A Quality of Life Study of Patients with Leprosy Attending the Dermatology OPD of a Tertiary Care Center of Eastern India.

BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae affecting the skin, peripheral nervous system, and other tissues. The disease is associated with social stigma, and the patients sometimes suffer social discrimination because it often leads to visible physical deformities. Hence, leprosy may have severe impact on the quality of life (QoL) of patients. AIMS AND OBJECTIVES: The aim of this study was to assess the effect of leprosy on the QoL of the affected patients and to find out whether there is some association with certain demographic and clinical factors. MATERIALS AND METHODS: The Dermatology Life Quality Index (DLQI) questionnaire was used to assess the QoL of 114 patients with leprosy who attended dermatology outpatient department of a tertiary care center of eastern India. This was a cross-sectional study. RESULTS: Among a total of 114 patients, leprosy had no impact on the QoL of 15 (13.16%) patients. There was a mild impact in 23 (20.18%) of the patients. There was moderate impact in 37 (32.46%) of the patients. The disease had severe impact in the QoL of 39 (34.21%) patients. None of the patients had a very severe impact. Several of the clinical aspects such as nerve involvement, systemic features, deformity, disability grade, and type of leprosy have significant impact on QoL. Among the demographic factors, gender had some effects on QoL. CONCLUSION: Leprosy adversely affects the QoL of those affected. Although it is considered a social disease, at least in our part of the country, demographics have minimal effect on the QoL. Rather, important clinical aspects such as systemic features, nerve involvement, reaction, deformity, and disability have profound impact on the QoL of the patients.

Correlation of Venous Clinical Severity Score and Venous Disability Score with Dermatology Life Quality Index in Chronic Venous Insufficiency.

BACKGROUND: Chronic venous insufficiency (CVI) is an underestimated public health problem involving the lower limbs. It exerts a significant impact on patient's quality of life (QoL). The severity of the disease was measured by venous clinical severity score (VCSS) and venous disability score (VDS). AIMS: The aim of the study was to evaluate VCSS, VDS, and dermatology life quality index (DLQI) among the patients of CVI and to evaluate the correlation among DLQI with VCSS, VDS, and leg ulcer. MATERIALS AND METHODS: In this institution-based cross-sectional study, clinically and sonographically confirmed cases of CVI were included. Clinical severity of the disease and disability were assessed by using VCSS and VDS, respectively. QoL was assessed by a validated DLQI questionnaire. Correlation between DLQI with VCSS and VDS was analyzed. The association between DLQI with different characteristics of the ulcer was also evaluated. RESULTS: Mean VCSS, VDS, and DLQI in the study population were 11 ± 4.96, 1.47 ± 0.67, and 6.94 ± 3.87, respectively. Both VCSS and VDS had a strong positive correlation with DLQI. The number of active ulcers, size of the ulcer, and duration of the ulcer had a strong positive correlation, whereas the age of onset of the disease had a negative correlation and duration of the disease had poor correlation with DLQI. Pain (P = 0.03) and edema (P = 0.04) had significant association with VDS. CONCLUSION: VCSS and VDS are important tools for measuring severity and disability in CVI, respectively. CVI had a strong impact on patients QoL more than it was thought hitherto.

Eccrine angiomatous hamartoma: late onset facial presentation.

Eccrine angiomatous hamartoma (EAH) is a very rare benign neoplastic condition characterized by hamartomatous proliferation of eccrine glands and accompanying blood vessels and lymphatics. These lesions are more often present at birth or appear during early infancy and childhood and present as solitary nodule or plaque with occasional pain and sweating. They are generally present on the extremities, mostly the palms and soles. We report here a case of EAH in a 20-year-old female who presented with a solitary angiomatous plaque close to the lower eyelid of the right eye with occasional pain and sweating for its rarity.

Multiple generalized xanthogranuloma in adult: case report and treatment.

Xanthogranuloma is a benign, asymptomatic, and self-healing disorder of non-Langerhans cell histiocytosis, affecting mostly infants, children, and rarely adults. Diagnosis is easy in typical cases but become more complex in unusual forms. We report a case of a 28-year-old male patient who presented with multiple diffuse brown-to-yellowish papulonodular eruptions over extremities, ears, face, trunk, and extensors of joints with almost bilaterally symmetrical distribution for a period of one month. Histopathological examination of the skin biopsy specimen revealed features of xanthogranuloma. The patient was put on isotretinoin 20 mg once daily. Most of the lesions subsided or flattened within two months of isotretinoin therapy. This case is interesting because of the severity and atypical nature of the disease and also, the patient responded with isotretinoin therapy. But further study is required to observe the effectiveness of isotretinoin in xanthogranuloma.

Epidcermolytic hyperkeratosis: a case report.

Epidermolytic hyperkeratosis is a rare autosomal dominant genodermatosis that presents at birth as generalised erythema, blisters and erosions. In subsequent periods, erythema and blistering improves but patients go on to develop hyperkeratosis scalingthat is especially prominent along joint flexures, neck, hands and feet. The disease is caused by mutations in either keratin 1 or 10. Treatment options include topical emollients containing glycerin, lactic acid, urea and alpha-hydroxy acid and topical and systemic retinoids. Here a rare case in a 23 years old male is reported with epidermolytic hyperkeratosis and treated successfully with mixture of topical emollients with retinoid and systemic isotretinoin.