ABSTRACT
Background: An adverse cutaneous drug reaction (ACDR) is an undesirable change in structure and function of the skin, its appendages, or mucous membranes due to drugs. Aims and Objectives: To study the demographic details, clinical patterns, mucocutaneous involvement, causality, and the offending drugs causing ACDR. Materials and Methods: In this observational study, we have seen 2,96,544 patients in the skin department at a rural-based tertiary health-care hospital, out of which 728 cases were diagnosed to have ACDR from a time span of April 2010 to March 2021. The causality assessment system WHO-UMC (World Health Organization Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre), the Naranjo probability scale, and Hartwigs score were calculated for patients. Results: Out of 728 cases, males were 371 (50.96%); most common age group was 21-30 years (25.13%). The most common presenting complaint was erythematous rash (21.29%). Antimicrobials (n = 345, 47.39%) were the most common drug group. Most common mucosa involved was oral mucosa and most common pattern of reaction seen was maculopapular rash (25%) among these patients. In the causality assessment using WHO guidelines, there were 66 (9.1%) certain, 224 (30.83%) probable, and 436 (60%) possible cases. Naranjo score showed 73 (10%) definite cases, 255 (35%) probable cases, and 400 (55%) possible cases, while Hartwigs score showed level 2 in 122 (16.7%) cases and level 3 in 412 (56.7%) cases. Conclusion: Wide spectrum of drug reactions were observed in this study. Antimicrobials were the most common causative agents of ACDR.
ABSTRACT
Context: Chemotherapy and radiation therapy given to treat internal malignancies may cause cutaneous, hair, nail, and oral mucosal changes. The present study is an effort to know the pattern of cutaneous drug reactions with chemo and radiotherapy. Materials and Methods: Patients of internal malignancies with skin lesions attending the dermatology and oncology OPD/ward were recruited after taking their written consent in vernacular language. A detailed history of skin lesions, malignancies, and treatment was taken. Clinical examination was carried out. Relevant investigations and biopsy were carried out as and when required. Being a descriptive study, age group and gender-wise frequency and percentage were calculated for the treatment of malignancies and dermatosis. Results: The study included 150 patients with 28 different types of internal malignancies, of which 127 (84.66%) patients were treated, 45 (35.43%) treated exclusively with chemotherapy, 16 (12.59%) with exclusive radiation therapy, and 66 (51.96%) with combined chemo and radiation therapy. Total 111 (87.41%) patients received chemotherapy and 82 (64.56%) patients received radiation therapy. Most common internal malignancy was breast carcinoma in 43 (28.67%) cases. Most common chemotherapeutic agent given was paclitaxel to 33 (29.73%) patients. Most common dermatosis associated with exclusive chemotherapy was hand-foot syndrome in 7 (15.55%) cases and with exclusive radiation therapy was radiation dermatitis in 8 (50%) cases. Conclusions: The study was useful in understanding various chemo and radiation therapy-associated dermatosis so that early interventions can be done to prevent further treatment-related adverse effects. Limitation: Small sample size and inability of pinpointing a single drug as the side effect.
ABSTRACT
Introduction: Skin is the largest organ in the human body and mirrors the changes in the organism it envelops. Internal malignancies can cause various specific and non-specific cutaneous manifestations along with hair, nail and oral mucosal changes. Some of the changes are detected early indicating a strong association with cancer, while some occur in later stage indicating dissemination or immunosuppression. The present study is an effort to know pattern of dermatosis associated with internal malignancies so that early diagnosis and interventions can be done. Aim: To determine the pattern of specific and non-specific dermatosis associated with internal malignancy. Methods and Material: Patients of internal malignancies with skin lesions attending dermatology and oncology department during July 2020 to June 2021 were recruited in the study after taking written informed consent. A detailed history of skin lesions and malignancies were taken. Clinical examination (skin/hair/nail) was carried out and photographs were taken. Relevant investigations were carried out. Frequency and percentage of dermographic data and dermatosis associated with internal malignancies were calculated. Results: The study included 150 patients with maximum number of patients 78 (52%) in 41-60 years of age group with female: male ratio of 1.2:1. Most common internal malignancy was breast carcinoma in 43 (28.67%) cases. Specific dermatosis were seen in 5 (3.33%) cases and non-specific dermatosis in 121 (80.66%) cases. Specific dermatosis were vasculitis, necrolytic migratory erythema, lymphocytoma cutis, growth and cutaneous metastasis with 1 (0.67%) patient each. Most common non-specific dermatosis was herpes zoster in 17 (11.33%) cases. Conclusion: The study was useful in understanding the various specific and non specific dermatosis associated with internal malignancies and thereby helping the physician to manage the conditions.
ABSTRACT
Halo nevus (HN) is benign skin condition with a central melanocytic nevus, surrounded by an area or halo of depigmentation. It is the result of immunological response of the body toward the nevus, which destroys the melanocytes in surrounding skin, leading to the depigmented halo. An increased frequency of HN in patients with vitiligo is observed. It is more commonly seen in children or young adults of either sex, particularly on the trunk, less commonly on the face, neck, and limbs. We present a rare case of HN which was present on the lower eyelid associated with poliosis, diagnosed with dermatoscopy.
