BACKGROUND:Lichen planus is a chronic inflammatory disease that effects skin, mucous membranes, hair and nails. There are several drugs both topical and systemic for the treatment of lichen planus. AIMS AND OBJECTIVES: Present study was done to compare the efficacy between oral mini pulse therapy with betamethasone and with acetretin in the management of generalised lichen planus. MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen planus, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Vishakhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups. Group1 patients were treated with 0.1mg/kg of oral betamethasone given on 2 consecutive days in a week till 8 weeks and tapered. Group 2 patients were treated with 0.5mg/kg of acetretin for 8 weeks and tapered. INCLUSION CRITERIA: All patients of age group in between 11-60 years, of either sex, suffering from lichen planus of duration >3 months, and women in group 2 who were in reproductive age group on two methods of contraception were included. EXCLUSION CRITERIA: Pregnant and lactating women, in Group 1: patients suffering from diabetes, hypertension, peptic ulcer disease, renal, hepatic, heart disease or tuberculosis, in Group 2: patients with abnormal lipid profile, diabetes, hypertension, renal, liver or heart disease were excluded. RESULTS: out of 60 patients enrolled in study, 2 patients from group 1 and 5 patients from group 2 were dropped from study and results were concluded. Majority of patients were in age group of 31-60 (78.3%) with male to female ratio of 2.1:1.Group 1 patients at the end of 8 weeks response was seen in 92.8%, with relapse rate of 15.38% after 6 months of follow up. Group 2 patients at end of 8 weeks response was seen in 72 % with relapse rate of 5.5%. CONCLUSION: In our study oral mini pulse therapy with betamethasone has early onset of action and with a complete response in majority of patients with slightly more relapse rate when compared to oral acetretin. Oral acetretin has less relapse rate due to prolonged half-life.
Chronic folliculitis of legs results from the inflammation of the ostium of the hair follicle. Clinically, it is characterised by profuse eruption of follicular papules and pustules with the hair piercing the centre of the lesion. It involves predominantly lower legs and also thighs and forearms in severe cases. Usually asymptomatic, but sometimes associated with pruritus and pain. The lesion resolve without any sequelae. There are no associated systemic disturbances. In majority of cases, coagulase positive Staphylococcus aureus isolated from the lesions. It runs a chronic recurrent and relapsing course and usually resistant to treatment affecting the quality of life of the patient. A number of therapeutic agents have been tried in various studies including Cotrimoxazole, Psoralen with UV-A (PUVA) therapy, (1) Ciprofloxacin, (2,3) Rifampicin, Dapsone, (4) Minocycline (5) with variable success rates. Complete cure is not seen with any antibiotic therapy. The present study was undertaken to compare the efficacy of Ciprofloxacin and Tetracycline in the management of chronic folliculitis of legs. MATERIALS AND METHODSYoung adults above 18 years presenting with chronic folliculitis were included in the study. It was a comparative study of 100 patients with chronic folliculitis attending Outpatient Department of Dermatology of KGH affiliated to AMC, Visakhapatnam for a period of 1 year. These patients were divided into 2 groups and the efficacy of Ciprofloxacin and Tetracycline in the management of chronic folliculitis was compared at the end of the study. RESULTSWith Ciprofloxacin we reported early and excellent response when compared to Tetracycline. Recurrences were reported in all cases studied. Early recurrences were reported following treatment with Tetracycline when compared to Ciprofloxacin. CONCLUSIONSClinically best results were obtained with Ciprofloxacin in a dose of 500 mg BD for 2 weeks followed by Tetracycline. KEYWORDSChronic Folliculitis, Ciprofloxacin. HOW TO CITE THIS ARTICLE: Rama R, Suryanarayana G, Prasad PG, et al. Efficacy of ciprofloxacin and tetracycline in the manage ment of chronic folliculitis of legs -a comparative study.
Syphilis is one of the most fascinating diseases of humans. Widespread use of antibiotics now has reduced the incidence of early syphilis and recognized new cases of late syphilis have decreased. Serological tests are the basis for the diagnosis of latent syphilis. They vary in their sensitivity and specificity. While non-treponemal tests (VDRL and RPR) are most frequently used as screening procedures, treponemal tests (FTA-ABS and TPHA) are considered to be highly sensitive and specific. MATERIALS AND METHODSIn this study 100 serum samples collected from the patients attending STD Department, King George Hospital, Visakhapatnam. Samples were subjected to VDRL, RPR and Micro-TPHA tests to evaluate the sensitivity and specificity of Micro-TPHA test in patients with various stages of syphilis and to evaluate the efficacy of Micro-TPHA to confirm the diagnosis of syphilis and to rule out biological false positive reactions or false negative reactions of VDRL tests. RESULTSThree tests (VDRL, RPR and Micro-TPHA) were applied to all 100 patients. Among them 85 were VDRL reactive, 84 were RPR positive and 89 were TPHA positive. In them males were more in number, in 3 tests with respect to age, (21-30) age group patients showed predominance. Out of 100 patients, 81 sera were positive for all three tests and one serum sample was VDRL reactive, but RPR and TPHA were non-reactive. This may be a false positive reaction. The following tables showed the sensitivity and specificity of each test and also the sensitivity of each test in various stages of syphilis. CONCLUSIONIt is concluded as by performing TPHA test, false positive reactivity of VDRL test could be detected. Even in the cases of treated primary and secondary syphilis, TPHA was reactive. The lipoidal antigen tests primarily reflect disease activity and serial quantitative performance of these tests used to measure the treatment response.
