Nail fold dermoscopy in collagen vascular disorders: A cross-sectional study.

BACKGROUND: The collagen vascular disorders, particularly systemic sclerosis, dermatomyositis, systemic lupus erythematosus and mixed connective tissue disorder, are often characterized by microangiopathic abnormalities of the nail folds. Nail fold dermoscopy is a well-established technique to assess these vascular changes. AIMS: To evaluate finger nail capillary vascular abnormalities by dermoscopy and their correlation with cutaneous and systemic involvement in the patients of collagen vascular disorders. METHODS: This was a cross-sectional study involving patients of collagen vascular disorders presenting to Government Medical College, Amritsar over a period of 2 years. Nail fold dermoscopy was done in these patients and correlated with cutaneous and systemic involvement. Statistical analysis was done using SPSS 17.0 version. RESULTS: A total of 30 patients were enrolled in the study. Sixteen (53.3%), 11 (36.7%) and 3 (10%) patients of systemic sclerosis, systemic lupus erythematosus and mixed connective tissue disorder, respectively were included for nail fold dermoscopy. The commonest change recorded in our study was dilated capillaries in 21 (70%) patients, followed by capillary dropouts in 17 (56.7%) patients and avascular areas in 16 (53.3%) patients. Of 17 patients presenting with sclerodactyly, active, early and late patterns were seen in 7 (41.2%), 2 (11.8%) and 7 (41.2%) patients, respectively. Out of 13 patients with respiratory involvement, active, early and late patterns were seen in 1, 1 and 7 (53.8%) patients, respectively (P value = 0.004). LIMITATIONS: Owing to lesser number of patients in our study, it is difficult to draw conclusive recommendations, and more studies with a larger sample size are required. CONCLUSION: Dermoscopy is a valuable tool not only to diagnose collagen vascular disorders but also for prognostication by correlating with systemic involvement.

Psychiatric morbidity among inmates of leprosy homes.

CONTEXT: Leprosy affected people are having high psychological distress and it in turn leads to psychiatric disorders. There is a paucity of literature from our country in this significant health problem. AIMS: The aim of this study was to find the prevalence of psychiatric morbidity and its association with sociodemographic and clinical factors among the inmates of leprosy homes. SETTINGS AND DESIGN: Study sample was obtained from individuals residing in two leprosy homes of malwa belt of Punjab. MATERIALS AND METHODS: In screening stage, the study subjects were administered sociodemographic proforma and general health questionnaire (GHQ-12). In the confirmation stage, the study subjects were interviewed in detail and disability assessment was done using World Health Organization disability scale. Final psychiatric diagnosis was made as per ICD-10 criteria's. STATISTICAL ANALYSIS: Statistical analysis was performed using the descriptive statistics, Chi-square test, analysis of variance, and correlation analysis. RESULTS: Majority of the subjects was in the age group 41-50 years, female, married, illiterate, Hindu and were from nuclear families. Nearly, 50.38% of subjects were having GHQ-12 score more than twelve. Nearly, 55.6% subjects were having psychiatric disorders out of which a large number of patients was diagnosed as having dysthymia. The other psychiatric disorders found in the study population were moderate depressive episode, generalized anxiety disorder, mixed anxiety and depressive disorder and schizophrenia unspecified. Psychiatric morbidity was found to be significantly related to age, family status, and duration of leprosy illness and presence of deformities among inmates. CONCLUSIONS: This study highlighted that psychiatric disorders were found in a large number among inmates of leprosy homes. Leprosy eradication program must place specific emphasis on psychiatric care of these patients.

Congenital melanocytic nevus studded with strawberry haemangioma on the scalp.

A six-month-old male infant presented with congenital melanocytic nevus (CMN) studded with strawberry haemangioma on the right side of scalp since birth. Both lesions were gradually increasing up to the present size. The case is being reported for its rare occurrence.

Topical 20% KOH--an effective therapeutic modality for moluscum contagiosum in children.

Topically 20% KOH aqueous solution once daily at bedtime was applied in 27 children having molluscum contagiosum by their parents, till lesions showed signs of inflammation or superficial ulceration. 24 children (88.9%) completed the trial and complete clearance was achieved after a mean period of 17 days. No recurrence was observed during follow up period. Thus in this open trial topical 20% KOH aqueous solution has proved to be convenient, easy to apply at home, safe and inexpensive alternative therapeutic modality for the treatment of molluscum contagiosum in children.

