Indian Journal of Dermatology
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REVIEW ARTICLES
Aloe vera: A short review
Amar Surjushe, Resham Vasani, DG Saple
October-December 2008, 53(4):163-166
DOI:10.4103/0019-5154.44785  PMID:19882025
Aloe vera is a natural product that is now a day frequently used in the field of cosmetology. Though there are various indications for its use, controlled trials are needed to determine its real efficacy. The aloe vera plant, its properties, mechanism of action and clinical uses are briefly reviewed in this article.
  46 43,373 1,617
Melanokeratosis from arsenic contaminated tubewell water.
KC Saha
October 1984, 29(4):37-46
PMID:6545887
Full text not available    [CITATIONS]  [PubMed]
  44 1,485 0
ORIGINAL ARTICLE
Vitiligo: Clinical profiles in Vadodara, Gujarat
EM Shajil, Deepali Agrawal, Krishna Vagadia, YS Marfatia, Rasheedunnisa Begum
April-June 2006, 51(2):100-104
DOI:10.4103/0019-5154.26928  
Purpose: Vitiligo is an acquired depigmentary condition involving a progressive loss of melanocytes from the epidermis and hair follicles We have earlier reported impairment of systemic antioxidant status of Baroda vitiligo patients ( Pigment Cell Res 2004; 17; 289-94) and we now show analysis of the clinical profiles of these patients. Procedure: The study comprised of 424 vitiligo patients. Clinical and demographic details of all the patients were obtained from the vitiligo clinical proformas. Lipid peroxidation levels (LPO) in erythrocytes of vitiligo patients and healthy controls were estimated. Result: Out of four hundred and twenty four outpatients, males constituted 38.44% and females were 61.56%. Mean age of the patients was 25.59 years. The sites of onset were the lower limb, face, trunk, upper limb, genital, hand, labia and scalp in the descending order of frequency. Koebner's phenomenon was observed in 12.74%, diabetes mellitus in 1.18%, leukotrichia in 9.2% and premature graying of hair in 23.11% patients. A family history of vitiligo was present in 21.93% of the patients. Significant increase ( P <0.002) in the LPO levels of the vitiliginous patients was observed compared to the controls. Conclusion: Vitiligo vulgaris was the most common form of the disease which constituted 52.36% of the patients followed by focal vitiligo (28.54%), segmental vitiligo (6.84), acrofacial (7.55%), mucosal (2.83%) and universal vitiligo (1.89%). Systemic oxidative stress may have a pathophysiological role in precipitating all clinical types of vitiligo in Vadodara vitiliginous patients.
  28 11,030 473
SPECIAL ARTICLE
Vitiligo and the melanocyte reservoir
Rafael Falabella
October-December 2009, 54(4):313-318
DOI:10.4103/0019-5154.57604  PMID:20101329
Repigmentation of vitiligo depends on available melanocytes from three possible sources: from the hair follicle unit which is the main provider of pigment cells, from the border of vitiligo lesions, and from unaffected melanocytes within depigmented areas; pigment cells at these locations originate a perifollicular, border spreading and a diffuse repigmentation pattern. In order for repigmentation to take place under stimulation with diverse therapies, melanocytes should be present in appropriate numbers. Melanocyte tissue stem cells located in the niche at the bulge region of the hair follicle are the most important sources for providing immature pigment cells that undergo terminal differentiation and originate repigmentation, but cytokines, UVR and other molecules acting in melanogenesis with adequate regulation mechanisms contribute to successful recovery in vitiligo. The presence of keratinocyte stem cells in the interfollicular epidermis raises the question on the possibility of melanocyte stem cells in a similar location and the development of future strategies for therapeutic purposes.
