Psychosocial burden of lichen planus pigmentosus is similar to vitiligo, but greater than melasma: A cross-sectional study from a tertiary-care center in north India.

BACKGROUND: Lichen planus pigmentosus can have a negative impact on the quality of life; however, this has not been studied in detail. OBJECTIVES: To study the quality of life in patients with lichen planus pigmentosus and compare it with patients with vitiligo and melasma. METHODS: This was a cross-sectional study conducted in a tertiary-care center in north India from January 2018 to May 2019. Patients ≥ 18 years of age with lichen planus pigmentosus (n = 125), vitiligo (n = 113) and melasma (n = 121) completed the Dermatology Life Quality Index (DLQI) questionnaire and answered a global question on the effect of disease on their lives. In addition, patients with vitiligo completed the Vitiligo Impact Scale (VIS)-22 questionnaire, while those with lichen planus pigmentosus and melasma filled a modified version of VIS-22. RESULTS: The mean DLQI scores in patients with lichen planus pigmentosus, vitiligo and melasma were 10.9 ± 5.95, 9.73 ± 6.51 and 8.39 ± 5.92, respectively, the difference being statistically significant only between lichen planus pigmentosus and melasma (P < 0.001). The corresponding mean modified VIS-22/VIS-22 scores were 26.82 ± 11.89, 25.82 ± 14.03 and 18.87 ± 11.84, respectively. This difference was statistically significant between lichen planus pigmentosus and melasma, and between vitiligo and melasma (P < 0.001 for both). As compared to vitiligo, patients with lichen planus pigmentosus had a significantly greater impact on "symptoms and feelings" domain (P < 0.001) on DLQI, and on "social interactions" (P = 0.02) and "depression" (P = 0.04) domains on VIS-22. As compared to melasma, patients with lichen planus pigmentosus had significantly higher scores for "symptoms and feelings," "daily activities," "leisure" and "work and school" domains of DLQI, and all domains of VIS-22. Female gender was more associated with impairment in quality of life in patients with lichen planus pigmentosus, while lower education, marriage, younger age and increasing disease duration showed a directional trend. LIMITATIONS: Use of DLQI and modified version of VIS-22 scales in the absence of a pigmentary disease-specific quality-of-life instrument. CONCLUSION: Patients with lichen planus pigmentosus have a significantly impaired quality of life. The psychosocial burden of lichen planus pigmentosus is quantitatively similar to that of vitiligo, but significantly greater than melasma.

Baixo conhecimento de doadores de sangue sobre a hanseníase como fator de vulnerabilidade para a disseminação da doença / Low knowledge of blood donors about leprosy as a vulnerability factor for the spread of the disease

Objetivo: caracterizar o doador de sangue e seu conhecimento sobre a hanseníase, visando contribuir para identificar pontos de vulnerabilidade sobre a doença. Metodologia: foram entrevistados doadores de sangue (n=199) através de um questionário estruturado abordando características socioeconômicas e o conhecimento sobre a hanseníase. Para a análise dos dados foi utilizado o método de Goodman e considerado significativo p<0,05. Resultados: dentre as perguntas sobre a hanseníase, a maioria dos participantes (65,83%) não tinha conhecimento da doença e nem o seu modo de transmissão (75,88%) e quando computado o conhecimento da Hanseníase, 1,51% conheciam, 39,70% conheciam pouco e 58,79% não conheciam a doença. Nossos resultados demonstraram que somente a escolaridade teve associação significativa com a falta de conhecimento sobre a hanseníase (p=0,0273). Conclusão: verificou-se déficit de conhecimento da população geral quanto à hanseníase. Sugerimos um aprimoramento da divulgação das informações quanto à doença a fim de promover melhoras nos serviços de saúde, acompanhamento dos doentes e prevenção da população saudável.

