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Introduction: The pathogenesis in systemic sclerosis (SSc) mainly involves vascular injury, fibrosis, and immune activation. Visualization of these microvascular changes by nailfold capillaroscopy (NFC) can help in the early diagnosis of the disease. Even though the gold standard for NFC is a videodermoscope, the ease, practicality, and accessibility make the hand-held dermoscope a more versatile and suitable device in the hands of the dermatologists in the busy outpatient department. Aim: To study the pattern of nail fold capillaries using hand-held dermoscope in the patients of SSc and correlate the findings with disease severity. Materials and Methods: An observational, cross-sectional hospital-based study was carried out over a span of 2 years, from January 2020 till December 2021, in 50 patients of SSc. NFC using DermLite DL4 was performed in all the patients and distribution, morphology, density of capillaries, and nail fold capillary pattern were observed. Results: Out of 50 patients, 38 patients had diffuse type of disease, and 12 had limited type of disease. The mean capillary density in our patients was 4.7 ± 0.81/mm. Dilated capillaries was the most common NFC finding (80%), whereas active scleroderma pattern was the most common pattern (56%). A significant association was found between the type of capillary pattern and duration of disease, type of disease, and cutaneous manifestations. Conclusion: Hand-held dermoscope is reliable, practical, and assessable tool that aids in early diagnosis of the disease and also helps in assessing the severity and prognosis of SSc.
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Dermoscopy refers to evaluation of the skin surface using surface microscopy. It is mainly used for the diagnosis of skin disorders. We report two cases in which dermoscopy played a role in treatment. Our first case was a 40-year-old female with history of insect bite. We evaluated the patient using a dermoscope and removed the tick with mouth part embedded in dermis using forceps ensuring full removal after procedure. The second case was a 35-year-old female who presented with a non-healing ulcer over lower back, following excision of epidermoid cyst. Dermoscopy showed the presence of a thread which was removed and repeat dermoscopy following extraction ensured its full removal.
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Introduction: Skin disorders represent a major proportion of occupational disorders. Dermatoses are becoming a source of concern in various population groups. In Kashmir valley, a large number of people are associated directly or indirectly with horticulture. Fruit cultivation is the main occupation of around 33 lakh people in the Union Territory. Aim: To study the profile of dermatological disorders in workers involved in fruit growing industry of Kashmir valley. Materials and Methods: This study was a cross-sectional observational study, carried out over a period of 2 years, in which 701 workers of fruit growing industry of Kashmir valley were screened. Results: 276 (39.37%) of these workers were found to have skin lesions while the rest, that is, 425 (60.63%) were not found to have any dermatoses. Out of the total dermatological lesions observed, occupational dermatoses contributed to 94 cases (34.05%), while non-occupational dermatoses accounted for 182 cases (65.94%). Among the occupational dermatoses, friction-related disorders (callosities and cuts) were predominant (15.9%) followed by allergic (12%) and irritant contact dermatitis (6.2%). Out of the non-occupational dermatoses group, the major portion was comprised by polymorphic light eruption (6.2%) in non-infectious type while in infectious type, onychomycoses predominated (3.3%). Conclusion: Dermatological conditions form a major group of occupational dermatoses among workers involved in fruit cultivation.
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Background: Systemic sclerosis is a multisystem auto-inflammatory disease-causing fibrosis in the skin and internal organs. A frequent complication of systemic sclerosis is the limited mouth opening (LMO), a difficult-to-treat condition with only a few treatment options available. Aims and Objectives: The aim of this study was to evaluate the response of fractional carbon dioxide (CO2) laser resurfacing in LMO associated with systemic sclerosis. Materials and Methods: This was a hospital-based prospective study in which diagnosed cases of systemic sclerosis were taken. Patients who had significant LMO and who gave informed consent were included in the study. Fractional CO2 laser treatment was performed in the perioral area. Patients were assessed at baseline, after three and six sessions, and 3 months after the last session. Assessment was done by measurement of the interincisor distance (IID) using a ruler and calculation of the mouth handicap in systemic sclerosis (MHISS) scale. Results: Improvement in IID occurred 3 months after the first session with a mean gain of +5 mm (range 2-7). At 6 months, a mean gain of +8.5 mm (range 7-10) in IID was observed (P < 0.001). The MHISS score decreased by a mean of 14 (range 11-17) (P < 0.001). All patients showed improvement of mouth opening, which allowed the patients to have better phonation and the patients were able to have proper dental care posttreatment in the form of brushing of teeth and other dental procedures. The adverse effects noted in these patients included erythema that resolved spontaneously or after icing posttreatment. Other adverse effects noted were stinging and burning sensations that were mild and transient. Conclusion: Fractional CO2 laser forms a safe, effective, and well-tolerated treatment modality for improvement of LMO in systemic sclerosis. Limitations: The limitations of this study were less number of patients and no long-term follow-up.
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INTRODUCTION: Health care workers form an important occupational group with a high risk of hand eczema. All health care professionals are exposed to a variety of allergens and irritants which can cause hand dermatitis, resulting in significant morbidity. AIMS AND OBJECTIVES: To assess the clinical profile of hand eczema in hospital employees, to perform patch test in relevant cases and to find out the most common sensitizers in them. MATERIALS AND METHODS: This was a cross-sectional, hospital-based study in which the staff was screened for features of hand eczema and patch testing was done in the suspected cases of allergic contact dermatitis. RESULTS: Out of 340 employees screened, 46 employees (13.5%) suffered from hand eczema. The most common type was wear and tear dermatitis accounting for 17 (36.9%) cases, followed by discoid eczema, pompholyx, focal palmar peeling, finger-tip eczema, hyperkeratotic eczema, ring eczema, and unspecified types. Patch testing was positive in 15 (32.6%) cases. The most common allergen was paraphenylene diamine, followed by fragrance mix, nitrofurazone, mercaptobenzothiazole, potassium bichromate, black rubber mix, and thiuram mix. A statistically significant association (0.001) was found with an underlying history of atopy. CONCLUSION: Hand eczema is a commonly encountered dermatological complaint in many hospital employees. Proper counseling, work, up, patch testing, and treatment can mitigate the symptoms in such employees.