Correlating Impairment of Quality of Life and Severity of Melasma: A Cross-sectional Study of 141 Patients.

BACKGROUND: The relationship between impaired quality of life (QoL) due to melasma and its clinical severity remains equivocal despite several studies. AIM: The aim was to study the correlation, if any, between the clinical severity and the impairment in QOL due to melasma. METHODS: This cross-sectional, questionnaire-based study was conducted on a cohort of 141 patients of melasma attending the outpatient department of our referral hospital. A physician measured the severity of melasma using the melasma area and severity index (MASI), while melasma-related QoL (MELASQOL) score was calculated utilizing the validated Hindi version of the MELASQOL questionnaire filled by the patients. Correlations of these two scores with each other and with components of the demographic data were attempted using the Statistical Package for the Social Sciences, version 20. RESULTS: Significantly greater impairment in QoL was found in patients with a history of prior use of triple combination therapy and in patients with hirsutism and/or polycystic ovarian disease. The severity of melasma was found to be significantly higher in patients with a history of recurrence and tobacco chewing. LIMITATIONS: The sample size could have been larger. Ultrasonography could have been carried out in all cases of hirsutism. CONCLUSION: The severity of melasma does not correlate with the impairment in QoL.

Acquired angiokeratomas of the vulva.

Angiokeratomas are benign cutaneous lesions consisting of numerous ectatic blood vessels present in the superficial dermis and usually involving the scrotum. Although usually asymptomatic, they may be complicated by sporadic or profuse bleeding. We report the development of multiple vulvar angiokeratomas in a 40-year-old female after undergoing a perineoplasty successfully treated with electrocautery.

Giant molluscum contagiosum unmasked probably during an immune reconstitution inflammatory syndrome.

Restoration of specific immune responses by combined antiretroviral therapy (cART) in patients infected with human immunodeficiency virus (HIV) may paradoxically cause an inflammatory reaction known as immune reconstitution inflammatory syndrome (IRIS). We report the emergence of giant nodules of molluscum contagiosum (MC) on the face and thighs 2 months after initiation of cART in a 45-year-old male patient with acquired immune deficiency syndrome. To the best of our knowledge, our report describes the first case of MC probably unmasked during IRIS from India.

Association of Dermatoses with Duration and Quantum of Alcohol Intake: A Comparative Cross-sectional Study.

BACKGROUND: Chronic alcohol intake impacts skin directly, through organ dysfunction or by modifying preexisting dermatoses. However, dermatoses afflicting chronic alcoholics figure in a few studies only. AIM: This study aims to correlate the spectrum of dermatoses in chronic alcoholics with the quantum/duration of alcohol intake and raised liver transaminases. MATERIALS AND METHODS: Adult males, totaling 196, ascertained to fulfill the Royal College of Psychiatry criteria for chronic alcoholism by the de-addiction center and referred for dermatological consult were enrolled as cases, and similar number of age-/sex-matched teetotallers, as controls. Data emanating from detailed history, clinical examination, and routine liver functions tests were summarized and subsequently analyzed, including statistically using the Chi-square, independent "t" and Spearman's rank correlation tests, and compared with data from previous studies. RESULTS: Majority (104) drank 41-50 units of alcohol/week since 3-40 (mean: 20.01 ± 9.322) years. Generalized pruritus (odds ratio [OR]: 31.15, P < 0.001), xerosis (OR: 3.62, P = 0.008), and seborrheic dermatitis (OR: 12.26, P < 0.001) were significantly more common in cases than controls. Infections (73; 37.2%), eczemas (45; 22.9%), and generalized hyperpigmentation (28; 14.2%) were the major presenting complaints. Spider nevi, gynecomastia, and pellagroid dermatitis were present in 34 (17.3%), 19 (9.7%), and 8 (4.1%) respectively exclusively in cases only. Commonly seen systemic abnormalities were an alcoholic liver disease (45; 22.9%), diabetes mellitus (23; 11.7%), and peripheral neuropathy (19; 9.7%). CONCLUSION: Knowledge of cutaneous manifestations of chronic alcoholism could prompt in-depth history taking of alcohol intake, lead to specialist referral and thereby enable timely de-addiction, hopefully before serious adversities in the chronic alcoholics.

Quality of life in acne vulgaris: Relationship to clinical severity and demographic data.

BACKGROUND: Acne vulgaris is known to impair many aspects of quality of life. However, the correlation of this impairment with clinical severity remains equivocal despite various school, community and hospital-based studies. AIM: A hospital-based study was undertaken to measure the impairment of quality of life of patients of acne vulgaris and correlate it with the severity of lesions. METHODS: This was a cross-sectional, questionnaire-based study in a cohort of 100 patients of acne vulgaris attending the outpatient department of our referral hospital. A physician measured the severity of lesions using the global acne grading system, and patients assessed quality of life by completing a questionnaire (Cardiff acne disability index). A correlation of these two was done; some additional correlations were brought out through demographic data collected from the patients. RESULTS: There was no correlation between the severity of acne vulgaris and an impaired quality of life. Patients who consumed alcohol and/or smoked cigarettes were found to have an impaired quality of life. While the severity of acne progressively lessened in older patients, the impact on quality of life increased. LIMITATIONS: The sample size was small and there was a lack of guaranteed reliability on the self-reported quality of life. CONCLUSION: The severity of acne vulgaris does not correlate with impairment in quality of life.