  28 7,055 518
EPIDEMIOLOGY
Epidemic of hand, foot and mouth disease in West Bengal, India in August, 2007: A multicentric study
Nilendu Sarma, Abhijit Sarkar, Amlan Mukherjee, Apurba Ghosh, Sandipan Dhar, Rajib Malakar
January-March 2009, 54(1):26-30
DOI:10.4103/0019-5154.48982  PMID:20049265
Background: Hand, foot, and mouth disease (HFMD) is caused mostly by Coxsackievirus A16 (CA16) and enterovirus 71 (EV71). Epidemic of HFMD has occurred in India only once in Kerala in 2003. We report here a recent outbreak of HFMD in three districts of West Bengal, India. Materials and Methods: A case detection system developed with 1) three private clinics in three districts; two at Howrah and one at Hooghly, 2) Pediatrics Department of two medical colleges in Kolkata, 3) 12 practioners of these three districts with 4) a central referral center at Department of Dermatology, NRS Medical College, Kolkata where all cases from this system were confirmed by a single observer. Pediatric Dermatology unit of the Institute of Child Health, Kolkata was another independent unit. Results: A total of 38 cases of HFMD were reported till 08.10.07. Age group ranged from 12 months to 12 years (mean 40.76 months, SD 29.49). Males were slightly higher than females (M:F - 21:17). Disease was distributed mostly over buttocks, knees, hands, feet - both dorsum and palmar or the plantar surface and the oral mucosa. Highest severity noted over the buttocks and the knee. Healing time for skin lesions was 6-13 days (mean 9.13 days, SD 1.93). Oral lesions were found in 33 (86.8%) cases. Conclusion: This outbreak far away from the initial one confirmed regular outsourcing of the virus with possibilities of future epidemics. Also the fact that EV71 induced epidemic is on rise in this part of globe is alarming for India. We hope this early report will be of help for strategic planning for a better management of the disease and prevention of dreaded neurological complications in India.
  23 9,600 409
SHORT COMMUNICATIONS
Utility of dermoscopy in alopecia areata
Mandar Mane, Amiya Kumar Nath, Devinder Mohan Thappa
July-August 2011, 56(4):407-411
DOI:10.4103/0019-5154.84768  PMID:21965849
Background: Alopecia areata (AA) shows several well-defined dermoscopic features which may help in confirming diagnosis in AA. Aims: We carried out a study to examine the dermoscopic features of AA and develop a protocol for diagnosis of AA by dermoscopy. Materials and Methods: Dermoscopy was performed in 66 patients with AA. Hanse HVS-500NP dermoscope (magnification of ×32 and ×140) was used. Results: The mean age of the patients (46 males and 20 females) was 26.85 years. The mean age of onset was 25.15 years. The mean duration of alopecia was 10.3 months. Most common AA in our study was patchy type (57/66, 87.7%). Single patch was seen in 24 patients and multiple patches in 33 patients. Diffuse AA was seen in five patients. Ophiasis and alopecia universalis were seen in two patients each. Nail changes were fine pitting (4), ridging (2), thinning of nail plate (2). Twenty nail dystrophy, distal onycholysis, striate leukonychia and coarse pitting were seen in one patient each. Intralesional triamcinolone acetonide was the most common therapy offered. Others were oral betamethasone minipulse therapy, dexamethasone pulse, minoxidil, anthralin and corticosteroids. The most common dermoscopic finding was yellow dots seen in 54 patients (81.8%), followed by black dots (44 patients, 66.6%), broken hairs (36 patients, 55.4%), short vellus hair (27 patients, 40.9%) and tapering hairs (8 patients, 12.1%). Conclusions: The most common dermoscopic finding of AA in our study was yellow dots, followed by black dots, broken hairs, short vellus hair and tapering hairs. Dermoscopic findings were not affected by the type of AA or the severity of the disease.
  21 10,795 299
REVIEW ARTICLE
Topical treatment of melasma
Debabrata Bandyopadhyay
October-December 2009, 54(4):303-309
DOI:10.4103/0019-5154.57602  PMID:20101327
Melasma is a common hypermelanotic disorder affecting the face that is associated with considerable psychological impacts. The management of melasma is challenging and requires a long-term treatment plan. In addition to avoidance of aggravating factors like oral pills and ultraviolet exposure, topical therapy has remained the mainstay of treatment. Multiple options for topical treatment are available, of which hydroquinone (HQ) is the most commonly prescribed agent. Besides HQ, other topical agents for which varying degrees of evidence for clinical efficacy exist include azelaic acid, kojic acid, retinoids, topical steroids, glycolic acid, mequinol, and arbutin. Topical medications modify various stages of melanogenesis, the most common mode of action being inhibition of the enzyme, tyrosinase. Combination therapy is the preferred mode of treatment for the synergism and reduction of untoward effects. The most popular combination consists of HQ, a topical steroid, and retinoic acid. Prolonged HQ usage may lead to untoward effects like depigmentation and exogenous ochronosis. The search for safer alternatives has given rise to the development of many newer agents, several of them from natural sources. Well-designed controlled clinical trials are needed to clarify their role in the routine management of melasma.
  20 28,376 2,746
THERAPEUTIC ROUND
Efficacy of 2% metronidazole gel in moderate acne vulgaris
Effat Khodaeiani, Rohollah F Fouladi, Neda Yousefi, Mehdi Amirnia, Shahla Babaeinejad, Javad Shokri
July-August 2012, 57(4):279-281
DOI:10.4103/0019-5154.97666  PMID:22837561
Background: Acne vulgaris is an inflammatory disease of the pilosebaceous units. Various systemic and topical options are available for its treatment. Aims: This study aimed to evaluate the efficacy of 2% metronidazole gel in acne vulgaris. Materials and Methods: Double-blind, randomized, placebo-controlled, split-face clinical trial. Seventy young adults with moderate acne vulgaris received 2% metronidazole gel on the right side of their face and placebo on the left side of their face twice daily for 8 weeks. The number of inflamed and noninflamed facial lesions and side effects of treatment were documented on weeks 1, 2, 4, and 8. The patients' overall satisfaction was recorded at the end of the study. For statistical analysis we used the repeated-measures analysis, the chi-square test, Fisher's exact test, and the independent-samples t-test as appropriate. Results: Counts of inflamed and noninflamed facial lesions were comparable between the two sides at baseline. The number of the lesions was significantly lower on the metronidazole-treated side at all follow-up visits. Erythema and oily face decreased by 85.7% and 87.1%, respectively, on the metronidazole-treated side. Mild burning sensation and dryness on the metronidazole-treated side was reported by 3.4% and 22.9% of the patients, respectively. Eighty-eight percent of the patients were satisfied with the results of treatment on the metronidazole-treated side. Conclusions: Metronidazole gel (2%) is an effective, safe, and well-tolerated topical medication for moderate acne vulgaris.
  19 5,746 194
REVIEW ARTICLES
Deflazacort versus other glucocorticoids: A comparison
Surajit Nayak, Basanti Acharjya
October-December 2008, 53(4):167-170
DOI:10.4103/0019-5154.44786  PMID:19882026
Steroids form an important component of dermatological therapy and are used since very long time for different conditions in different forms. Though very few molecules are used since very long time, the side effect associated with this group of drugs are almost always there. Recently a new molecule deflazacort has been introduced into Indian market, is a glucocorticoid and a derivative of old molecule prednisolone. Though claimed to be having less side effect, very few studies have been done in Indian prospective. This review will highlight the very basics of this drug and its advantages and disadvantages.
