BACKGROUND Chronic dermatophytosis is increasing in an alarming proportion all over India. This study was undertaken to understand the possible factors predisposing to chronic dermatophytosis in patients attending the OPD of this tertiary care center in Alappuzha district of Kerala. MATERIALS AND METHODS 50 consecutive patients with chronic dermatophytosis attending the OPD of the tertiary care centre in Alappuzha district, Kerala, were enrolled in the study after taking informed consent. Detailed history, physical examination, direct microscopy and culture was done in all patients. RESULTS 50 patients with chronic dermatophytosis were studied. 66% were females. Maximum number (32%) of patients were in the fourth decade. 52% were manual labourers. 64% patients had sun exposure for more than 3 hours per day. 20% patients had contact with animals. 22% had associated diabetes mellitus. 80% patients were using topical steroid as part of treatment. 94% were not compliant to treatment. 56% of patients had both T. cruris and T. corporis. Trichophyton rubrum was the most common species isolated. CONCLUSION Avoidance of topical steroids and strict adherence to the treatment schedule is very important to prevent the development of chronicity in dermatophyte infection. Detailed study about the various aspects of fungal resistance and also the genetic, host and environmental factors is needed further to curtail the occurrence of this menace.
Background: Psoriasis is a chronic inflammatory disease that affects millions of people throughout the world. Nail involvement is a common feature in psoriasis which is often overlooked despite causing significant functional impairment, disfigurement, and psychological stress to the patient. Dermoscopy is a non-invasive novel tool that enables a rapid and magnified visualization of the nail changes which are often imperceptible to the unaided eye. Aims and Objectives: To study the dermoscopic profile of nail changes in patients with chronic plaque psoriasis. Materials and Methods: The study was conducted from December 2018 to May 2020, in the Department of Dermatology of a tertiary care center in Kerala, including 155 patients of clinically diagnosed chronic plaque psoriasis who had nail involvement. A detailed history was noted along with a clinical and dermoscopic examination of all 20 nails of each patient. Results: The most common finding on dermoscopic examination of the nails was onycholysis seen in 91%, followed by pitting (78.8%) and subungual hyperkeratosis (78.1%). Other findings noted in our study which are not commonly described are wavy lamellar microsplitting (41.9%), cuticular hypertrophy (18.1%), pseudofiber sign (16.1%), dilated nailfold capillaries (12.3%), capillary prominence at onychodermal band (7.7%), dilated hyponychial capillaries (7.7%), and fuzzy lunula (7.1%). Conclusion: Nails are frequently involved in psoriasis but often overlooked. Dermoscope is an effective tool that facilitates the assessment of nail changes in psoriasis.
BACKGROUND Neurocutaneous disorders are a heterogeneous group of genetically determined diseases usually involving the skin and nervous system. Neurofibromatosis (NF) is a classical example of neurocutaneous disorder having autosomal dominant inheritance with 100% penetrance affecting around one in 3000 live births. Though there is high prevalence of genetic disorders in Kerala, a survey of the literature reveals only a few reports from South India about this disease. Hence, we decided to study neurofibromatosis as a model of genodermatosis, as this disease has the classical involvement of both skin and nervous system. The aims of the study were to assess the clinical spectrum, prevalence and inheritance pattern of neurofibromatosis in patients and their progeny, to study physical statistics and intelligence quotient of neurofibromatosis patients; and to evaluate the systemic involvement and complications. MATERIALS AND METHODS This cross-sectional descriptive study was done on 41 patients with neurofibromatosis who attended to a tertiary care hospital in Kerala. A detailed history, dermatologic and systemic examination, ophthalmological evaluation and IQ assessment were done in all patients. Results of physical examination and investigations were analysed by using appropriate biostatistics. RESULTS Frequency of neurofibromatosis was found to be high in our population. Significant proportion of patients had neurological and skeletal manifestations. Association with malignancy was also observed in our study. CONCLUSION If a medical examination along with IQ assessment is done at the time of admission to school, all cases of NF can be detected early and its future complications can be reduced.
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