Severity and risk of COVID-19 in cancer patients: An evidence-based learning.

The immune system of cancer patient gets compromised because of cancer therapy, surgery, and malignancy and thus the probability of infection are increased than the general patients. Immunosuppression can expose cancer patients to serious complications which can lead to delay in diagnosis and unnecessary hospitalizations that may adversely affect the prognosis of the disease. Patients who received chemotherapy or surgery within the 30 days before novel coronavirus disease pandemic have more risk of infection than the patients who had not undergone chemotherapy or surgery.

Prolonged Remission of Psoriasis with Azathioprine Pulse Therapy.

BACKGROUND: Although various therapies used for the treatment of psoriasis are able to produce remission, yet relapses, a common problem, remains frequent. It was observed that treatment with intermittent high dose (IHD) and continuous low dose (CLD) azathioprine can produce prolonged and durable remission in psoriasis. AIMS: To see the long term effect of azathioprine pulse therapy (APT) in psoriasis. METHODS: Ten patients with psoriasis who has completed more than 5 years in remission with azathioprine pulse therapy are being taken in the study. They were given IHD azathioprine (500 mg on 3 consecutive days which is repeated every month) with CLD azathioprine (100 mg orally) daily in between IHD. The entire treatment schedule was divided into four phases. During phase I, treatment with IHD and CLD azathioprine was started and continued till complete clearance of lesions after which, patients proceeded to Phase II. In phase II, they continued to get treatment with IHD and CLD. After continued remission for a period of nine months, they entered into phase III, when the treatment with IHD was stopped, but CLD continued. If there was no recurrence after nine months of phase III treatment, CLD was also withdrawn, and patients were followed-up without any treatment (Phase IV). RESULTS: All 10 patients completed treatment and are in remission for more than five years without any treatment. CONCLUSIONS: Out of 60 patients in phase IV, 10 patients were in continuous remission for more than five years, after all treatment had been stopped. Thus, azathioprine pulse therapy regimen produces prolonged remission in psoriasis.

Topical adapalene in the treatment of plantar warts; randomized comparative open trial in comparison with cryo-therapy.

BACKGROUND: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. AIMS: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. MATERIALS AND METHODS: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. RESULT: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47) days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11) days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. CONCLUSION: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy.

Fixed drug eruption due to ornidazole.

A 56-year-old male developed an ulcer on his glans penis and mucosae of upper and lower lips 3 days after taking ofloxacin, cephalexin, and ornidazole. Clinically, a provisional diagnosis of fixed drug eruption was made. The causative drug was confirmed by an oral provocation test which triggered a reactivation of all lesions only with ornidazole.

Plantar warts treated with topical adapalene.

BACKGROUND: Treatment of plantar warts caused by human papilloma virus (HPV) strain types 1, 2 and 4 is often difficult and a challenging problem. Various therapeutic modalities available for treating this problem have not been uniformly successful. PURPOSE: The purpose of present study is to evaluate the efficacy of adapalene applied locally with occlusion in plantar warts. MATERIALS AND METHODS: A total of 10 patient with 118 plantar warts were included in an open study. All were treated by applying adapalene gel 0.1% after paring of warts if needed followed by occlusive dressing with polythene paper in each patient. The effects of the treatment were evaluated every week till the clearance of all warts. FINDINGS: Adapalene was used in 10 patient having 118 plantar warts. All the warts cleared in 39±15.07 days. There was no side effects like scar formation, irritation, erythema or infection with adapalene. CONCLUSION: Adapalene clears the plantar warts faster compared to other modalities available. LIMITATION: Need trial with large number of patients.

Dexamethasone cyclophosphamide pulse therapy in systemic lupus erythematosus: a case report.

