{"title":"A Cross-Sectional Study to Determine the Prevalence of Thyroid Autoimmunity in Patients with Chronic Spontaneous Urticaria","authors":"Pallavi Singh, Vidyadhar R Sardesai","doi":"10.4103/cdr.cdr_55_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_55_22","url":null,"abstract":"Abstract Background: Chronic spontaneous urticaria (CSU) can be a distressing condition for both the patient and the treating doctor due to the lack of a definite underlying etiology. The condition has been found to be associated with autoimmune (AI) conditions, which brings to light possible pathogenesis being shared by AI conditions and chronic urticaria. This can help us understand the condition better as well as have a bearing on the treatment. Thyroid autoimmunity is one such condition which has commonly been associated with chronic urticaria. Objectives: To determine the prevalence of thyroid autoimmunity in patients with CSU. To determine the correlation between thyroid autoantibodies level and the severity and duration of CSU. Materials and Methods: Forty-eight adult patients of CSU were enrolled, in whom thyroid autoimmunity was determined by detecting the levels of anti-thyroid peroxidase (anti-TPO) antibody. Urticaria Activity Score was used to determine the activity of the disease. Results: Nine out of 48 (18.75%) patients showed raised anti-TPO antibody levels. Eight out of those 9 (88.89%) patients were female. No correlation was found between the duration of disease and the antibody levels. A significant association was found between the disease activity and anti-TPO antibody levels. Conclusion: The prevalence of thyroid autoimmunity is higher in patients of CSU compared to the general population. The condition occurs more frequently and with greater severity in the female population.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136301489","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":"How and when to Use Psychotropic Drugs in Psychodermatology","authors":"Sharmishtha S. Deshpande, Sanket Bhailume","doi":"10.4103/cdr.cdr_6_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_6_22","url":null,"abstract":"Abstract A significant number of patients coming to dermatologists have psychiatric symptoms as predisposing, precipitating, and perpetuating factors. Assessment and treatment of these conditions is complex. However, looking at the number of patients with these problems, dermatologist needs to be well versed with an assessment of these patients and use of some of the psychotropic drugs. Some such drugs are discussed here along with a discussion about the decision to use them. Benzodiazepines such as clonazepam and lorazepam, doxepin, selective serotonin reuptake inhibitor like fluoxetine, escitalopram, and low dose of antipsychotics like risperidone, haloperidol, and olanzapine are discussed. As the patients are often reluctant to visit a psychiatrist, a dermatologist needs to help in allaying the initial anxiety and to provide understanding about the psychiatric conditions and available options for treatment. In long term, liaison with a psychiatrist can be established and joint treatment by both consultants can be continued.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136301515","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":"Psychological Interventions in Psychodermatological Practice","authors":"Ettappurath N Abdul Latheef, Bishrul N A Hafi","doi":"10.4103/cdr.cdr_11_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_11_22","url":null,"abstract":"Abstract There is a well-established connection between the skin and the mind. Based on current evidence, many dermatological conditions are triggered or exacerbated by stress. Therefore, intervention needs to target stress, anxiety, and other psychiatric comorbidities which may be secondary to skin conditions or may lead to aggravation of the illness. Psychological interventions should be based on the underlying emotional issues that may affect the way skin problems respond to medical treatment. Before starting the intervention, it is very important to know which psychodermatological conditions will be targeted. In primary psychocutaneous illness (delusion of parasitosis, obsessive-compulsive disorder, dysmorphophobia, etc.) the target is to modify or eliminate the symptoms of illness with specific models and approaches. If stress is playing an active role in the etiology and course of skin conditions (e.g., psoriasis, atopic dermatitis, and urticaria) or it is delaying the improvement, then the aim should be to apply stress reduction techniques. In some skin conditions (pemphigus vulgaris, Hansen’s disease, etc.), the aim of the intervention should be to strengthen the defenses and teach new and better mechanisms to maintain control. The common psychotherapy procedures useful in dermatology practice include psychoeducation, behavior therapy, habit reversal, relaxation procedures, biofeedback, cognitive behavior therapy, hypnotherapy, and group therapy.