HLA- A & B Association in Psoriasis in Tamil Speaking South Indian Population.

Psoriasis is an auto-immune skin disease affecting skin, nails and joints. The association of HLA with psoriasis is already established with HLA- C*06 known to be associated strongly with the disease. We wanted to determine the HLA -A & HLA-B pattern and its association with psoriasis in a Tamil speaking ethnic population.METHODSA total of 100 psoriasis patients attending the Dermatology OPD at SRMC were taken up for the study. This was a case control study and hence 100 voluntary blood donors donating at the SRMC Hospital blood bank were taken up for study as controls. Voluntary blood donors are considered as healthy normal individuals and hence chosen as controls. All the 100 patients and 100 controls were typed for HLA (Human Leucocyte Antigen) - A & B by PCR-SSP (Polymerase Chain Reaction-Sequence Specific Primers) and the results were analysed statistically using OpenEpi software (2 X 2 table). The Odds Ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests which were studied.RESULTSHLA-A*02, 24 and HLA-B*35 were found to be strongly associated with psoriasis among Tamil speaking ethnic population.CONCLUSIONSThere are different HLA – A & B alleles associated with psoriasis in Tamil ethnic population in comparison with other ethnic studies

Association of HLA-C 06 with Psoriasis in a Tertiary Care Hospital.

Prevalence of psoriasis is 1-3% in India. HLA-C*06 has been shown to be strongly associated with psoriasis in different ethnic populations. This study was carried out to determine the association of HLA-C in psoriasis patients in a south Indian ethnic population.METHODSA total of 200 samples were included in the study. In all, 100 psoriasis patients and 100 healthy controls were studied. HLA-C typing was done by PCR-SSP method. Results were analysed statistically using open epi software (2 X 2 table). The Odds ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests applied and analysed.RESULTSA total of 14 different HLA-C alleles were identified in both 100 cases and 100 controls. Among the 14 different HLA-C alleles, the alleles which were found to be strongly associated with psoriasis which were statistically significant were both HLA-C*06 and HLA-C*07. HLA-C*06 was found to be present in 52% of the patients and HLA-C*07 was found to be present in 33% of the patients. HLA-C*06 was found to be strongly associated with the disease in 52% of the patients.CONCLUSIONSThis study confirms HLA-C*06 association with psoriasis which is in concordance with other previous studies.

A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital.

The aim of cancer treatment is to target and destroy cancer cells. Adversely it affects rapidly dividing cells of bone marrow, hair, nails, skin and gastrointestinal mucosa. Drug induced side effects are seen in 25% of hospitalized cancer patients resulting in a variety of cutaneous adverse effects. This study analyses the cutaneous manifestations in patients on cancer therapy at a tertiary care hospital.METHODSThis is a hospital based observational study, done over a period of 2 years (September 2016 - September 2018), on cancer patients undergoing chemo or radiotherapy having cutaneous manifestations, referred to the Dermatology OPD from Oncology OPD in a tertiary hospital.RESULTSAmong 106 cases, 47% were males and 53% were females. Majority of patients belonged to the age group of 41-60 years (40%). Carcinoma of breast (13%) and lung (9%) presented in highest frequency. Out of 59 patients who were treated with chemotherapy alone, most common was anagen effluvium (59%) and least common were ichthyosis, erythema multiforme and herpes zoster (each 2%). Among 5 patients who were treated with radiation therapy alone, most common was radiation dermatitis and seborrheic dermatitis (each 40 %). Among 18 patients who underwent combined chemo and radiotherapy, most common was anagen effluvium (39%) and least was folliculitis, lichenoid dermatitis (each 7%). Among 8 patients who underwent surgery followed by adjuvant chemotherapy, most common was anagen effluvium (40%) and least was surgical site infection, eczema, folliculitis (each 12%). Among 16 patients who underwent combined chemo, radiation and surgery, most common was anagen effluvium (25%) and least common was surgical site infection (6%). 14% fungal, 10% bacterial and 6% viral infections were noted. Among 101 patients who received at least 1 chemotherapeutic agent, most commonly used agent was cisplatin (50%) and least commonly used agent was gemcitabine (3%).CONCLUSIONSEarly identification of adverse effects might help us to give a better quality of life and reduce psychosomatic distress of the patients. It might also assist in tailoring the therapy accordingly.

Primary multicentric cutaneous epithelioid angiosarcoma.

Cutaneous epithelioid angiosarcoma is a rare malignant vascular tumor, most commonly affecting elderly men, and is usually located on the extremities. We report a case of an 81-year-old lady who presented with two ulcerated plaques over the right temporal and parietal scalp of 1 year duration. The right submaxillary and submandibular lymph nodes were enlarged and tender. Computed tomography (CT) scan of the head showed soft tissue swelling over parietal and temporal areas and there was no intracranial extension. Ultrasonogram of the abdomen showed hyperechoic areas in liver suggestive of secondaries. Histopathology of the skin lesion showed the dermis and subcutis composed of clusters of atypical epithelioid cells with vesicular nuclei, prominent nucleoli and eosinophilic cytoplasm with increased mitotic figures. Immunohistochemical staining revealed CD-31, 33, 34 and vimentin positivity, while cytokeratin was negative confirming the diagnosis of epitheloid angiosarcoma. This case report highlights the unusual occurrence of multicentric epitheloid angiosarcoma on the scalp with secondaries in the liver.