Nephrogenic systemic fibrosis following hair-dye ingestion induced acute renal failure.

We report a patient who developed acute renal failure following the ingestion of a hair-dye with a suicidal intent. He was managed by hemodialysis and other symptomatic measures. He developed generalized seizures and underwent MRI scan of the brain using gadolinium containing contrast material followed by development of bilateral and symmetrical thickening and induration of the skin over the extremities and verrucous papules and plaques over the lower back. Skin biopsy and immunohistochemistry showed typical features of nephrogenic fibrosing dermopathy as well as deposits of calcium. Successful management of renal failure resulted in clearing of all skin lesions except a small bony hard plate like area overt the left leg, the biopsy of which showed features of osseous metaplasia.

A study of allergen-specific IgE antibodies in Indian patients of atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing, pruritic dermatitis frequently associated with the hyperproduction of IgE to various allergens. Identification of these allergens is possible by various laboratory investigations. AIM: The present study was designed to assess these allergen-specific antibodies in the diagnosis of AD in the Indian context. METHODS: This prospective study comprised 50 patients of AD. The diagnosis was made clinically after satisfying Hanifin and Rajka's criteria. Serum IgE levels were estimated and specific IgE antibodies were measured for 20 food allergens and aeroallergens. RESULTS: Serum IgE was elevated in 88% of the patients. The highest elevation of mean IgE levels was seen in the 10-20 years age group. Sixty five percent of the children under the age of ten years were positive to one or more food allergens. Food allergens were more often positive in the < or = 10 years age group and specific antibodies to inhalants were seen more frequently in the older age groups. Specific antibodies to apples were found in all age groups. CONCLUSION: Antibodies against apples and hazelnuts were the more commonly seen specific antibodies in children. Incidence of positivity was much higher in children when compared to earlier studies. Identification of food allergens can be an important factor in the diagnosis of AD in children in India. Positivity to inhalant allergens in the older age groups was lower in this study. The allergen profile with regard to inhalants in Indian patients was similar to that of earlier studies.

Enoxaparin experience in percutaneous coronary intervention.

To investigate the efficacy and safety of enoxaparin in 135 consecutive patients who were undergoing emergency/non-emergency percutaneous coronary intervention (PCI), a prospective, observational study of procedural anticoagulation was carried out with enoxaparin in elective, primary PCI. Documentation of the in-hospital clinical and angiographic outcomes was performed in eligible patients undergoing elective or primary PCI. This data helped to capture how patients while on anticoagulation with enoxaparin were being managed. As this was a prospective observational registry and not a randomised controlled trial, there was no single hypothesis from which to calculate the minimum sample size required. We recorded outcomes with 135 consecutive patients undergoing PCI who were enrolled in the study. While analysing the results the points taken into consideration were: Patient demography, PCI, methods of haemostasis and timing of sheath removal, dose and timing of enoxaparin and clinical and angiographic outcome. Statistical analysis was performed using statistical analysis system (SAS) software. Enoxaparin when used in PCI, can be a safe alternative to unfractionated heparin (UFH).

Pigmentary demarcation lines over the face.

BACKGROUND: We have been observing that a significant proportion of our patients, especially females, have certain pigmentary demarcation lines (PDL) over the face. However, systematic studies of the subject are lacking. AIMS: We categorized the different clinical patterns of facial PDLs in the Indian subpopulation and assessed their prevalence in this study. METHODS: About 4000 consecutive patients, both males and females, attending our skin clinic were examined for the presence of any pigmentary demarcation lines on the face, from October 1998 to February 2000. RESULTS: Out of the study population of 4037 patients, 243 (6%) were found to have demarcation lines on the face. The demarcation lines were far more common in women (9%) than in men (0.75%). These lines could be classified into three patterns that we would like to label as F, G, H as PDLs A to E have already been described. CONCLUSIONS: Pigmentary demarcation lines are fairly common in the Indian population especially amongst the females. Hormonal influences could possibly explain the female preponderance. Aggregation of cases within families or among close relatives suggests a genetic background.