  18 38,362 1,526
REVIEW ARTICLE
Adverse cutaneous drug reaction
Surajit Nayak, Basanti Acharjya
January-March 2008, 53(1):2-8
DOI:10.4103/0019-5154.39732  PMID:19967009
In everyday clinical practice, almost all physicians come across many instances of suspected adverse cutaneous drug reactions (ACDR) in different forms. Although such cutaneous reactions are common, comprehensive information regarding their incidence, severity and ultimate health effects are often not available as many cases go unreported. It is also a fact that in the present world, almost everyday a new drug enters market; therefore, a chance of a new drug reaction manifesting somewhere in some form in any corner of world is unknown or unreported. Although many a times, presentation is too trivial and benign, the early identification of the condition and identifying the culprit drug and omit it at earliest holds the keystone in management and prevention of a more severe drug rash. Therefore, not only the dermatologists, but all practicing physicians should be familiar with these conditions to diagnose them early and to be prepared to handle them adequately. However, we all know it is most challenging and practically difficult when patient is on multiple medicines because of myriad clinical symptoms, poorly understood multiple mechanisms of drug-host interaction, relative paucity of laboratory testing that is available for any definitive and confirmatory drug-specific testing. Therefore, in practice, the diagnosis of ACDR is purely based on clinical judgment. In this discussion, we will be primarily focusing on pathomechanism and approach to reach a diagnosis, which is the vital pillar to manage any case of ACDR.
  17 12,788 1,183
Cutaneous remodeling and photorejuvenation using radiofrequency devices
Mohamed Lotfy Elsaie
July-September 2009, 54(3):201-205
DOI:10.4103/0019-5154.55625  PMID:20161847
Radio frequency (RF) is electromagnetic radiation in the frequency range of 3-300GHz. The primary effects of RF energy on living tissue are considered to be thermal. The goal of the new devices based on these frequency ranges is to heat specific layers of the skin. The directed use of RF can induce dermal heating and cause collagen degeneration. Wound healing mechanisms promote the remodeling of collagen and wound contraction, which ultimately clinically enhances the appearance of mild to moderate skin laxity. Preliminary studies have reported efficacy in the treatment of laxity that involves the periorbital area and jowls. Because RF energy is not dependent on specific chromophore interaction, epidermal melanin is not at risk of destruction and treatment of all skin types is possible. As such, radiofrequency-based systems have been used successfully for nonablative skin rejuvenation, atrophic scar revision and treatment of unwanted hair, vascular lesions and inflammatory acne. The use of RF is becoming more popular, although a misunderstanding exists regarding the mechanisms and limitations of its actions. This concise review serves as an introduction and guide to many aspects of RF in the non ablative rejuvenation of skin.
  16 8,035 509
Allergic contact dermatitis due to the plant Calotropis procera (Vern : AK). A case report.
F Handa, JK Sadana, PK Sharma
July 1984, 29(3):27-9
PMID:6545244
Full text not available    [CITATIONS]  [PubMed]
  15 981 0
BASIC RESEARCH
A study of androgen and estrogen receptors α, β in skin tags
Omar El Safoury, Lila Rashid, Magdy Ibrahim
January-March 2010, 55(1):20-24
DOI:10.4103/0019-5154.60345  PMID:20418971
Background: In women, the age of 50 is suggested to be the turning point of life at which the development of skin tags comes to a stop. A major event that occurs around this period of life is menopause/andropause. After menopause, estrogen receptors amounts decrease significantly. As skin is considered as the largest nonreproductive target on which estrogens and androgens act, we assume a possible relationship between the pathogenesis of skin tags and sex steroid balance. Another phenomenon is the association of skin tags in obese patients, which may also be explained by the interplay of sex steroids and their receptors in skin tags. Aims: Here we see that in obese patients, hyperandrogenism occurs as a result of hyperinsulinemia as well as peripheral conversion of estrogens into androgens in the excessive adipose tissue. To examine the possible role of androgen and estrogen receptors in etiopathogenesis of skin tags. Materials and Methods: To examine these hypotheses, we measured the level of androgen and estrogen receptors (both α and β) in skin tags compared to control. We also correlated the level of receptors to body mass index, and compared those levels in patients with acanthosis nigricans compared to normal. Results: The level of estrogen receptors (both α and β) was significantly higher in skin tags than in controls with a P value of 0.004 and 0.001, respectively. The same upsurge was found for androgen receptors in skin tags relative to control with a P value of 0.001. No statistically significant difference in receptor level was found either among patients with acanthosis nigricans and those without, or in correlation to body mass index (our participants were overweight non diabetic). Conclusion: These results suggest the possible role of androgen and estrogen receptors in etiogenesis of skin tags, and propose that the neck is an androgen dependent area just similar to the axillae and the groins, though hairless.
