No abstract
Objective: Granulomatous mastitis (GM), including idiopathic granulomatous mastitis (IGM) and tuberculous mastitis (TBM), is a rare and benign disease of the breast. Our aim is to highlight the nonspecific clinical presentations, diagnostic difficulties and therapeutic approaches of GM.Methods: Sixty-eight women with GM (52 with IGM and 16 withTBM) were included in the study. All clinical characteristics, diagnostic methods, and therapeutic approaches were evaluated in detail. Results:The patients with IGM had earlier onset in comparison to the patients with TBM. Suspicion of malignancy clinically was more frequent in patients with TBM than in those with IGM. While anti-TB therapy was quite effective in TBM patients, surgical excision had the lowest recurrence rate in patients with IGM. Conclusion:GM usually poses a diagnostic and therapeutic challenge for the physicians. TB is still an important cause of GM, and should be always kept in mind in the differential diagnosis. Due to the diagnostic and therapeutic challenges, a multidisciplinary approach is needed to avoid mistakes and to obtain well outcomes.
<p class="abstract">Dermatophytosis continues to be a worldwide public health problem, predominantly in developing countries like India. Early diagnosis and appropriate management are imperative to enhance patient outcomes and improve quality of life of individuals with dermatophytosis. Multiple focused group discussions involving 76 dermatologists across 36 cities in India were conducted to provide a consensus clinical viewpoint of expert dermatologists to gain insights toward effective diagnosis and management of Indian subjects with dermatophytosis. These discussions mainly aimed at reviewing current literature on prevalence, etiology, diagnosis and management of dermatophytosis and highlighting variations in diagnostic and treatment approaches in routine clinical practice. The current article summarizes the experts’ clinical viewpoint on overall management of dermatophytosis. Diagnosis of dermatophytosis involves clinical observation, microscopic examination and dermoscopy. Molecular techniques have certain advantages over conventional microscopy and culture methods but are associated with issues of cost and technique complexity. Oral itraconazole 200 mg–400 mg daily and terbinafine 500 mg/day could be considered for recalcitrant tinea infections. Topical azoles like luliconazole, sertaconazole, and terbinafine could be beneficial. A combination of oral and topical antifungal drugs is effective in patients with steroid-modified and difficult-to-treat tinea infections. Also, patient counselling and use of adjunctive therapies like antihistamines, retinoids, and moisturizers are essential for managing tinea infections. </p><p class="abstract"> </p>
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