Little information is available about the prevalence of skin conditions among children in the general population of northern India. Low socioeconomic status, malnutrition, overcrowding, and poor standards of hygiene are important factors accounting for the distribution of skin diseases in developing countries such as India. In order to estimate the burden and relative frequency of dermatologic diseases among children in the community, we measured the point prevalence of skin conditions in 12,586 Indian school children ages 6-14 years. The overall point prevalence of one or more identifiable/apparent skin conditions was 38.8%. Of those studied, 3786 children (30%) had only one skin disease, 765 (6%) had two, and 336 (2.7%) had three skin pathologies. The most common skin conditions and their respective point prevalences were skin infections (11.4%), pityriasis alba (8.4%), dermatitis/nonspecific eczemas (5.2%), infestations (5.0%), disorders of pigmentation (2.6%), keratinization disorders (mostly keratosis pilaris) (1.3%), and nevi/hamartomas (1.1%). This study shows that skin conditions are common in children and about one-third of them are affected at any given time. The finding that more than 85% of the disorders can be grouped into fewer than eight categories is important in designing training programs for medical teams involved in the delivery of primary health care services in developing countries such as India, where about one-third of the population is less than 15 years of age.
Aim:The aim was to study various morphological patterns of cutaneous adverse drug reactions (CADRs) and identify the culprit drug or drugs by establishing a causal link using Naranjo adverse drug reaction probability scale.Materials and Methods:The study was carried out between November 2010 and November 2011 at the Department of Dermatology, Government Medical College, Jammu. A total of 150 patients with CADR reporting to the dermatology department or referred from other departments were evaluated. Detailed history, clinical examination, hematological, and biochemical investigations were recorded. The venereal disease research laboratory test, HIV (ELISA), and histopathological examination were done wherever indicated.Results:A total of 150 patients were evaluated after applying the inclusion and exclusion criteria. The mean age of the patients with CADRs was 33.26 years. A majority of patients (30.6%) were in the age group of 21–30 years. The male to female ratio was 1.7:1.2. The most common CADRs were fixed drug eruption in 33.3% of patients followed by urticaria in 17.3%, and maculopapular rash in 13.3%. The most common classes of drugs implicated were antimicrobials in 40% of patients followed by nonsteroidal antiinflammatory drugs in 35.3%. The Naranjo adverse drug reaction probability scale indicated probable association of 77.3%, highly probable association of 12.6%, and 1% possible association with the implicated drugs.Conclusion:The pattern of CADRs and the drugs causing them is remarkably different in our population. Knowledge of these drug reactions, their causative drugs, and prognostic indicators is essential for the clinician.
Cutaneous leishmaniasis (CL) is a vector-borne tropical disease caused by a heterogeneous group of protozoan parasites that belong to the genus Leishmania. With an annual incidence of 1.5 million new cases, CL is a global health concern mainly in developing countries. The treatment options for CL are numerous but none is optimal. Pentavalent antimonials despite their side effects remain the preferred choice since decades. Alternate new treatment options are being explored to expand the therapeutic armamentarium of CL. In this study, we intend to describe our therapeutic experience with intralesional amphotericin B in the treatment of CL in a series of Indian patients, hitherto not commonly used in old world CL (OWCL). We also endeavour to review the literature on the use of amphotericin B in OWCL. Five consecutive patients diagnosed with cutaneous leishmansis at the out-patient department of Dermatology, Government Medical College, Jammu were treated with weekly injections of intralesional amphotericin B (2.5 mg/mL). Treatment response was assessed at each visit and the cases were followed up for 6 months. All the five patients responded well to the treatment and remained recurrence-free during follow-up. Intralesional amphotericin B was found to be safe and effective treatment for OWCL. Large randomized control trials need to be conducted to establish its efficacy.
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