Toxic epidermal necrolysis (TEN) is severe adverse cutaneous drug reaction that predominantly involves the skin and mucous membranes. It is usually induced by medications. Anti-convulsants such as phenytoin, carbamazepine and phenobarbital have been enlisted as high risk drugs for causing TEN. Objectives: The main objective of this case report is to evaluate the importance of detection, assessment and reporting of an adverse drug reaction and to improve the medication adherence. Methods: This is an observational type of case report which we observed in our hospital on regular ward rounds. Results: This is a case report of Toxic epidermal necrolysis due to a Phenytoin which was used in the treatment of epilepsy in a 25 year old female patient. Causality assessment of the event with Naranjo' scale suggest "Probable". Conclusion: Proper counselling to the patient regarding the use of medications is of utmost importance, in such life threatening conditions where treatment guidelines remain hazy.
<p class="abstract"><strong>Background:</strong> Melasma is an acquired hyperpigmentation of face predominantly affecting women with multiple factors like high estrogen states, genetic factors, sunlight, cosmetics & autoimmune thyroid disease implicated in its etiology. Current therapeutic modalities are beneficial for many patients but for some they may remain ineffective. The objective of the study was on clinical study of melisma and to study efficacy of 40% glycolic acid facial peels in melasma.</p><p class="abstract"><strong>Methods:</strong> Woods lamp examination was done and patients were classified as having epidermal, dermal or mixed type. 40% glycolic acid peel was carried for a period of 20-30 seconds and was left for a period of 3 minutes or till the development of erythema. The peel was terminated by dilutional effect of washing with cold water. Six peelings were done at 15 days interval.<strong></strong></p><p class="abstract"><strong>Results:</strong> In total 50 patients, 56% belong to 31-40 years.<strong> </strong>Females constitute 82%. Majority were housewives (64%). Malar distribution was most common type (90%). Family history was present in 38%. Photo aggravation was present in 56% patients. Onset of melasma was associated with pregnancy in 22%. Epidermal melasma was seen in 62%. >75% improvement in 2%, 51-75% improvement in 14% and 25-50% improvement in 40% patients. Erythema (54%) and burning sensation (56%) were common side effects.</p><p class="abstract"><strong>Conclusions:</strong> So management of melasma in our patients with superficial glycolic acid peels alone is not highly rewarding.</p>
<p class="abstract"><strong>Background:</strong> Cutaneous tuberculosis (TB) is frequently found worldwide, especially in tropical countries. The number of extrapulmonary TB reaches up to 14%, and 1% to 2% are cutaneous TB. Diagnosis of cutaneous tuberculosis (CTB) is complicated and requires a full work-up. Clinical manifestation of cutaneous TB is varied and causes difficulties to diagnose. Scrofuloderma and plaque type of lupus vulgaris (LV) are common forms of cutaneous TB.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted on patients attending Department of Dermatology, Venereology and Leprosy, at Basaveshwara Medical College and Hospital, Chitradurga over a period of 2 years. A total of 15 cases of cutaneous tuberculosis were diagnosed.</p><p class="abstract"><strong>Results:</strong> A total of 15 cases out of which included predominantly males, with age group being affected commonly are 20-40 decades, histopathology showing tuberculoid granuloma in 11 cases, and common clinical variant being lupus vulgaris seen in 66.6% of the cases and. Second common being scrufuloderma seen in 26.6% of the cases and least common is TB verrucosa cutis (TBVC) seen in 6.6% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> The study showed that the common clinical type of cutaneous tuberculosis during the study period was lupus vulgaris, scrofuloderma and less common being TBVC.</p>
Mal de Meleda is a rare autosomal recessive palmoplantar keratoderma characterized by transgradient keratoderma with associated scleroatrophy, knee changes and onychogryphosis. This case of a 20 year old girl born of second degree consanguineous marriage is reported for its uniqueness in conformity with criteria enunciated by Stulli associated with hyperkeratotic warty papules clinically fitting into Darier's disease with lip involvement. Another interesting feature being black pigmentation of fingers and nails which was due to cashew nut shell paste application mistaken for dry gangrene.
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