  15 4,731 146
CASE REPORTS
Cutaneous zygomycosis due to Saksenaea vasiformis in an immunocompetent host
VP Baradkar, S Kumar
October-December 2009, 54(4):382-384
DOI:10.4103/0019-5154.57621  PMID:20101346
Saksenaea vasiformis is an emerging zygomycete species, most often associated with cutaneous, subcutaneous and rhino- orbito-cerebral infections. Herein, we report a case of cutaneous zygomycosis of face caused by Saksenaea vasiformis in a 54-year-old immunocompetent female. The diagnosis was carried out by microscopy using KOH mount, Gram staining, Gomori's methenamine silver staining, hemotoxylin and eosin staining and culture on Sabouraud's Dextrose agar without actidione. Slide cultures were put up on Czapek Dox agar, which showed typical flask-shaped sporangium with rhizoids. The patient was treated successfully with intravenous amphotericin B.
  15 3,428 135
ORIGINAL ARTICLES
Study of mast cell count in skin tags
Hesham Zaher, Omar Soliman El Safoury, Mohamed Hussein Medhat El Komy, Sara Bahaa Mahmoud, Hanan Abd El Hameed
October-December 2007, 52(4):184-187
DOI:10.4103/0019-5154.37722  
Background: Skin tags or acrochordons are common tumors of middle-aged and elderly subjects. They consist of loose fibrous tissue and occur mainly on the neck and major flexures as small, soft, pedunculated protrusions. Objectives: The aim was to compare the mast cells count in skin tags to adjacent normal skin in diabetic and nondiabetic participants in an attempt to elucidate the possible role of mast cells in the pathogenesis of skin tags. Participants and Methods: Thirty participants with skin tags were divided into group I (15 nondiabetic participants) and group II (15 diabetic participants). Three biopsies were obtained from each participant: a large skin tag, a small skin tag and adjacent normal skin. Mast cell count from all the obtained sections was carried out, and the mast cell density was expressed as the average mast cell count/high power field (HPF). Results: A statistically significant increase in mast cells count in skin tags in comparison to normal skin was detected in group I and group II. There was no statistically significant difference between mast cell counts in skin tags of both the groups. Conclusion: Both the mast cell mediators and hyperinsulinemia are capable of inducing fibroblast proliferation and epidermal hyperplasia that are the main pathologic abnormalities seen in all types of skin tags. However, the presence of mast cells in all examined skin tags regardless of diabetes and obesity may point to the possible crucial role of mast cells in the etiogenesis of skin tags through its interaction with fibroblasts and keratinocytes.
