G. Menghani, N. Kaur, K. Vyas, Kalpana Gupta, K. Maheshwari, R. Singh
{"title":"A prospective, randomized, open-label, active-controlled study to compare the efficacy and safety of levocetirizine and bepotastine in chronic spontaneous urticaria","authors":"G. Menghani, N. Kaur, K. Vyas, Kalpana Gupta, K. Maheshwari, R. Singh","doi":"10.4103/cdr.cdr_105_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_105_21","url":null,"abstract":"Background: Management of chronic spontaneous urticaria (CSU) is challenging because of its unpredictable course and negative influence on the quality of life. Second-generation antihistaminics are the first-line treatment. Levocetirizine, a time-tested antihistaminic, has proven efficacy in CSU. Bepotastine, which was previously used for allergic rhinitis and conjunctivitis, has recently been tried in urticaria. It may be a better alternative to levocetirizine because of its long-term safety. Objectives: The aim of this study was to compare the efficacy and safety of levocetirizine and bepotastine in CSU. Materials and Methods: A randomized, active-controlled, open-label, prospective, interventional study was conducted on 70 patients of CSU. After initial clinical assessment and baseline investigations, bepotastine and levocetirizine were prescribed to separate groups of 35 patients for a period of 12 weeks. Urticaria Activity Score (UAS) and Dermatology Life Quality Index (DLQI) were used for assessing the severity of disease. Follow-up visits were planned for evaluating clinical improvement and adverse effects. Results were compared using Mann–Whitney U test and Fisher's exact test. P < 0.05 was considered statistically significant. Results: The reduction in UAS and DLQI score in levocetirizine group was better than bepotastine group, and the results were statistically significant at 12 weeks (P = 0.0001). Incidence of adverse effects such as sedation and weight gain was higher in levocetirizine group at 12th week (P = 0.0003). Conclusion: The result of the study reveals the superiority of levocetirizine in terms of efficacy, i.e., reduction of UAS and DLQI scores. Bepotastine although slightly lower in efficacy shows better safety profile.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49052399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A retrospective study to analyze the pattern of referrals to the department of dermatology, venereology, and leprosy at a tertiary care center in Karnataka","authors":"S. Somaiah, S. Manjunath, T. Nagesh","doi":"10.4103/cdr.cdr_12_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_12_22","url":null,"abstract":"Background: Dermatology is mainly considered as an outpatient specialty. In an institutional set up, the patients who are hospitalized in nondermatology departments may have skin diseases. The patients visiting other outpatient departments might have skin disorders. Such patients are referred to the department of dermatology and can be diagnosed and treated better in dermatology departments. Objectives: The objective was to analyze the pattern of referrals to the department of dermatology, venereology, and leprosy from other departments of the hospital. Materials and Methods: The records of the department of dermatology, venereology, and leprosy were analyzed for referrals between September 2019 and February 2020. Results: There were 214 males (46.8%) and 188 (53.2%) females in the study. The mean age of the patients in the study was 40.9 ± 20.8 years. Maximum number of referrals were received from the department of general medicine (192 cases, 47.7%), followed by general surgery (64 cases, 15.9%). Infections and infestations accounted for 183 (45.5%) cases out of the 402 referrals, and eczematous disorders were seen in 58 (14.4%) cases. The referring departments mentioned their dermatological diagnosis in 24% of the cases and were found to be correct in 18% of cases. Conclusion: The common dermatological conditions are often undiagnosed or misdiagnosed by nondermatologist, leading to incorrect treatment, and contributes to delay in treatment. By focusing on improving the training of undergraduate and postgraduate students in the conditions for which dermatology referrals are usually sought might help in improving their knowledge and later help them treat patients better.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46732538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Punctate palmoplantar keratoderma: A case report and literature review","authors":"J. Prathibha, Vijay V Aithal","doi":"10.4103/cdr.cdr_49_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_49_21","url":null,"abstract":"Punctured palmoplantar keratodermas are rare autosomal-dominant keratodermas presenting as asymptomatic, tiny hyperkeratotic pigmented papules on the palms and soles. We present a rare case of punctate palmoplantar keratoderma type 1 extending to the dorsum of the foot with pes cavus deformity of the foot. We did the literature review.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42735030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nevus unius lateris with coexisting unilateral atrophoderma vermiculatum: A rare presentation","authors":"S. Singh, Deeksha Goyal, A. Mohan","doi":"10.4103/cdr.cdr_32_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_32_22","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48237285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoganand J. Phulari, Ram Kukreja, R. Hiremath, Chetan C. Patil, P. Patel
