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Managing dermatophytoses in pregnancy, lactation, and children
Smitha S Prabhu, Pragathi Sankineni
October 2017, 1(3):34-37
Chronic and recurrent dermatophytosis is on the rise. Managing dermatophytosis in special circumstances such as pregnancy and lactation and in children is a challenge. Topicals are safe in most cases, whereas oral antifungals are better avoided in pregnancy and lactation. In children, systemic antifungals are to be dose modified according to body weight.
  32,159 1,213 -
Lines in dermatology
AS Savitha
January-June 2017, 1(1):27-31
  23,144 1,661 -
Topical antifungals: A review and their role in current management of dermatophytoses
Shital Amin Poojary
October 2017, 1(3):24-29
Topical antifungals are an important adjuvant in treatment of dermatophytosis. Also specific situations such as dermatophytoses in pregnancy and infants often warrant topical therapy. Several new topical antifungals and newer formulations hold out the promise of enhanced effectiveness of topical therapy in dermatophytosis. This article reviews the entire spectrum of topical antifungals and formulations and their role in management of dermatophytosis.
  20,104 2,303 1
Umbilicated lesions in dermatology
Aditya Kumar Bubna
January-June 2019, 3(1):99-103
  14,307 742 -
Autonomic denervation dermatitis: A new type of eczematous dermatitis
Bhushan Madke, Madhulika Mhatre, Piyush Kumar, Adarsh Lata Singh, Anil Patki
July-December 2017, 1(2):61-64
We hereby describe a case series of eczematous dermatitis in a peculiar clinical setting. The cases presented with eczematous dermatitis at the site of surgical incision and adjoining skin after a varying lag period. Clinically, all patients presented with xerosis and eczematous rashes around the surgical sites. In our observation, the time taken to develop skin rashes around the surgical sites ranged from 6 months to 3 years. We believe that denervation injury due to dermal nerve transections may lead to autonomic disturbance in the involved area and contribute to the development of dermatitis. Treatment is essentially medical with topical emollients and judicious use of topical corticosteroids. Through this case series, we propose to introduce a new dermatological entity - “autonomic denervation dermatitis” in postsurgical patients.
  13,313 476 3
Systemic therapy of dermatophytosis: Practical and systematic approach
Madhu Rengasamy, Janaki Chellam, Sentamilselvi Ganapati
October 2017, 1(3):19-23
Superficial dermatophytosis caused by dermatophytes belonging to the three genera, “Trichophyton, Microsporum and Epidermophyton” is the most common fungal infection seen in human beings, worldwide. Medical fraternity in India has been observing an increase in the prevalence of dermatophytosis and that too of the difficult to treat recalcitrant, recurrent and chronic dermatophytosis, over the last 3-4 years. This change in the clinical scenario with increasing frequency of treatment failures has given rise to innumerable treatment options mainly based on individual's experience, as the therapeutic regimens given in the standard textbooks, both Western and Indian, have ceased to result in a good clinical response. With this background, this article will focus on the treatment schedule given in standard textbooks and the current modifications that have evolved to treat dermatophytosis of the glabrous skin.
