RFP Journal of Dermatology

Acne vulgaris is a chronic inflammatory disease of pilosebaceous glands & is the leading cause of visits to dermatologists. It is common during adolescence, which isa time period of physical and emotional development. Acne involves the face affecting one’s view of beauty and self worth, thus a person already susceptible develops significant psychosocial disability resulting in anxiety, anger to depression. Assessing QoL at baseline provides important information about patients perceptions at the start of the therapy and an added perspective to the assessment of new therapies . But the scarce use of QoL tools is a major hindrance to developing a strong relationship between patients of acne and their mental health services. Quality of life measurements in acne vulgaris can be basically divided into two types ie, either Dermatology Specific Measures or Disease Specific Measures. Thus, taking this into consideration, the purpose of this article is to explore “Acne vulgaris and Quality of Life”. Hence, “subjective” impairment in the Quality of Life has to be addressed conjointly in addition to treating the acne according to its severity for a comprehensive management of the patient.

Keywords: Acne Vulgaris; Quality of Life; DLQI.

Introduction: Cutaneous findings in HIV disease are frequent and include viral, bacterial, fungal, and noninfectious dermatoses. Common cutaneous conditions like seborrheicdermatitis, often have an increased prevalence or severity in these individuals. Susceptibility to otherwise rare infections, which are manifested in part or in whole as dermatologic findings, is significantly enhanced with HIV disease.

Methodology: This study was undertaken at the Department of Skin and STD.HIV positive patients attending Skin and STD Department and also patients referred from other departments of Hospital were screened for skin diseases by taking detailed history, clinical examination and relevant laboratory investigations.

Results: Infectious dermatoses were seen in 48 patients (80%) in our study. Majority (32 patients, 53.4%) had viral infections followed by bacterial (9 cases, 15.0 %), mixed infections (3 cases, 5.0%), fungal and parasitic infections (2 cases each, 3.3%).

Conclusion: The most common dermatome involved in herpes zoster was thoracic (16.7%) followed by lumbar (11.7%), ophthalmic (8.3%) and others. Two patients (3.3%) presented with disseminated zoster.

Keywords: Dermatoses; HIV; Herpes Zoster.

Introduction: Skin harbours specialized subsets of antigen-presenting dendritic cells, that  take up microbial and tissue antigens, migrate to peripheral lymph nodes and present processed antigens to naïve T lymphocytes. The T lymphocytes are thereby induced to become activated and to expand in number, and T cells so activated acquire the capacity to migrate preferentially to skin, directed by specific homing receptors, where they exert their effector functions against relevant antigens .

Methodology: HIV positive patients attending Skin and STD Department and also patients referred from other departments of Hospital were screened for skin diseases by taking detailed history, clinical examination and relevant laboratory investigations. HIV positive patients having skin diseases were included in the study.

Results: Out of 60 patients included in the study 15 patients (25%) had non-infectious dermatoses. Seven patients (11.7%) presented with pruritic papular eruptions, 4 (6.7%) had adverse cutaneous drug reactions, 2 (3.3%) had photodermatitis and only 1 case (1.7 %) of pityriasisrosea was seen.

Conclusion: Photodermatitis was seen in 2 patients (3.3%) included in the study. Only 1 (1.7%) patient had pityriasis – rosea with typical clinical features.

Keywords: Noninfectious Dermatoses; PityriasisRosea; HIV.

Introduction: Pityriasisversicolor occurs in both sexes and is not limited to any race. It occurs from childhood to old age but is seen most often in young adults. It is widely distributed in tropical and temperate climate. The fungus has not been found as a free living saprophyte and it is probable that it spreads from person to person directly or indirectly by exposure to desquamated epidermis.

Methodology: The site from which the materials was to be collected, was cleaned with the help of gauge piece and surgical spirit and was allowed to dry and then scales were scraped with the help of a blunt scalpel and the scraped material was collected in the butter paper and then part of it was used for direct microscopic examination and part of it was transported to the microbiology laboratory for further investigations.

Results: It was observed, in this study, VDRL test was reactive 1:64 and ELISA test for HIV was negative in primary syphilis. VDRL test was non reactive and ELISA test for HIV was negative in Herpes simplex. 8 patients had associated dermatophytic infection (tineacruris, tineacorporis, tineamanum).

Conclusion: There was no fungus growth in culture media.

