Indian Journal of Dermatology最新文献

{"title":"Clinico-Mycological Study of Dermatophytosis among Diabetic and Non-Diabetic Patients in a Tertiary Level Hospital: A Comparative Study.","authors":"Abarna Rajagopal, Rangappa Vinutha, Padubidri Kombettu Ashwini, Veeranna Shastry, Chitharagi B Vidyavathi","doi":"10.4103/ijd.ijd_1111_23","DOIUrl":"10.4103/ijd.ijd_1111_23","url":null,"abstract":"<p><strong>Background: </strong>Dermatophytosis is a major public health concern in India, especially in recent years, with an alarmingly rising trend, particularly in relation to recurrent and chronic infection. The number of studies examining the relationship between an individual's glycemic status and the development of dermatophytosis, and a comparison of the evolving species trend between diabetic and non-diabetic patients infected with dermatophytes, is limited.</p><p><strong>Aims and objectives: </strong>To study and compare the clinical and mycological aspects of dermatophytosis among diabetic and non-diabetic patients and to compare the culture isolates in both groups.</p><p><strong>Materials and methods: </strong>The study included 378 patients of clinically suspected dermatophytosis, divided into two groups of 189 known diabetics and non-diabetics each. We subsequently analysed and compared the demographics, clinical data, potassium hydroxide (KOH) mount, calcofluor white (CW) staining and fungal culture results of all patients in both groups.</p><p><strong>Results: </strong>Among the 378 patients, diabetic patients had a significantly greater extent of involvement and higher rates of recurrence when compared to non-diabetics. The overall positivity rate was higher in CW staining (77.8%) as compared to KOH (57.7%) in both non-diabetics and diabetics. <i>Trichophyton mentagrophytes</i> was the most common isolate (47.6%) in both diabetic (55.0%) and non-diabetic (61.4%) patients, followed by <i>Trichophyton rubrum</i> (31.8% and 29.6%, respectively). The positivity percentages of fungal culture, KOH and CW staining increased to 100%, 77.9% and 95.7%, respectively, when scrapings were taken from ≥2 sites.</p><p><strong>Conclusion: </strong>The pattern of dermatophytosis is comparatively more chronic and severe in diabetics compared to non-diabetics. <i>T. mentagrophytes</i> was the most common culture isolate in both groups. CW staining can potentially be used as the initial method of choice for the diagnosis of dermatophytosis as it has significantly outperformed the conventional KOH mount. Scrapings can regularly be taken from ≥2 sites to avoid false negative results.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 6","pages":"486"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Fungal Infections of Skin and Role of Histopathology in Diagnosis.","authors":"Subhra Dhar, Swetalina Pradhan, Abhijit Saha, Gautam Mazumder, Sudip K Ghosh, Manas Biswas, Abhishek De, Pradip Srivastava, Amrita Madnani, Rashmi Agarwal, B S Chandrashekar, Lalthleng Liani, Rajib Malakar, Ruby Jain, Rakesh Biswas, Sunanda Dey, Sandipan Dhar","doi":"10.4103/ijd.ijd_419_23","DOIUrl":"10.4103/ijd.ijd_419_23","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Deep mycoses acquired by penetrating trauma to the skin can have varied and sometimes atypical morphological presentations resulting in diagnostic dilemmas and delay in treatment onset. Histopathology can be a useful tool in not only diagnosing but also differentiating various deep mycoses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;To observe various morphological presentations and histopathological features of deep fungal infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective multi-centric study was conducted from 2010 to 2020 at 16 centres. The cases with diagnoses of various deep mycoses were included in the study. The patients presenting with cutaneous manifestations were included in the study. Their demographic details, history, presenting signs and symptoms, morphological presentations, histopathological features and treatment details were collected from the case sheets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 124 cases were found from the case records. The most common type was chromoblastomycosis (42) followed by mycetoma (28) and rhinosporidiosis (17). The mean age was 43.76 ± 5.44 years. The average duration of symptoms before presentation was between 