  11,690 1,516 4
Dermoscopy of general dermatological conditions in Indian population: A descriptive study
Sunita S Nayak, Hita H Mehta, Prachi C Gajjar, Vivek N Nimbark
July-December 2017, 1(2):41-51
Background: Patients attending the dermatology outpatient department (OPD) come with varied presentations. It is a challenge for a dermatologist to make a right diagnosis in a short time noninvasively. Hence in such conditions, dermoscope provides a rapid handy diagnostic aid. Objectives: The aim is to evaluate and compare the dermoscopic features of common dermatological conditions in an Indian population with brown skin. Materials and Methods: A total of 475 dermatoses including inflammatory, infectious, vesiculobullous, vascular, benign face tumors, hypopigmentary, drug reactions and miscellaneous conditions attending the OPD between March 2011 and January 2013 were enrolled in the study after obtaining informed consent. Detailed history and thorough dermatological examination were conducted to reach the final diagnosis. Dermlite II PRO dermoscope was used for the study. Data collected was analyzed by frequency and percentage. P value for each dermoscopic parameter in three groups was calculated using Chi-square test for independence using graph pad where the value of P < 0.05 was considered statistically significant. Results: Red dotted vessel was a prominent feature in inflammatory conditions (P < 0.0003), which was found to be regular in a pattern in psoriasis (100%). The unique feature of lichen planus was Wickham's striae (P < 0.0001). Collarette scales were observed in 93% of cases of pityriasis rosea. Live nymphs depicting as brown oval structure (46.67%) were observed. Scabies mites head was characterized using “Triangular sign” (93%). Red brown dots and papilla-like structure were observed in most of the cases of warts. Comedo-like opening (P = 0.024) and milia-like cyst (P = 0.0495) are typical features of seborrheic keratosis. Conclusion: Dermoscopy findings provide an extra clue for the diagnosis of common dermatoses and it also helpful in prognostic evaluation and monitoring response to treatment.
  11,363 991 2
Overview and update on the laboratory diagnosis of dermatophytosis
Shivaprakash M Rudramurthy, Dipika Shaw
October 2017, 1(3):3-11
Dermatophytosis, caused by dermatophytes is becoming difficult to treat due to various reasons. Accurate diagnosis is essential for the accurate management of this infection and prevention of relapse or recurrence. Although this condition is easy to diagnose clinically, due to overlapping signs and symptoms of few dermatological conditions it may be misdiagnosed necessitating laboratory confirmation. Isolation, identification of the dermatophytes and the antifungal susceptible profile may further help to initiate appropriate antifungal agent. The classical conventional techniques such as direct microscopic examination and isolation of fungi from the clinical specimens are still considered as an important modality of diagnosis. With the rise of the molecular era, molecular techniques are increasingly being applied to diagnose dermatophytosis and identify the dermatophytes. The present review provides an overview and update on the laboratory diagnosis of dermatophytosis.
  9,911 1,429 7
Comparison of efficacy of oral azithromycin with oral minocycline in the treatment of acne vulgaris
Vidyadhar R Sardesai, Yashodhara T Deka
July-December 2017, 1(2):37-40
Background: Acne vulgaris is a common skin disease seen primarily in adolescents and young adults. As the treatment involves long-term therapy with antibiotics, an agent with a long half-life can be very useful in increasing the compliance. Objectives: The objective of this study was to evaluate the efficacy of a pulse dose of azithromycin and compare it with daily dose of minocycline in the treatment of acne vulgaris. Materials and Methods: This prospective, randomized, open-label, comparative study was conducted on sixty patients with moderate-to-moderately severe (Grade II and III) acne vulgaris. Patients were randomly assigned to two treatment groups, A and B. Patients in Group A received 50 mg minocycline orally daily whereas patients in Group B were given 500 mg azithromycin orally once a day for 3 consecutive days/week. Both the groups were advised topical application of 2.5% topical benzoyl peroxide gel in the night. The total duration of treatment was 3 weeks. All the patients were evaluated at the end of 3 weeks. Statistical analysis was done using Wilcoxon signed-rank test and Mann–Whitney U-test. Results: Group A showed a reduction in lesional count of 39.7% for noninflammatory papules, 65.11% for inflammatory papules, and 52.22% for pustules. Similarly, Group B showed 30.39%, 54.69%, and 57.76% reduction in lesional count for noninflammatory papules, inflammatory papules, and pustules, respectively. Conclusions: Both minocycline and azithromycin were equally effective and safe for the treatment of acne vulgaris.
