Alstrom Syndrome was first described by Carl Henry Alstrom in 1959. The key features include childhood onset obesity, congenital retinal dystrophy leading to blindness, sensori-neural deafness. The associated endocrinologic aspects are early onset type 2 Diabetes Mellitus, hyperinsulinemia, hypertriglyceridemia. Mutations in the ALMS1 gene have been found to be causative for AS.The normal protein is present at very low levels in most tissues. The mutation results in a non-functional protein, explaining the various signs and symptoms of Alstrom's. Here we report on a case with Alstrom Syndrome at the age of 28 years. She came with the complaints of generalised swelling of the body, breathlessness, decreased urine output with a significant past history of visual and hearing impairment, diabetes, hypertension, and recurrent urinary tract infections. Awareness of Alstrom Syndrome is lacking despite the complexity and lethality of this disorder. Thus Alstrom Syndrome can be thought of as a rare genetic disorder with several feature similar to metabolic syndrome. It is a rare disease and difficult to make differential diagnosis with other similar syndromes, therefore this case will be a good example of Alstrom Syndrome for the literature.
BACKGROUND Vitiligo is a multifactorial depigmenting condition affecting skin and/or mucous membrane. The aim of this study is to assess the clinical patterns of vitiligo and its associated diseases in patients attending a tertiary level care centre. MATERIALS AND METHODS This study is a retrospective observational study that includes 200 self-reporting patients of age group 4-80 years with vitiligo, who attended Dermatology OPD in Chengalpattu Medical College over a period of one year from October 2015 to September 2016. RESULTS Among various patterns observed, the study obtained the following results overall-vitiligo vulgaris (37%), focal (19%), segmental (16%), mucosal (14%), acrofacial (8%), lip-tip (4%). Among children most common was vitiligo vulgaris (34.4%) followed by segmental pattern (27.5%). Most common systemic association was diabetes (18%) followed by anaemia (14.4%). Most of them were asymptomatic (85%) except for the depigmented patches. Most of the associated systemic and cutaneous diseases were found to be common in patients with vitiligo vulgaris than with any other type of vitiligo. CONCLUSION Irrespective of age, sex and duration of disease, the most common pattern is vitiligo vulgaris. Other patterns observed in decreasing order overall are focal, segmental, mucosal, acrofacial, lip-tip, vitiligo universalis with children showing predilection for segmental vitiligo. Most of the patients presented were asymptomatic except for the depigmented patches with the commonest systemic disease association being diabetes followed by anaemia.
BACKGROUND Objective-Pityriasis rosea is an acute self-limiting disease, probably infective in origin, affecting mainly children and young adults and characterised by distinctive skin eruption and minimal constitutional symptoms. Aim of the study is to analyse the incidence of PR in Government General Hospital, Chengalpattu during the period from November 2016 to January 2017, age and sex distribution, probable aetiological factor, symptoms of PR, morphological types and distribution of PR, associated cutaneous findings and the course of the disease. MATERIALS AND METHODS 100 self-reporting patients of age group 3-68 years with clinical features of Pityriasis rosea, who attended Dermatology OPD in Chengalpattu Medical College over a period of 6 months from September 2016 to February 2017 were enrolled. RESULTS Out of 100 cases studied 27 (27%) were females and 73 (73%) were males. Prodromal illness prior to the onset of rash was reported by 8 patients (8%), of whom 1 had fever alone, 1 had fever with history of jaundice and 6 had upper respiratory tract infection. Itching was absent in 51 patients; 49 patients (49%) had itching, of whom most patients (46) had only mild itch. Herald patch was present in 82 cases and absent in 18 cases. Both morphology and distribution were classical in 45% patients. In the remaining 55%, atypical morphology and/or atypical distribution were observed. In our study, none of the patients had mucous membrane or nail involvement. In 81% of patients, the lesions resolved within a period of 6-8 weeks. Active acne vulgaris is seen in 5 patients, of whom 1 had eczema also and 1 had seborrhoeic dermatitis in addition. Post Acne scar is seen in 1 patient. Nevus achromicus is seen in 1 patient. Epidermal nevus in 1 patient and combined hypo-and hyperpigmented moles in 1 patient. CONCLUSION Clinical diagnosis of Pityriasis rosea was easy based on the presence of Herald Patch, characteristic morphology and distribution pattern of the lesions. The present study has revealed male preponderance. The age incidence was found to be high in adolescents and young adults. No familial incidence was observed. Factors like wearing of new garments, stress and upper respiratory tract infections were found to precipitate the disease in some cases. In most of the patients the lesions vanished without trace and postinflammatory hypopigmentation was noted in few patients, but none had hyperpigmentation. History of recurrence of the disease was also present in one case. Histopathological study showed the features of nonspecific chronic dermatitis.
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