RESUMEN
BACKGROUND: Abuse of topical corticosteroids (TC), especially over the face, is prevalent worldwide, including in India. Data about the magnitude of this problem in our country is lacking. AIMS: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face in the dermatology outpatient department (OPD) attendees in order to raise awareness about this problem and to analyze its causes. METHODS: This was a prospective multicenter questionnaire-based clinical study conducted at 12 dermatology centers nationwide. Patients with relevant facial dermatoses reporting to the investigator were asked about their current use of over-the-counter topical formulations and a structured questionnaire applied in case the same was confirmed to be TC. RESULTS: A total of 2926 patients with facial dermatoses were screened, of which 433 (14.8%) were using TC. TC was used as a fairness/general purpose cream or aftershave in 126 (29%) and in 104 (24%) for acne. Steroid combinations were used by 258 (59.6%). Potent and super-potent TC were significantly (P = 0.05) more frequently used by the rural/suburban population. The younger age groups used more potent formulations. A non-physician recommendation for TC use was obtainable in 257 (59.3%) patients. Of these, 232 (90.3%) were for potent/super-potent steroids. Among 176 physician prescriptions, 78 (44.3%) were from non-dermatologists. All non-physician prescriptions and 146 (83%) physician prescriptions for TC were inappropriately refilled. Adverse effects were seen in 392 (90.5%) TC users. Acne/exacerbation of acne was the most common adverse effect. CONCLUSIONS: TC misuse in patients with facial dermatoses is quite common, and most of this use is unwarranted. Use as a fairness cream is the most common indication in this cohort. LIMITATIONS: This was an OPD-based study and, therefore, it may or may not accurately reflect the community data.
Asunto(s)
Corticoesteroides/efectos adversos , Atención Ambulatoria/métodos , Cara , Dermatosis Facial/inducido químicamente , Medicamentos sin Prescripción/efectos adversos , Administración Tópica , Adolescente , Corticoesteroides/uso terapéutico , Adulto , Anciano , Niño , Preescolar , Estudios de Cohortes , Dermatosis Facial/diagnóstico , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Medicamentos sin Prescripción/uso terapéutico , Pacientes Ambulatorios , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto JovenAsunto(s)
Acné Vulgar , Acné Vulgar/diagnóstico , Acné Vulgar/epidemiología , Acné Vulgar/genética , Acné Vulgar/terapia , Algoritmos , Antibacterianos/uso terapéutico , Terapia Combinada , Cosméticos , Hormonas/uso terapéutico , Humanos , India/epidemiología , Calidad de Vida , Retinoides/uso terapéutico , Procedimientos Quirúrgicos OperativosRESUMEN
BACKGROUND: To date, periorbital melanosis is an ill-defined entity. The condition has been stated to be darkening of the skin around the eyes, dark circles, infraorbital darkening and so on. AIMS: This study was aimed at exploring the nature of pigmentation in periorbital melanosis. METHODS: One hundred consecutive patients of periorbital melanosis were examined and investigated to define periorbital melanosis. Extent of periorbital melanosis was determined by clinical examination. Wood's lamp examination was performed in all the patients to determine the depth of pigmentation. A 2-mm punch biopsy was carried out in 17 of 100 patients. RESULTS: In 92 (92%) patients periorbital melanosis was an extension of pigmentary demarcation line over the face (PDL-F). CONCLUSION: Periorbital melanosis and pigmentary demarcation line of the face are not two different conditions; rather they are two different manifestations of the same disease.
Asunto(s)
Dermatosis Facial/patología , Melanosis/patología , Pigmentación de la Piel , Adulto , Preescolar , Dermatosis Facial/diagnóstico , Femenino , Humanos , Masculino , Melanosis/diagnóstico , Embarazo , Complicaciones del Embarazo/patología , Factores Sexuales , Piel/patologíaAsunto(s)
Amiodarona/efectos adversos , Angioedema/inducido químicamente , Antiarrítmicos/efectos adversos , Fibrilación Atrial/tratamiento farmacológico , Anciano , Amiodarona/uso terapéutico , Angioedema/fisiopatología , Antiarrítmicos/uso terapéutico , Fibrilación Atrial/diagnóstico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Humanos , Medición de RiesgoRESUMEN
Proteus syndrome is a complex developmental abnormality. It is characterized by both hypertrophic and hypoplastic changes. Deformities have been occasionally found to be localized in one half of the body in head or digit but presence of all signs in one half of the body in a wide spread manner is not reported in the literature. We report the case for its unusual presentation of unilateral localization of signs.
Asunto(s)
Síndrome de Proteo/diagnóstico , Síndrome de Proteo/patología , Adulto , Diagnóstico Diferencial , Femenino , HumanosAsunto(s)
Hipopigmentación/patología , Adolescente , Femenino , Pie , Mano , Humanos , Hipopigmentación/clasificaciónRESUMEN
BACKGROUND: Punch grafting followed by PUVA/PUVASOL is an established mode of therapy in vitiligo including that on the lips. AIMS: To assess the efficacy of NB-UVB along with regrafting in patients in whom punch grafting had failed to evoke any response. METHODS: Five patients with stable and isolated lip vitiligo in whom punch grafting and PUVA had failed to produce pigmentation were treated by regrafting and subsequent NB-UVB (311 nm) phototherapy. RESULTS: Complete repigmentation was observed in three of the five cases after 16 weeks. In the remaining two, the results were mixed. CONCLUSIONS: Stable lip vitiligo usually responds very well to punch grafting and PUVA/PUVASOL. In patients who fail to respond to this treatment, complete repigmentation following regrafting and NB-UVB is an observation that needs to be explained.