  10,719 481 1
Genital lesions in a female child: Approach to the diagnosis
Bhakthavatsalam Anitha, Ragunatha Shivanna
July-December 2018, 2(2):49-57
Genital lesions in a female child cause a lot of apprehension in the parents. Hence, thorough knowledge and proper approach to the diagnosis is very important. The aim of this article is to present an overview of the pattern of diseases affecting genitalia in a female child, significance of these diseases, and an approach to the diagnosis of these diseases. Most of these vulval dermatoses present with one of the four clinical scenarios such as pruritus with/without lesions, pain with/without lesions, discharge with/without lesions, and asymptomatic lesions. The approach to the diagnosis has been discussed accordingly. Diseases such as genital warts and genital herpes which are not common in this age group always raise the suspicion of child sexual abuse. There are certain adult vulval dermatoses such as chronic vulvovaginal candidiasis, which are not seen in prepubertal group.
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Common misconceptions about acne vulgaris: A review of the literature
Rex WH Hui
July-December 2017, 1(2):33-36
Acne vulgaris (acne) is a common chronic skin disease and affects over 90% of teenagers worldwide. Despite its prevalence, acne vulgaris is shrouded in multiple misconceptions that are widespread in the general public, among acne patients, and even in health-care professionals. This article reviewed six common misconceptions about acne vulgaris: (1) acne is a trivial condition and does not require medical attention; (2) acne is a transitory disease of adolescence; (3) dietary factors cause acne; (4) acne is caused by uncleanliness; (5) acne improves rapidly upon treatment; and (6) acne can be treated by sunlight. These misconceptions span across the natural history, etiology, and treatment of acne vulgaris. The paucity of knowledge about acne has potentially severe consequences and should not be overlooked. Underestimating the severity and progression of acne may delay treatment, while misinterpreting the etiology of acne could lead to unnecessary and disruptive lifestyle changes. Unrealistic expectations about therapy will lead to dissatisfaction, which may decrease treatment compliance. Actions in public health, medical education, and research are warranted to eradicate these misconceptions about acne vulgaris.
  8,125 703 2
Emerging atypical and unusual presentations of dermatophytosis in India
Sunil Dogra, Tarun Narang
October 2017, 1(3):12-18
In the recent past, there has been an alarming rise in patients presenting with atypical clinical types of dermatophytosis. These patients require prolonged treatment with systemic and topical antifungal agents. In majority of patients, close household contacts are affected. Frequent relapses and extensive disease affect the quality of life of the patient significantly. The emergence of such a challenging scenario is attributed to complex interplay of host, environment, and agent factors. The change in prevalence of dermatophytes causing the disease; host factors such as comorbidity and immunosuppression; and hot and humid climate, lifestyle changes, and poor hygiene are responsible for atypical dermatophytosis. Several atypical clinical types such as psoriasis-like, eczematous dermatitis-like, seborrheic dermatitis-like, and rosacea-like have been reported. Hence, dermatophytosis has been suggested to be included in the list of great imitators. The collaborative effort involving dermatologists, microbiologists, and public health professionals is required to address this emerging public health problem.
  6,833 952 7
Red dots caught red handed: Dermoscopy of genital psoriasis
Balachandra Suryakant Ankad, Mahajabeen Madarkar
January-June 2017, 1(1):25-26
Dermoscopy is an in vivo diagnostic technique that aids in the visualization of epidermis, dermoepidermal junction, and papillary dermis. Histopathology contributes tremendously in confirming the clinical diagnosis of unusual presentations of inflammatory skin disorders. Being noninvasive, dermoscopy assists significantly in differentiation of many inflammatory skin disorders which clinically resemble one another. In this report, authors describe the importance of dermoscopy in the diagnosis of genital psoriasis which was mimicking dermatophytic infection and contact dermatitis.
