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  Citation statistics : Table of Contents
   2005| September-October  | Volume 71 | Issue 5  
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Carbamazepine - The commonest cause of toxic epidermal necrolysis and Stevens-Johnson syndrome: A study of 7 years
K Devi, Sandhya George, S Criton, V Suja, PK Sridevi
September-October 2005, 71(5):325-328
DOI:10.4103/0378-6323.16782  PMID:16394456
Background : Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are a group of severe life threatening drug reactions. The drugs commonly implicated as the cause of these drug reactions vary depending on host factors and the prescription pattern of drugs in that particular area. Aim : The aim of the study was to find the drugs implicated as the cause of SJS/TEN in the patients admitted in the dermatology ward at the Medical College, Thrissur and to find the clinical outcome. Methods : It was a retrospective study of 7 years from 1997 to 2004. The case records of all patients with a clinical diagnosis of TEN or SJS were studied in detail regarding the drugs implicated as the cause, the management and the clinical outcome. Results : During the study period, 41 patients in the age group ranging from 12 to 72 years were treated as inpatients, of which 20 were males and 21 were females. The commonest drug implicated as the cause of SJS/TEN was carbamazepine (44%). The indication for carbamazepine was control of pain in more than 50% of the cases. Presence of a major systemic disease before the onset of SJS/TEN was associated with a bad prognosis. Conclusion : The increased use of carbamazepine, especially for control of pain, may be the reason for the increased incidence of SJS/TEN due to the same drug. Awareness about the drugs implicated in life threatening drug reactions will help physicians in preventing them by judicious use of the drugs.
  38 22,377 914
Improving adherence to antiretroviral therapy
KC Nischal, Uday Khopkar, DG Saple
September-October 2005, 71(5):316-320
DOI:10.4103/0378-6323.16780  PMID:16394454
Antiretroviral therapy (ART) has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen's pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression), lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.
  29 88,971 883
Striae distensae
Gurcharan Singh, Lekshmi P Kumar
September-October 2005, 71(5):370-372
DOI:10.4103/0378-6323.16800  PMID:16394474
  20 21,135 953
Surgical therapy of vitiligo: Current status
Satish S Savant
September-October 2005, 71(5):307-310
DOI:10.4103/0378-6323.16778  PMID:16394452
  16 16,157 867
Pityriasis rosea - An update
Antonio Chuh, Albert Lee, Vijay Zawar, Gabriel Sciallis, Werner Kempf
September-October 2005, 71(5):311-315
DOI:10.4103/0378-6323.16779  PMID:16394453
Recent controversies on the etiology, diagnosis and treatment have led to increased interest in pityriasis rosea (PR). We review these aspects of the disease. PR is universal. The incidence is around 0.68 per 100 dermatological patients, or 172.2 per 100,000 person-years. The prevalence in people aged between 10 and 29 years is 0.6%. The male to female ratio is around 1: 1.43. Evidence on seasonal variation is conflicting, but there is no evidence that the incidence is dependent on mean air temperature, mean total rainfall, or mean relative humidity. Spatial-temporal and temporal clustering of cases of PR has been reported. The association of PR with human herpesvirus-7 infection is still controversial. Owing to the extreme high sensitivities of sequence-based detection methods such as polymerase chain reaction, novel criteria should be applied to evaluate the evidence. There is no evidence that PR is associated with other viral or bacterial infections. The role of autoimmunity in PR warrants further investigations. Many patients with PR have one or more atypical features. Application of validated diagnostic criteria may be helpful for atypical cases. The efficacy of macrolides, including erythromycin, in PR is still under evaluation. There is no evidence that antiviral agents are effective. The efficacies of ultraviolet radiotherapy and systemic corticosteroids are not well established. In managing a patient with PR, we should concentrate more on how the eruption is affecting the quality of life, i.e. the illness, rather than the extent and severity of the eruption, i.e. the disease.
  16 30,600 1,183
A retrospective study of the pattern of sexually transmitted diseases during a ten-year period
Beena Narayanan
September-October 2005, 71(5):333-337
DOI:10.4103/0378-6323.16784  PMID:16394458
Background: Proper knowledge of the patterns of sexually transmitted diseases (STDs) in different geographical regions is necessary for evolving proper strategies for control of these diseases. Aims: To study the pattern of STDs and to analyze the changes during a ten-year period from 1990 among patients attending Medical College Hospital, Kottayam Methods: Case records of 686 patients with STDs who attended the outpatient wing of the Department of Dermatology and Venereology were studied. Results: There were 504 males and 182 females in the total of 686 patients. Marital contact alone was reported by 123 (67.6%) female patients. Genital ulcer diseases (GUDs) accounted for the maximum number of STDs, with 504 cases (73.5%), followed by condyloma acuminatum (17.5%) and gonorrhea (10.1%). Forty-three patients had multiple infections. The total number of patients during the first year of study was 129, while it was 41 during the last year. Bacterial STDs showed a striking reduction in numbers. The decline was less marked in the case of viral STDs. Conclusion: The majority of patients had genital ulcer diseases. Spouses were the most common source of infection for female patients. There was a marked decline in the number of patients with various STDs during the ten-year period. The decline was more evident in the bacterial STDs resulting in an apparent increase of the viral STDs towards the end of the period of study.
