Background:Chronic autoimmune urticaria (CAU) is one of the most challenging therapeutic problems faced by a dermatologist. Recently, weekly autologous serum injections have been shown to induce a prolonged remission in this disease.Aim:To evaluate the efficacy of repeated autologous serum injections in patients with CAU.Materials and Methods:Seventy patients of CAU were prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a post-intervention follow-up of 12 weeks. Total urticaria severity score (TSS) was monitored at the baseline, at the end of treatment and lastly at the end of 12 weeks of follow up. Response to treatment was judged by the percentage reduction in baseline TSS at the end of treatment and again at the end of 12 weeks-follow-up.Results:Out of the 70 patients enrolled, 11 dropped out of the injection treatment after one or the first few doses only. Among the rest of 59 patients, only 7 patients (12%) went into a partial or complete remission and remained so over the follow-up period of 12 weeks. Forty patients (68%) did not demonstrate any significant reduction in TSS at the end of the treatment period. Rest of the 12 patients showed either a good or excellent response while on weekly injection treatment, but all of them relapsed over the follow-up period of 12 weeks.Conclusion:Autologous serum therapy does not seem to lead to any prolonged remission in patients of CAU.
<p class="abstract"><strong>Background:</strong> Acne scars have a lot of psychosocial implications, they are difficult to treat and can cause depression in the affected patient. The objective of the study was to assess the efficacy of combination of platelet rich plasma (PRP) injections and microneedling in the management of acne scars.</p><p class="abstract"><strong>Methods:</strong> Thirty-five patients with atrophic acne scars were enrolled and graded using Goodman and Baron qualitative grading. Platelet rich plasma injection and microneedling were done at 2-week interval alternatively for a total of 6 sessions of each. Acne scars were graded before and 6 months after starting the treatment. Patients own evaluation of improvement was also recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 12 patients had grade 4 acne scars, 8 (66.6%) improved to grade 2 and 4 (33.3%) improved to grade 3 scars. Out of 15 grade 3 scars, 8(53.3%) improved to grade 1, 7 (46.6%) improved to grade 2. 8 (100%) grade 2 patients improved to grade 1. All patients were highly satisfied with the results.</p><p><strong>Conclusions:</strong> This combination has shown good results in all grades of acne scars.</p>
Lichen scrofulosorum is a tuberculid that is usually seen in children or young adults. Although a rare occurrence, this tuberculid is an important marker of occult tuberculosis, which may not be detected otherwise. We report here a case of lichen scrofulosorum in a ten year-old boy with typical grouped lichenoid papules on the trunk associated with axillary tuberculous lymphadenitis.
Background: Nephrogenic diabetes insipidus (NDI) due to obstructive uropathy is not widely known by physicians and hence not well represented in the literature. To better understand its presentation, clinical course, and available treatments, we conducted a systematic review of case reports on NDI due to urinary tract obstruction. Material and Methods: This observational study was a systematic review of 19 human cases found in the literature. It was done retrospectively to focus on whether NDI can occur due to obstruction of the urinary tract and, if so, what the mechanism (pathophysiology) is. Results: We found that the most common symptom of NDI due to urinary tract obstruction was polyuria. The most common cause of NDI due to urinary tract obstruction was cancer. The most common site for obstruction was the ureter. And the most common test used to confirm the diagnosis was failure to concentrate urine after the administration of desmopressin. Surgical intervention was the most common treatment to relieve obstruction. Conclusion: We found that urinary tract obstruction can cause NDI. With early diagnosis and timely relief of the obstruction, NDI can be reversible.
Background: Periungual myxoid cyst is a benign cyst of the digits, usually occurs in hands although reported in toes as well. They are commonly located between distal nail crease and proximal nail fold. Aim: The aim of our study was to study the outcome of excision of periungual cyst using flap surgery. Methods: Clinical features of all six patients were recorded. All were treated with flap surgery. Intra operative findings and treatment outcome were recorded and analyzed. Results: We enrolled four male and two female patients with average age being 27+/-7.5 years. Presenting symptom was swelling over dorsal surface of distal interphalangeal joint. Nail plate deformity was seen in all patients. Follow up was done for 8 months to 1 year. Follow up period was un-eventful. Conclusion: Periungual myxoid cyst have characteristic clinical presentation. Excision using flap surgery is an excellent mode of treatment allowing better visualization, easy exploration and excellent outcome.
INTRODUCTIONThe neonatal period is defined as first four weeks of extra uterine life. The skin of the newborn serves a pivotal role in transition from aqueous intra uterine environment to extra uterine terrestrial life. Neonatal skin differs in structure and function from that of adults and hence the dermatoses seen during this period differ in their clinical presentation and therapeutic requirements. The skin of neonate is thinner less hairy has, weaker inter cellular attachments, increased susceptibility to external irritants, microbial infections and decreased contact allergen reactivity.1 The appreciation of normal physiological phenomena and their differentiation from more significant cutaneous disorders of new born is critical for dermatologist in order to modify the approach for caring of new born skin during this period. Most of the studies.2-4 regarding neonatal dermatoses have focused on the first few hours or days after birth but literature regarding full neonatal period is meagre and no such study is available from this part of the country and hence this study is an attempt to provide the frame work for an effective ABSTRACT Background: The neonatal period is the first 4 weeks of extra-uterine life. Neonatal dermatology encompasses a spectrum of cutaneous disorders from benign to life threatening. The present study was undertaken to evaluate the various dermatoses and hence assess the spectrum of dermatological conditions during the neonatal period and to study the relationship of neonatal dermatoses with maturity and birth weight of the neonates. Methods: Three hundred neonates with cutaneous manifestations, attending the OPD of dermatology and Paediatrics during one year period, were studied. Neonates receiving phototherapy and those with lesions secondary to trauma were excluded. Clinical history coupled with complete general physical, systemic and dermatological examination. Results: Three hundred cases of neonatal dermatoses were included in study. Out of 300 cases, 179 (59.7%) were male babies and 121 (140.3%) were female (sex ratio 1:5), 271 (70.3%) were term babies, 27 (9%) were preterm and 2 (0.7%) were post term. Transient/non-infective cutaneous lesions were the commonest 144 (48%) followed by Infectious 68 (22.67%), eczematous disorder 33 (11%) and pigmentary dermatoses 25 (8.33). Vascular lesions and hematomas accounted for 18 (6%) while genodermatoses were seen 7 (2.33%). 5 cases of subcutaneous fat disorders were observed. Conclusions: As the spectrum of neonatal dermatology is vast, its knowledge to dermatologist is very important so as to differentiate the more common benign disorders from less frequent life-threatening dermatoses, so that timely intervention could facilitate a better therapeutic outcome.
Lyme disease is a vector-borne illness of North America and Europe transmitted by Borrelia burgdorferi, over 30,000 cases are reported in the United States yearly. Patients typically present having early localized disease with fevers, headaches, myalgias, and a single erythema migrans. Usually, oral doxycycline is administered with a good disease prognosis but we report the case of a 58-year-old male who presented with Lyme disease diagnosed by immunoassay; he was treated with doxycycline but was refractory and saw an improvement in his symptoms with IV ceftriaxone.
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