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136301982","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":"Clinical and Dermoscopic Features of Eruptive Collagenomas Localized Only on the Neck in a Young Female","authors":"Satyendra Kumar Singh, Vandana Yadav, Chandra Pratap Singh, Atul Mohan","doi":"10.4103/cdr.cdr_92_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_92_22","url":null,"abstract":"Abstract Eruptive collagenomas are rare nonfamilial connective tissue nevi of unknown etiology and pathogenesis, which are characterized by an abrupt onset of asymptomatic papules, nodules, and plaques on the trunk and extremities. Herein, we report a unique case of eruptive collagenoma in a 29-year-old female, who presented with multiple asymptomatic skin-colored to slightly hyperpigmented papules over the anterolateral aspect of the neck with no systemic involvement. Family history was unremarkable, and the diagnosis was confirmed by histopathological examination which showed thickened homogenized collagen bundles in the superficial dermis. We report this case due to the paucity of cases in Indian literature on eruptive collagenoma in a young female with only neck involvement.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136303779","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":"I Am Anxious, I Bleed – A Rare Clinical Case of Facial Hematohidrosis","authors":"Sahana Srihari, T N Revathi","doi":"10.4103/cdr.cdr_81_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_81_22","url":null,"abstract":"Abstract Hematohidrosis is a rare clinical condition in which an individual sweats blood from intact, unbroken skin. Psychogenic cause is found to be the most frequent among other causes such as vicarious menstruation and systemic disease. We report a case of a 9-year-old boy who had bloody sweat discharge from the face and pinna of the ears while going to school. Pharmacotherapy with oral propranolol and psychotherapy were followed by a complete remission.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136304069","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 dermatology consultations for inpatients: The scope for telemedicine during the COVID-19 pandemic and beyond","authors":"R. Pangti, Somesh Gupta","doi":"10.4103/cdr.cdr_20_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_20_22","url":null,"abstract":"Background: Attending dermatology consultations for inpatients is an integral part of the role of dermatologists inpatient care. Materials and Methods: A retrospective study was conducted at a large tertiary care hospital when the country, particularly the city, was severely affected by the COVID-19 pandemic. The aim was to study the profile of dermatology referrals for inpatients at the time of the COVID-19 pandemic and assessing the need for telemedicine in these inpatients. Results: A total of 341 dermatology consultations for 288 patients were received. Most of the consultations were from internal medicine (15.3%) and obstetrics and gynecology (8.7%). Around 65% of consultations were for new-onset (≤30 days) skin conditions while around 35% were for chronic (>30 days) conditions. The most commonly seen conditions were superficial fungal infections (14.9%) followed by eczematous disorders (13.2%). On grading the level of urgency of the referrals, 34.4% required an immediate consultation, 41% required it within a week, 12.8% within 2–4 weeks, 8% within 1–3 months, and 3.8% after the pandemic settles. The need for urgent consultation was more in acute cases than in chronic cases (P = 0.00). 62.5% of the consultations could have been done by telemedicine. Conclusion: As a majority of the consultations were for common and straightforward skin conditions and could mostly be done on telemedicine, this study underlines the need for strengthening the telemedicine services for inpatients referrals during this COVID-19 pandemic and even beyond.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229108","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":"Drug reaction with eosinophilia and systemic symptoms syndrome with toxic epidermal necrolysis: Overlap in an HIV seropositive male with diffuse large “B” cell lymphoma – A rare case report","authors":"N. Bhatt, V. Belgaumkar, R. Chavan, N. Deshmukh","doi":"10.4103/cdr.cdr_94_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_94_21","url":null,"abstract":"Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction with varied presentations. We report a rare case of DRESS syndrome with toxic epidermal necrolysis (TEN) overlap associated with non-Hodgkin lymphoma (NHL). A 52-year-old male with retroviral disease presented with fever and diffuse skin peeling with mucosal erosions. The patient was on antitubercular therapy (ATT) for 1 month for suspected tubercular cervical lymphadenitis. He had facial edema, extensive skin tenderness, and denudation with a positive Nikolsky's sign, icterus, hepatosplenomegaly and multiple enlarged immobile nontender cervical, and axillary and inguinal lymph nodes. Investigations showed leukocytosis with hepatic and renal dysfunction. Skin histopathology was consistent with TEN. Based on Registry of Severe Cutaneous Adverse Reaction criteria, a diagnosis of ATT-induced DRESS with TEN overlap was made. Cervical lymph node biopsy and immunohistochemistry confirmed diffuse large B-cell NHL. ATT was withheld and the patient was treated with systemic steroids and assessed for initiation of chemotherapy. The profound immunological dysregulation in individuals with retroviral disease leads to varied clinical presentations, increasing the chances of diagnostic errors, and culminating in challenging scenarios. Therefore, seemingly innocuous symptoms and signs warrant thorough evaluation. Sound clinical acumen and prompt investigations for unusual causes such as malignancies can improve outcomes by aiding accurate diagnosis as well as avert untoward complications such as DRESS syndrome/TE.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44593911","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}
S. Shetty, Ruta Joshi, A. Kombettu, Chethana Gurumurthy, G. Kanthraj
{"title":"An image-based scoring system as an alternative to face-to-face examination for acne vulgaris to deliver follow-up care: A comparative study","authors":"S. Shetty, Ruta Joshi, A. Kombettu, Chethana Gurumurthy, G. Kanthraj","doi":"10.4103/cdr.cdr_24_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_24_22","url":null,"abstract":"Background: AV is a chronic disease with flares and remissions requiring regular follow-ups. Image-based lesion counting (LC) is useful when in-person consultations are not possible, like the COVID-19 pandemic. Objective: The aim of this study is to validate the proposed scoring system for teledermatology consultation and compare it with face to face. Materials and Methods: The face was divided into three zones which was further divided by drawing the imaginary lines from fixed points. AV (Grade 1 and 2) lesions were counted by co-investigator in person at baseline, first, and second follow-up visits. The images of the same were evaluated and scored by the principal investigator. Acne scores obtained were compared and statistically analyzed. Results: Two hundred cases were enrolled. Mean acne scores for in-person were 945.37, 647.57, and 550.81 and for teledermatology 1044.99, 718.79, and 654.36 for baseline, 1st, and 2nd follow-up, respectively. The mean decrease from baseline, 1st and 2nd follow-up, independent sample t-test and correlation analysis was significant in both groups (P = 0.001). Limitations: AV grade 3 and 4 are not included. Conclusion: During the 1st follow-up, a decrease in acne scores was observed, along with consistency in the scores between the evaluators. Image-based lesion counting is a promising approach. The proposed scoring system can be used for both modes of consultation-face-to-face and teledermatology.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41830565","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":"Undiagnosed Diabetes Mellitus Type 2 Unmasked by Herpes Zoster with Dissemination: Report of Two Cases","authors":"P. Kamboj, Preema Sinha, M. Madakshira, D. Shahi","doi":"10.4103/cdr.cdr_22_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_22_22","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70701998","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}
A. Waśkiel-Burnat, W. Dorobek, M. Kotowska, M. Starace, B. M. Piraccini, M. Olszewska, L. Rudnicka
{"title":"Cardiovascular risk in patients with alopecia areata:\u0000a cross-sectional study","authors":"A. Waśkiel-Burnat, W. Dorobek, M. Kotowska, M. Starace, B. M. Piraccini, M. Olszewska, L. Rudnicka","doi":"10.5114/dr.2023.128016","DOIUrl":"https://doi.org/10.5114/dr.2023.128016","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77747799","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}