  15 6,608 249
EPIDEMIOLOGY ROUNDS
Dermatological manifestations in HIV-infected patients at a tertiary care hospital in a tribal (Bastar) region of Chhattisgarh, India
Harminder Singh, Prabhakar Singh, Pavan Tiwari, Vivek Dey, Navin Dulhani, Amita Singh
October-December 2009, 54(4):338-341
DOI:10.4103/0019-5154.57609  PMID:20101334
Background: Cutaneous disorders during HIV infection are numerous and skin is often the first and only organ affected during most of the course of HIV disease. Some Cutaneous disorders reflect the progression of HIV disease; though the relation is still controversial. Aims : The objective of this study, conducted at a tertiary care centre in Bastar, Jagdalpur, is to estimate the status of cutaneous manifestation in HIV-infected patients and its relationship with CD4 cell counts. Methods: We enrolled 137 HIV positive subjects. Demographic information such as age, gender, weight, height, socioeconomic status, and educational status were recorded. Laboratory parameter (CD4 counts) and treatment regimen were noted. Patients were examined for skin disorders by a dermatologist. Data were analyzed using chi-square test for categorical variables. Results: Majority of the patients were from rural area (65.69%) and belonged to a low socioeconomic and educational status. 30.65% of the patients were housewives, 23.35% drivers, and 16.78% labourers. Predominant mode of transmission was heterosexual contact (94.16%). Most common HIV-related dermatological manifestations were seborrheic dermatitis (74.16%), xerosis (52.5%), generalized skin hyperpigmentation 56 (46.67%), onychomycosis 53 (44.16%), pruritic papular eruption 27 (22.5%), oral candidiasis 21 (17.5%), photo dermatitis 21 (17.5%), and scabies 4 (3.33%). Significant correlation with low CD4+ cell counts was found for oral candidiasis (P < 0.0001) and Kaposi's sarcoma ( P = 0.03), while other disorders such as seborrheic dermatitis ( P = 0.22), xerosis ( P = 0.25), and onychomycosis (P = 0.08) were not statistically significant. Conclusion : This study showed high prevalence of dermatological manifestations in HIV-infected subjects, and they occur more frequently with progression of HIV and decline in immune functions. Therefore, early diagnosis and management of skin disorders can improve the quality of life of HIV-infected subjects.
  14 5,722 267
IJD SYMPOSIUM
Dengue viral infections
Padmalal Gurugama, Pankaj Garg, Jennifer Perera, Ananda Wijewickrama, Suranjith L Seneviratne
January-March 2010, 55(1):68-78
DOI:10.4103/0019-5154.60357  PMID:20418983
Dengue viral infections are one of the most important mosquito-borne diseases in the world. Presently dengue is endemic in 112 countries in the world. It has been estimated that almost 100 million cases of dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur worldwide. An increasing proportion of DHF is in children less than 15 years of age, especially in South East and South Asia. The unique structure of the dengue virus and the pathophysiologic responses of the host, different serotypes, and favorable conditions for vector breeding have led to the virulence and spread of the infections. The manifestations of dengue infections are protean from being asymptomatic to undifferentiated fever, severe dengue infections, and unusual complications. Early recognition and prompt initiation of appropriate supportive treatment are often delayed resulting in unnecessarily high morbidity and mortality. Attempts are underway for the development of a vaccine for preventing the burden of this neglected disease. This review outlines the epidemiology, clinical features, pathophysiologic mechanisms, management, and control of dengue infections.
  14 9,315 845
ORIGINAL ARTICLES
Melasma: A clinico-epidemiological study of 312 cases
Arun Achar, Sanjay K Rathi
July-August 2011, 56(4):380-382
DOI:10.4103/0019-5154.84722  PMID:21965843
Background: Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin. The pathogenesis is unknown, but genetic or hormonal influences with UV radiation are important. Aims: Our present research aims to study the clinico-epidemiological pattern and the precipitating or provocation factors in melasma. Materials and Methods: A total of 312 patients were enrolled for the study over a period of one year. Results: The mean age of patients with melasma was 33.45 years, ranging from 14 to 54 years. There was female preponderance with a female to male ratio of approximately 4 : 1. The mean age of onset was 29.99 years, with the youngest and oldest being 11 and 49 years, respectively. The patients sought medical treatment on an average of 3.59 years after appearance of melasma. About 55.12% of our patients reported that their disease exacerbated during sun exposure. Among 250 female patients, 56 reported pregnancy and 46 reported oral contraceptive as the precipitating factors. Only 34 patients had given history of exacerbation of melasma during pregnancy. A positive family history of melasma was observed in 104 (33.33%) patients. Centrofacial was the most common pattern (55.44%) observed in the present study. Wood light examination showed the dermal type being the most common in 54.48% and epidermal and mixed were seen in 21.47% and 24.03% of the cases, respectively. We tried to find an association with endocrinal diseases and observed that 20 of them had hypothyroidism. Conclusion: The exact cause of melasma is unknown. However, many factors have been implicated in the etiopathogenesis of this disorder. Here we try to identify the causative factors and provocation to develop melasma.
