In India, phenytoin is the most frequently prescribed medication for most forms of epilepsy except for absence seizures. It has been associated with various cutaneous reaction, however Oral Lichenoid Drug Reaction (OLDR) are rarely documented. We report a case of Phenytoin induced Oral Lichenoid Eruption and Melasma.
Background: Studies on mice and aging human hair follicles provide compelling evidence that graying of hair results from premature differentiation of Melanocyte stem cells (MeSC) in the niche/bulge. Objective: To analyze whether differentiation of melanocyte stem cells is responsible for premature graying of hair (PGH). Methods: Twenty- five patients of PGH (n=25) attending dermatology department were recruited. Five unpigmented and five pigmented hairs were obtained per patient by separating individual follicles by 1 mm punch biopsies. The hairs were dissected at a distance of 2 mm from the bulb to separate the stem cells (upper segment) (US) from the melanocytes (lower segment) (LS). RNA was extracted from hair follicle segments US and LS, and expression of GP100, Tyrosinase (TYR) and Tyrosinase related protein-1 (TYRP1) genes was quantified using Qiagen one-step RT-PCR kit. Results: We found melanogenesis gene expression in both temporary (US) and permanent (LS) segments of unpigmented and pigmented hair follicles. When compared between the US and LS of white hair, the expression of TYR and GP100 was much higher in US than LS, suggestive of melanogenesis in the bulge. Similarly, when compared between white and black US, the expression of all three genes was higher in white US than black US, although not statistically significant. Limitations: Low samples size and lack of data pertaining to the expression of genes at protein level are the limitations of current study. Conclusion: Even though this pilot study data yielded key information about the expression of GP100, TYR and TYRP-1 at mRNA level, further studies quantifying the expression of these genes at protein level are needed to provide additional clues to further address the results in detail.
Childhood psoriasis is recognized as a potential multisystem disorder and hence it is imperative to optimize disease management to arrest progression, minimize psychological burden and evolution of metabolic syndrome. Clinical practice recommendations are necessary to assist practitioners in appropriate decision making based on available evidence. Owing to the lack of Indian recommendations on childhood psoriasis, the SIG Pediatric Dermatology under IADVL Academy undertook an evidence-based approach based on published literature on the topic, between January 2000 and July 2020 to frame the recommendations.
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