Genital molluscum contagiosum in females - therapeutic efficacy and comparative evaluation of topical 10% and 20% potassium hydroxide.

INTRODUCTION: Molluscum contagiosum (MC) is a cutaneous viral infection caused by a poxvirus, manifested by discrete, papular, pearly lesions with central umbilication. Genital lesions are mainly transmitted sexually. Till date, several forms of medical and surgical therapies have been used with variable success. In the present study, an attempt was made to review all the female patients of genital MC attending the sexually transmitted infection (STI) clinic of the Department of Dermatology, Venereology, and Leprosy of Guru Nanak Dev Hospital, Amritsar. AIMS AND OBJECTIVES: In the present study, therapeutic efficacy and comparative evaluation of topical 10% and 20% of potassium hydroxide (KOH) were undertaken. MATERIALS AND METHODS: A total of 30 female patients of age group 18-50 years with clinically diagnosed MC and more than ten lesions were enrolled in this study. The lesions in each patient were divided into two equal Groups A and B. Topical 10% KOH was applied over lesions of Group A and 20% over lesions of Group B with the help of 26G needle. First, two applications were done by the doctor, and subsequent applications were done twice a week at bedtime at home by the patient herself until crusting. These cases were followed up at 4th day, 1st, 2nd, 3rd, 4th, 6th, 8th, 10th, and 12th week. Results were analyzed objectively and photographically at each follow-up and at the end of the study statistically. RESULTS: Mean duration of treatment ± standard deviation in normal patients, HIV-positive patients, patients with associated STIs, patients with associated non-STIs, and pregnant patients in Group A and Group B was 6.83 ± 2.692, 9.33 ± 1.633, 6.83 ± 2.887, 8.20 ± 3.347, and 8.75 ± 2.121 weeks and 5.2 ± 2.156, 7.33 ± 1.633, 5.25 ± 2.050, 6.20 ± 2.864, and 6.50 ± 1.414 weeks, respectively. CONCLUSION: Topical 20% KOH is better than 10% KOH in genital MC in females.

Correlation of Vitamin D3 Levels and SCORAD Index in Atopic Dermatits: A Case Control Study.

INTRODUCTION: Atopic Dermatitis (AD) is a common chronic inflammatory condition characterized clinically by pruritus and eczematous lesions. An inverse relationship has been suggested between serum 25-hydroxyvitamin D concentration and severity of atopic dermatitis. AIM: We carried out this controlled cross-sectional study to evaluate the association between the serum vitamin D3 levels and SCORAD index. MATERIALS AND METHODS: For this study, 40 patients with clinical diagnosis of AD based on UK diagnostic criteria were enrolled and 40 patients with minor ailments like superficial bacterial, fungal or viral infections and not suffering from atopic dermatitis were taken as controls. Salient presentations were recorded in a pre-set proforma. Serum 25-hydroxyvitamin D levels were determined through Sandwich-ELISA technique. SCORAD (Scoring AD) index was used to evaluate the severity of the disease. RESULTS: Mean value of serum 25-hydroxyvitamin D levels in cases was 30.38 nmol/l whereas in controls, it was 53.46 nmol/l. The decrease in serum levels in cases was statistically highly significant (p-value <0.001). Mean±S.D of serum vitamin D levels in mild disease was 33.29±5.89 nmol/l, in moderate disease was 31.52±6.04 nmol/l and in severe form of disease was 21.24±3.17nmol/l. The correlation between SCORAD and serum 25-hydroxyvitamin D levels was also statistically significant. CONCLUSION: The data suggests an inverse relationship between serum levels of vitamin D3 and the SCORAD Index.

Clinico-epidemiological profile of patients attending Suraksha Clinic of tertiary care hospital of North India.

BACKGROUND: Sexually transmitted infections (STIs) are a global health problem. Trends of STIs vary from place to place depending on various epidemiological factors prevailing in that respective geographic area. AIMS AND OBJECTIVES: The present study was conducted to find the pattern and prevalence of different STIs out of total STI clinic attendees, to identify any change in the trend of STIs, various epidemiological factors, and behavior of individual diseases. MATERIALS AND METHODS: Case records of the patients, attending the STI clinic (Suraksha Clinic) attached with Department of Dermatology, Venereology, and Leprosy of a tertiary care medical college and hospital of North India from April 2007 to March 2014, were analyzed. All the patients were thoroughly examined and investigated. RESULTS: This study included a total of 5468 STI clinic attendees out of which 3908 were diagnosed to have STIs. Most of the patients were male, married, and in the third decade of their lives. In our study, the highest number of patients had herpes genitalis, i.e., 850 patients (21.75%) followed by 415 patients (10.61%) having genital warts. Molluscum contagiosum was present in 239 patients (6.11%), 106 patients (2.71%) had urethral discharge whereas 81 patients (2.07%) diagnosed to have syphilis. Viral infections accounted for 38.48% of cases. Human immunodeficiency virus (HIV) positivity was seen in 414 patients (10.59%) of total STI cases. CONCLUSION: The trend of STIs is changing from bacterial to viral diseases. This is because of the widespread use of antibacterial, self-medication, and treatment through national program. STIs enhance the susceptibility of an individual to acquire or transmit HIV through sexual contact.

Is Early Onset Androgenic Alopecia a Marker of Metabolic Syndrome and Carotid Artery Atherosclerosis in Young Indian Male Patients?

BACKGROUND: Androgenic alopecia (AGA) is a common cosmetically and psychosocially distressing condition. High androgen level contributes to the development of atherosclerosis, thrombosis leading to hypertension and hypercholesterolemia. OBJECTIVES: To study the clinico-epidemiological profile of AGA and the presence of metabolic syndrome (MetS) and carotid artery atherosclerosis in male patients with early onset AGA as compared to controls. MATERIALS AND METHODS: In this case-control study, 100 male patients of age 18-35 years with AGA and an equal number of age-matched healthy controls attending skin and STD OPD were included. Assessment of the degree of hair loss, evaluation of MetS and carotid artery color Doppler for the atherosclerotic plaque was done in all patients. RESULTS: Statistically significant number of patients with early onset AGA 22/100 (22%) (P < 0.05) fulfilled the criteria for MetS compared to 8/100 (8%) in the control group. There were statistically significant differences in mean values of waist circumference, serum triglycerides, serum cholesterol, systolic blood pressure, diastolic blood pressure, fasting glucose concentration, and very low-density lipoprotein (LDL). However, no significant differences were observed in the mean values of high-density lipoprotein cholesterol and LDL cholesterol. The atherosclerotic plaque was found in two patients of the study group, and no plaque was found in control patients. CONCLUSION: We suggest that all men with AGA should be thoroughly investigated, and lifestyle changes should be started in the early period of life so as to reduce the risk of various problems associated with MetS. AGA can be considered as an early marker for MetS.

Tinea faciei caused by Trichophyton mentagrophytes in a 20-day-old neonate.

Although candidiasis in newborns is not uncommon, superficial dermatophyte infections of infants is quite rare. The causative agents of neonatal tinea reported in various case studies have been Trichophyton rubrum, Microsporum canis, Microsporum gypseum, and Trichophyton violaceum. To the best of our knowledge, no case report of neonatal tinea faciei caused by Trichophyton mentagrophytes has been reported earlier.