Keywords: PityriasisVersicolor; Mycological Study; Dermatophytic Infection.

Background: Vitiligo is an acquired, polygenic, multifactorial melanocytopenia  of unknown etiology. This study was conducted to know the epidemiological patterns of vitiligo.

Methods: One hundred patients were included in the study over one and half-year period. Patients were diagnosed by clinical findings and Wood’s lamp. Each patient’s age, sex, age of onset, site and clinical type, disease activity, coexisting systemic or dermatological diseases, and family history were recorded. A complete blood count, routine biochemistry tests, complete urinalysis were done.

 Results: The majority of patients were male (n = 58, 58%), and the rest females (n = 42, 42%). The age at onset of the condition varied from 3 months to 78 years. History of trauma or stress as was seen in 34% of patients; 13% had family history of vitiligo. In 56 patients vitiligo was generalized, whereas in 44 it was localized. The most common site was the lower limbs (42%), followed by the face (26%), upper limbs (16%), trunk (14%) and least was genitalia (2%).

Conclusion: The findings of this study are similar to those obtained by other authors,  howing younger age of onset and generalized variety, the commonest clinical type of vitiligo.

Keywords: Vitiligo; Autoimmunity; Diabetes Mellitus.

Background: Psychodermatology encompasses disease that involve the complexinteraction between the mind, the cutaneous nerve, the cutaneous immune system and their cutaneous manifestations. The relationship between the skin and the mind is complex and despite its clinical importance, remains underexplored and under-reported.

Objectives: To detect the frequency and type of psychiatric disorders among patients with dermatologic symptoms presenting to the skin out-patient department of a tertiary care hospital in western India.

Methodology: An open, cross sectional, observational descriptive study was conducted, including all patients with some dermatologic manifestation of primary psychiatric disorder  excepting patients with known chronic/medical illness, pregnant, lactating, and those already on any psychiatric medication, the patients were then referred to psychiatry department of our hospital for further evaluation and confirmation of the diagnosis.

Results: Among 50 serial patients studied, 39 were females and 11 males. Most of the cases were in 2nd to 5th decade, the mean age being 28 years. The frequency-distribution of the associated psychodermatological disorder was neurotic excoriations (30%), being the most common, psychogenic pruritus (24%), lichen simplex chronicus (20%), acne excoriee (10%), trichotillomania (6%), delusional parasitosis (6%), onychophagia (2%), and dermatitis artefacta (2%). Most common underlying psychiatric disorders included obsessive and compulsive disorder (43%), anxiety disorders (27%), and major depression (26%). Schizophrenia, substance abuse, and bipolar disorder, each were detected in 1.3%. A stressor could be identified in 60% of psychodermatologic patients. SSRIs (Serotonin reuptake inhibitors) were the most commonly used medication along with habit reversal behavioral therapy, followed by benzodiazepines and antipsychotics.

Conclusion: It can be inferred that patients do not realize and even if they occasionally do or are made aware of their psychiatric disorder, they prefer consulting a dermatologist rather than a psychiatrist due to the prevailing stigma related to mental illness. Increased understanding of the complex needs of these patients is necessary for a dermatologist, the value of shared care with a psychologist and a psychiatrist is highly recommended.

Keywords: Psychodermatology; Primary Psychiatric Disorders; Neurotic Excoriations;  Acne Excoriee; Dermatitis Artefacta. 

Pediatric age group is commonly involved in electrical burn  injury. Fluid resuscitation is vital for any burn injury and more so for electrical burn injury to prevent complication. There are no fixed guidelines for fluid therapy in electrical burns especially in pediatrics. In this study we report the effect of maintenance fluid in pediatric electrical burns. 

Keyword: Pediatrics; Electrical Burns; Maintenance Fluid.

Herpes zoster (HZ), a reactivation of virus after initial chickenpox infection was earlier believed to be rare in children and a marker for immunodeficiency and malignancy. Data regarding epidemiology of HZ in Indian children is lacking; we report here a series of 64 cases of paediatric HZ seen over a year. Fourteen patients had one or more systemic disease; most of these were more than 7 years of age. Complications such as keratitis, secondary skin infection, scarring, dyspigmentation and associated psychological effects are a major concern in children. Universal varicella vaccination is likely to aid in reduction in paediatric HZ.

Keywords: Pediatric Herpes Zoster; Varicella.