{"title":"Vitiligo: Prevalence, clinical patterns, and efficacy of narrow band ultraviolet B phototherapy","authors":"Yoganand J. Phulari, Ram Kukreja, R. Hiremath, Chetan C. Patil, P. Patel","doi":"10.4103/cdr.cdr_49_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_49_22","url":null,"abstract":"Background: Vitiligo denotes an acquired primary, usually progressive, melanocytopenia of unknown etiology, and clinically manifested by circumscribed achromic macules often associated with leukotrichia. Objective: The objective was to assess the prevalence and various clinical patterns of vitiligo and to study the efficacy of narrow-band ultraviolet B (NB-UVB) radiation. Materials and Methods: A prospective case series study was carried out at dermatology outpatient department (OPD), of tertiary care center in Central India on 50 patients of Vitiligo, who were diagnosed clinically, age ranging from 5 to 70 years of age. A thorough history and clinical examination as per institutional protocol was done for all the patients included in the study. Patients were exposed to NB-UVB rays in a phototherapy unit (Dermaindia Spiegel Series) with a standard protocol. Two scores designed for the assessment of vitiligo are Vitiligo Area Severity Index and Wallace Rule of Nines. Results: During the period of two years, 6638 patients were seen in dermatology OPD, out of which 129 patients were having vitiligo clinically. Thus, the prevalence of vitiligo was 1.9% in our study. The mean age in male was 40.4 years and that of female was 30.85 years. The female-to-male ratio was 2:3. 6% had a positive family history of vitiligo. The most common site affected was leg (pretibial region) (48%). Two patients (4%) were in Category– 0, 12 patients (24%) were in Category– I, 24 patients (48%) were in Category-II, and 12 patients (24%) were in Category– III, when graded according to their improvement. Forty-five patients (90%) had vitiligo vulgaris, two patients (4%) had segmental vitiligo, and one patient (2%) each of acrofacial vitiligo, lip-tip vitiligo, and focal vitiligo. On comparing the level of significance before treatment and after 2 months of treatment, after 4 and 6 months of treatment, and before treatment and at the end of treatment, it was found that the results were statistically highly significant. Thus, indicating that the improvement in the disease after NB-UVB therapy is statically significant. Conclusion: Our study found 1.9% prevalence of vitiligo among patients attending OPD. On comparing the level of significance, before treatment and at the end of treatment, it was found that the results were statistically highly significant with respect to improvement. Side effects were minimal in our participants. Thus, our study concludes that NB-UVB radiation is an effective and safe therapy for vitiligo.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45703124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of metabolic syndrome among children with psoriasis in urban Bengaluru","authors":"H. Lakshmi, L. Budamakuntla, C. M. S. Sundar","doi":"10.4103/cdr.cdr_73_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_73_21","url":null,"abstract":"Background: Psoriasis is a common, chronic inflammatory dermatosis that often has its onset during childhood. There is increasing evidence that psoriasis in adults is associated with obesity, metabolic syndrome (MetS), and associated comorbidities. Such an association raises concern with regard to the long-term health implications for children with psoriasis and suggests that better awareness, evaluation, and management of overweight and obese patients and associated metabolic disease are warranted in this population. Objectives: The present study was undertaken to evaluate the prevalence of MetS in childhood psoriasis. Materials and Methods: It was a cross-sectional, observational study in children aged between 6 and 18 years with psoriasis involving >10% body surface area. All children were evaluated and investigated for MetS. Results: The study included 32 children, female-to-male ratio was 5:3 with an earlier presentation in females. Body mass index was >75th centile in eight children, and among them, four had >90th centile. The waist circumference of four children was in the 90th percentile for age. Mean fasting plasma glucose, serum triglycerides, and serum high-density lipoprotein (HDL) were 89.81 ± 6.56 mg/dl, 109.25 ± 36.29 mg/dl, and 37.78 ± 7.40 mg/dl, respectively. Four of 32 children met the criteria for MetS, 14 others had at least one criterion. Fifty percent (16/32) of them had HDL lower than 40 mg/dl. The mean duration of psoriasis was more in those with MetS (4.75 years vs. 1.44 years, P = 0.005). Conclusion: Pediatric psoriasis is found to be associated with obesity and MetS. The presence of obesity with psoriasis mandates evaluation for MetS.