  6,883 329 -
Facial frictional melanosis in Indian patients: Defining the entity
Sharad D Mutalik, Suresh V Pethe, Balkrishna P Nikam, Yashashree D Rasal
January-June 2019, 3(1):78-83
Background: Facial melanosis in tropics presents as a diagnostic and therapeutic challenge. We report characteristic patterns of facial pigmentation following vigorous rubbing or cleaning of the face in Indian patients. Awareness of the condition shall guide the clinician to a specific diagnosis. Objective: To study clinicohistopathological profile and patterns of facial frictional melanosis (FFM). Materials and Methods: A multicenter clinicohistopathological hospital-based cross-sectional case descriptive study of sixty patients with characteristic patterned facial melanosis underwent a detailed history taking and clinical examination over a period of 5 years. Biopsy specimens of thirty patients were analyzed for histopathology with hematoxylin-eosin stain. Ten biopsy specimens were also processed for both Fontana Mason and Congo red staining. Results: Sixty patients (males n = 48, females n = 12) with typical clinical features of FFM were studied. Ages of patients varied from 16 to 68 years. Patients on direct questioning confirmed history of vigorous rubbing with hand/handkerchief to clear the face of sweat and grime. Pigmentation was distributed symmetrically over the bony prominences with several characteristic patterns. Histology showed epidermal hypermelanosis, dermal melanin incontinence, and consistent absence of amyloid deposits. Conclusion: We present characteristic facial melanosis in Indian patients due to friction as a specific type of benign friction melanosis. We aim to bring to notice; friction as a distinct etiology of patterned facial hyperpigmentation.
  6,847 318 1
A randomized, single-blind, active controlled study to compare the efficacy of salicylic acid and mandelic acid chemical peel in the treatment of mild to moderately severe acne vulgaris
Shishira R Jartarkar, Bugude Gangadhar, M Mallikarjun, P Manjunath
January-June 2017, 1(1):15-18
Background: Various modalities of treatment have been used in the treatment of acne and nowadays, clinicians seek to employ new technologies in acne care like chemical peeling. Objectives: The objective of this study is to compare the efficacy of salicylic acid and mandelic acid peel in the treatment of mild to moderately severe acne vulgaris. Methodology: A total of fifty patients with mild to moderately severe acne graded based on Global Acne Grading System were divided randomly into two groups of 25 patients each. Group A patients were treated with 20% salicylic acid and Group B patients were treated with 30% mandelic acid every 15 days for six sessions. Pre- and post-peel sunscreen and moisturizer were prescribed. Percentage of improvement in inflammatory and noninflammatory lesions at the end of six sessions was the primary endpoint measure. The improvement was graded as mild, moderate, good, and significant. Results: All the patients showed improvement of acne at the end of the treatment. The mean improvement of inflammatory acne in Group A was 73.3% and in Group B was 65.4%. The mean improvement of noninflammatory acne in Group A was 39.4%, and Group B was 27.9%. In both groups, the improvement in both inflammatory and noninflammatory lesions was found to be statistically significant (P < 0.05). Conclusion: Salicylic acid peel was found to be more efficacious than mandelic acid peel. However, the side effects were less common with no postinflammatory hyperpigmentation with mandelic acid peel.
  5,784 661 3
Efficacy of platelet-rich plasma in acne scars
Anirudha D Gulanikar, Renu Vidholkar
July-December 2019, 3(2):109-114
Background: Platelet-rich plasma (PRP) is an autologous preparation which contains a large amount of platelets concentrated into a small volume of plasma. PRP provides various growth factors which aid in quick wound healing. It is used as an adjuvant therapy for acne scars. Thus, in this prospective study, the efficacy of PRP as single modality of treatment for acne scars was evaluated. Methods: Thirty patients of Grade 2 and 3 acne scars according to the Goodman and Baron's qualitative acne scar grading system and Fitzpatrick Skin Type IV and V received six sittings of PRP at an interval of 1 month and followed up for 3 months after the completion of six sittings. Patients were assessed for the improvement in the scar grade, 1 month after the last sitting. Pre- and post-treatment comparative photographs and patient's and physician's satisfaction score were used to assess the results. Results: All the types of scars showed response in terms of reduction in size. Rolling scars responded better to PRP as compared to boxcar and ice pick scars. Estimation of improvement with Goodman and Baron's global qualitative acne scarring system showed that out of 30 patients with Grade 2 and 3 acne scars, 50% showed improvement in terms of acne scar grading at the end of the treatment. Among 25 patients with Grade 3 scars, 15 patients (60%) showed improvement by one grade. Adverse effects were mild being limited to transient pain, erythema, edema, and hyperpigmentation. Conclusion: The current study introduces autologous PRP as a cost-effective, well-tolerated office procedure in the treatment of acne scars without serious side effects. Further studies are needed to be carried out to compare the results of this present study.