  14 6,862 296
Outbreak of tinea gladiatorum in wrestlers in Tehran (Iran)
Shahindokht Bassiri-Jahromi, Ali Asghar Khaksar
July-September 2008, 53(3):132-136
DOI:10.4103/0019-5154.43219  PMID:19882012
Background: In recent years, skin diseases in wrestling have finally received the attention they deserve. Outbreaks of tinea corporis are often associated with sports involving extensive bodily contact; such sports include wrestling. Tinea corporis gladiatorum is primarily caused by Trichophyton tonsurans , infecting wrestlers at alarming rates. The management of skin infections in wrestlers and other athletes in sports involving skin-to-skin contact entails numerous challenges, from making an accurate diagnosis to determining eligibility for playing the sports. To control outbreaks, we conducted an epidemiologic investigation. The purpose of this article is to determine the prevalence of tinea corporis gladiatorum in wrestlers in Tehran, Iran. Materials and Methods: A study of dermatophytosis was carried out during the period of March 2004 to December 2005 on 612 mycological proven cases of dermatophytosis found in male wrestlers in Tehran. Mycological examination consisted of culturing of pathologic material followed by direct microscopic observation. Diagnosis was based on macroscopic and microscopic characteristics of the colonies. Results: T. tonsurans was the predominant dermatophyte, accounting for >90% of all tinea corporis gladiatorum isolates during the 2 year analysis. Tinea corporis gladiatorum was found to be more frequent in individuals between the ages of 10 and 20 years of age (72.7%). Wrestlers with tinea corporis gladiatorum were predominantly from wrestling clubs in southern and southeastern Tehran. Transmission of tinea corporis is primarily through skin-to-skin contact. Conclusion: Rapid identification and treatment of tinea corporis gladiatorum is required to minimize the disruption of team practices and competitions. Infection with dermatophytes can disqualify a wrestler from competing in matches, and thus, vigilant surveillance and rapid initiation of treatment is important to prevent the suspension of team practices and competitions.
  14 4,060 155
STUDIES
Alopecia areata and autoimmunity: A clinical study
Emy Abi Thomas, RS Kadyan
April-June 2008, 53(2):70-74
DOI:10.4103/0019-5154.41650  PMID:19881991
Alopecia areata (AA) frequently occur in association with other autoimmune diseases such as thyroid disorders, anemias and other skin disorders with autoimmune etiology. Despite numerous studies related to individual disease associations in alopecia areata, there is paucity of literature regarding comprehensive studies on concomitant cutaneous and systemic diseases. The present study has been designed to determine if there is a significant association between alopecia areata and other autoimmune diseases. This study covers 71 patients with the diagnosis of alopecia areata as the case group and 71 patients with no evidence of alopecia areata as the control group. Among the cutaneous diseases associated with AA, atopic dermatitis (AD) showed maximum frequency with an O/E ratio of 2.5, which indicates that it is two to three times more common in patients with alopecia areata. In our study, thyroid disorders showed the highest frequency with on O/E ratio of 3.2 and a P value of 0.01, which is statistically highly significant. Among the thyroid disorders, hypothyroidism was the most frequent association (14.1%) in our study. Since systemic involvement is not infrequent in patients with alopecia areata, it is imperative to screen these patients for associated disorders, particularly atopy, thyroid diseases, anemias and other autoimmune disorders, especially if alopecia areata is chronic, recurrent and extensive.
