Spectrum of Dermatological Disorders in Patients of Metabolic Syndrome

Introduction: Over the years, a paradigm shift is evidentworldwide including India with chronic diseases likecardiovascular diseases(CVD), diabetes, hypertension makinga huge impact sending alarm bells across the world. Changinglifestyle with predominance of sedentary habits along withnew dietary habits are responsible for this. As a result of this,metabolic syndrome has become a global epidemic and so thelink between skin diseases and metabolic syndrome is alsobeing increasingly established. This study was undertakento assess the spectrum of dermatological disorders prevalentamong the patients with metabolic syndrome.Material and methods: This was a prospective study carriedout at a tertiary care centre of north India for a period of sixmonths. Proper ethical clearance from the ethical committeeof the institution was taken up and a written informedconsent was taken from all patients for the study. All patientspresenting to the out patient department having metabolicsyndrome, which was diagnosed according to the NationalCholesterol Education Program's Adult Treatment Panel IIIwere thoroughly analysed. Various dermatological disorders,either one or more than one pravelent among patients wasnoted down.Results: A total of 180 patients were taken up for the studyand females outnumbered the males. There were 111(61.6%)females and 69(38.3%) males. Maximum patients (95, 52.7%)were in the 40-50 years age. In 120 patients more than onedisorder was present. The most common dermatologicaldisorder seen was acanthosis nigricans in 111(61.6%) patients,skin tags in 110(61.1%), acne in 95(52.7%), hirsutism in92(51.1%)patients.Conclusion: In this study, we have tried to study the variousdermatological disorders seen among patients of metabolicsyndrome. Withrising incidence of metabolic syndrome andincreasing link being found between various skin disordersand metabolic syndrome, it becomes the responsibility of theclinicians to diagnose early and advise accordingly to preventthe adverse events like cardiovascular accidents among suchpatients

Spectrum of Mucocutaneous Manifestations among Patients with Various Liver Disorders

Introduction: Skin is the first barrier against any externalagent and a reflection of any deviation in the internal milieu.Any systemic disorder or organ dysfunction can leaveits imprints on the skin and so also the liver certainly hascutaneous manifestations in case of any disorder affecting it.Study objective was to investigate the spectrum of cutaneousmanifestations of various liver disorders and liver diseasespecific association.Material and methods: A total of 220 patients with primaryliver disorders were taken up for the study after proper ethicalclearance. A detailed clinical history was taken from thepatients regarding liver disorder and cutaneous symptoms. Athorough clinical examination was done and all specific andnonspecific cutaneous manifestations were recorded.Results: Out of 220 patients, 135(61.3%) were males and85(38.6%) were females with a male preponderance. Amongthe various liver disorders, most commonly seen was alcoholicliver disease seen in 84(38%) patients, nonalcoholic fatty liverdisease (NAFLD) and nonalcoholic steatohepatitis(NASH)in 51(23.2%) patients, cirrhosis in 35(16%) patients. Themost common cutaneous manifestation seen was icterus in190(86.3%) patients, pruritus in 178(80.9%) patients, xerosisin 112(51%) patients.Conclusion: The knowledge of the cutaneous manifestationsin liver disorders can be of great help as many liver disorderscan easily be detected at their incipient stage. This study wasdone to assess the spectrum of cutaneous manifestations inliver disorders and a significant observation made was liverdisease wise specific evaluation of cutaneous manifestationsthus providing better insight into the type of liver diseases.

A clinicoepidemiological study of fixed drug eruptions at a tertiary centre of North India

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls.