Comparison of efficacy and safety of 30% hydrogen peroxide with 50% trichloroacetic acid in seborrheic keratosis: a randomized controlled study.

BACKGROUND: Seborrheic keratosis is a benign skin tumour. None of the common therapies is satisfactory. This study compared the efficacy of 30% hydrogen peroxide versus 50% trichloroacetic acid in treatment of seborrheic keratoses. METHODS: This unblinded, comparative interventional study was conducted on 85 patients of seborrheic keratosis. Lesions were graded using physician's lesion assessment (PLA) scale (0, clear; 1, nearly clear; 2≤1 mm thick; 3≥1 mm thick). Patients were randomly assigned into two groups: A and B. Five target seborrheic keratosis lesions with PLA score of three were selected in each patient. Group A was treated with 30% hydrogen peroxide and group B with 50% trichloroacetic acid. Both groups received treatment every week up to 5 weeks or till complete resolution of lesions. Clinical photographs of all patients were taken every 2 weeks. RESULTS: Both the groups were comparable in terms of age and sex. At the end of 6 weeks, lesions were cleared completely in 41.8% of patients in group A and in 23.8% in group B. Mean PLA score decreased significantly in group A from 3 to 1.79 (40.3%) at 2 weeks and to 0.63 (79%) at 6 weeks (P<0.001). The decrease in PLA score in group B was 2.41 (19.7%) and 1.13 (62.3%) at 2, and 6 weeks respectively (P<0.001). Hydrogen peroxide produced greater clearance of seborrheic keratosis (P=0.017) than trichloroacetic acid. Also, no major adverse effects were observed in the two groups. CONCLUSIONS: Application of 30% hydrogen peroxide appears to be more efficacious as compared to trichloroacetic acid (50%) for treatment of seborrheic keratosis.

Efficacy of Topical 5% 5-Fluorouracil with Needling versus 5% 5-Fluorouracil Alone in Stable Vitiligo: A Randomized Controlled Study.

BACKGROUND: Vitiligo is a chronic disease of great cosmetic concern presenting with depigmented macules and patches. It is often recalcitrant to medical treatment. AIM: The aim of the study was to study the efficacy and safety of topical 5% 5-fluorouracil with needling versus topical 5% 5-fluorouracil alone in stable vitiligo. MATERIALS AND METHODS: This interventional prospective study was conducted from July 2018 to June 2019. Total of 60 patients, with stable vitiligo of age older than 10 years, were randomly assigned into two groups of 30 patients each. Group A was treated with needling followed by topical 5% 5-fluorouracil over vitiligo patches. The procedure was performed every 2 weeks for 3 months. Group B was treated with topical 5% 5-fluorouracil alone. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading score. RESULTS: Initiation of repigmentation started at 1 month in 76 patches (65%) in Group A, whereas in group B, it was seen in 45 patches (38.7%), which was statistically significant (P = 0.0001). Excellent improvement (>75% repigmentation) was noted in 55 patches (47%) in Group A as compared to 5 patches (4.3%) in group B at the end of 6 months (P = 0.03). CONCLUSION: Needling with 5% 5-fluorouracil appears to be simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.

The Impact of Onychopathies on Quality of Life: A Hospital-based, Cross-sectional Study.

BACKGROUND: Onychopathies or nail disorders are associated with social stigma and causes limitation of daily activities by hampering the function of both fingers and toes. AIM: To evaluate the impact of onychopathies on quality of life (QoL) and compare the severity of impact on QoL in various nail disorders. MATERIALS AND METHODS: A hospital-based cross-sectional study consisting of 540 patients with onychopathies was conducted in the dermatology outpatient department. Patients were requested to complete a nail-specific QoL questionnaire consisting of 24 and 16 questions, respectively, for fingernails (group F) and toenails (group T) with five possible responses to each question. A score of 1-5 was given to each response. Statistical analysis was done to compare the impact of QoL on the different types of onychopathies. RESULTS: We found that onychopathies have a significant impact on QoL. QoL was significantly more affected when multiple nails were involved (P = 0.020 for group F and P = 0.001 for group T). QoL impact was statistically more significant in women (P = 0.038 for group F and P < 0.001 for group T) and in younger people aged <20 years in group F and 20-39 years in group T (P < 0.001 for both groups F and T). Patients with onychomycosis, structural nail defects, and psoriasis had a more significant impact than other diseases (P < 0.001 for both groups F and T). CONCLUSION: Onychopathies have a significant adverse effect on QoL because of their serious physical, psychological and social impact. Hence, clinicians should treat the nail disorders with utmost seriousness.

