RESUMEN
Background: Dermatology and psychiatry are two specialties which often have a bearing on each other. Multiple indices have been used to study the quality of life in skin diseases; however, very few studies have correlated these indices with questionnaires of common psychiatric comorbidities like anxiety and depression. Methods: The study was conducted in a dermatology out patient department (OPD) of a tertiary care hospital. All patients with chronic dermatological conditions (meeting the inclusion criteria) were included, and each patient was made to fill two questionnaires that are Skindex-29 for skin-related quality of life and Beck Depression Inventory (BDI-II) for depression. They were also assessed for anxiety using the Hamilton Anxiety Scale (HAM-A), which was filled under the supervision of a psychiatrist. Results: The scores for the common diagnoses were collated and analyzed using SPSS 20.0 software, and the results were tabulated. It was found that both the HAM-A and BDI-II had a moderate positive correlation with the Skindex which was statistically significant. Also, on correlating the individual domains of the Skindex with the HAM-A and BDI, the domain of emotions depicted the best correlation. Conclusion: The study brings to light that a relatively easy to administer quality of life questionnaire can be used as a screening tool to identify psychiatric morbidity and in a busy skin OPD, questions from the emotion domain can only be asked for early referral to a psychiatrist.
RESUMEN
Filariasis caused by nematodes affects the structure and function of lymphatic vessels. Lymphedema due to lymphatic blockage and lymphadenitis is the usual mode of presentation of filariasis. However, rarely extralymphatic filariasis has been reported in uncommon sites, including skin and soft tissue. Wuchereria (W.) bancrofti is the most common nematode causing extralymphatic filariasis. We report a rare case of a 25-year-old man with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling confirmed by ultrasonography (USG), which revealed the filarial dance sign. Filariasis can present in many different ways and pose a significant dilemma for the clinician. It is essential to be aware of atypical presentations of filariasis for prompt diagnosis and further treatment.
RESUMEN
The Special Interest Group (SIG) on leprosy thought it to be prudent to revisit its previous practice recommendations through this update. During this period, the pandemic course shifted to a 'second wave' riding on the 'delta variant'. While the number of cases increased manifold, so did the research on all aspects of the disease. Introduction of vaccination and data from various drug trials have an impact on current best practices on management of diseases including leprosy. The beneficial results of using steroids in management of COVID-19, gives elbow room regarding its usage in conditions like lepra reactions. On the other hand, the increase in cases of Mucormycosis again underlines applying due caution while recommending immunosuppressants to a patient already suffering from COVID-19. This recommendation update from SIG leprosy reflects current understanding about managing leprosy while the dynamic pandemic continues with its ebbs and flows.
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Psoriasis is increasingly considered a systemic disease with comorbidities. There is sufficient evidence that systemic inflammation lies at the heart of these developments. Considering the chronic nature of psoriasis and its comorbidities, timely manipulation of systemic inflammation could avert both mortality and morbidity. Data from retrospective studies suggest that aggressive treatment of psoriasis with traditional systemic agents and/or biologic drugs improves health outcomes. To maximize treatment outcomes, severe psoriasis needs to be managed as a systemic disease with likely comorbidities.
RESUMEN
Generalized pustular eruptions may occasionally present challenges both for diagnosis and treatment. A 55-year-old male was hospitalized with fever and a severe generalized pustular eruption after recent intake of diltiazem. A careful interpretation of history, clinical course and investigation findings and an active treatment intervention proved the key to management of the case.