On the Scheme for Obtaining a Better Knowledge of Endemic Skin Diseases of India by Tilbury Fox (1836-1879): A Medico-Historical Overview.

With the presence of western nations in India, a change started appearing in the medical scenario. The civilians and soldiers had to suffer from many endemic diseases like fever, cholera, plague, small pox etc. prevalent in India and it caused great loss to the new comers. To protect the life and properties and to gain a firm ground in the Indian soil, Europeans established various medical institutions that provided western medical care. In the course of time British got hold of the power in most part of this country. As the administrators were more engaged with the fatal endemic diseases, cutaneous disorders with lower mortality got less importance. Tilbury Fox, a distinguished British physician accompanied the Earl of Hopetoun in a tour to the East and reached India in 1864. Fox noticed the chaotic situation in the systematic study of dermatological disorders. He proposed a scheme to study the proper situation in this country which laid the beginning of systematic study of dermatology in India. Though his study was the steppingstone of Indian dermatology, but Fox got little attention in the history of dermatology in India. This article discusses about a brief overview of the scheme and the contribution of Tilbury fox.

Teigne Tondante and Mahon Brothers: Two Laymen "Physicians" of Hôpital Saint-Louis, Paris.

In the early and mid-nineteenth century Europe, ringworm of the scalp was a vexing problem. It affected children in such numbers that the famous Hôpital Saint-Louis of Paris had a separate Tinea School. Before advent of radiation method of epilation, painful method of peeling was the mainstay of management. A family bearing title Mahon with no conventional medical training and qualification developed a secret method of epilation which was far superior to the existing method of treatment. Two brothers of this family, whose identity is obscure in the history of dermatology, were given the charge of treatment of such cases in various hospitals of France. Though they were not physician per se, their observations surprise us even today. Mahon the junior wrote a book on ringworm which is the first ever monograph on the subject. They also described favus of the nail and named ringworm of the scalp.

On the History of Classification in Dermatology.

Since the early days of cutaneous medicine, naming of the entities had remained a confusing subject. Earlier texts of all ancient civilisations are almost similar in this topic The Biblical controversy regarding the actual translational meaning of the original Hebrew term Zara 'at has become a centre of controversy amongst many research scholars of the medical history. Similar debate exists about the Ayurvedic term Kustha---- whether it meant leprosy or stood for a number of skin affliction is a matter of controversy. A scientific and rational classification system was, therefore needed. The process started with Galen and traversed a long path and ultimately with the eight orders classification system proposed by Robert Willan in the early part of the nineteenth century resolved the issue. This whole journey was eventful….almost all the great doyens of dermatology directly or indirectly contributed to this process. This overview will focus on the main such events of the medical history in nutshell.

Skin in health and diseases in rgveda samhita: an overview.

Rgveda is the oldest religious book of the Aryans. It picturises the early lives of the Aryans. We get mention of various diseases in this Veda. Skin - both in health and diseases had caught attention of the Vedic sages. Skin was not merely an organ of attraction and look but its colour was important socially. Mentions of various diseases like leprosy, guinea worm, jaundice etc., are interesting. Mention of different disorders of the nails and hair are also there, though in a very primitive and mystic form. Management strategy was consisted of herbs, amulates, chanting of mantras, touching the body, uses of water and sunrays etc. This may be presumed that this Veda founded the base for the Ayurveda of the later period.

Unilateral Nevus of Ota with Bilateral Nevus of Ito and Palatal Lesion: A Case Report with a Proposed Clinical Modification of Tanino's Classification.

Nevus of Ota and nevus of Ito are rare dermal melanocytoses. Nevus of Ota may be very rarely associated with the nevus of Ito and other extra cutaneous features. Both nevi are similar in all respect apart from the area of distribution. Bilateral distribution of nevus of Ito is seldom reported in the literature. A 24-year-old male patient reported with nevus of Ota of the right side of his face since his infancy and nevus of Ito on both shoulder regions since early childhood. He had bluish lesions on the right side of his hard palate. Systemic examination was normal. Relevant laboratory investigations were non contributory. The histopathological examination of the skin from the affected areas showed the presence of elongated dendritic dermal melanocytes. The present case is the first report of an association of bilateral nevus of Ito with nevus of Ota and palatal lesions. Tanino classified Nevus of Ota into four groups. As both the nevi are similar in all respect except the area of distribution, a minor modification of the existing Tanino's classification to incorporate the nevus of Ito into the classification for the Ota's nevus may be appropriate.

