,389 13
Comparison of efficacy of topical clindamycin and nicotinamide combination with plain clindamycin for the treatment of acne vulgaris and acne resistant to topical antibiotics
VR Sardesai, VM Kambli
March-April 2003, 69(2):138-139
PMID:17642859
A total of 75 patients with inflammatory acne vulgaris were divided into three groups. Group A was treated with combination of 4% nicotinamide and 1% clindamycin combination, Group B was treated with plain 1 % clindamycin and Group C which was considered to have resistance to local antibiotics due to no response to treatment was treated with the combination. At the end of 8 weeks the results were compared. It was concluded that addition of nicotinamide was of not much value in treating inflammatory acne and results were some as for plain clindamycin and also the combination did not offer much relief in treatment of resistant acne.
  1 10,667 1
HIV prevalence in patients with herpes zoster
PK Kar, CV Ramasastry
March-April 2003, 69(2):116-119
PMID:17642851
To monitor HIV seroprevalence and to determine the sexual risk behaviour of men with herpes zoster (HZ), a study was conducted from Jan 98 to Dec 99 among 115 men of 21 to 55 years of age suffering from HZ. The diagnosis of HZ was clinical and relevant investigations when indicated were carried out to exclude immunodeficiency state. None of the cases were on immunosuppressive drugs. All cases were tested for HIV by immunocomb method and if found positive were confirmed by Western blot assay. Out of 115 cases of HZ 11 (9.5%) were found to be HIV positive. 11 (10.8%) of HIV positive cases were 21-40 years of age. More than one dermatome was involved in 7 (63.6%) HIV positive and in 2(1.9%) HIV negative cases. 2 HIV positive cases had multiple cranial nerve involvement and one had generalized HZ. None of the cases showed evidence of progression to symptomatic HIV disease. Out of 11 HIV positive cases 9(81.8%) gave history of multiple unprotected sexual exposures with female commercial sex workers and 2 (18.1 %) with amatures. None of our cases had used condom during sexual intercourse. None gave history of blood transfusion in the past or intravenous drug use.
  1 7,650 0
Management of pemphigus vulgaris during acute phase
PK Kar, PS Murthy, R Rajagopal
March-April 2003, 69(2):109-113
PMID:17642849
We present our experience with 21 patients of pemphigus vulgaris seen over a period of 10 years managed in service hospitals during acute phase of the disease. Age groups of patients ranged from 25-45 years. Eighteen (85.7%) were young adults, 30-40 years of age. Fifteen (71.4%) were men and 6(28.6%) were women. All the cases were hospitalized in ICU, till the acute phase of the disease subsided. Complete hematological profile, urinalysis, serum biochemistry and repeated bacterial cultures from the skin were carried out in all patients at the time of admission and thereafter weekly. The treatment comprised of potassium permanganate lotion bath (1:10000) and 1 framycetin gauze dressing of the denuded areas, maintenance of fluid and electrolyte balance. All suspected infections and septicemia were treated with appropriate antibiotics. The corticosteroids were usually administered as a single dose of prednisolone 1 mg/kg/day. Cyclophosphamide was given at an initial dose of 50mg/day and the dose was escalated to 100mg/day. Once the bulk of the lesions were healed, the dose of corticosteroids was gradually lowered by approximately 50% every two weeks and cyclophosphamide was continued till patients were symptomfree. Out of 21 patients receiving corticosteroids, cyclophosphamide and other supportive therapy, 20(95%) had undergone clinical resolution of the disease. During follow up study 15(71.4%) patients remained symptom-free and undergone clinical remission. Five patients (23.8%) had relapse, out of which 4(19%) remained symptom free, after subsequent treatment. There was one death (4.7%) in our study.
  1 10,287 0
Incidence of various causes of vaginal discharge among sexually active females in age group 20-40 years
KJ Puri, A Madan, K Bajaj
March-April 2003, 69(2):122-125
PMID:17642853
The present study was undertaken to know incidence of various causes of vaginal discharge in sexually active females of age group 20-40 years. One hundred sexually active females in the age group of 20-40 years, with vaginal discharge, were selected for this study at random. A detailed clinical history and a thorough examination of all the cases was done. After making the clinical diagnosis, appropriate tests for diagnosing candidiasis, trichomoniosis, gonorrhoea and bacterial vaginosis were done. The present study showed 45% incidence of bacterial voginosis, 31% vulvovaginalcandidiasis, 2% trichomoniasis, 3% gonorrhoea, 5% non-specific urogenital causes, and 14% with other causes.
