A retrospective analysis of dermatoses in the perimenopausal population attending a tertiary care centre in South India.

INTRODUCTION: Menopausal is a normal physiologic aging process in women characterized by decreasing estrogen levels. The skin is an organ dependant on hormones, estrogen being the most important in case of females, thereby influencing both the biology of skin and composition. Studies show that the systemic effects of estrogen deprivation occur years after attaining menopausal, however cutaneous features have been noticed earlier. The purpose of this study is to evaluate the common disorders occurring in perimenopausal women of Indian ethnicity. MATERIALS AND METHODS: A retrospective observational study of outpatient records from Dermatology clinic between 2005 and 2012. All female patients between 45-55 years of age from an outpatient register that outlines the final diagnosis made by a qualified dermatologist after investigations. The data was entered according to the pattern of dermatoses and their seasonal variation and analyzed were included. RESULTS: A total of 8,156 cases were found. After analysis of the many variables, the most common dermatoses in the perimenopausal population were eczematous disorders (23.6%), followed by urticaria (12.4%) and papulosquamous disorders (10.7%). Of the eczematous disorders, allergic and photosensitive disorders were found to be more frequent. CONCLUSION: The leading dermatoses being eczema and urticaria in the perimenopausal population probably accounts for a tendency of exaggerated response to external factors. The population studied in the current study might be of significance due to complete lack of treatment in the form of hormone replacement therapy (HRT), while routine sun exposure and cultural practices predominate. However, evaluation with respect to individual factors is beyond the scope of the current study and may be necessary to define a causal relationship.

Acquired zinc deficiency in an adult female.

Acrodermatitis enteropathica is an autosomal recessive inherited disorder of zinc absorption. Acquired cases are reported occasionally in patients with eating disorders or Crohn's disease. We report a 24-year-old housewife with acquired isolated severe zinc deficiency with no other comorbidities to highlight the rare occurrence of isolated nutritional zinc deficiency in an otherwise normal patient.

Atypical forms of lupus vulgaris - a case series.

Atypical presentations of cutaneous tuberculosis are not so uncommon and are frequently overlooked in clinical practice, leading to late diagnosis and increased morbidity. We report three cases of lupus vulgaris with atypical presentations. The cases mimicked other chronic skin lesions like actinomycosis, mycetoma, and so on. Strong clinical suspicion, histopathology, and response to antituberculous treatment led to the diagnosis and all three had excellent response to treatment. Today, when tuberculosis threatens to burst into pandemics again, early diagnosis and treatment are more important than ever for control and prevention of morbidity.