ABSTRACT
Introduction: Localized scleroderma is a rare disorderwith not well recognized aetiology. Though consideredto be a benign disorder it may result in a severe cosmeticdisfigurement or even functional disability. There is no proveneffective therapy for localized scleroderma so far makingmanagement of such cases challenging. Lack of evidencebased treatment and standardization of evaluation methodsmay be reason for it. The Study was conducted to evaluatethe role of corticosteroid and methotrexate therapy in ourpopulation with severe localized scleroderma (morphoea).Material and Methods: All patients attending with OPD inDepartment of Dermatology SKIMS-MCH from Jan, 2014,to Jan, 2019, with clinical features suggestive of active,moderate to severe morphoea were enrolled in the study. Adetailed clinical history was followed by a thorough clinicalexamination and calculation of LoSSI score. Patients werestarted on i/v methyl-prednisolone 30mg/kg monthly pulsesas 3 consecutive doses for 3 months (maximum 1gm) andintramuscular MTX at 0.2 to 0.4 mg/kg/week (maximum 25mg/week) for 12 months.Results: A total of 21 patients were included in the study.Male: Female ratio was 1:3.2. Mean age was 21.19years.Linear morphoea was most common type (13 cases) followedby plaque morphoea (6 cases). There was a significantdecrease in mean LoSSI score (from 15.19 to 6.62) at 4months after completion of steroid methotrexate phase (valueof t is -8.621425, value of p is < .00001). Mean LoSSI scoreafter completion of 12 months of treatment was 0.94 (valueof t is -9.644953, value of p is < .00001). The treatment waswell tolerated.Conclusion: The study suggests that systemic corticosteroidsand methotrexate in combination is effective and well toleratedtreatment for both adults and children with localized moderateto severe scleroderma.
ABSTRACT
Background: Superficial fungal infections are among the most common skin diseases, affecting millions of people throughout the world. These infections, which occur in both healthy and immunocompromised persons, are caused by dermatophytes, yeasts and nondermatophyte molds. Effective treatment can reduce the duration of symptoms in patients with superficial fungal infections. Unfortunately, there is a strong tendency for fungal infections to recur in many people even after effective clearing with medication. Aims and Objectives: To study the relapse of cutaneous fungal infection in healthy people. Materials and Methods: 160 patients with a history of relapse of fungal infections who came to the out-patient department of this tertiary care hospital within 6 months period were studied in detail regarding patient characteristics, demographic details and line of management. Results: Relapse of cutaneous fungal infection occurs most commonly in adults greater than 30 years (75%). There was a definite family history of fungal infections (15.6%) in patients coming with history of relapse. Tinea cruris (34.38%) was the most common site to come with history of relapse followed by onychomycosis (15.6%). Relapse occurred in 38.75% of the cases treated with terbinafine as this was the most common drug used. Conclusion: Regardless of the drug taken there were cases of relapse in cases of cutaneous fungal infection even in healthy individuals.
ABSTRACT
Ellis-van Creveld (EVC) syndrome is a rare autosomal recessive congenital disorder characterized by chondrodysplasia and polydactyly, ectodermal dysplasia and congenital defects of the heart. We present here a case of a 16-year-old short-limbed dwarf with skeletal deformities and bilateral postaxial polydactyly, dysplastic nails and teeth, also having left-sided facial hemiatrophy. The diagnosis of EVC syndrome was made on the basis of clinical and radiological features. To the best of our knowledge, this is the first report of EVC syndrome with facial hemiatrophy in the medical literature from India.
ABSTRACT
BACKGROUND: Alopecia areata (AA) is a recurrent, nonscarring type of hair loss considered to be an autoimmune process. Though its etiopathology is not fully understood, there are claims that imbalance of trace elements may trigger the onset of AA. AIM: The aim of the present study was to assess the levels of zinc, copper, and magnesium in the serum of AA patients. METHODS: Fifty AA patients (34 men and 16 women), and fifty age and sex matched healthy control subjects were studied. Samples were analyzed using atomic absorption spectrometric methods. RESULTS: Serum zinc levels were significantly decreased (P < 0.05) in AA patients whose disease was extensive, prolonged, and resistant to treatment, whereas serum copper and magnesium levels showed insignificant rise compared to controls. CONCLUSION: We conclude that copper and magnesium levels are not altered in AA, but the decreased zinc levels found in our study may merit further investigation of the relationship.