  1 23,553 0
SHORT COMMUNICATION
Evaluation of dexamethasone pulse therapy in systemic sclerosis
QM Ahmad, I Hassan, I Majid
March-April 2003, 69(2):76-78
PMID:17642837
The treatment of systemic sclerosis, a multisystem disorder, is for from satisfactory. Dexamethasone pulse therapy was started in 25 patients of systemic sclerosis and of the 10 patients who successfully completed the treatment, the results have been quite encouraging. Adverse effects to the pulse were minimal.
  1 4,744 0
CASE REPORT
Nevomelanocytic nevus with leukotrichia
C Kaur, GP Thami, S Kaur
March-April 2003, 69(2):184-185
PMID:17642876
Nevomelanocytic nevi exhibit clinical variations in morphology, location, texture and number related to age, race and geographical distribution. Development of age related greying of hair over pigmented melanocytic nevus is being discussed.
  - 5,142 0
Lymphocutaneous sporotrichosis treated with three different modalities
S Banerjee, AK Jaiswal
March-April 2003, 69(2):186-187
PMID:17642877
Three cases of lymphocutaneous sporotrichosis were treated with three different modalities and oral saturated solution of potassium iodide was found to be best modality.
  - 4,818 0
Basal cell carcinoma-treatment with cryosurgery
S Kaur, GP Thami, AJ Kanwar
March-April 2003, 69(2):188-190
PMID:17642878
Basal cell carcinoma is a common cutaneous malignancy, frequently occurring over the face in elderly individuals. Various therapeutic modalities are available to treat these tumors. We describe three patients with basal cell carcinoma successfully treated with cryosurgery and discuss the indications and the use of this treatment modality for basal cell carcinomas.
  - 9,557 5
Pyoderma gangrenosum
B Devi, J Mohanty
March-April 2003, 69(2):193-193
PMID:17642880
Four patients aged 8, 35, 45 and 50 years (3 males and 1 female) were admitted to SCBMCH, Cuttack, skin and VD Department with multiple, painful, non healing phagadenic ulcers over body and not responding to the conventional therapeutic agents. The female patient was having severe seropositive rheumatoid arthritis. Pus culture was negative in all the cases. All the patients responded well to corticosteroid given systemically, but one male patient was having recurring episodes and ulcers healing hardly. He was given topical oxoferrin (TCDO) topically twice daily along with other supportive therapy. He responded well.
  - 5,698 4
LETTER TO EDITOR
Myiasis complicating herpes zoster in an immuno compromised patient
SC Murthy, MM Udagari
March-April 2003, 69(2):194-194
PMID:17642882
  - 3,064 0
Systemic sclerosis in a patient with maxillary antrum carcinoma following external beam radio therapy
R Chakravarthi, V Singh
March-April 2003, 69(2):195-195
PMID:17642883
  - 4,130 0
ORIGINAL ARTICLE
Ladakhi koilonychia
MP Sawhney
March-April 2003, 69(2):79-80
PMID:17642838
Atotal of 176 highlander Ladakhis staying at an altitude of 3445 meters were examined for nail changes. Mean age of the subjects was 22.28 years (range 3-58 years). Koilonychia was seen in 47.16% of the subjects. It was most common during fourth (80.56%) and fifth (80%) decade. Males (49.60%) were slightly more commonly affected than females (41.34%). Soldiers (69.57%) were most commonly affected. Peasant and labourers (64.26%) were also equally affected. Most of the soldiers were also involved in forming during their leave period. Recruits (39.29%) and students (30.30%) were less commonly affected. Right index finger (36.36%), right middle finger (30.68%) and right thumb (29.55%) finger nails were most commonly affected followed by left thumb (13.64%), left index finger (10.23%), right ring finger (8.52%) and left middle finger nails (7.95%). Mean haemoglobin levels in those with or without koilonychia were 14.17 and 14.12 gm % respectively. Chronic hypoxia of high of high altitude causing increased erythropoesis and depletion of iron stores leads to thinning of nail plate and atrophy of the distal nail bed with superadded mechar.ical trauma of farming or hard labour is the most likely cause of Ladakhi koilonychia. Dietary iron supplementation as a public health programme should be started in Ladakh to meet the demands of increased erythropoesis in chronic hypoxic conditions.
