Nutritional Status of Patients With Leprosy Attending a Tertiary Care Institute in North India.

Introduction Leprosy is a chronic, infectious disease resulting in significant physical and social morbidity. This study aims to assess the nutritional status of patients with leprosy. Methods Treatment-naïve leprosy cases seen over two years at a tertiary care center were recruited in this prospective observational study. Demographic details, type of leprosy, and presence of reactions and disabilities were recorded. Nutritional assessment was done by calculating the body mass index (BMI) and measuring the hemoglobin, serum iron, serum albumin, and serum cholesterol. Results Fifty patients were recruited with a mean age of 40.5 (15.3) years. Most patients (60%) had a normal BMI of 18.5-24.9, and 14% were underweight. Two-thirds of the patients had low hemoglobin, with 18 (36%) having low serum iron. A statistically significant association was observed between low serum iron and the multibacillary form of leprosy. Conclusion A nutritional assessment should be included in the initial evaluation of leprosy.

Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study.

BACKGROUND: Topical corticosteroid (TCS) abuse is rampant and results in steroid addiction labeled as topical steroid-dependent or damaged face (TSDF). Indian market is replete with triple combination creams containing TCS sold as over-the-counter products at low cost, luring people to use them without prescription. The resultant damage if detected late is irreversible and difficult to treat. Dermoscopy can help in the early identification of features of TSDF at a preclinical stage resulting in better prognosis. However, the literature on the same is limited. AIMS: This study is undertaken to characterize dermoscopic features of TSDF and to correlate them with potency and duration of application of the TCS. METHODS: One hundred and thirty-two patients aged 18 years or above, with clinical symptoms and signs suggestive of TSDF and with history of application of TCS on the face for a period of more than one month, were enrolled in the study. Their demographic details, clinical features, and dermoscopy findings were recorded using a predesigned structured format. Comparison of dermoscopic findings with clinical examination, gender, potency of TCS, and duration of TCS use was done using Chi-square test, Fisher's exact test, and one-tailed Z-test. RESULTS: Mean age of the patients was 31.7 ± 8.1 years. Male to female ratio was 2:9. Sixty-nine (52.3%) patients abused TCS for more than one year. Clinical findings noted in the patients were erythema (81.1%), hyperpigmentation (80.3%), and hypertrichosis (68.2%). The most common dermoscopy findings seen were brown globules (96.2%), red diffuse areas (92.4%), vessels (87.1%), white structureless areas (86.4%), and hypertrichosis (80.3%). Red diffuse areas, vessels, brown globules, white structureless areas, and white hair were observed in a statistically higher proportion of cases dermoscopically. Y-shaped vessels and brown globules were seen in significantly higher number of patients, using TCS for more than three months and in those continuing it beyond six months, polygonal vessels were predominant. LIMITATIONS: Lack of histopathological correlation is the limitation of our study. Furthermore, brown globules seen in 96.2% patients of TSDF on dermoscopy may have been over-estimated and not always signify TSDF; instead, it could represent melasma for which patient applied TCS. CONCLUSION: Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.