Background:Periorbital hyperpigmentation (POH) is one of the most commonly encountered conditions in routine dermatology practice. There are only few published studies about its prevalence, classification, and pathogenesis but none showing its association with habits, and other medical conditions in Indian patients.Aims:To determine prevalence and type of POH, common causative factors, and its association with personal habits and other disorders within various age and sex groups.Materials and Methods:Two hundred patients attending the dermatology OPD were included in study and were subjected to detailed history, careful clinical and Wood's lamp examination, eyelid stretch test and laboratory investigations. Clinical photographs of all patients were taken.Results:POH was most prevalent in 16-25 years age group (47.50%) and in females (81%) of which majority were housewives (45.50%). Commonest form of POH was constitutional (51.50%) followed by post inflammatory (22.50%). Lower eyelids were involved in 72.50%. Grade 2 POH was seen in 58%. Wood's lamp examination showed POH to be dermal in 60.50%. Faulty habits were observed viz. lack of adequate sleep (40%), frequent cosmetic use (36.50%), frequent eye rubbing (32.50%), and lack of correction for errors of refraction like myopia in 12% patients. Strong association of POH with stress (71%), atopy (33%) and family history (63%) was noted.Conclusions:Periorbital hyperpigmentation is a multi-factorial entity. It is absolutely essential to classify the type of POH and determine underlying causative factors in order to direct appropriate measures for better and successful outcome in future.

Permethrin and topical ivermectin were equally effective against scabies while oral ivermectin was significantly less effective up to 2 weeks. Topical ivermectin can be used as an alternative to permethrin.

Background:The wide and indiscriminate use of drugs has increased the incidence and the modes of presentation of cutaneous drug reaction. Adverse cutaneous drug reactions are common, comprehensive information about their incidence, severity and ultimate health effects are unavailable.Objective: To study and evaluate incidence of adverse cutaneous drug reaction (ACDR) at our tertiary care hospital and assess the impact of active surveillance on adverse drug reaction (ADR) reporting. Materials and Methods:Prospective study involving 29,156 patients was carried out by active observation of patients attending Dermatology department over a period of 21 months. Retrospective study involving 61000 patients attended Dermatology OPD over last 4 years was carried by available data of dermatology department. Both the studies were compared by chi square test. Results:In prospective study 48 (0.17%) were diagnosed as having ACDR. Acneform eruption (25%) followed by fixed drug eruption (FDE) (22.92%) were the most common morphological forms. The most common drugs responsible were betamethasone, isoniazid and rifampicin for acneform eruption, while metronidazole and paracetamol for FDE. WHO causality assessment showed 13 were certain, 24 were probable and 11 were possible in nature. Hartwig severity assessment revealed 40 were moderate, 07 were mild and 01 was severe. Modified Schomock and Thronton scale showed 37.5% were definitely preventable, 33.33% were probably preventable and 29.17% were not preventable. In retrospective study 63 (0.10%) ACDRs were reported, out of them FDE was most common (28.57%), followed by acneform eruption (11.11%). Antimalarials and metronidazole were most commonly responsible for FDE while systemic steroids were responsible for acneform eruption. There is significant association between both the studies with higher incidence in prospective study (p<0.05). Conclusion:Most common ACDRs were acneform eruptions and FDE in both prospective study and retrospective study. Pharmacovigilance activity is significantly effective in increasing the reporting of ADRs.

Background:Dermatophytoses are the superficial fungal infections of skin, hair, and nail. Butenafine is a benzylamine group of antifungal that inhibits the biosynthesis of ergosterol by blocking squalene epoxidase. Sertaconazole is a newer imidazole antifungal which inhibits the biosynthesis of ergosterol by inhibiting 14-α lanosterol demethylase. The study was done to compare a newer antifungal with a relatively older one.Aim:To compare the efficacy, safety and cost effectiveness of topical 2% sertaconazole cream and 1% butenafine in tinea infections of skin.Materials and Methods:Patients were randomly allocated to two treatment groups. They were advised to apply the drug topically twice a day for one month on the lesions. They were followed up at an interval of 10 days. Clinical score and Global Evaluation Response were assessed at baseline and during each follow up.Results:A total 125 patients were recruited, out of them 111 completed the whole study. Median Sign and Symptom Score of tinea on the baseline was 9 [5,9] that was reduced to 0 [0,4] by 2% sertaconazole while it was 9 [6,9] in the butenafine group on the baseline that was reduced to 0 [0,6] at the end of the treatment. 98% and 90% of the patients got complete clearance of the lesions with butenafine and sertaconazole, respectively. Treatment with butenafine was more cost effective as compared to sertaconazole.Conclusion:1% butenafine is more efficacious, cost effective, and equally safe as compared to 2% sertaconazole in the tinea infections of skin.

Aims and Objectives:The aim of this study is to compare the efficacy, safety and cost-effectiveness of topical Whitfield's ointment plus oral fluconazole with topical 1% butenafine in tinea infections of the skin.Materials and Methods:Patients were randomly allocated to the two treatment groups and advised to apply either agent topically twice-a-day for 4 weeks on the lesions and fluconazole (150 mg) was administered once a week for 4 weeks in the study group applying Whitfield's ointment. Patients were followed-up at an interval of 10 days for clinical score and global evaluation response was assessed at baseline and during each follow-up.Results:Out of 120 patients enrolled in the study 103 completed the study. Patients treated with Whitfield's ointment and oral fluconazole reduced mean sign and symptom score from 8.81 ± 0.82 to 0.18 ± 0.59 while butenafine treated patients reduced it from 8.88 ± 0.53 to 0.31 ± 0.67 at the end of the treatment. Nearly, 98% patients were completely cleared of the lesion on the 3rd follow-up with both treatments.Conclusion:Whitfield's ointment with oral fluconazole is as efficacious, safe and cost-effective as compared with 1% butenafine in tinea infections of the skin.