Objective: to characterize the blood donor and his knowledge about leprosy, aiming to contribute to identify vulnerability points about the disease. Methodology: blood donors (n=199) were interviewed through a structured questionnaire addressing socioeconomic characteristics and knowledge about leprosy. For the data analysis, the Goodman method was used and considered significant p<0.05. Results: Among the questions about leprosy, most participants (65.83%) did not know about the disease and its mode of transmission (75.88%) and when computing the knowledge of leprosy, 1.51% knew, 39,70% knew little and 58.79% did not know the disease. Our results showed that only schooling had a significant association with the lack of knowledge about leprosy (p=0,0273). Conclusion: there was a lack of knowledge of the general population regarding leprosy. We suggest an improved dissemination of information about the disease to promote improvements in health services, patient monitoring and prevention of the healthy population.

Psychiatric morbidity among leprosy patients in Teso and Busia districts of Western Kenya.

OBJECTIVE: To establish the magnitude of psychiatric disorders among leprosy patients in western Kenya. DESIGN: A cross-sectional descriptive study. SETTING: Busia and Teso districts in western Kenya. SUBJECTS: A sample of 152 male and female, adult leprosy patients. RESULTS: The prevalence of psychiatric morbidity (PM) was 53.29%. The PM was positively correlated with physical disability and marital status but not with age, sex, education, type of leprosy, or duration of the illness. The prevalence of psychiatric morbidity was lower among Kenyan leprosy patients compared to studies carried out in India (56% to 78%). It was high compared to the rate of psychiatric morbidity in those seeking medical help in primary health care centres in Kenya, which was recently estimated to be 10%. CONCLUSION: The prevalence of PM in leprosy patients in western Kenya was lower than that in studies carried out in India. This could be attributed to de-institutionalisation and re-integration of leprosy sufferers back into their local communities. Since the rate was more than double that in the general Kenyan population and seemed to be related to presence of physical disability, an appraisal of psychiatric services offered to these patients is needed.

A retrospective study of the pattern of sexually transmitted diseases during a ten-year period.

BACKGROUND: Proper knowledge of the patterns of sexually transmitted diseases (STDs) in different geographical regions is necessary for evolving proper strategies for control of these diseases. AIMS: To study the pattern of STDs and to analyze the changes during a ten-year period from 1990 among patients attending Medical College Hospital, Kottayam. METHODS: Case records of 686 patients with STDs who attended the outpatient wing of the Department of Dermatology and Venereology were studied. RESULTS: There were 504 males and 182 females in the total of 686 patients. Marital contact alone was reported by 123 (67.6%) female patients. Genital ulcer diseases (GUDs) accounted for the maximum number of STDs, with 504 cases (73.5%), followed by condyloma acuminatum (17.5%) and gonorrhea (10.1%). Forty-three patients had multiple infections. The total number of patients during the first year of study was 129, while it was 41 during the last year. Bacterial STDs showed a striking reduction in numbers. The decline was less marked in the case of viral STDs. CONCLUSION: The majority of patients had genital ulcer diseases. Spouses were the most common source of infection for female patients. There was a marked decline in the number of patients with various STDs during the ten-year period. The decline was more evident in the bacterial STDs resulting in an apparent increase of the viral STDs towards the end of the period of study.

Some risk factors for the progression of periodontal disease.

Inflammatory periodontal disease is one of the most common diseases of mankind. Gingival inflammation is widespread, but advanced periodontitis is limited to relatively small subgroups of the population. Gingivitis is initiated by microbial plaque deposits on the dento-gingival interface but progression to periodontitis is modified by several environmental, behavioural, biological and health care variables. This paper reviews the reports dealing with some risk factors for periodontal disease published in recent years and compares the data with findings in a Ljubljana population. It is concluded that male smokers with lower education and low frequency of tooth brushing represent a risk population for progression of periodontal disease. Marital status and body mass need further study to be proved as risk factors for periodontitis. A socioecological model proposed by Hansen et al. (1993) should be used for understanding the interplay of different risk factors for progression of periodontal disease.

Market work, wages, and men's health.

In this paper, we investigate the complex interrelations among work-time, wages, and health identified in the Grossman model of the demand for health. Hansen's generalized method of moments techniques are employed to estimate a 3-equation simultaneous model designed to capture the time dependent character of these interrelationships. We then estimate simpler models with more restrictive assumptions commonly found in the literature and find substantial differences between these estimates and those from our simultaneous model. For example, the positive relationship between work-time and health found in other studies disappears when the relevant simultaneities are taken into account.