OBJECTIVE: To put systemic lupus erythematosus (SLE) in remission for a prolonged period. METHODS: Dexamethasone cyclophosphamide pulse (DCP) therapy was used in a 40-year-old female with SLE of 3 years' duration. DCP therapy comprises an intravenous infusion of 100 mg dexamethasone in 500 ml of 5% glucose over 1-1(1/2) hours on 3 consecutive days along with cyclophosphamide 500 mg in the same drip on the first day. This was repeated at 4-week intervals till 9 months after all the lesions cleared. In between the DCP therapy she was given 50 mg cyclophosphamide orally daily. RESULTS: The skin lesions cleared with 11 DCP therapies. There was no relapse 24 months after stopping all treatment. CONCLUSION: DCP therapy appears to put SLE into prolonged remission.

Methotrexate-betamethasone weekly oral pulse in psoriasis.

OBJECTIVES: Methotrexate in psoriasis helps to clear the lesions fast but remission is short. To produce long-term remission, methotrexate has been combined with betamethasone. METHODS: A total of 40 patients with psoriasis (plaque type: 36, erythrodermic: four) were included in an open randomized study. Twenty-eight patients received weekly 15 mg methotrexate and 3 mg betamethasone orally and 12 patients received weekly 15 mg methotrexate orally alone until the Psoriasis Area Severity Index (PASI) scores were reduced to 95-100% of the baseline scores. Follow-up was carried out until relapse of the lesions. RESULTS: Methotrexate combined with betamethasone orally weekly cleared the lesions in 27.13+/-2.39 (24.74-29.52) days with a remission period of 91.78+/-14.19 (77.59-105.97) days, whereas methotrexate alone took 33.09+/-5.61 (27.48-38.70) days to clear the lesions with a remission period of 20.30+/-2.50 (17.80-22.80) days. CONCLUSIONS: Methotrexate combined with betamethasone cleared the lesions faster and with a longer remission period compared with methotrexate alone.

Dexamethasone cyclophosphamide pulse therapy in lichen amyloidosus: a case report.

OBJECTIVE: To clear the itching and lesions of lichen amyloidosus completely, which is a chronic, troublesome disease of the skin with variable results from various therapeutic modalities. METHODS: Dexamethasone cyclophosphamide pulse (DCP) therapy was given to a 53-year-old man with lichen amyloidosus of 3 months duration. DCP therapy comprises an intravenous infusion of 100 mg dexamethasone in 500 ml of 5% glucose over 1-1(1/2) hours on 3 consecutive days. On day 1, cyclophosphamide 500 mg was also given through the same drip. DCP therapy was repeated at 4-week intervals. In between, the patient received 50 mg of cyclophosphamide orally daily. RESULTS: The itching stopped completely after five DCP sessions and all the lesions cleared after nine DCP sessions with no relapse during 30 months of follow-up after stopping the treatment. CONCLUSION: DCP therapy is an effective alternative for lichen amyloidosus.

Homoeopathy for the treatment of lichen simplex chronicus: a case series.

Twenty-seven patients with chronic lichen simplex involving various parts of the body were treated. Hydrocotyle was prescribed to 21 patients in different potencies (6c, 30c, 200c, 1 M, 10 M), Thuja to three patients (1 M, 10 M), Graphites (6c), Kali bich (30c) and Sulphur (200c) to one patient each during 1 year study period. Only two patients showed complete improvement with Thuja and one with Graphites. In other cases, the response was limited to partial relief of [corrected] itching.

Fixed Drug Eruptions in a 9 Months Old Child.

A 9-month-old child developed fixed drug eruptions due to co-trimoxazole. Causative agent was confirmed by repeated provocation tests.

Pruritic Psoriasiform Cutaneous Lesions in Secondary Syphilis.

A 33 year old male had severely itchy psonasiform lesions on his scalp, face, arms and shaft of penis. He also had loss of hair on the lateral half. of both eyebrows and the temporal. part of his scalp, generalized lymphadenopathy, coppery coloured macules on his pahns and soles, ulcers on the mu,cosa of his upper lip and soft palate and condyloma lata on his anal mucosa. VDRL test was positive in the titre of 1: 128. The itching along with the other symptoms and signs disappeared completely in one mouth with a single dose of 2.4 mega units of benezathine pencillin given inramuscularly.