RFP Journal of Dermatology

Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by pruritus, inflammatory skin lesions. It causes severe impairment of quality of life along with the impairment of physical well of the patient. The management of AD has been always challenging due to its chronic and recurrent course with periods of remission. As the medical science progresses many modalities of treatment have been introduced, beginning from bathing methodology, topical and systemic. This study tries to give a narrative review of the different management options, which clinical dermatologists can use for the management of atopic dermatitis. These options needs to be evaluated and matched according to the age, sex and severity of atopic dermatitis.

Key words: Atopic dermatitis; Treatment; Pruritus.

Fogging of the surgical loupes is a common problem for every surgeon. Not only the surgical loupes, any of the eye protection goggles used during surgery can have fogging. There have been various methods to prevent this like applying adhesive tape over the upper part of the mask, anti-fogging coating over the goggles etc. Recently, we came across an article on a novel method of tying a surgical mask to prevent fogging and tried it. We would like to share our experience.

Keywords: Fogging; Loupes; Surgical mask tying.

Background: Dermatology is a department mainly concerned without patients examination and treatment. But sometimes dermatologists expertise is sought for by the inpatients who are admitted in wards of other specialities. Aims: The aim of the study is to know from which departments the referrals are commonly sought for from department of dermatology and their cutaneous diagnosis and to analyse the knowledge of non-dermatologists on various common dermatoses. Materials and Methods: The study included all in patients referred to dermatology department in a tertiary care centre between January 2018 to December 2018. Results: A total of 215 referrals with dermatological diagnosis were recorded. Internal medicine (70; 32.55%), topped the number of referrals to dermatologists department followed by paediatrics (56; 26.04%), obstetrics and gynaecology (20; 9.30%), ENT (20;9.30%) and surgery (19; 8.83%). Infectious skin diseases were most common (42.79%) followed by eczema (5.58%) and drug reactions (5.11%). Before referral to the dermatology opd, a tentative dermatological diagnosis was made in 30% patients only by the referring department, and it was found to be correct in 20% of the patients, common skin conditions like scabies, psoriasis were missed. Conclusion: Maximum referrals to Dermatology department were from department of internal medicine and infectious dermatoses were the most common cause. Prompt dermatology referral from other departments helps in better patient management and there is a need for better training of nondermatologists to recognise and treat common skin disorders.

Key Words: Referral; Inpatients; Dermatology.

Background: Skin biopsy is one of the most commonly used diagnostic tests in dermatology to achieve accurate and rapid diagnosis. However, it is important to incorporate detailed clinical information for histopathological evaluation. Aims: To retrospectively evaluate the quality of data entered in the histopathology request forms and biopsy reports and to investigate the consistency between clinical and pathological diagnoses in the reported biopsy specimens. Methods: A retrospective analysis of histopathology request forms and their corresponding skin biopsy reports done over a period of two years was undertaken. Details like clinical history, examination findings, biopsy site and technique, purpose of biopsy, number of differential diagnosis, microscopic description, pathologist’s diagnosis, duration of reporting and level of clinicopathological correlation were analyzed. Statistical analysis was carried out for two-tailed significance, and p < 0.05 was considered significant. Results: A total of 456 biopsy reports were analyzed. On assessing the clinicopathological correlation, we observed a concordance rate of 70.2% and discordance rate of 29.8%. No correlation was observed between clinicopathological consistency and inadequate clinical history, inadequate examination findings and number of differential diagnosis. However, correlation was observed between clinicopathological consistency and inadequate clinical history and examination findings, when both were clubbed together. Clinicopathological consistent reports had a significantly higher rate of definitive pathologist’s diagnosis and a significantly shorter duration for issuing the histopathology reports. Conclusions: Several shortcomings were identified in the histopathology request forms during the review. Standardising the methodology of including all details in histopathology request forms would be useful.

Key words: Biopsy; Clinicopathological correlation; Consistency.

Background: Palmoplantar warts are always challenging to the treating dermatologist because of their high rates of failures and recurrences. First line treatment modalities available currently are associated with recurrences and second line modalities are associated with scarring. Clinical trials with MMR suggests that this approach could speed up the resolution of recalcitrant warts. Objective: To evaluate efficacy and safety of intralesional MMR vaccine in treatment of recalcitrant palmoplantar warts by comparing it with intralesional distilled water. Materials and methods: Seventy clinically diagnosed patients were divided into a study group and a control group. MMR injections (0.5 ml) were administered to the study group patients every 3 weeks to the single largest wart. Distilled water (0.5 ml) was administered to the control group at similar intervals. Follow up of patients in both groups were done every month after completion of treatment for 9 months for result, side effects and recurrence. Result: Among 64 patients who completed the study, 32 patients received MMR and 32 patients received distilled water. An 81.30% reduction of wart size and number was noted in study group were as only a 18.80% reduction was seen in control group which was statistically highly significant (p value < 0.001).

Keywords: Warts; MMR vaccine; Distilled water.