The minor haplotype -3575A/-2849G/-2763C in IL-10 promoter has been defined as a marker of disease resistance to leprosy and its severity in Brazilian population. Our investigation of six single-nucleotide polymorphisms (SNPs) in IL-10 promoter in 282 Indian leprosy patients and 266 healthy controls by direct PCR sequencing, however, showed that the extended haplotype: -3575T/-2849G/-2763C/-1082A/-819C/-592C was associated with resistance to leprosy per se and to the development of severe form of leprosy, using either a binomial (controls vs cases, P=0.01, OR=0.58, CI=0.37-0.89) or ordinal (controls vs paucibacillary vs multibacillary, P=0.004) model. Whereas, IL-10 haplotype -3575T/-2849G/-2763C/-1082A/-819T/-592A was associated with the risk of development of severe form of leprosy (P=0.0002) in contrast to the minor risk haplotype -3575T/-2849A/-2763C in the Brazilian population. The role of IL-10 promoter SNPs in Brazilian and Indian population strongly suggests the involvement of IL-10 locus in the outcome of leprosy.

Mycetoma is a localized chronic, suppurative, and deforming granulomatous infection seen in tropical and subtropical areas. It is a disorder of subcutaneous tissue, skin and bones, mainly of feet, characterized by a triad of localized swelling, underlying sinus tracts, and production of grains or granules. Etiological classification divides it into eumycetoma caused by fungus, and actinomycetoma caused by bacteria. Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory, though difficult. Serological test exists but is not so reliable; however, molecular techniques to identify relevant antigens have shown promise. The disease is notoriously difficult to treat. Eumycetoma may be unresponsive to standard antifungal therapy. Actinomycetoma responds to antibiotic therapy, but prolonged treatment is necessary. This review focuses on the etiopathogenesis, clinical features, laboratory diagnosis, and treatment of mycetoma.

Chronic paronychia is an inflammatory disorder of the nail folds of a toe or finger presenting as redness, tenderness, and swelling. It is recalcitrant dermatoses seen commonly in housewives and housemaids. It is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Repeated bouts of inflammation lead to fibrosis of proximal nail fold with poor generation of cuticle, which in turn exposes the nail further to irritants and allergens. Thus, general preventive measures form cornerstone of the therapy. Though previously anti-fungals were the mainstay of therapy, topical steroid creams have been found to be more effective in the treatment of chronic paronychia. In recalcitrant cases, surgical treatment may be resorted to, which includes en bloc excision of the proximal nail fold or an eponychial marsupialization, with or without nail plate removal. Newer therapies and surgical modalities are being employed in the management of chronic paronychia. In this overview, we review recent epidemiological studies, present current thinking on the pathophysiology leading to chronic paronychia, discuss the challenges chronic paronychia presents, and recommend a commonsense approach to management.

We investigated the Toll-like receptor 2 (TLR2) Arg677Trp polymorphism, associated with lepromatous leprosy in the Korean population and shown to abrogate TLR2-mediated signalling in response to mycobacterial ligands, in 286 Indian leprosy patients and 183 ethnically matched controls. The case-control comparison also involved investigation of possible variation(s) in the promoter region of the TLR2 gene. Genotyping results after direct PCR sequencing showed that the TLR2 Arg677Trp polymorphism associated with lepromatous leprosy in the Korean population is not a true polymorphism of the TLR2 gene and has resulted from the variation present in the 93% homologous duplicated region of TLR2 exon 3 present approximately 23 kb upstream.

Forty patients with psoriasis and forty healthy controls were enrolled to study the levels of total blood thiols (an important part of the body's antioxidant defence system) and plasma malondialdehyde (a lipid peroxidation product). The levels of total blood thiols in psoriatic patients in the acute phase were significantly lower than those in controls, but total blood thiol levels in psoriatic patients in the remission phase were not significantly different from those in controls. There was a significant difference between levels of total blood thiols of patients in the acute phase and in remission. The levels of plasma MDA were significantly raised in psoriatic patients in the acute phase as compared to those in controls and in patients in remission. The differences in levels of plasma MDA were not significant between control subjects and patients in remission. These findings suggest a role of oxidative stress in the etiopathogenesis of psoriasis.

No abstract

Platelet-rich plasma (PRP) is a new modality of treatment in the field of dermatology. There are paucity of studies evaluating the effects of PRP in nonscarring alopecia especially alopecia areata (AA). To compare the efficacy and safety of PRP in patchy AA of the scalp in a placebo and active controlled trial. This was a randomized, placebo and active controlled, split scalp study. Fifty patients of patchy AA of the scalp were recruited and allocated to two treatment groups. Left side of the scalp received placebo (intralesional normal saline), right side of the scalp received intralesional PRP in one group and intralesional triamcinolone acetonide in second group. Three treatment sessions were given at 4-week interval and final follow-up was done at 8 weeks later. SALT scoring, dermoscopy were the parameters used to assess the efficacy. The SALT score showed statistically significant improvement from baseline in both the treatment groups (P value <.001). The maximum absolute regrowth was shown by the steroid group followed by PRP followed by placebo group (P value .016).

Erythromelanosis follicularis faciei et colli (EFFC) is characterized by well-demarcated erythema, hyperpigmentation, and follicular papules. Since the orginal description, < 50 patients have been reported in the literature. Five cases of EFFC have been seen in our outpatient department in the past 5 years. All patients except one presented with the classic triad of erythema, brown pigmentation and follicular papules on the face and keratosis pilaris lesions on the trunk. In all cases, there was no family history for related disorders or history of atopy. Histopathological examination in all cases was consistent with the diagnosis of EFFC. Age at presentation ranged from 11 to 19 years, and the male female ratio was 4 : 1. Patients had the classic lesions of keratosis pilaris on the face (5/5), trunk (2/5) and legs (4/5). All patients except one had a background of erythema. One patient (patient 2) had itching and a history of photosensitivity. Of the patients who were on treatment (4/5), complete clinical regression was seen in one patient. To our knowledge, this is the first case series of EFFC from India, and we believe that EFFC is a common but infrequently reported condition.