RESUMO
Background/Objectives: There has been a recent explosion in the incidence of dermatophytic infections globally, especially in tropical countries including India. This increase is associated with a change in the clinical pattern and mycological profile with poor response to treatment, in adults and children. Limited studies in India have focused on pediatric dermatophytoses. Our study's primary objective was to assess the clinicomycological profile of pediatric dermatophytosis in our region and secondarily to understand the association of lifestyle factors with poor response to treatment. Methods: This was an observational study including children ≤16 years of age, clinically diagnosed with tinea. Clinical and lifestyle data regarding site, affected surface area, duration of infection, previous treatment, possible sources of infection, overcrowding, and bathing practices were collected. Samples were collected for potassium hydroxide mount and fungal culture. Results: A total of 183 children participated in our study. The most common diagnosis was tinea corporis. Tinea cruris was more frequent in preadolescents, where males were more affected. Positive associations were seen between increased duration of infection, increased household infection, infection among playmates, irregular bathing, and use of steroid creams. The most common organism isolated was Trichophyton mentagrophytes/interdigitale (55.19%) followed by Trichophyton rubrum (14.75%). Conclusions: There is a change in the mycological profile of pediatric dermatophytosis with an increase in Trichophyton mentagrophytes/interdigitale infection. Important sources of infection in children must be identified in chronic and recurrent cases. Misinformed and ignorant use of steroid creams is an important reason for recurrent infection.
RESUMO
BACKGROUND: The treatment of vitiligo is often challenging and requires a multi-modality approach. Fractional carbon dioxide (FCO2) laser has been studied as an adjuvant therapy in cases of vitiligo. Autologous platelet-rich plasma (PRP) is rich in growth factors, which may contribute to the growth of melanocytes, and thus help in the repigmentation of vitiligo patches. We aimed to study the combination of these two modalities for the treatment of vitiligo. AIMS AND OBJECTIVE: The aim of this study was to compare the efficacy and safety of FCO2 laser with PRP and FCO2 laser alone as an adjuvant therapy in stable non-segmental vitiligo (NSV) patients. SETTINGS AND DESIGN: A prospective, randomized, comparative, open-label interventional study was carried out for a period of 18 months from December 2017 to June 2019, at a tertiary care hospital. MATERIALS AND METHODS: Seventy patients with stable, NSV were assessed for eligibility; 66 patients were randomized equally into two groups. Group A received treatment with FCO2 laser with intralesional PRP, whereas Group B was treated with FCO2 laser alone. Patients in both the groups were treated with one therapy session and were followed up monthly for a period of 3 months. All the patients received topical psoralen with ultraviolet A (UVA) PUVA-sol treatment. Baseline and monthly assessments were done by VITILIGO AREA SEVERITY INDEX and standardized photographs. RESULTS: VASI score reduction was significantly more in the Group A with (mean ± standard deviation [SD]) 9.5 ± 0.22, 5.8 ± 1.12, and 3.6 ± 1.81 as compared to Group B 11.9 ± 2.83, 9.9 ± 3.11, and 8.9 ± 3.46 at each subsequent follow-up visits, respectively. Side effects such as burning sensation, erythema, and crusting were seen less frequently and lasted for a short period in Group A in comparison to those in Group B. CONCLUSION: Combination of FCO2 laser and autologous intralesional PRP has a synergetic effect in treating patients with vitiligo as an adjuvant therapy with minimal adverse effects.