Development and validation of a Hindi language health-related quality of life questionnaire for melasma in Indian patients.

BACKGROUND: Melasma, which is fairly common in Indians, causes significant emotional and psychological impact. A Hindi instrument would be useful to assess the impact of melasma on the quality of life in Indian patients. OBJECTIVE: To create a semantic equivalent of the original MELASQOL questionnaire in Hindi and validate it. METHODS: A Hindi adaptation of the original MELASQOL (Hi-MELASQOL) was prepared using previously established guidelines. After pre-testing, the Hi-MELASQOL questionnaire was administered to 100 women with melasma visiting the out-patient registration counter of Safdarjung Hospital, Delhi. These women were also administered a Hindi equivalent of the Health Related Quality of Life (HRQOL) questionnaire. Melasma area severity index (MASI) of all the participants was calculated. RESULTS: The mean MASI score was 20.0 ± 7.5 and Hi-MELASQOL score was 37.19 ± 18.15; both were highly, positively and significantly correlated. Reliability analysis showed satisfactory results. Physical health, emotional well-being and social life were the most adversely affected life domains. LIMITATIONS: It was a single-center study and the number of patients studied could have been larger. CONCLUSION: Hi-MELASQOL is a reliable and validated tool to measure the quality of life in Indians with melasma.

Great auricular nerve involvement in leprosy: scope for misdiagnosis.

Three patients with neuritis of the great auricular nerve (GAN) have been reported. Two patients seen by physicians and an otolaryngologist had prominent and tender cord along the neck with facial edema and history of fainting attack in one, and erythema and hyperaesthesia of the ear in the other simulating vascular occlusion, which were confirmed to be leprosy in Type 1 reaction by the dermatologist. In the third, cold abscess in the nerve that had persisted after anti-leprosy treatment was mistaken as tuberculous cervical lymphadenitis by a surgeon since aspiration had revealed acid-fast bacilli. The probable reasons for misdiagnosis include rarity of involvement of the GAN and its proximity to main blood vessels, and the need for careful interpretation of laboratory results.

Hypoacusis in vitiligo.

BACKGROUND: Vitiligo affects melanocytes in the skin. Since melanocytes are present in other organs as well, it is plausible that they may be similarly affected. METHODS: A comparative study of audiological functions was carried out in 180 patients of vitiligo and 60 non-vitiligo controls in the age group of 5-40 years. RESULTS: In vitiligo patients sensorineural hypoacusis of mild degree was found in 18, moderate in 13 and mild conductive hypoacusis in 3. In controls sensorineural hypoacusis of mild degree was found in only 2 cases. CONCLUSION: The difference between the two groups was statistically significant. Vitiligo patients have a higher prevalence of sensorineural hypoacusis.

Multiple eccrine hidrocystomas: report of two cases treated unsuccessfully with atropine ointment.

Eccrine hidrocystomas are rare, benign, cystic lesions with a lining that resembles that of the eccrine sweat gland and may be solitary or multiple. Multiple eccrine hidrocystomas occur predominantly on the face as asymptomatic, skin-colored to bluish lesions associated with a chronic course and seasonal variability. Treatment of multiple lesions on the face is challenging. Efficacy with atropine ointment is variable. Botulinum toxin and pulsed dye laser are reported to be beneficial. Two cases of multiple eccrine hidrocystomas are reported who showed no response to 1% atropine ointment.

Histoid leprosy with ENL reaction.

A 23-year old man presented with firm cutaneous and subcutaneous nodules of histoid leprosy. Some of the nodules suppurated after multidrug therapy (MDT) and these nodules showed features of erythema nodosum leprosum (ENL) on histopathological examination. ENL is a rare phenomenon observed in histoid leprosy.

Abdominal hernia following abdominal herpes zoster.

We report a case of abdominal hernia in TIO and 11 segments following herpes zoster at T11 segment.

Epidemic dropsy: a study of cutaneous manifestations with histopathological correlation.