2 months to 10 years (average 2.5 ± 1.33 years). Male to female ratio was 1:0.7. Prior history of trauma was recorded in 36% of cases. Chromoblastomycosis cases presented with verrucous to atrophic plaques with black dots on the surface and histopathology findings included pesudoepitheliomatous hyperplasia, epithelioid cell granulomas, copper penny bodies within granulomas and abscesses. Rhinosporidiosis cases had polypoid grape-like lesions in the nose and eyes most commonly with histopathology findings of abundant thick-walled sporangia in dermis packed with thousands of spores. Eumycetoma patients had pigmented, indurated swelling with multiple sinuses discharging black granules and histopathology showed dermal abscesses and foreign body granulomatous reaction with PAS-positive hyphae. Histoplasmosis patients presented with few to multiple nodulo-pustular lesions on skin and palatal ulcers while small basophilic bodies packed in the cytoplasm of histiocytes were noted in histopathology. Phaeohyphomycosis cases presented as deep-seated cystic lesions and biopsy revealed deepithelialized cysts in the dermis or hypodermis with lumen showing necro inflammatory debris and fungal hyphae. Sporotrichosis cases had erythematous, tender nodules and papules either as single lesions or as multiple lesions arranged in a linear fashion and histopathology showed pseudoepitheliomatous hyperplasia of epidermis, loose to well-defined epithelioid cell granulomas and microabscesses. Spores were found in two cases. Cryptococcosis patient had multiple umbilicated lesions resembling giant molluscum contagiosum loose epithelioid cell granulomas and medium-sized spores lying in both intra and extracellularly on histopathology. Penicilliosis patients had n","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 6","pages":"442-452"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulcerative Necrobiosis Lipoidica Involving Atypical Site Over Upper Limb.","authors":"Preema Sinha, Choudhary S Raj, G B Prashantha, Manoj G Madakshira","doi":"10.4103/ijd.ijd_309_24","DOIUrl":"10.4103/ijd.ijd_309_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 6","pages":"487"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria.","authors":"Xiaonan Qiu, Qiao Ran, Juanjuan Pan, Guozhen Tan","doi":"10.4103/ijd.ijd_558_22","DOIUrl":"10.4103/ijd.ijd_558_22","url":null,"abstract":"<p><strong>Backgrounds: </strong>A large proportion of patients with chronic spontaneous urticaria (CSU) are resistant to a standard dose of antihistamine. Acknowledged biomarkers for identifying these patients have not been determined. The neutrophil/lymphocyte ratio (NLR) has been considered as an important indicator of inflammation in chronic diseases.</p><p><strong>Aims: </strong>To explore whether NLR could serve as a biomarker for predicting the response to H1-antihistamine in patients with CSU.</p><p><strong>Methods: </strong>This hospital-based, retrospective study included 109 patients with CSU diagnosed from 2017 to 2020 in our clinic and divided them into two groups by their responses to the 2-week antihistamine therapy of standard-dose: 69 with H1-antihistamine-refractory and 40 with non-H1-antihistamine-refractory CSU. The laboratory test results were collected from the hospital information system and integrated with SPSS software.</p><p><strong>Results: </strong>Patients refractory to H1-antihistamine had significantly higher median NLR (<i>P</i> = 0.039), age (3 <i>P</i> = 0.021), complement C3 (<i>P</i> = 0.026), presence of elevated WBC (<i>P</i> = 0.026) and elevated monocytes (MONO) (<i>P</i> = 0.045) and significantly lower IgM (<i>P</i> = 0.022). The binary logistic regression model revealed that NLR was significantly associated with H1-antihistamine-refractory of CSU (odds ratio (OR) 1.717, 95% confidence interval (CI) 1.065-2.766, <i>P</i> = 0.026), which was consistent with that after adjusted for potential confounding factors including age, complement C3, presence of elevated WBC and MONO, and IgM (OR 1.681, 95% CI 1.019-2.773, <i>P</i> = 0.042).</p><p><strong>Conclusion: </strong>Our results showed a strong and significant association between higher NLR and H1-antihistamine resistance in CSU, suggesting that NLR may be a potential biomarker for predicting the response to H1-antihistamine therapy in patients with CSU.