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Background and objectives Systemic lupus erythematosus (SLE) is a chronic multisystem disorder exhibiting a wide spectrum of clinical and immunological abnormalities. Skin is the second most affected organ; lesions may precede systemic manifestations and foretell systemic involvement. Correlation between systemic manifestations and immunological profile is known but the interplay between antibodies and cutaneous findings is an area of recent interest. The present study aims to evaluate the demographic differences, pattern and prevalence of skin lesions, and correlation between cutaneous, systemic manifestations, and serological profile in SLE. Methods A total of 40 patients diagnosed with SLE, fulfilling Systemic Lupus International Collaborating Clinics (SLICC) criteria (2012), who visited the Dermatology outpatient department between April 2019 to April 2020 were recruited. Demographic details, evaluation of cutaneous lesions as lupus erythematosus (LE) specific and LE non-specific, systemic examination, hematological tests, and serological profile findings were noted. Results The mean age of onset was 23.3 years with a female to male ratio of 19:1. Common LE-specific lesions were malar rash (77.5%), photosensitivity (70%), and generalized maculopapular rash (20%). Frequently occurring LE non-specific lesions were non-scarring alopecia (60%), oral ulcers (45%), and vasculitis (12.5%). Arthritis (77.5%) and nephritis (30%) were common systemic findings. Among 14 patients with cutaneous manifestations alone, 12 (85%) had antinuclear antibody (ANA), eight (57%) had anti-double-stranded DNA (anti-dsDNA), four (28%) had anti-Smith (anti-Sm) and anti-RO/Sjögren's syndrome antigen A (Anti-RO/SSA), three (21%) had anti-histone, and one (7%) had anti-ribonucleoprotein (anti-RNP) antibodies in serum. Conclusions Lower age at onset, high prevalence of photosensitivity, anemia, and alopecia with a low prevalence of Raynaud's phenomenon suggest environmental influence in the context of the Indian population. A positive immunological profile in patients with cutaneous involvement alone gives an opportunity to the caregiver to identify the disease process much before systemic manifestations are expressed.
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Objective The pathophysiology of polymorphic light eruption (PMLE) is uncertain; however, it is considered to commonly involve an autoimmunological mechanism. It is a common condition, usually affecting subjects staying at temperate latitudes, and presents with eruptions post-exposure to sunlight and artificial UVR (ultraviolet radiation), lasting from hours to, in rare cases, days of exposure. This present study aims to compare biochemical thyroid function tests in cases of PMLE. Methodology The present case-control study was conducted with a total of 120 participants. Patients with polymorphic light eruption aged 18 years or above of either sex attending the dermatology outpatient department were included in the study. TSH (thyroid-stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine) were analyzed among the participants. The data was recorded on a Microsoft Excel spreadsheet and analyzed using SPSS Statistics v. 21 (IBM Corp., Armonk, NY). The qualitative data was assessed in the form of numbers and percentages and the quantitative data was assessed using measures of central tendency such as mean and standard deviation. A chi-square test was applied to find out the association and their strength between the variables to validate the findings of the study. A p-value <0.05 was considered to be statistically significant. Results The TSH was elevated in 56 (93.3%) cases and two (3.3%) among the controls; T3 and T4 were low in 24 (40%) cases, and in seven (11.7%) among the controls. Conclusion PMLE usually has an autoimmune basis for its occurrence; similarly, thyroid disorders being themselves autoimmune in origin might lead to hypersensitivity reactions and generation of autoantibodies. We suggest that screening for thyroid should be conducted for all PMLE patients as they are at higher risk of developing thyroid disorders. The relationship between the two should be studied with a much larger cohort of participants to evaluate whether this is autoimmune-related or accidentally related.
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BACKGROUND: Eczema of foot adversely impacts daily activities, work productivity, and interpersonal relationships. MATERIALS AND METHODS: This cross-sectional, questionnaire-based study collated epidemiological data of 70 outpatients of foot eczema, evaluated their quality of life by 10-item dermatology life quality index (DLQI) questionnaire, and undertook the correlation thereof. RESULTS: Cases were predominantly males (48; 68.5%); 26 (37.1%) belonged to fifth decade of life and 47 (67%) presented within 12 months of onset. Dorsa of feet was involved in most (59; 84.2%) cases. Itching was a universal complaint followed by scaling (51; 72.9%), dryness (22; 31.4%), and oozing (21; 30%). History of atopy was reported by 15 (21.4%) patients; tobacco and/or alcohol abuse 32 (45.7%) patients; past treatment was received by 37 (52.9%) patients; and winter aggravation in 9 (12.3%) patients. Mean DLQI score was 13.64; with very large effect (11-20) on QoL in 38 (54.3%) patients; moderate (6-10) in 15 (21.4%) patients; extremely large (21-30) in 9 (12.9%) patients; and small (2-5) in 8 (11.4%) patients. Mean scores of questions of DLQI tool were 2.46 in first question (symptoms), 1.99 in fifth (social activities); 1.81 in seventh (working/studying); and 0.17 in fourth (clothes) question. Significant (P < 0.05) impairment of quality of life emerged with respect of burning, scaling, oozing, history of atopy, seasonal variation, and past treatment. CONCLUSION: Our study reports significant association of atopy, winter aggravation, past treatment, burning, scaling, and oozing with adverse quality of life in our study on cases of foot eczema and appears to be first study from India.