Efficacy and safety of a nano-emulsion gel formulation of adapalene 0.1% and clindamycin 1% combination in acne vulgaris: a randomized, open label, active-controlled, multicentric, phase IV clinical trial.

BACKGROUND: Acne vulgaris is a very common skin disease with a significant detrimental effect on the quality of life of the patients. AIMS: To assess the comparative efficacy and safety of a nano-emulsion gel formulation of adapalene and clindamycin combination with its conventional formulation in the treatment of acne vulgaris of the face. It was a prospective, randomized, open label, active-controlled, multicentric, clinical trial. METHODS: Eligible patients suffering from acne vulgaris of the face were randomized to receive once-daily treatment with a nano-emulsion gel or conventional gel formulation of adapalene 0.1% and clindamycin (as phosphate) 1% combination for 12 weeks. Total, inflammatory and noninflammatory lesion counts, with grading of acne severity were carried out on a monthly basis. Safety assessments were done to determine the comparative local and systemic tolerability. Two-tailed significance testing was carried out with appropriate statistical tests, and P-values < 0.05 were considered as significant. RESULTS: 209/212 patients enrolled in the study were eligible for efficacy and safety assessments in both nano-emulsion gel (118/119 patients) and conventional gel (91/93 patients) groups. Significantly better reductions in total (79.7% vs. 62.7%), inflammatory (88.7% vs. 71.4%) and noninflammatory (74.9% vs. 58.4%) lesions were reported with the nano-emulsion gel as compared to the conventional gel (P < 0.001 for all). Mean acne severity score also reduced significantly more with the nano-emulsion formulation (1.9 ± 0.9 vs. 1.4 ± 1.0; P < 0.001) than the comparator. Significantly lower incidence and lesser intensity of adverse events like local irritation (4.2% vs. 19.8%; P < 0.05) and erythema (0.8% vs. 9.9%; P < 0.05) were recorded with the nano-emulsion gel. CONCLUSIONS: The nano-emulsion gel formulation of adapalene and clindamycin combination appears to be more efficacious and better tolerated than the conventional formulation for the treatment of acne vulgaris in Indian patients. Further studies can elucidate the comparative treatment benefits of this nano-emulsion gel formulation.

A study to evaluate the efficacy and safety of hydrocortisone aceponate 0.127% lipophilic cream in steroid responsive dermatoses in Indian patients.

BACKGROUND: Topical corticosteroids (CSs) are the mainstay of therapy in various steroid responsive dermatoses. Newer CSs are more efficacious and safer than the older ones. There is no published data on the efficacy and safety of a new steroid hydrocortisone aceponate in the Indian population. AIM: To evaluate the efficacy and safety of hydrocortisone aceponate (0.127%) lipophilic cream in the treatment of steroid responsive dermatoses in Indian patients. METHODS: Four hundred and fifteen patients with clinically diagnosed steroid responsive dermatoses enrolled in this study. They were advised to apply hydrocortisone aceponate (0.127%) lipophilic cream as a thin film to all the affected areas twice daily. Cleansing was done prior to the application with either soap-free cleanser or soap (that would not affect the study result). Use of oral antihistamines and/or antibiotics was permissible. However, other oral/topical steroid use was not permitted during the study. Patients were evaluated at day 0 and at day 21. Data were recorded regarding clinical improvement and side-effects, if any. They were then analyzed to determine the efficacy and safety of the cream. RESULTS: Physician's global evaluation of therapy showed that lesions were cleared in 82 (22.10%), excellent result in 200 (53.91%), good result in 72 (19.41%), fair response in 15 (4.04%) and no change in 2 (0.54%) patients. There was no history of exacerbation in any patient. CONCLUSION: The study showed that hydrocortisone aceponate (0.127%) lipophilic cream is an effective therapeutic agent with a very good safety profile in various steroid responsive dermatoses in the Indian patient population.