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"367-370"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sweet Syndrome Mimicking Flagellate Dermatitis.","authors":"Mendez-Flores Silvia, Rebeca Palafox Romo, Andrea Malagon Liceaga, Marcela Saeb-Lima","doi":"10.4103/ijd.ijd_202_24","DOIUrl":"10.4103/ijd.ijd_202_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"423"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Progression from Pseudo-Vesicular Lesions to Polymorphic Eruption: A Diagnostic Dilemma.","authors":"Srishti Tripathi, Kiran P Malhotra, Parul Verma, Shailendra P Verma, Gopa Banerjee, Swastika Suvirya","doi":"10.4103/ijd.ijd_193_23","DOIUrl":"10.4103/ijd.ijd_193_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"418-419"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Study on Female Genital Dermatoses and the Impact of Chronic Genital Dermatoses on Quality of Life in Adult Females.","authors":"A S A Nivalika, Smitha S Prabhu","doi":"10.4103/ijd.ijd_1118_23","DOIUrl":"10.4103/ijd.ijd_1118_23","url":null,"abstract":"<p><strong>Background: </strong>Female genital dermatoses (FGD) or vulvar dermatoses are a group of disorders that affect the vulva and contiguous parts. Most of the FGDs can be chronic or recurrent. Effects on Quality of life (QoL) in patients having dermatological conditions are well studied but this is not the case in vulvar dermatoses.</p><p><strong>Aims: </strong>We aimed to study the etiology of genital dermatoses in females attending the Dermatology Out Patient Department (OPD) and to assess QoL in females with chronic FGD (>6 weeks duration).</p><p><strong>Settings and design: </strong>This was an observational study on female patients with vulvar complaints presenting to dermatology OPD. Both venereal and nonvenereal dermatoses were enrolled. QoL was assessed in females with chronic FGD using a self-administered Dermatological Life Quality Index (DLQI) questionnaire.</p><p><strong>Statistical analysis: </strong>Sample size was calculated using the formula Categorical variables were presented as numbers and percentages (%) and continuous variables were presented as mean ± standard deviation (SD) and median. The normality of the data was tested by the Kolmogorov-Smirnov test or non-parametric test. A t-test was used for the estimation of the mean.</p><p><strong>Results: </strong>Ninety-seven patients were included in our study; Vulvovaginal candidiasis was the most common dermatoses (22.6%); Lichen simplex chronicus (11.3%) the commonest non-venereal dermatoses. 57 (58.7%) had chronic FGD, among whom 43 (75.4%) had significant QoL impairment.</p><p><strong>Conclusions: </strong>Infectious etiologies predominated. There was significant impairment in QoL in females with chronic FGD.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"385-390"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Probiotic in Vulvovaginal Candidiasis: A Randomised Controlled Non-blinded Trial from India.","authors":"Apaopa Jemima Thekho, Vibhu Mendiratta, Taru Garg, Ravinder Kaur, Vidya Yadav","doi":"10.4103/ijd.ijd_193_24","DOIUrl":"10.4103/ijd.ijd_193_24","url":null,"abstract":"<p><strong>Background: </strong>Vulvovaginal candidiasis (VVC) is a prevalent form of vaginitis, and most patients show improvement when treated with antifungal medications. However, recurrence may affect a minority. It has been found through previous research that the concomitant utilisation of probiotics during acute VVC leads to early relief of symptoms and signs and offers a preventive measure against recurrences.</p><p><strong>Objectives: </strong>This study aimed to assess the efficacy of the combination of oral probiotics with conventional antifungal treatment as compared to conventional antifungal treatment alone.</p><p><strong>Methods: </strong>Sixty patients who were newly diagnosed with VVC were enrolled in a randomised controlled trial. They were divided into two groups. Group A included 30 cases treated with conventional antifungal medication (oral fluconazole 150 mg single dose), while Group B included 30 cases treated with conventional antifungal medication (oral fluconazole 150 mg single dose) alongside oral probiotic capsules (<i>Lactobacillus rhamnosus</i>, <i>L. crispatus</i>, <i>L. gasseri</i>, <i>L. jensenii</i>) for 2 months. The clinical and mycological findings were recorded before and after treatment. The relapse rate and side effects were recorded during the period of our study.