  5,767 416 -
Bowenoid papulosis of genitalia responding to topical 5-Fluorouracil
Ragunatha Shivanna, Meenakshi Kapoor, B Niranjana Murthy, Gangaiah Narendra
January-June 2018, 2(1):25-27
Bowenoid papulosis (BP), a rare disease with malignant potential, is a distinct clinicopathological entity strongly associated with human papillomavirus (HPV) infection. We described an adult male presenting with well defined, purplish papules of varying size with verrucous to smooth surface distributed discretely over medial side of the left thigh, scrotum, and penile shaft. Histopathology showed focal areas of full thickness epidermal atypia comprising irregularly arranged nuclei which are large, hyperchromatic, and crowded at few places. Pap smear from spouse showed inflammatory infiltrate with moderate-to-severe dysplasia. The patient was treated with topical 5-fluorouracil. Excellent response was noticed at the end of 2 weeks. A patient with BP should be thoroughly educated regarding HPV infection and emphasis should be on prevention. Female patients or sexual partners of male patient with BP are at the risk of developing cervical cancer and hence should be followed with regular cytologic, colposcopic, and histologic examinations.
  5,745 278 -
Management of dermatophytosis in elderly and with systemic comorbidities
Ragunatha Shivanna, Rajesh
October 2017, 1(3):38-41
Various factors unique to elderly patients such as physical, physiological, psychological, and socioeconomic factors affect the outcome of dermatophytic infection and its management. The associated comorbidities such as renal and hepatic failure and polypharmacy influence the pharmacological properties of antifungal agents. These drugs are potent inhibitors of hepatic enzymes involved in drug metabolism leading to accumulation and subsequent toxicity of various classes of drugs. All these factors are considered in the management of dermatophytosis in elderly especially with comorbidities.
  5,151 522 -
A study of clinical patterns of acute radiation dermatitis among patients attending dermatology outpatient department at tertiary center in Western India
Shivani Saini, Varadraj Pai, Pankaj Shukla, Harshal Ranglani
January-June 2018, 2(1):8-12
Background: Radiation dermatitis (RD) is a commonly encountered adverse effect of definitive radiation therapy. The severity of RD is influenced by multiple patient and treatment-related factors. Radiation depletes the basal cell layer of skin and initiates a complex sequence of events leading to dose-dependent acute or late sequelae. The management of RD requires a multidisciplinary approach. Objectives: The aim is to highlight the pattern and the profile of patients with acute RD attending dermatology outpatient department. Materials and Methods: Hospital-based cross-sectional study of 47 consecutive adult patients with acute RD attending skin outpatient department over a period of 12 months. Results: A total of 47 patients of RD attended the skin clinic, of which were 16 males and 31 were female. The RD was reported within the first 2 weeks of initiation of therapy in most of the patients. Grade 1 RD was the least common presentation. Conclusions: This study highlights the importance of grading the RD, for the appropriate management of the patients suffering from the same and is also a step toward the prevention of the RD.
