Hand eczema was particularly common in hospital cleaners and staff with atopic dermatitis. Further studies are needed to address the burden of occupational hand eczema and develop guidelines for its management at a national level.
Vitiligo, a common skin disorder, is characterized by the loss of functional melanocytes resulting in the depigmentation of skin. Previous studies have demonstrated molecular and architectural alterations in the epidermal keratinocytes upon loss of melanocytes. The physiological implications of these "altered" keratinocytes are yet not known. We investigated the wound healing efficiency of lesional vs nonlesional skin in 12 subjects with stable nonsegmental vitiligo using histological and ultrastructural evaluation of partial-thickness wounds. The wounds were examined 12 days postinjury, coinciding with the reepithelialization phase of healing marked primarily by keratinocyte migration and proliferation. This study demonstrated a significant difference in the reepithelialization potential between the lesional and nonlesional skin. While all 12 nonlesional wounds demonstrated considerable neoepidermis formation on the 12th day post wound, only four of the corresponding lesional samples showed comparable reepithelialization; the rest remaining in the inflammatory phase. Ultrastructural studies using transmission electron microscopy as well as immunohistochemical staining revealed a reduced number of desmosomes, shorter keratin tonofilaments and an increase in myofibroblast population in the dermis of lesional reepithelialized tissue compared to the nonlesional reepithelialized samples. This study implicates gross functional perturbations in the lesional skin during physiological wound healing in vitiligo, suggesting that the breakdown of keratinocytemelanocyte network results in delayed wound repair kinetics in the lesional skin when compared to patient-matched nonlesional skin.
The prescription of antibiotics empirically without confirmation of an infective etiology is on the rise. Administration of appropriate antibiotics can be guided by real-time fluorescence imaging using a point-of-care device. These composite images show the presence, type and the burden of infection. The time saved by this method over microbiological testing, especially in resource-poor settings, can lead to a paradigm shift in treatment by facilitating prompt and adequate antimicrobial therapy, surgical debridement as well as follow-up. Thumbnail sketches of a series of four cases highlighting different scenarios in which a fluorescent imaging device utilizing artificial intelligence and machine learning was found useful is presented in this report.
Acute bilateral recurrent laryngeal nerve injury leading to acute vocal cord paralysis (VCP) is a serious complication of head and neck surgery, often requiring emergent surgical intervention. Although well documented, its presentation may be sudden and unexpected, occurring despite lack of obvious intraoperative nerve injury. There is limited literature on airway management strategies for patients with acute bilateral VCP before attaining a secure airway. We report a case of acute VCP that was successfully treated with continuous positive airway pressure via facemask ventilation. This effective temporizing strategy allowed clinicians to plan and prepare for tracheostomy, minimizing potential complications.
<p class="abstract"><strong>Background:</strong> Genetic diseases causing abnormalities in structure and<strong>/</strong>or function of skin are termed as genodermatoses. As there is paucity of epidemiological data of genodermatoses from our country, this study was conducted to determine the latest clinical and epidemiological trends of pediatric genodermatoses.</p><p class="abstract"><strong>Methods:</strong> A hospital-based observational study consisting of 35 clinically diagnosed pediatric genodermatoses cases, who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of two years. Socio-demographic and clinical information was collected and clinical examination was performed on all patients to record any cutaneous<strong>/</strong>extra-cutaneous abnormality. The participants were then subjected to necessary investigations to elucidate the additional disease components. The data was evaluated using appropriate statistical methods.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 4032 pediatric patients<strong>, </strong>35 were found to have genodermatoses.<strong> </strong>Majority (57.14%) cases belonged to the first decade of life. There was no sexual predilection (male:female - 0.94:1). The commonest genodermatoses detected were neurofibromatosis and tuberous sclerosis (17.14% each). Most common mode of inheritance seen was autosomal dominant (57.14%). Family history and consanguinity were recorded in 45.71% and 22.86% cases respectively. Café-au-lait macules seen in 22.86% cases and ocular anomalies recorded in 34.38% cases were the commonest cutaneous and extracutaneous manifestations, respectively.</p><p class="abstract"><strong>Conclusions:</strong> Genodermatoses are rare skin disorders with systemic involvement at times, resulting in poorer prognosis. This necessitates more focus on this speciality.</p>
<p class="abstract"><strong>Background:</strong> The high burden of menopausal symptoms notwithstanding, there is a paucity of published work evaluating its impact specifically on the skin and mucosa. With high incidence of underreported cases in developing countries, active screening of all women is essential for accurate assessment of prevalence of cutaneous features, as highlighted by this study. The objective of this study is to assess clinical patterns of dermatosis in menopausal women.</p><p class="abstract"><strong>Methods:</strong> A cross‑sectional study conducted in the dermatology department conducted on postmenopausal patients below 65 years having dermatoses after taking their written consent. Data analysis using SPSS 20.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of 350 postmenopausal women, 165 had genital involvement, atrophic vaginitis (41.21%) being the most common manifesting typically as vaginal dryness. Of 82 women having oral complaints, 42.7% women had complaints of pain or difficulty swallowing in the absence of mucosal lesions. Of the total sample size, 34% women had had female pattern hair loss, maximum women with grade I-2 (45.4%) and I-3 (36.13%). Two key findings which we did not find previous records of included incidence of keratoderma climactericum (2.29%) and hirsutism in early menopause which we found to be 8%. It is important to note that only 28% of women were aware that their complaints were related to menopause or chose to seek active treatment for existing complaints.</p><p class="abstract"><strong>Conclusions:</strong> This study highlights the various clinical patterns of postmenopausal dermatoses to raise awareness in dermatologists and gynecologists for prompt diagnosis, treatment and patient education.</p><p class="abstract"> </p>
<p class="abstract"><strong>Background:</strong> Alopecia areata is one of the commonest types of non-scarring alopecia involving the scalp and/or body. As there is paucity of recent epidemiological data from our country, this study was conducted to determine the latest clinical and epidemiological trends of scalp alopecia areata.</p><p class="abstract"><strong>Methods:</strong> A hospital-based observational study consisting of 100 cases of clinically diagnosed scalp alopecia areata who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of six months. Socio-demographic and clinical information was collected and clinical examination was performed on all patients. The data was evaluated using appropriate statistical methods.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of the 100 cases enrolled, males (64%) outnumbered females (36%). The commonest presenting age group was 21-30 years (44%). Disease onset was sudden in 80% patients and 59% cases had a progressive disease course. Majority (75%) had a disease duration of less than 3 months. Majority cases were asymptomatic (80%) with no precipitating factors (90%). Past history and family history of alopecia areata were present in 13% and 9% cases, respectively. Personal and family history of associated diseases were present in 27% and 22% patients, respectively. Most patients had single (61%), patchy (83%) lesions with occiput (45%) being the commonest initial site. Nail changes were present in 22% cases, of which pitting (13%) was the commonest nail finding.</p><p class="abstract"><strong>Conclusions:</strong> This study reflects the clinical profile of scalp alopecia areata in a tertiary care hospital.</p>
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