ABSTRACT
Introduction Diabetes mellitus (DM) is associated with significant morbidity and mortality due to vascular complications. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. Videocapillaroscope has been the predominant tool for nailfold capillary analysis. We aimed at using the commonly available handheld dermatoscope and observe changes in the nailfold capillaries as a part of evaluating diabetic microvascular involvement. Materials and methods A cross-sectional observational study involving 262 patients of diabetes mellitus and 150 controls was conducted for nailfold capillaroscopic changes using a hand-held dermatoscope over a period of 1 year. Results All the capillaroscopic variables like tortuosity, increased capillary density, neoangiogenesis, microhaemorrhages, avascular areas, crossing and meandering capillaries and receding capillaries were significantly more among diabetic than healthy controls. Patients with diabetic retinopathy had significant nailfold capillaroscopic features as compared to patients without DR (P value < 0.001). Neoangiogenesis, receding capillaries and avascular area were significantly higher in proliferative DR as against nonproliferative DR (P < 0.001). A positive association was found between the duration of DM and HbA1c values and NFC features. A decrease in the visualisation of NFC features was noted with increasing skin tone. The difference was significantly more between Fitzpatrick skin phototypes 4 and 5. Limitations The study was limited by its qualitative nature of accessing parameters as precise quantitative assessment of various findings cannot be done by a hand-held dermatoscope. Conclusion Nailfold capillaroscopy is a quick, cost-effective screening tool for identifying patients at high risk of DR in patients with skin of colour. NFC findings may mirror DR changes. The qualitative findings of NFC using a hand-held dermatoscope were comparable to other modes of nailfold capillaroscopy.
ABSTRACT
BACKGROUND AIMS AND OBJECTIVES: Nail changes have been reported in approximately 40% of psoriasis patients. Occasionally nail psoriasis may be the sole finding or the first presentation of the disease. Assessment of the nail changes associated with psoriasis can be done clinically, ultrasonographically, and most recently using a dermoscope. The aim of this study is to assess the dermoscopic features in nails of psoriasis as well as to compare the dermoscopic with the clinical findings. This study has also assessed the correlation between disease duration and the severity of skin and nail involvement. MATERIALS AND METHODS: A total of 50 patients with psoriatic nail changes were recruited in the study. The psoriasis area severity index (PASI) was used to assess the severity of the disease. The nail psoriasis severity index (NAPSI) was used to determine the severity of nail involvement. The patient's nails were examined both clinically and dermoscopically. RESULTS: Pitting was the commonest feature (84%) noted both clinically and dermoscopically. A statistically significant higher NAPSI score (P < 0.05) was obtained by a dermoscope than by clinical examination. Salmon patch and splinter hemorrhage were better visualized using a dermoscope than by clinical evaluation (P < 0.05). The duration of the disease had a strong positive correlation (R = 0.901) with the duration of nail involvement whereas there was a weak correlation between the duration of the disease and the clinical NAPSI (R = 0.23) and dermoscopic NAPSI (R = 0.28). A weak positive correlation (R = 0.3) was noted between the PASI and NAPSI scores. CONCLUSION: Dermoscopy of nails proved to be an efficient, supportive, easy, noninvasive method that provides a better insight into the subtle nail changes in psoriatic patients, which may have been missed clinically.
ABSTRACT
Eosinophilic pustular folliculitis (EPF) was originally described by Ofuji in Japanese patients without any systemic disease. Later it was widely associated with HIV. Lately a large number of hematological malignancies have been associated with EPF. We hereby report an association of non-Hogkins lymphoma with EPF, probably the first in Indian context.