</p><p><strong>Results: </strong>No significant difference between the clinical cure rate, mycological cure, and relapse rate was seen between the two groups. (<i>P</i> < 0.05). However, a larger proportion of patients in Group B (97%) achieved complete remission compared to Group A (90%). No side effects were noted in either of the groups.</p><p><strong>Conclusion: </strong>Based on the findings, it can be concluded that the addition of probiotics to conventional antifungal treatment led to better rates of clinical and mycological cure and a lower likelihood of relapse compared to conventional antifungal treatment alone.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"422"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addisonian Pigmentation - The Great Mimicker - A Review.","authors":"Damini Verma, Rashmi Sarkar, Vibhu Mendiratta, Amol Srivastava","doi":"10.4103/ijd.ijd_234_23","DOIUrl":"10.4103/ijd.ijd_234_23","url":null,"abstract":"<p><p>Skin colour usually depends upon melanin, haemoglobin, and carotenoids. Pigmentary disorders indicate an increased amount of melanin, leading to a darker colour of the skin, called hypermelanosis. Addison's disease is a rare endocrinal disorder with severe oral and systemic manifestations. Any form of diffuse skin hyper-pigmentation which is more pronounced on sun-exposed areas mimics Addison's disease and is called Addisonian pigmentation. Pigmentation often precedes other manifestations by months to years and hence can lead to early diagnosis and can prevent life-threatening adrenal crisis. The most common cause of adrenal insufficiency in developing countries is tuberculosis. A similar pattern of pigmentation has been reported in Cushing's syndrome, ectopic ACTH-producing tumours, vitamin B12 deficiency, and thyrotoxicosis. Addisonian pigmentation can be a manifestation of multiple systemic diseases; hence, an inter-disciplinary approach is needed with extensive clinical and laboratory evaluation. It is not merely a cosmetic concern. Not much data are available in the literature regarding this entity. This brief review serves as an important source for clinicians to stay up-to-date regarding the history, clinical presentation, differential diagnosis, and management of this entity.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"422"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steri-Strip Sling Technique - A Simple Procedure for the Management of Ingrown Toenails - A Prospective Study.","authors":"Eeshaan Ranjan, Sandeep Arora, Neha Sharma, Durga M Tripathy, Shekhar Neema, Shailendra Srivastava, Reetu Agarwal","doi":"10.4103/ijd.ijd_1174_23","DOIUrl":"10.4103/ijd.ijd_1174_23","url":null,"abstract":"<p><strong>Background: </strong>Ingrown toenail is a nail disorder that commonly affects great toenails. Surgical modalities are commonly used as first-line treatment. A conservative approach is preferable as surgical procedures lead to pain and affect routine activities. Our aim is to study the efficacy of a new conservative technique using steri-strip^TM for the treatment of mild to moderate ingrown toenails as an outpatient procedure.</p><p><strong>Methods: </strong>Fifty patients presenting with stage 1-2 ingrown toenails were treated with the 'steri-strip sling technique'. Steri-strip^TM is inserted between the disto-lateral edge of the nail plate and nail fold and secured with an elastic bandage. The dressing is kept till the nail edge grows over the nail fold and stops penetrating the skin. Patients were reviewed every week for a month after the treatment and monthly thereafter. The final result was assessed at 6 months. The success of treatment was assessed clinically and by patient satisfaction levels.</p><p><strong>Results: </strong>Fifty patients were treated and followed up. Immediately after the procedure, all patients reported significant relief in pain. After 6 months, 46 out of 50 patients were satisfied with the treatment and showed no recurrence. No complications were reported.</p><p><strong>Conclusion: </strong>The 'Steri-strip^TM sling technique' is a simple and effective outpatient procedure for the management of mild to moderate ingrown toenails.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 5","pages":"391-395"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}