  5,288 337 -
Comparison of cutaneous manifestations of diabetic with nondiabetic patients: A case-control study
Banavasi S Girisha, Neethu Viswanathan
January-June 2017, 1(1):9-14
Background: Diabetes mellitus is a metabolic disorder characterized by raised fasting and postprandial blood glucose levels and a variety of multisystem complications. The prevalence of skin manifestations seems to be similar between type 1 and type 2 diabetes mellitus patients. Cutaneous manifestations usually develop following the diagnosis of diabetes, but in some patients, they are the initial presenting signs, thereby helping in the early diagnosis of diabetes mellitus. Objectives: The objective of this study is to describe the cutaneous lesions in patients with type 2 diabetes mellitus and to compare the pattern of skin manifestations in diabetics and nondiabetics in coastal Karnataka and neighboring districts of Kerala. Methodology: This case-control study included 400 patients with type 2 diabetes mellitus and cutaneous manifestations attending the outpatient Departments of Dermatology and General Medicine and those admitted under these departments. A total of 400 age and sex-matched nondiabetic patients were included as controls. Results: Cutaneous infections were noted in 148 (37%) diabetics of which fungal infections were the most common seen in 106 (26.5%) patients, followed by xerosis in 121 (30.25%) and acrochordons in 71 (17.75%) patients. Other dermatoses associated with diabetes mellitus noted were acanthosis nigricans (5.5%), scleredema diabeticorum (0.25%), diabetic bullae (0.5%), and Kyrle's disease (1%). Cutaneous changes associated with neurovascular complications included diabetic foot in 3%, diabetic dermopathy in 2%, and pigmented purpuric dermatosis in 0.25% of the diabetics. Conclusion: A joint effort between dermatology and general medicine is necessary for the early recognition and treatment of the skin conditions and also to ensure adequate metabolic control.
  4,937 502 -
A bird's eye view of common antiandrogens used by dermatologists
Aditya Kumar Bubna
January-June 2020, 4(1):1-11
The use of antiandrogens is gaining significance in dermatology practice these days. Though once considered a domain of endocrinologists and gynecologists, these drugs now constitute an important category while treating a number of dermatologic conditions. A thorough knowledge of these drugs, as well as their applications in dermatology would therefore be of immense value for the practicing dermatologist. This review will throw a bird's eye view on the salient aspects of these drugs and their importance in those conditions, where their usage in applicable.
  4,117 414 -
A randomized, assessor-blinded, comparative study to evaluate the efficacy and safety of oat extract-based moisturizer in adult individuals with dry skin
Sarvajnamurthy Aradhya Sacchidanand, Satish Udare, Dhammraj Madhukar Borade, Varsha Narayanan, Sagar Katare, Ashish Mane, Agam Shah
July-December 2018, 2(2):58-63
Background: Dry skin or xeroderma is a very frequent condition which occurs at any age. Moisturizers including conventional oatmeal have been widely used to improve dry skin conditions. Oat-based moisturizer can protect, hydrate, and promote the endogenous barrier repair. Aim: This study aims to evaluate the efficacy and safety of oat extract-based moisturizer in adult individuals with dry skin. Materials and Methods: This study was a treatment-randomized, assessor-blinded, no treatment controlled, comparative study. A total of 36 individuals were included in the study. Oat extract-based moisturizer (test product) and control treatment (no product application) were randomized, as per randomization plan and applied to all individuals on the surface of volar forearm 2 cm (1 cm radius) in diameter. In addition, right cheek as control site and left cheek as test site (oat extract-based moisturizer lotion) were considered for sebum level and facial skin pH analysis. Results: Oat extract-based moisturizer possessed excellent skin moisturizing properties. Both the Corneometer® and modified Kligman score, respectively, showed significant improvement (P < 0.0001) in skin hydration and decrease in skin dryness with respect to baseline till 24 h postapplication. Furthermore, Cutometer® reading had statistically significant increase in skin elasticity as compared to baseline till 6 h postapplication. There was no statistically significant effect on skin pH and sebum level as compared to control treatment. This concludes that oat extract-based moisturizer is effective in improving skin hydration and elasticity without any change in skin pH and sebum levels. Conclusion: Test product (oat extract-based moisturizer lotion) was safe and well tolerated. Efficacy analysis showed that the effect of oat extract-based moisturizer was significant in terms of skin hydration and skin elasticity.
  4,026 424 -
Management of systemic sclerosis: A dermatologist's approach
Deepthi Ravi, Smitha Prabhu
January-June 2019, 3(1):34-40
Systemic sclerosis (SSc) is an autoimmune connective tissue disease affecting the blood vessels, skin, and internal organs. The main pathogenic mechanisms are vascular dysregulation, tissue fibrosis due to collagen and extracellular protein deposition, and autoantibody production due to immune dysfunction. The treatment also targets these mechanisms. Various criteria including the American College of Rheumatology and the European League against Rheumatism are laid down for the clinical diagnosis of scleroderma, and treatment is tailored to the systems involved. In the initial stages of the SSc, immunosuppressants are more useful, whereas in the later stages, antifibrotic therapies are important. Vasospasm and endothelial dysfunction are seen in all stages of the disease, and hence, vascular therapies are needed throughout the course of the disease. Special care should be taken to rule out gastrointestinal, pulmonary, and renal system involvement if the primary treatment is by a dermatologist.
  3,880 550 -
Study of cutaneous adverse effects of cancer chemotherapy
Ashok Menon, Sripathi Handattu, Jayaram Shetty, Banavasi Shanmukha Girisha
January-June 2018, 2(1):19-24
Background: Cancer is a leading cause of mortality and morbidity in both developed and developing parts of the world with the disease burden projected to grow exponentially in future. Over the past several decades great advances have been made in the area of cancer chemotherapy. Objectives: To study the various cutaneous adverse events associated with cancer chemotherapy. Methodology: 100 patients diagnosed with cancer attending the departments of a tertiary hospital who underwent chemotherapy and satisfied the inclusion and exclusion criteria were included in this study. It is a hospital based observational study. All patients were counselled about the study and informed written consent was obtained. Patients were examined before start of chemotherapy treatment and after every cycle of chemotherapy. Data collected was analysed using SPSS version 16.0. Results: In this study, 100 patients including 37 females and 63 males were included in this study. Majority (56%) of the patients belonged to the age group of 41-60 years. The common indications for chemotherapy were carcinoma oropharynx (24%), carcinoma breast (18%), tongue and stomach. Among the cutaneous adverse events noted, hair changes were the most common presentation and were reported in 68 patients. Skin changes were seen in 65 cases, nail changes in 30 cases and mucosal changes in 12 patients. Xerosis (26%) and hyperpigmentation (22%) were the most commonly observed adverse event affecting skin. Cisplatin, cyclophosphamide, 5 fluorouracil, carboplatin, paclitaxel and doxorubicin were the most frequently prescribed chemotherapeutic drugs. Conclusion: Our observations necessitate a joint effort between dermatology and oncology for the early recognition and adequate treatment of the cutaneous adverse effects associated with cancer chemotherapy which may help in reducing morbidity and improving compliance.
  3,900 519 1
Comparative study of safety and efficacy of oral betamethasone pulse therapy and azathioprine in vitiligo
Mahajabeen Madarkar, Balachandra S Ankad, R Manjula
July-December 2019, 3(2):121-125
Background: Vitiligo is a common skin disorder causing depigmented macules that can impair a patient's quality of life. There are number of treatment modalities are available but at the present, there are no studies compairing betamethasone pulse therapy versus azathioprine daily therapy in treatment of vitiligo. Objectives: To compare the safety and efficacy of Azathioprine daily and Betamethasone pulse therapy in the treatment of in vitiligo. Materials and Methods: We included two vitiligo patient groups. namely group A and group B Patients of group A were given oral Azathioprine to be given 50mg twice daily and those of second group B, Betamethasone were given as a single oral dose of 5 mg on two consecutive days per week. Therapy in both groups was given for a total of 6months with follow up at 1, 3 and 6th month. Clinical photographs were taken at each visit. Side-effects if any were noted. Results were calculated with help of VASI score (vitiligo area severity index). Results: At the baseline: The patients to group A (SD 3.81± 2.3) and of group B (SD 3.76± 2.28) were having depigmented patches (P = 0.90). At the first follow up: Although there was significant improvement with perifollicular repigmentation started in both groups but the patients are of group B (SD 3.38±2.06) were showing slower response as compared to oral group A (SD 3.70± 2.28). At the second follow up: Remarkable improvement is seen in both groups compared (P = 0.17). At the third follow up: Significant improvement is seen in both groups compared (P = 0.09). Conclusions: Azathioprine and betamethasone pulse therapy are equally effective in treatment of vitiligo.
  4,027 300 2