  15 7,918 378
Kikuchi's disease associated with systemic lupus erythematosus
S Chidambara Murthy, Shivakumar M Dandin, Archana S Dandin, Manjula Y Patwardan
September-October 2005, 71(5):338-341
DOI:10.4103/0378-6323.16785  PMID:16394459
A 25-year-old multiparous female presented with fever, joint pains, facial rash and lymphadenopathy of three months' duration. Lymph node biopsy revealed a diagnosis of Kikuchi's disease. She fulfilled seven out of the 11 ARA criteria for SLE. The association of Kikuchi's disease and SLE is rare.
  9 11,288 377
Keloidal granuloma faciale with extrafacial lesions
Rajesh Verma, AL Das, SS Vaishampayan, Sachin Vaidya
September-October 2005, 71(5):345-347
DOI:10.4103/0378-6323.16787  PMID:16394461
Granuloma faciale (GF) is a rare cutaneous disorder characterized by one to several soft, erythematous to livid papules, plaques or nodules, usually occurring on the face. Extrafacial lesions are uncommon. A 52-year-old lady with multiple asymptomatic, variously sized brownish-black colored, firm, sharply circumscribed plaques resembling keloids on both cheeks and extrafacial lesions on the right arm and the right breast is presented for its unusual keloidal appearance and typical histopathological findings. She failed to respond to oral dapsone 100 mg daily administered for 3 months. Local infiltration of triamcinolone combined with cryotherapy led to only partial flattening of the lesions. All the skin lesions were excised surgically followed by flap transfer grafting on both cheeks. The cosmetic outcome was highly satisfactory.
  7 6,465 168
Fixed drug eruption due to levocetirizine
S DN Guptha, Sangolli M Prabhakar, S Sacchidanand
September-October 2005, 71(5):361-362
DOI:10.4103/0378-6323.16793  PMID:16394467
  7 5,301 273
Reliable site for suction blister induction and harvesting
Chandrashekar Laxmisha, Devinder Mohan Thappa
September-October 2005, 71(5):321-324
DOI:10.4103/0378-6323.16781  PMID:16394455
Background: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. Methods: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1) were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. Results: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%), 15 of 17 cases (88.2%) on the flexor aspect of the forearm, 4 of 5 cases (80%) on the abdomen, 11 of 16 cases (68.7%) on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6%) on the flexor aspect of the forearm, 6/11 cases (54.5%) on the anterolateral thigh, and in all cases over leg. Conclusion: The flexor aspect of the forearm is a good site for suction blister harvesting.
  7 10,432 296
Kindler syndrome
PK Kaviarasan, P VS Prasad, Shradda , P Viswanathan
September-October 2005, 71(5):348-350
DOI:10.4103/0378-6323.16788  PMID:16394462
Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.
  6 9,451 366
Laugier-hunziker pigmentation
C Ajith, Sanjeev Handa
September-October 2005, 71(5):354-356
DOI:10.4103/0378-6323.16790  PMID:16394464
Laugier-Hunziker pigmentation (LHP) is an acquired disorder of hypermelanosis characterized by mucocutaneous hyperpigmentation. LHP may resemble various disorders characterized by mucocutaneous pigmentation. A 58-year-old lady presented with progressively increasing number of variable sized, hyperpigmented macules over the lips, fingers, toes and nails. There was no family history of similar illness. Systemic examination and all relevant investigations were within normal limits. Histopathology of a skin lesion had features consistent with LHP. The diagnosis of LHP must be made only after relevant investigations to rule out any associated systemic involvement. This case further highlights that LHP is not restricted to European countries.
  5 7,746 227
Proteus syndrome
Basanti Debi, Surajit Nayak, Rajendra Prasad Da, Basanti Acharjya
September-October 2005, 71(5):357-359
DOI:10.4103/0378-6323.16791  PMID:16394465
Proteus syndrome is a variable and complex disorder characterized by multifocal overgrowths affecting any tissue or structure of the body. We present a girl aged 3 years and 8 months with an epidermal nevus, port-wine stain, macrodactyly with gigantism of the feet, lymphohemagiomas and multiple lipomas.
  4 7,696 264
Relapsing linear acantholytic dermatosis in a four-year-old boy
Sandeep Arora, Gulhima Arora, P Ranjan
September-October 2005, 71(5):351-353
DOI:10.4103/0378-6323.16789  PMID:16394463
Linear acantholytic dermatoses are a spectrum of cutaneous disorders that form a subset of linear dermatoses with distinct clinical features and histopathologically show acantholysis. The lesions may be zosteriform or follow the lines of Blaschko. This report describes a four-year-old boy who, on a follow up of two years, exhibited a relapsing acantholytic dermatosis along the lines of Blaschko. Histopathology of a representative lesion revealed epidermal acantholysis with multiple acantholytic keratinocytes with in the prickle cell layer and an absence of corp ronds and grains, consistent with features of Hailey-Hailey disease. This, to our knowledge, is the third case of relapsing linear acantholytic dermatosis reported.