Clinical and histopathological features of epidemic dropsy were studied in 19 patients. Bilateral pitting pedal oedema, erythrocyanosis and tachycardia without fever were the predominant clinical features. Histology revealed deposition of hyaline material on the walls of dermal blood vessels.

Progressive reticulate zosteriform hyperpigmentation.

A 24-year-old healthy Bengali woman presented with progressive, macular tanned lesions in a zosteriform pattern located upon her right upper limb, breast and chest. The biopsy from the tanned lesion showed mild increase in the pigment in the basal layer.

Mucocutaneous disorders in Hiv positive patients.

Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs) was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9%) was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25%) and seborrhoeic dermatitis (21.4%). There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

Comparison of topical tretinoin and betamethasone in oral lichen planus.

Thirty-one patients of oral lichen planus were enrolled in this study and two groups were made. Group 1 consisting of 16 patients who applied topical tretinoin 0.05% and Group 2 comprising of 15 patients who were given topical betamethasone dipropionate 0.05%. The patients applying tretinoin showed statistically significant improvement as compared to patients applying betamethasone.

Disseminated cutaneous herpes zoster: A clinical predictor of human immunodeficiency virus infection.

A 45-year-old woman presented with thoracic (3,4,5) herpes zoster with cutaneous dissemination. She was found positive for human immunodeficiency virus infection. Mucocutaneous examination revealed presence of oral thrush and oral hairy leukoplakia. The patient possibly acquired the infection through blood transfusion.

Papuloerythroderma of ofuji.

A 62-year old female had intensely pruritic eruption consisting of widespread coalescing sheets of uniform erythematous papules with characterstic sparing of body folds (deck-chair sign). Papuloerhthroderma of Ofuji is a rare disease of unknown aetiology.

Oral leucoplakia.

Oral leucoplakia was predominantly seen in elderly age group. Addiction to tobacco was observed in majority of patients (80.8%). Clinically commonest site of involvement was buccal mucosa (67.33%), followed by labial mucosa (13.86%). Majority of patients (57.35%) were having homogenous type of leucoplakia, followed by verrucous variety (25%). 26-48% cases were also having oral submucous fibrosis. Histologically various combinations of hyperkeratosis, hyperorthokeratosis and acanthosis were observed in 77.93% of cases. Dysplastic lesions were reported in 17.65% cases. In 80% of dysplastic lesions, band like infiltrate of mononuclear cells in subepithelial zone was seen. Malignant transformation was noticed in 2.94% cases. Excellent therapeutic results were obtained by cryosurgery. In resistant cases good results were observed with high dosage of vitamin A.

Porokeratosis of mibelli in a family.

The occurrence of porokeratosis of Mibelli in all members of a family when only one parent (mother) had the disease is reported. The 17 members of the third generation are still under 17 years of age and have not revealed any lesions of porokeratosis.

Topical Human Placental Extract For the Treatment of Vitiligo.

Fifty percent human placental hydroalcoholic extract was used topically on 34 vitiligo patients. Complete clearing of lesions was seen in 20.6% cases, whereas 50% cases showed mild to moderate improvement, and 29.4% showed no response. No serious side effects were seen in any of the patients.

Type 1 (reversal) lepra reaction in borderline leprosy with unusual clinical presentation--a case report.

A male 26 years old patient with BB type of leprosy was encountered with a typical clinical presentations of up-grading (reversal) Type 1 Lepra Reaction. These included sudden appearance of tender, erythematous nodular eruptions mimicking ENL, severe constitutional symptoms like high grade fever, malaise, vomiting, epistaxis, joint pain and tenosynovitis simulating Type 2 Lepra Reaction. To the best of our knowledge, this may be the first such case in our hand.

Matting of the Hair Due to Onic Detergent.

A 27 year old developed matting of her hair after using 5% cetrimide lotion for dandruff.

Multifocal Pilomatricoma.

A 10 year old,male child developed four tumours of multifocal pilomatricoma.