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Alopecia areata - pattern in industrial city of Baroda
S Jain, YS Marfatia
March-April 2003, 69(2):81-82
PMID:17642839
Department of Dermatology, Venereology and Leprology, S.S.G. Hospital, Baroda. The profile of Alopecia areata (AA) was studied in 150 subjects in industrial city of Baroda, alopecia areata is the problem of young males as 52.1 %patients are in 2-39 years age group and male to female ratio being 1.7: 1. Most of alopecia areata presents within 6 month of onset. The problem of AA is of cosmetic significance. AA pattern is the commonest and only few have combined AA and ophiasis. The common site is scalp (parietal, occipital, frontal) followed by beard and moustache. Associated atopic state is not common hence indicating good prognosis. Nail involvement though not common but is in form of pitting.
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Waist dermatoses in Indian women wearing saree
BR Eapen, S Shabana, S Anandan
March-April 2003, 69(2):88-89
PMID:17642842
Presence of any skin lesion along the waistline in 140 female patients was recorded. We found that most of them had some lesions over the waist, but only few of them accepted the fact. The commonest cutaneous change observed were hyperpigmentation and scaling. But we failed to find any association with diabetes, atopy, skin type, abesity or the type of fabric.
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Herediatry punctate palmoplantar keratoderma - A clinical study
RR Mittal, A Jha
March-April 2003, 69(2):90-91
PMID:17642843
28 patients of hereditary punctate palmoplantar keratoderma (HPPK) were selected from DermatoVenereology out patients of Rajindra Hospital, Patiala. Cases were divided into group Awith PPK as majorfeature and group 6 with PPK as minorfeature. 11 /28 belonged to group A and 17/28 to group B. Group A patients revealed scattered pundate PPK in 6 and scattered pundate plus focal plaques in 5, while in group B patterns seen were KPPC (6), KPPC with focal (6), focal plus scattered punctate (3) and diffuse with superimposed KPPC (2).
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Efficacy of beta-carotene topical application in melasma - An open clinical trial
HK Kar
March-April 2003, 69(2):92-94
PMID:17642844
Beta-carotene, a structural analogue of vitamin A, works as an agonist of this vitamin, by reversibly sticking the chemical mechanism of melanogenesis by saturating the nuclear receptors of melanocytes and /or binding protein. To study the safety and efficacy of Beta-carotene lotion on topical application in melasma, clinically diagnosed 31 adults (26Fand 5M) with melasma were included in this trial. All of them applied Beta-carotene lotion daily, morning and evening to the affected areas. Twenty six of them, completed regular 8 weeks treatment. Nine of them continued same treatment for 16 more weeks. All cases were evaluated clinically using melasma intensity (MPI) index (Grade I, II, III) and size of the lesion. Clinical photograph was taken for each case at 0 week, 8th week and 24th week. Initial 8 weeks treatment revealed that the single case with grade-I pigmentation included in this study recovered completely. Two out of 13 cases with grade-II pigmentation, showed no change, in 10 cases, pigmentation became lighter to grade-I (76.9%) and one case recovered completely. Out of 12 grade-III cases, one did not show any change, 10(83.3%) converted to grade-II and one to grade-I. At the end of 24 weeks, all the nine cases (2 grade-II and 7 grade-III) showed further clearing of the pigmentation to the next lower grade. Side effects like mild erythemo and local irritation were observed in two cases each, who were advised to discontinue treatment as per the protocol. In control group, out of 12 (two with grade -II, six in grade - II, and four in grade-III) cases 11 showed no improvement, only one case with grade-II melasma revealed reduction of pigmentation to grade-I. One case developed local irritation. In conclusion, topical application of Beta-carotene lotion appears to be an effective and safe for melasma. Longer duration of application is associated with better result.