  4 6,597 146
Glomus tumor with mucinous change
Kiran V Godse
September-October 2005, 71(5):367-368
DOI:10.4103/0378-6323.16798  PMID:16394472
  4 4,899 130
Occupational contact dermatitis among the traditional 'tie and dye' cottage industry in Western Rajasthan
MK Singhi, PR Menghani, LK Gupta, Dilip Kachhawa, Mohit Bansal
September-October 2005, 71(5):329-332
DOI:10.4103/0378-6323.16783  PMID:16394457
Background : Dyeing is an age-old process and forms an integral part of textile industries. Tying is a process by which a particular part of cloth is prevented from the process of dyeing. The skin diseases in workers engaged in the 'tie and dye' industry have not been extensively studied. Aims : To study the prevalence of contact dermatitis among workers engaged in the 'tie and dye' industries in and around Jodhpur (Western Rajasthan). Methods : One thousand three hundred workers engaged in 'tie and dye' work were evaluated for occupation-related dermatitis. Those with skin lesions were subjected to patch tests using 2% aqueous solution of the dyes and chemicals commonly used by them. These included direct dyes, VAT dyes, sulfur dyes and azo dyes. Fifty workers without skin lesions served as controls. Results : One hundred patients (7.69%) had dermatitis involving the exposed sites, mainly the hands and forearms. Eighty-one patients showed positive reactions to one or more dyes, most commonly Red RC base (azo dye), followed by naphthol. Conclusion: Red RC base and naphthol were the commonest allergens in the 'tie and dye' industry.
  4 10,369 215
Preventing strongyloidiasis in the immunosuppressed
P Narasimha Rao, KU Kiran
September-October 2005, 71(5):363-364
DOI:10.4103/0378-6323.16795  PMID:16394469
  3 4,321 100
Rosai-dorfman syndrome
Najeeba Riyaz, Anza Khader, S Sarita
September-October 2005, 71(5):342-344
DOI:10.4103/0378-6323.16786  PMID:16394460
Rosai-Dorfman syndrome is characterized by sinus histiocytosis with massive lymphadenopathy. A 25-year-old woman presented with multiple erythematous and yellowish papules on the forehead, cheeks, chin and thigh. She had massive generalized, firm, non-tender and non-matted lymphadenopathy and mild hepatomegaly. Her hemogram was normal. A skin biopsy showed collections of histiocytes with emperipolesis and plenty of plasma cells. A lymph node biopsy showed partial loss of architecture, dilated sinuses filled with histiocytes, which showed lymphocytophagocytosis, anisonucleosis and a clear cytoplasm. She was referred to an oncologist for further management.
  2 13,071 356
Wood's lamp: A modified method of examination
S Veeranna
September-October 2005, 71(5):364-365
DOI:10.4103/0378-6323.16796  PMID:16394470
  2 7,298 350
Granulomatous rosacea mimicking eyelid dermatitis
C Ajith, Sunil Dogra, BD Radotra, Sanjeev Handa
September-October 2005, 71(5):366-365
DOI:10.4103/0378-6323.16797  PMID:16394471
  1 8,305 140
An evaluation of the efficacy and safety of tazarotene (0.1%) cream in acne vulgaris
PK Nigam, S Anant
September-October 2005, 71(5):360-361
DOI:10.4103/0378-6323.16792  PMID:16394466
  1 4,829 178
Textbook of dermatology, venereology and leprology
Bhushan Kumar
September-October 2005, 71(5):373-373
  - 3,230 114
Recurrence of palmar hypertrophic chronic cutaneous LE after surgical excision
Ramesh Bansal, Rajeev Sen
September-October 2005, 71(5):368-369
DOI:10.4103/0378-6323.16799  PMID:16394473
  - 3,810 70
Iontophoretic delivery of lignocaine and epinephrine
Reena Rai, Shanmuga V Sundaram, S Karthick Prabhu, CR Srinivas, Anil Mathew
September-October 2005, 71(5):362-363
DOI:10.4103/0378-6323.16794  PMID:16394468
  - 4,727 137
Asymptomatic skin coloured plaques over the lower limbs
Muthu S Kumaran, Sunil Dogra, Amrinder J Kanwar
September-October 2005, 71(5):374-378
DOI:10.4103/0378-6323.16801  PMID:16394475
  - 4,617 124
An elderly man with a violaceous nodule and anemia
Aparna Palit, Arun C Inamadar, SB Athanikar, VV Sampagavi, NS Deshmukh, BR Yelikar
September-October 2005, 71(5):376-378
DOI:10.4103/0378-6323.16802  PMID:16394476
  - 4,879 104
Online since 15th March '04
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