Skin as an endocrine organ: A narrative review

Skin being the largest organ of the body, is equipped with numerous functional properties. Over the past few years, intricate research into the biology of skin has led to a gamut of discoveries. Skin is now regarded as one of the most vital endocrine organs. The skin contains equivalents of the hypothalamo-pituitary-adrenal axis, hypothalamo-pituitary-thyroid axis and the appendages produce multiple hormones such as Vitamin D, sex steroids, retinoids and opioids. In this article, we will explore the role of skin as a target and source of some of the hormones of the human body, and briefly touch on the clinical applications

Topical corticosteroid induced ulcerated striae

Abstract We report four cases of ulcerated striae following misuse of fixed dose combinations creams containing clobetasol propionate with antifungal and antibacterial agents.

From physician to anxious parent

It was 1 am when my wife woke me up, saying that our tiny tot (who was six months old) was shivering and had a high fever. We immediately wrapped him in his blankets and rushed to the paediatric ward of my hospital. Surprisingly, there was less chaos than usual in the ward that night. I requested one of the senior postgraduate students to examine my baby. Wasting no time, she started assessing all the parameters and told us that the baby’s temperature was 102 °F. Meanwhile, the rigours started again and the baby had two bouts of vomiting. In view of the entire clinical picture, the paediatrician advised us to get the baby admitted in the intensive care unit (ICU).

Appearances in dermatopathology: The diagnostic and the deceptive.

Dermatopathology involves study of the microscopic morphology of skin sections. It mirrors pathophysiologic changes occurring at the microscopic level in the skin and its appendages. Sometimes, we come across certain morphologic features that bear a close resemblance to our physical world. These close resemblances are referred to as "appearances" in parlance to dermatopathology. Sometimes, these "appearances" are unique to a certain skin disorder and thus help us to clinch to a definitive diagnosis (e.g., "tadpole" appearance in syringoma). However, frequently, these appearances are encountered in many other skin conditions and can be therefore be misleading. In this paper, we attempt to enlist such "appearances" commonly found in the dermatopathologic literature and also enumerate their differential diagnoses.

Pediculosis capitis: An update.

Head louse infestation, or pediculosis capitis, caused by Pediculus humanus var. capitis, is a common health concern in pediatric age group. An itching of the scalp is the chief symptom, whereas presence of viable nits confirms the diagnosis of head louse infestation. Secondary bacterial infection with impetignization with cervical and occipital lymphadenopathy can complicate the clinical scenario with physician misdiagnosing pediculosis to a primary bacterial infection. Screening and treatment of all close contacts is necessary for an adequate management of pediculosis. Medical management of head louse infestation requires proper application of topical pediculicidal agents', chiefly permethrin lotion and wet combing with a fine toothcomb. Severe cases with high parasitic load justify the use of either oral cotrimoxazole or Ivermectin. Other described technique involves a single application of hot air for 30 minutes. Radical but culturally unacceptable method would be shaving of scalp in resistant cases. Environmental fogging with insecticides is neither necessary nor recommended.

Are doctors soft targets for government.

Every medical graduate is aware of the fact that getting a post-graduate seat in a good medical college in India is not child’s play. The numbers of post-graduate seats, especially in medical colleges run by state governments, are dwindling every year. One has to spend a good 10 years up to post-graduation in intense study and get out of medical college as aged, unmarried, balding doctors. To add to our woes, a few states in the country have made compulsory a bond service period of three years after post-graduation.

Phenomena in dermatology.

For a better understanding of various dermatoses, it is imperative for any physician practising dermatology to have a good theoretical knowledge of the underlying pathophysiologic processes involved in various systemic diseases involving the skin. For an easy grasp over this topic, we have discussed the various phenomena under three broad categories, like (a) clinical - Meyerson, Meirowsky, pathergy, Renbok, (b) laboratory - LE cell, prozone and (c) histopathology - Splendore-Hoeppli.

Latrogenic STD inoculation study.

Susan M Reverby has unearthed a glaring example of unethical research, carried out by the United States Public Health Service and co-sponsored by the National Institutes of Health, the Pan American Health Sanitary Bureau and the Guatemalan government in 1946-48. In this study of the effectiveness of penicillin in syphilis and gonorrhoea, 700 Guatemalan nationals including prison inmates, mentally challenged people and military personnel were intentionally infected with various sexually transmitted diseases including syphilis and gonococcal infection. Prison inmates were allowed to have sex with syphilis-infected prostitutes paid by US health officials. There are no records on whether informed consent was obtained from the subjects participating in the trial.