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Role of anti-depressant fluoxetine in the puva treatment of psoriasis vulgaris
A Mitra, A Dubey, A Mittal
March-April 2003, 69(2):168-169
PMID:17642869
Severity of Psoriasis Vulgaris is known to be modified by psychological stress. The objective of this study was to evaluate the role of Fluoxetine in the PUVA treatment of Psoriasis. Twenty patients with progressive disease having more than thirty per cent body area involvement were included in a randomized, double blinded, placebo-controlled, age and sex matched study. All patients were on PUVAtreatment; half of the patients were given Fluoxetine 20 mgms daily whereas the other ten were given placebo. Assessment was done by Psoriasis Area and Severity Index (PASI) scoring after every 5 exposures of PUVA treatment till 20 treatments. All ten patients who took Fluoxetine along with PUVA treatment showed better response and quicker remission. Fluoxetine may be used as an adjuvant in PUVA treatment of Psoriasis.
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Study of genital lesions
BH Anand Kumar, D Vijaya, R Ravi, RR Reddy
March-April 2003, 69(2):126-128
PMID:17642854
A total of one hundred patients (75 males and 25 females) age ranged from 17-65 years with genital lesions attending the STD clinic of Bowring and LC Hospitals Bangalore constituted the study group. Based on clinical features, the study groups were classified as syphilis (39), chancroid (30), herpes genitolis (13), condylomato lato (9), LGV (7t condylomata acuminata (5), genital scabies (3), granuloma inguinole (2) and genital candidiasis (1). In 68% microbiological findings confirmed the clinical diagnosis. Of the 100 cases 13% and 2% were positive for HIV antibodies and HbsAg respectively.
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Evaluation of causes of vaginal discharge in relation to pregnancy status
KJ Puri, A Madan, K Bajal
March-April 2003, 69(2):129-130
PMID:17642855
The purpose of this study was to determine incidence of vaginal discharge in pregnant and non-pregnant sexually active females of age group 20-40 years presenting with the chief complaint of vaginal discharge. One hundred sexually active females in the age group of 20-40 years, with vaginal discharge, were selected for this study at random. A detailed clinical history and a thorough examination of all the cases were done. After making the clinical diagnosis, appropriate tests for diagnosing candidiasis, trichomoniasis, gonorrhoea and bacterial vaginosis were done. It was observed that out of 100 cases, 13 (13%) patients were pregnant and 87 (87%) were non-pregnant.
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Comparative immunological and histopathological study in fifty cases of mucosal/nonmucosal lichen planus
RR Mittal, RL Walia, P Sharma, A Singla
March-April 2003, 69(2):140-141
PMID:17642860
Lichen planus is a common disorder and 40-50% of LP patients also reveal mucosal lesions. It is well known that mucosal LP lesions take very long to heal in comparison to cutaneous lesions. Rarely erosive mucosal LP can turn malignant. Both CMI and humoral immunity may play role in aetiopathogenesis of LP. Present study was conducted to study and compare CMI, Humorol Immunity, histopothology in mucosal and nonmucosal LP.
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Utility of Direct Fluorescent Antibody Test for detection of Chlamydia trachomatis and its detection in male patients with non gonococcal urethritis in New Delhi
SK Agrawal, BS Reddy, P Bhalla, H Kaur
March-April 2003, 69(2):144-147
PMID:17642862
The purpose of this study was assessment of prevalence of Chlamydia trachomatis and utility of Direct Fluorescent Antibody (DFA) test for its detection in male patients with non gonococcal urethritis in New Delhi , India Thirty male patients with symptoms of dysuria showing polymorphs in their gram stained urethral smears with no evidence of Neisseria gonorrhoeae, and negative for Trichomonas vaginalis and Candida albicans by wet mount were subjected to DFA test for detection of C. trachomatis in urethral samples. Microscopic examination of gram stained urethral smears revealed 5-7 polymorphs / HPF in 90% of the patients. Evidence of C. trachomatis with DFA (MicroTrak) was detected in 11 cases (36.67%) when a cut off of 10 elementary bodies was considered essential. It is concluded that C. trachomatis is an important cause of non gonococcal urethritis in male patients in New Delhi and DFA test is a useful diagnostic tool in its detection. Where facilities are not available for its detection antichlamydial therapy should be recommended emperically.
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Online since 15th March '04
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