  14 13,303 602
BASIC RESEARCH
Characterization of Malassezia Furfur and its control by using plant extracts
R Vijayakumar, C Muthukumar, T Kumar, R Saravanamuthu
April-June 2006, 51(2):145-148
DOI:10.4103/0019-5154.26942  
Malassezia furfur, a lipophilic, dimorphic and yeast-like fungus, occurring in human skin as an opportunistic pathogen, causes diseases such as dandruff, pityriasis versicolar, seborrheic dermatitis, etc. Suitable media for culturing the organism were standardized. A modified medium for the culturing of M. furfur has been proposed. Growth of the fungus was also determined in the presence of different carbon sources under the influence of different temperature, pH and salinity. Plant extracts of 19 species were screened against the growth of the fungus by using disc diffusion method and the results are discussed.
  13 53,667 1,232
CONCISE COMMUNICATION
Acetylcholine esterase levels in different clinical types of vitiligo in Baroda, Gujarat
EM Shajil, YS Marfatia, Rasheedunnisa Begum
October-December 2006, 51(4):289-291
DOI:10.4103/0019-5154.30299  
Vitiligo is an acquired depigmentary disorder involving a progressive loss of melanocytes from the epidermis and hair follicles. Gujarat has a high prevalence of vitiligo. One of the major hypotheses in the pathogenesis of vitiligo is the neurochemical hypothesis. According to the neural hypothesis neurochemical mediator/s such as acetylcholine secreted by the nerve endings cause the destruction of melanocytes. Acetylcholine esterase (AChE) activity has been found to be lowered in vitiligo patients during the process of depigmentation. We have earlier reported impairment of systemic antioxidant status in Baroda vitiligo patients, and we now show analysis of blood AChE activity in these patients. The study consisted of 121 vitiligo patients and 126 age and sex-matched healthy controls. Acetylcholine esterase activity showed significant decrease in vitiligo patients. However, there is no significant difference in AChE activity in segmental and non-segmental types as well as in active and stable types of vitiligo. The age group 16-25 showed a significant decrease in AChE activity. This study suggests that AChE may be inactivated due to high systemic oxidative stress in these patients. This is the first report showing that AChE may be playing a role in the pathogenesis of vitiligo in Baroda patients.
  13 7,516 343
IJD SYMPOSIUM
Mucocutaneous manifestations of dengue fever
Emy Abi Thomas, Mary John, Bimal Kanish
January-March 2010, 55(1):79-85
DOI:10.4103/0019-5154.60359  PMID:20418984
Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition. Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue. The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash.
  13 7,769 543
ORIGINAL ARTICLE
A five-year survey of onychomycosis in New Delhi, India: Epidemiological and laboratory aspects
Ravinder Kaur, Bineeta Kashyap, Preena Bhalla
January-March 2007, 52(1):39-42
DOI:10.4103/0019-5154.31923  
Context: The worldwide incidence of onychomycosis is increasing and it continues to spread and persist. Knowledge of the epidemiological and mycological characteristics is an important tool for control of this infection. Aims: This study seeks to improve knowledge of onychomycosis epidemiology and mycological features. Settings and Design: Over a period of five years (Jan 2000 - Dec 2005) samples from 400 patients with clinical suspected fungal nail infections, who attended dermatology out patient department at a tertiary care hospital, were obtained. Materials and Methods: 400 nail specimens of suspected onychomycosis were evaluated clinically, KOH examination and fungal culture was done. Results: Onychomycosis was present in 218 (54.5%) by culture and /or direct examination. Fingernails and toenails were infected in 65% and 32% respectively and remaining 3% had both. Conclusions: This study demonstrated that dermatophytes were main agents causing onychomycosis in our region, as well as the importance of performing direct examination and culture in diagnosis of onychomycosis.
  13 8,853 598
Cutaneous tuberculosis--a clinical and investigative study.
RK Pandhi, TR Bedi, AJ Kanwar, LK Bhutani
January 1977, 22(2):99-107
PMID:608692
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