Context:The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age.Aims:The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations.Settings and Design:This was a hospital-based observational study.Materials and Methods:One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail) and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case.Statistical Analysis Used:Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis.Results:Out of 150 patients studied, majority belonged to the age group of 21–30 years (22.7%). Male-to-female ratio was 1.63:1. Tinea corporis (24.7%) was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%).Conclusions:The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka.
Summary Background and objective Keloids and hypertrophic scars (HTS) are abnormal fibrous reactions that persist for prolonged periods, rarely regress without treatment and recur after excision. Many modalities of treatment have been advocated but the success rates of these have been variable. The present study is an attempt to evaluate and compare the efficacy of combination of fractional CO2 laser (FCL) and intralesional steroid (ILS) against ILS alone in the treatment of keloids and HTS. Methods Patients with keloids or HTS were divided into two groups of 25 each receiving four sessions of therapy. Group 1 (FCL + ILS) received combination of FCL and intralesional triamcinolone acetonide (TAC) 10 mg/mL. Group 2 (ILS only) received intralesional TAC 10 mg/mL alone. Pretreatment measurements and photographs were taken. Two unbiased qualified dermatologists made independent evaluation of the photographs using modified Manchester quartile score (MQS). The patient's satisfaction to treatment was graded on a scale of 1‐4. Statistical analysis was done using a statistical software. Results Statistically significant improvement was seen in height and length of the lesions. Overall appearance criteria of modified MQS showed an improvement of more than 50% in 43.3% of the lesions by the end of four sessions. Degree of hypertrophy showed more than 50% improvement in 40% of the lesions treated. Dyschromia showed more than 50% improvement in 33.4%. Texture showed the least improvement, with only 30% of lesions showing an improvement of more than 50%. The improvement of these parameters in ILS only group was significantly lower than the improvement seen in the FCL + ILS group. Conclusion Combination therapy with FCL and ILS was superior in efficacy when compared to ILS alone, in the treatment of keloids and HTS.
Giant congenital melanocytic nevi are rare and occur in about one out of every 2,00,000 to 5,00,000 births. There is a significant association between bathing trunk nevus and neurofibromatosis and lipomatosis. Apart from this, association of bathing trunk nevus with abnormalities like spina bifida occulta, meningocele, club foot and hypertrophy or atrophy of deeper structures of a limb, have been described. We are herewith reporting two cases of bathing trunk nevi. In our first case, an eight-year-old girl presented with a bathing trunk nevus studded with multiple, large nodules. Histopathological examination of the biopsy taken from one nodule revealed features of both neurofibroma and lipoma. To the best of our knowledge, features of both these hamartomas in one nodule of a single patient are probably not reported in the literature. In our second case, a 12-year-old girl presented with bathing trunk nevus and she had spina bifida occulta. She also had lipoma in the lesion of bathing trunk nevus. Both of our patients had satellite melanocytic nevi over the face, forearm, upper back and legs. Our second patient, in addition, had small melanocytic nevi over the medial canthus and sclerocorneal junction of the right eye. By the time this girl presented to us, the melanocytic nevus started fading in color and it had become brownish. We are reporting these cases for their peculiarities and for their rare features.
We report a case of a patient with localized discoid lupus erythematosus (DLE) who was found to have high-grade squamous dysplasia (carcinoma in situ) over the upper lip. This report also consists of a brief review of 16 other cases of DLE with squamous cell carcinoma (SCC) we came across while going through the literature in an Indian scenario.Incidence of SCC over DLE in the Indian population is found to be 0.98% to 3.4% with a male-to-female ratio of 1.6:1. The latent period between onset of DLE and development of SCC was 9.59 ± 5.6 years.There was history of chronic sun exposure in 81.8% of patients, which indicates a possible role of prolonged ultraviolet light exposure in malignant transformation. The lips were the most commonly affected area (28.57%), with the upper lip being more commonly involved than the lower lip. We also observed that the latent period (5 ± 2.7 years) in lip tumours was shorter than that in other sites (11.22 ± 6.78 years), indicating a more rapid transformation in lips (p value = 0.038). Well differentiated was the most common (46.2%) type of SCC noted. Lymph node involvement was found in three of 17 cases (25%) and one case (8.3%) had recurrence of lesions after excision.We conclude that in India though SCC is rare per se, its occurrence in the context of DLE is not uncommon and is aggressive in nature.
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