Benign (Jessners) lymphocytic infiltration of the skin is a chronic, benign T-cell infiltrative disorder, usually manifesting as erythematous papules or plaques on the face, neck and back. We report the case of a 30-year -old female, who presented with erythematous papules and plaques on face, upper back, front of chest, of 4 months duration and erythematous plaque on both dorsa of hand and Fore arms of 1 month duration. Skin biopsy confirmed the diagnosis of jessner's lymphocytic infiltration of the skin. The evolution was favorable with hydroxy chloroquine.
The object of our study is to know the incidence of gonorrhea in reproductive age group women suffering with leucorrhoea attending STI Clinic in King George Hospital in Visakhapatnam. MATERIAL AND METHODSIn our present study, we included 120 female patients of reproductive age group women (20-45 years) with leucorrhoea attending STI Clinic; we also examined the male partners. The diagnosis of Gonorrhoea is confirmed by smear and culture examination. The vaginal discharge was collected with sterile swabs and inoculated in modified Thayer-Martin media for 48-72 hours. Gram staining was done to examine the smear under microscope to examine the diplococci. Urethral and rectal swabs collected from their male sexual partners and sent for smear and culture. RESULTSIn our study, results shows women suffering with Gonococcal infection and some percent of male partners suffering with Gonococcal infection and it shows the transmission occurs predominantly through sexual contact are asymptomatic carriers and source of infection to their male partners. We found Gonorrhoea is the common cause of Leucorrhoea next to Candidiasis and Trichomoniasis. CONCLUSIONTreatment of both male and female sexual partners is essential to control and prevent the recurrence of Gonorrhoea. Early diagnosis and treatment of Gonorrhoea in female patients will prevent late complications like PID, tubal block, ectopic pregnancy and sterility in reproductive age group women.
Jessners lymphocytic infiltration of the skin is a chronic, benign T-cell infiltrative disorder, usually manifesting as erythematous papules or plaques on the face, neck and back. we report the case of a 66-year -old man, who presented with erythematous papules and plaques on nose of 4 months duration and erythematous plaque on right arm of 1 month duration. skin biopsy confirmed the diagnosis of jessner's lymphocytic infiltration of the skin.The evolution was favorable with hydroxy chloroquine and prednisolone. KEYWORDS: Jessners lymphocytic infiltration of skin, hydroxy chloroquine and Prednisolone. INTRODUCTION:Jessner's lymphocytic infiltration of the skin (JLIS) is a skin condition of unknown aetiology characterized by erythematous papules and plaques located on the head, neck and upper back. The eruption resolves spontaneously after months or a few years but can recur for several years. A variety of empirical treatments has been tried with limited success. Here we report a case of jessners lymphocytic infiltration of skin successfully treated with hydroxychloroquine and prednisolone.
Pyoderma gangrenosum (PG) is a chronic, painful ulcerated skin disease of unknown etiology. Its association with inflammatory bowel disease like ulcerative colitis is common. The lesions generally appear during the course of active bowel disease, frequently concur with exacerbations of colitis, sometimes with inactive ulcerative colitis. 15 to 20 % of patients with Pyoderma gangrenosum have ulcerative colitis and 0.5 to 5 % of patients with ulcerative colitis have Pyoderma gangrenosum. occasionally skin lesions may preceed active inflammation of colon. Here we report a case of 50 year old female presenting with large ulcerated lesion over the anterior aspect of the middle 1/3 rd of left leg associated with severe pain and bloody discharge. skin biopsy shows epidermis with necrosis and diffuse dense neutrophilic infiltrate in superficial epidermis extending into the deep dermis. Colonoscopy shows features of ulcerative colitis. Patient showed rapid response with systemic steroids and specific treatment with 5-amino salicylic acid (mesalamine). ulcer healed within 6 weeks and followed for 3months with no recurrence.
AIMThe objective of this study is to analyse the association between sexually transmitted diseases and cervical cytology by doing Papanicolaou (Pap) smear in the female patients attending Sexually Transmitted Disease (STD) Clinics. MATERIALS AND METHODSThe present study was carried out on 200 female patients attending STD clinic Outpatient Department (OPD) in King George Hospital (KGH) for a period of 2 years. For all the patients Pap smears were taken. RESULTSA 39% of the cases had normal cytology, 26% had inflammatory cytology, 16% had mild dysplasia, 13.5% had moderate dysplasia, 5.5% had severe dysplasia. Higher incidence of cervical dysplasia was seen in patients with Genital Herpes and Genital warts. Higher incidence of cervical dysplasia (42.6%) in 20 to 30 years age group women in comparsion with diminished incidence in (28.7%) in 30 to 40 years age group. A 44.6% in Commercial Sex workers and women with history of sexual promiscuity had cervical dysplasia and 28.7% women having normal marital life had cervical dysplasia. We found higher number of cervical dysplasia in lower income group (37.8%) and (42.6%) in illiterates. CONCLUSIONSPap smear should be done as a routine screening procedure in all female patients attending STD Clinics to detect early cervical neoplasia, which will help to reduce morbidity and mortality due to cancer cervix in sexually active reproductive age group women.
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