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42725350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Profile of dermatological disorders among construction workers: A cross-sectional study","authors":"Nafina Jasmine, S. Shetty, S. Pai","doi":"10.4103/cdr.cdr_113_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_113_21","url":null,"abstract":"Background: The construction industry is a growing industry worldwide, including India, employing a large population. Construction workers perform a variety of work including mixing concrete and carrying heavy objects. Occupational contact dermatitis is a significant occupational dermatosis, cement being the most important agent and is an occupational hazard. Objective: The objective of this study was to estimate the prevalence of occupational skin diseases among construction workers. Materials and Methods: This cross-sectional study was conducted in Manipal, Karnataka, among 300 construction workers. A detailed inquiry was made on demographic parameters such as age, sex, nature of work, duration of the job, chemicals exposed to, symptoms, and use of protective devices. They were examined to note the symptoms, clinical pattern, and distribution of lesions. Results: The majority of the workers belonged to the age group between 20 and 29 years. The common skin disorders noticed were callosities (17.33%), traumatic injuries (10%), dermatophyte infections (8.33%), and dermatitis (5.7%) along with few other dermatoses encountered due to increased exposure to heat and due to increased wet work in workers who did not wear protective devices. Conclusions: There is a lack of preemployment and periodic medical examinations for construction workers. Common dermatoses seen among the construction workers were mainly due to the lack of preventive measures. Hence, it is important to raise health awareness to recognize early signs and symptoms of various dermatoses and educate regarding the use of personal protective equipment.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45850806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effective role of teledermatology in managing chronic urticaria patients during the COVID-19 pandemic","authors":"Y. Pathania","doi":"10.4103/cdr.cdr_101_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_101_21","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45429631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Navneet Kaur, Amandeep Saluja, K. Vyas, Kalpana Gupta
{"title":"Coexistence of lupus vulgaris and scrofuloderma in an immunocompetent patient: A rare presentation","authors":"Navneet Kaur, Amandeep Saluja, K. Vyas, Kalpana Gupta","doi":"10.4103/cdr.cdr_37_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_37_21","url":null,"abstract":"Tuberculosis (TB) may involve cutaneous tissue in approximately 0.1%–0.5% of the cases. There are various morphological presentations of cutaneous TB such as lupus vulgaris (LV), scrofuloderma, TB verrucosa cutis, and tuberculids. Usually, a single form is observed in an individual, but coexistence of the multiple forms has been rarely reported in the literature. These concurrences may be considered an interesting immunological phenomenon as two immunologically different poles are occurring simultaneously. We present a case of LV and scrofuloderma in the same patient at different sites.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41631538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sampriti Samanta, A. Bandyopadhyay, S. Bhattacherjee, A. Mukherjee
{"title":"Dermatological quality of life among leprosy patients residing at a rehabilitation center in North-Eastern India: A cross-sectional study","authors":"Sampriti Samanta, A. Bandyopadhyay, S. Bhattacherjee, A. Mukherjee","doi":"10.4103/cdr.cdr_112_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_112_21","url":null,"abstract":"Background: Leprosy has been affecting humans since ancient times. A chronic infectious disease, it affects skin, peripheral nervous system, and other tissues which lead to nerve damage, pain, and visible deformities. The characteristic skin lesions of leprosy can lead to significant social stigmatization and functional impairments which can affect the quality of life (QoL). Objective: The present study was conducted to assess the dermatological QoL among these leprosy patients. Materials and Methods: An observational cross-sectional study was conducted among 122 leprosy patients who were receiving treatments at a rehabilitation center in North-Eastern India in a 3-month time period. The dermatology QoL Index (DQLI) questionnaire was used to assess the QoL among these patients. Descriptive statistics and logistic regression analyses were used. Results: Among a total of 122 patients, leprosy had no effect on QoL in 4.9%, small effect in 11.5%, moderate effect in 37.7%, very large effect in 43.4%, and extremely large effect in 2.5% cases. Mean DQLI score was 10.5 ± 5.1. The most affected domain was leisure and social followed by symptoms and feelings. When adjusted for predictors, age and sex were found to have a significant association with QoL. Conclusions: Leprosy with dermatological manifestations had a very large effect on QoL. The impairment was more than other chronic skin diseases, such as chronic urticaria, vitiligo, and psoriasis. It is necessary that periodic assessment of QoL should be incorporated into the management of leprosy patients.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46424757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}