Profile of Skin Disorders in Unreached Hilly Areas of North India.

Background. The pattern of skin morbidity in an area depends on climate, geography, socioeconomic status, nutrition, genetics, and habits of the community. Objective. The objective of the present study was to describe the morbidity profile of patients attending dermatology outpatient department in a tertiary care centre of Garhwal hills, North India. Methodology. This is a record based study carried out using the morbidity registers. Patient details, diagnosis, and treatment provided by physicians were documented in the morbidity register. ICD coding was done to categorize the patients. Results. The total number of new episodes of illnesses treated in the skin outpatient department during 2009-2014 was 47465. Adults (>18 years) constituted about 80.9%. Among adults, about 59.9% were males. Overall the infections of the skin and subcutaneous tissue were the most common (32.6%) followed by the disorders of skin appendages (19.8%), and dermatitis and eczema (18.8%). Of the total patients 16.9% were affected by dermatitis and 16.7% by acne. Psoriasis, urticaria, melasma, and vitiligo were present in 3.4%, 3.4%, 3.6%, and 3.3% patients, respectively. Conclusion. This knowledge will help in planning appropriate range services to meet the patients' needs and help in training of health staff to meet these needs.

Retrospective Analysis of Pattern of Cutaneous Adverse Drug Reactions in Tertiary Hospital of Pauri Garhwal.

INTRODUCTION: Cutaneous Adverse Drug Reactions (CADR) are the common drug induced adverse reactions which usually have wide range of manifestations and severity. AIM: To describe the prevalence and clinical spectrum of CADR's in a tertiary hospital of the Garhwal region in Uttarakhand, India. MATERIALS AND METHODS: All patients suspected of having CADRs reported in the various out-patient departments, and in-patients of HNB Base & Teaching Hospital, from 1(st) January 2012 to 31(st) December 2014 were retrospectively analysed. Drug history was recorded in a format specified in Indian National Pharmacovigilance Programme. RESULTS: Total 111 cases of CADRs were reported from Jan 2012 to Dec 2014. Mean age of patients was 33.34±18.7 years and maximum ADRs were reported in the age group of 20-39 years (36.9%). Female were affected more than male (W:M :: 66:45). Most of the ADRs were exanthematous eruptions (EE) type (33.3%). Medicine department reported maximum cases of CADRs (47.7%), followed by Dermatology. Most of the CADRs were reported with antimicrobial agents (69.4%). Significant associations of different types of various cutaneous reactions were observed in relation to the duration (in days) of ADRs (p = 0.038), types of outcome (p= 0.006), different departments (p= 0.014) and between different groups of medicines (p = 0.008). CONCLUSION: CADRs have proved a significant problem in healthcare for decades. Major bulk of CADR result from physician prescribed drugs. Hence, awareness on part of the physician can help in timely detection of cutaneous reactions, thereby restricting damage from them.

Leprosy Continues to Occur in Hilly Areas of North India.

Background. The aim of present study was to describe the profile of leprosy patients attending the outpatient department of dermatology in tertiary care hospital in Srinagar, Uttarakhand, North India. Methodology. This descriptive retrospective study. Patient data at the time of diagnosis were retrieved onto a predesigned proforma, which concerned the following variables at the time of registration: age, sex, and residence. Newly registered outpatients leprosy cases between 2009 and 2014 were included in the study. Results. It was found that 65 were multibacillary leprosy cases. Males constituted 62.8% of all leprosy cases. The majority (83.7%) belonged to the age group of 18-60 years. Of the total 48.8% of the new leprosy cases were from the Pauri district. The leprosy incidence rate in this population was 2.71 per 1000 patients. Conclusion. Leprosy still continues to be a communicable disease of concern. The lower incidence in women and children provokes the need to strengthen contact screening, early case detection, and referral activities in the population to sustain elimination.

Incidence and epidemiology of onychomycosis in patients visiting a tertiary care hospital in India.

Onychomycosis is a chronic fungal infection of the nails that is largely underdiagnosed in developing countries such as India due to poor health care facilities. In this study, we evaluated the nails of 134 patients with a clinical suspicion of onychomycosis using direct microscopy and fungal culture techniques. The majority of participants (47.8%) were older than 40 years. On both direct microscopy and fungal culture, 71.6% of participants were confirmed with onychomycosis. Among the cases confirmed by laboratory testing, distal lateral subungual onychomycosis was the most common clinical pattern observed, followed by proximal subungual onychomycosis (PSO), candidal onychomycosis (CO), and white superficial onychomycosis (WSO). We concluded that laboratory examination is of great importance in the diagnosis and identification of the underlying pathogen in patients with onychomycosis as well as in the selection of a suitable antifungal agent for treatment.

De novo histoid leprosy in an elderly: a case report and review of the literature.

Histoid leprosy, an uncommon variant of lepromatous leprosy, develops usually as relapse in lepromatous patients who are on dapsone monotherapy, but uncommonly arises de novo. This rare form of the disease, with unique clinical and histopathological features, may pose a diagnostic challenge even to astute clinicians. We report the case that occurred de novo in an elderly who presented with small to large lesions all over the body. A fresh focus on histoid leprosy is the primary objective of this paper, especially in the context of the postglobal leprosy elimination era.