Clinical Significance Of Serum Vitamin D Level In Patients Of Vitiligo At Tertiary Care Centre, Surat, India

Background: Vitiligo is an acquired, idiopathic, heritable depigmentary disorder of the skin and/or mucous membranes. Autoimmunity plays an important role in pathogenesis of vitiligo which is also evident by coexistence of various autoimmune disorders with vitiligo. In turn, vitamin D levels have been found to be reduced in various autoimmune disorders, thus pointing to a plausible association between vitiligo and vitamin D levels. Few reports have evaluated serum vitamin D levels in vitiligo and their results are conflicting. Aim:To study clinico-epidemiological profile and to evaluate serum vitamin D levels of vitiligo patients and compare vitamin D level with control. Methods: Total 25 patients clinically diagnosed with vitiligo were enrolled in study and 25 age and sex matched control were included. Results were carried out using STATAversion 14.2 Results:The patients had lower serum vitamin D levels than the controls, but this difference was not statistically significant. (p = 0.557) Conclusions: Significantly lower vitamin D levels were found in majority of vitiligo patients, but this was not significant.

Sporotrichoid nocardiosis with cutaneous dissemination.

Dissemination of primary cutaneous nocardiosis is a rare event. A 37-year-old man working as farmer presented with multiple painful suppurative nodular and ulcerative skin lesions over left lower extremities, in a linear pattern, with duration of five months and single painful nodule over right elbow since last three months. We found the presence of beaded filamentous bacteria in Gram stain smear and partial acid fast stain, from the smear taken from pus. Patient responded well to cotrimoxazole therapy. Hence, we confirm our diagnosis of sporotrichoid pattern of cutaneous nocardiosis with dissemination to other cutaneous area.

Kaposi's sarcoma: A presenting sign of HIV.

Kaposi's sarcoma (KS) is a multifocal cutaneous and extra cutaneous vascular proliferative disorder. In India, there are only a few cases of HIV-associated KS in published literature. A 26-year-old married man presented with asymptomatic elevated skin lesions over the face, trunk, both upper limbs and lower limbs with a duration of one-and-a-half months. Cutaneous examination revealed multiple violaceous papules and nodules, on the face (right upper and lower eyelids, upper lip), trunk and proximal part of both limbs. Oral cavity showed erythematous plaques, two in number, on the hard palate. Skin biopsy showed proliferation of thin walled capillaries with formation of slit like spaces, spindle cell proliferation, abundant extravasation of RBCs and moderately dense inflammatory infiltrate in the dermis. Thus a clinical diagnosis of cutaneous KS was confirmed. On testing with ELISA for HIV, the patient was for the first time diagnosed as HIV reactive. Thus KS was the presenting manifestation of HIV disease.