Impact on quality of life in patients with dermatophytosis.

BACKGROUND/OBJECTIVES: Dermatophytosis can have a significant effect on patient's psychosocial and economic life. Despite this, knowledge on the quality of life (QoL) in patients with dermatophytosis is limited. The objective of the present study was to assess the quality of life in patients with dermatophytosis. METHODS: This was a cross-sectional study conducted in the Department of Dermatology at a tertiary care hospital from August 2018 to December 2018. All the patients with dermatophytosis aged ≥16 years were included and evaluated for impact on quality of life. The association of Dermatology Life Quality Index (DLQI) scores with disease characteristics was assessed using t-test, ANOVA and Pearson's correlation test, as applicable. RESULTS: A total of 348 patients were analysed. The mean ± SD DLQI score in our study was 13.4 ± 7.3. Dermatophytosis was found to have a very large effect on the QoL in majority (44.8%) of our patients. DLQI questions pertaining to symptoms and feelings and daily activity had the highest impact on patients. The DLQI score was significantly affected by the number of sites involved (P < 0.001), body surface area (P < 0.001) and the severity of symptoms (P = 0.007). CONCLUSION: Dermatophytosis was found to have a significant impact on the QoL of affected patients. The DLQI score was influenced by the severity of the disease. This study also underscores the feasibility of DLQI score based QoL assessment in dermatophytosis.

Clinico-epidemiological Study of Morphea from a Tertiary Care Hospital.

INTRODUCTION: Morphea is an uncommon disease that presents with skin induration and sclerosis. The disease is common in Caucasians and there are few studies describing the clinicoepidemiological profile of these patients from the Indian subcontinent. METHODS: This prospective study was conducted during a three year period from June 2014 to May 2017. All patients of morphea presenting to the dermatology outpatient department were evaluated for parameters like age, sex, duration, age of onset, clinical subtype and possible disease associations and triggering factors. The data was analysed, tabulated and mean, standard deviation and percentages calculated. RESULTS: 47 patients were incorporated into the study. These comprised of 10 (21.28%) males and 37 (78.72%) females. The average age of the patients was 23.92 ± 12.07 years with a mean age of onset being 22.13 ± 12.51 years. 22 (46.80%) patients presented within one year of onset of disease. Plaque morphea was the commonest type seen in 31 (65.96%) patients followed by linear morphea in 9 (19.15%) patients. We found preceding trauma in 3 patients and morphea developed following herpes zoster and intramuscular injection in one patient each. CONCLUSION: Morphea is an uncommon disease that is seen predominantly in females and young individuals. Circumscribed plaque morphea is the commonest variant. Certain predisposing factors like trauma can precede it.

Facile Synthesis and Tensile Behavior of TiO(2) One-Dimensional Nanostructures.

High-yield synthesis of TiO(2) one-dimensional (1D) nanostructures was realized by a simple annealing of Ni-coated Ti grids in an argon atmosphere at 950 degrees C and 760 torr. The as-synthesized 1D nanostructures were single crystalline rutile TiO(2) with the preferred growth direction close to [210]. The growth of these nanostructures was enhanced by using catalytic materials, higher reaction temperature, and longer reaction time. Nanoscale tensile testing performed on individual 1D nanostructures showed that the nanostructures appeared to fracture in a brittle manner. The measured Young's modulus and fracture strength are ~56.3 and 1.4 GPa, respectively.