Dermoscopy in the Diagnosis of Palmoplantar Eczema and Palmoplantar Psoriasis: A Cross-Sectional, Comparative Study from a Tertiary Care Centre in North India.

Introduction: Palmoplantar hyperkeratotic lesions pose a diagnostic difficulty when differentiating clinically between palmoplantar psoriasis (PPP) and palmoplantar eczema (PPE). Dermoscopy can provide valuable clues in reaching the final diagnosis. Objectives: To identify and compare dermoscopic findings seen in PPP and PPE. Methods: This was a cross-sectional, comparative study carried out prospectively between March 2019 and June 2020. All adult, consenting patients visiting the dermatology outpatient department who were clinically diagnosed and histopathologically confirmed as PPP and PPE were recruited into two groups. The dermoscopic examination was done, and images were taken from the representative area. The findings were analysed by two dermatologists who were unaware of the diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of these findings were assessed. Result: A total of 81 patients were recruited (39 patients of PPP and 42 patients of PPE). Significant findings seen in psoriatic plaques were the presence of regular vessels (84.6%, P < 0.001), with diffuse scales (87.2%) over a dull red/pink background (69.2%, P < 0.001). Dermoscopy of PPE displayed a significant presence of yellowish scales (76.2%, P < 0.001), with focal (61.9%) or absent vessels (35.7%), brown/orange-brown dots and/or globules (66.7%), yellow/yellow-orange crusts (57.1%) over a yellow/yellow-brown background (88.1%). Conclusion: Distribution of vessels, distribution of scales and the colour of scales, presence of brown/orange-brown dots and/or globules, yellow/yellow-orange crust and background colour (dull red vs. yellow/yellow-brown) of the plaques can be useful clues in the diagnosis of PPP and PPE.

Methotrexate Toxicity: A Case Series from a Tertiary Care Center in Northern India.

Methotrexate is widely prescribed by various specialists, including internists, dermatologists, rheumatologists, orthopedics, and oncologists. The clinical features of acute methotrexate toxicity vary and are influenced by the acute cumulative dose, duration of methotrexate, associated risk factors, comorbidities, and drug interactions. We present a series of six patients with acute methotrexate toxicity. The characteristics of their clinical presentation, diagnoses, and risk factors are highlighted. All patients were given intravenous leucovorin and other supportive treatments. This series highlights the importance of thorough counseling for patients regarding the course of disease for which methotrexate is prescribed and the dosing, schedule, and adverse effects that are associated with methotrexate. Physician awareness, diagnosis, and treatment are crucial for mitigating the complications of methotrexate toxicity. (SKINmed. 2022;20:274-281).

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.

Skin diseases in geriatrics and their effect on the quality of life: A hospital-based observational study.

BACKGROUND: World's population is aging at a very fast pace with 8.5% of current population being aged 65 years and above. Indian figures also reflect the exponential growth in number of older people. With advancing age a myriad of health-related problems arise. Due importance is given to diseases associated with high mortality such as malignancies, diabetes, and cardiovascular illness. However, skin diseases though being prevalent lack priority. This study is being conducted to identify the common geriatric dermatoses prevalent in sub-Himalayan region of Uttarakhand and also to assess their effect on the quality of life. AIMS: The aims of this study are to study the pattern and frequency of dermatoses in patients aged 60 years and above and to assess the effect of dermatoses on their quality of life. METHODS: In total, 117 patients aged 60 years and above presenting to Dermatology outpatient department were recruited from 1st August 2018 to 31st October 2018 after obtaining written informed consent. Socio-demographic details, presence of co-morbidities, and dermatological complaints were recorded on a data collection form. Skin diseases were categorized into seven categories for statistical analysis. For assessing the effect of dermatoses on the quality of life of participants, Dermatology Life Quality Index was administered. RESULTS: Out of 117 patients, two-thirds were males. Mean age of patients was 68.60 ± 7.011. Out of total, 40% patients had one or more comorbidity. Erythemato-squamous disorders were the commonest dermatoses seen in 40% patients. This was followed by infections and infestations (33.3%). In total, 17% patients had senile pruritus and age-related skin disorders. Around 16% reported moderate to large effect on their quality of life. CONCLUSION: Skin diseases are an important cause of psycho-social morbidity among geriatric population. Their special needs must be addressed by making appropriate changes in national health policies. It is imperative to include skin health as a component to assess the overall wellbeing of geriatrics.

Skin Disorders Among Geriatric Population at a Tertiary Care Center in Uttarakhand.

INTRODUCTION: Ageing results in decline of normal functioning in all organ systems including skin. This predisposes the elderly persons to develop various skin ailments. A thorough knowledge of different diseases prevalent in this population in different geographic regions help the health care providers in better health care policy making. AIM: This study was planned to know the common dermatological diseases prevalent in Uttarakhand region of India. MATERIALS AND METHODS: Hospital out patients records maintained in Department of Dermatology, Venereology & Leprosy were analysed and information regarding age, sex and diagnosis of patients were recorded. Descriptive statistics for prevalence of skin diseases in patients presenting to hospital were calculated. RESULTS: Out of the total 29,422 patients seen in dermatology department from August 2012 to 2014, 4.7% (1,380) were aged 60 years and above. Male to female ratio was 2:1. Erythemato-squamous disorders taken collectively constituted the major skin disorder seen in 38.9% patients. This was followed by infections and infestations (29.9%), senile pruritus (9.0%) and age related skin changes (3.7%). Benign neoplasms were seen in 1.1% patients followed by cutaneous malignancies in 0.8% and precancerous lesions in 0.4%. Fungal infections were the most common infections seen in 18% patients. CONCLUSION: This study strengthens the opinion that infections, senile pruritus and eczema-dermatitis are the major dermatological disorders in elderly population.

Oral dermatological conditions: a clinical study.

Oral cavity consists of a small vestibule and a larger oral cavity proper. A wide number of dermatological conditions can affect the oral cavity. The clinical characteristics of the same were studied in patients attending departments of Dermatology/ENT Himalayan Institute of Medical Sciences, Dehradun. To delineate and identify the various patterns of oral dermatological conditions in this part of the country. One hundred and fifty patients were included in the study having oral lesions irrespective of age, sex and duration. Clinical examination including cutaneous examination and simple investigations like routine blood, urine, stool, blood sugar, KOH mount and scraping, Tzanck test, and on certain cases biopsy were carried out. Out of 11,840 patients attending Dermatology/ENT OPD, HIMS, Dehradun from April 2008 to March 2009, 150 patients were having various disorders with oral manifestations. The incidence of oral cavity dermatoses in this study was 1.26%, male to female ratio was 2:3. (Out of 150 patients, 60 were males and 90 were females). Aphthous ulcer (28.57%) and pemphigus vulgaris (26.60%) formed the major bulk of patients followed by SLE (17.02%), oral candidiasis (16.07%), DLE (13.83%), lichen planus (12.77%) and others.