Therapeutic efficacy of intralesional triamcinolone acetonide versus intralesional triamcinolone acetonide plus lincomycin in the treatment of nodulocystic acne.

BACKGROUND: Intralesional triamcinolone is an established therapy for cysts of acne. However, intralesional antibacterials have not been used earlier. AIM: To compare the efficacy of intralesional triamcinolone with that of a combination of intralesional lincomycin and intralesional triamcinolone in nodulocystic acne. MATERIAL AND METHODS: Ten patients of nodulocystic were injected with intralesional triamcinolone acetonide (2.5 mg/ml), while nine patients were given lincomycin hydrochloride (75 mg/ml) in addition to the intralesional triamcinolone. They were followed up 48 hrs, one week and one month later. RESULTS: At one week, 7 patients (70%) treated with injection triamcinolone showed 66% improvement, whereas all 9 (100%) patients treated with lincomycin and triamcinolone showed 100% improvement which was stable at one month. CONCLUSION: A combination of intralesional triamcinolone and lincomycin is superior to intralesional triamcinolone alone in the treatment of nodulocystic lesions of acne.

Pachyonychia congenita-like nail changes treated successfully with a combination of vitamins A and E: a case report.

A 20-year-old man presented with thickening, subungual hyperkeratosis and discoloration of all the nails of both hands and both great toes since birth. No other ectodermal abnormalities were found. Treatment with vitamins A and E in high doses along with a moisturizing ointment topically for one year resulted in complete resolution of all nail abnormalities.

Skin grafting in chronic leg ulcers--a dermatologist's domain.

A case of chronic leg ulcer for the last two years in a 50-year-old male, not responding to conventional therapeutic modalities had shown faster healing and excellent cosmetic results by undertaking split skin thickness grafting in the hands of a dermatologist.

A study of behavioural changes and clinical evaluation of leprosy in school going children of leprosy parents.

Seventy-seven school going children in age group 5-15 years having one or both parents affected with leprosy and staying away from their parents in charitable ashram cum school for the last 6 months to 6 years time were examined for any behavioural changes and signs and symptoms of leprosy. None of these children showed any behavioural changes or signs and symptoms of leprosy.

Tattooing with electrocauterization: a cosmetically acceptable therapeutic modality for a single halo naevus.

Two cases of single lesion halo naevus were treated with tattooing followed by electrocauterization resulting in good cosmetic acceptability. Tattooing with electrocauterization should be tried as a new therapeutic modality in a single lesion halo naevus especially on exposed parts of the body to avoid the unavoidable psychological trauma.

Chemical peeling--evaluation of glycolic acid in varying concentrations and time intervals.

Thirty-one patients with melasma, 4 with superficial post acne scarring and one each with xeroderma pigmentosum and epidermal naevus were studied to know the efficacy of glycolic acid for chemical peeling in varying concentrations and time intervals such as 35% (4 minutes), 52.5% (3 minutes), 70% (2 minutes) at varying intervals upto 6 months. These patients were in the age group of 17-44 years. These patients were followed up regularly. Results showed significant improvement when peeling was done with 52.5% glycolic acid for 3 minutes in melasma, 70% glycolic acid for 2 minutes in superficial post acne scarring.

Intraoral giant condyloma acuminatum.

A case of intraoral giant condyloma acuminatum is reported in a 50- year- old Indian. He did not respond to topical application of podophyllin 20% but responded partially to electric cauterisation. Surgical excision was done to get rid of the warty growth completely. Since there were no skin or genital lesions and no history of marital or extramarital sexual contact the lesion was probably acquired from environmental sources. Nonsexual transmission should be considered especially when the lesions are extragenital.

Parakeratosis Ostrcea-an Unusual Variant of Rupoid Psoriasis.

A 25 year old male developed hard, lamellar, oyster's shell-like scaly lesions accompaniedwith psoriatic arthropathy. Occurrence of parakeratosis ostracca is rare still rare and therto unreported.