Adarshlata Singh

Dermatitis artefacta: Keloids and foreign body granuloma due to overvalued ideation of acupuncture

Skin is well recognized as an important somatic mirror of ones emotion and a site for the discharge of ones anxieties. We present a case of a 42-year-old female patient presenting with a vague history of generalized body pain and skin lesions in the form of cotton threads buried under the skin, crusted plaque, multiple keloids and rusted pin buried through the skin mostly in the easily accessible areas of the body. Histopathology from the crusted plaque revealed foreign body granuloma. To satisfy her psychological or emotional need, it is the deliberate and conscious production of self-inflicted skin lesions through overvalued ideation of acupuncture on her part.

Dowling-Degos disease and hidradenitis suppurativa: Co occurrence or association?

A 44 year old female patient presented with multiple, painful, relapsing, nodules, plaques with sinuses discharging pus and scars in apocrine gland bearing region since past 17 years. These lesions were clinically and histopathologically suggestive of hidradenitis suppurativa. Our patient was not aware about the flexural pigmentary lesions, comedones and pitted scars which were also clinically and histopathologically suggestive of Dowling–Degos disease. We are reporting a rare interesting association of Dowling Degos disease and hidradenitis suppurativa which is not reported in Indian literature till date.

Possible cross-sensitivity between sertraline and paroxetine in a panic disorder patient

Cross-sensitivity due to paroxetine and sertraline, the SSRIs, is rarely reported in the literature. We report an adverse drug reaction to paroxetine and sertraline in a patient of panic disorder, who initially developed a maculopapular, erythematous, pruritic rash in the third week with sertraline 50 mg/day. The rash resolved within 2 days of its discontinuation and oral supplementation of diphenhydramine and betamethasone. 10 days following discontinuation of sertraline, the patient was shifted on sustain release paroxetine 12.5 mg/day when another skin reaction with the same appearance and distribution appeared on day 4 of it, suggesting a possibility of cross-sensitivity, a drug class effect. This case report intends to improve the awareness among clinicians to use caution when choosing an alternative SSRIs.

Scenario of Pediatric Dermatoses in Rural Population of Central India

Introduction : Skin diseases in the pediatric population are common all over the world including rural and urban areas. The prevalence of pediatric dermatoses is higher in rural areas as compared to urban areas in relation to poor socio-economic status, poor personal hygiene, overcrowded, families lack of general awareness, lack of education, sanitation and specialized health facilities. Aim : To study the proportion of different skin conditions presenting in pediatric age groups. Material & Methods : This study was conducted in tertiary care center, Acharya Vinoba Bhave Rural Hospital. 710 patients were enrolled below the age group of 14 years and were divided in to 3 groups < 1 year, 1-4 years and 5-14 years. Results : Out of 710 patients 46.3% infection and infestation, 18.6% dermatitis and eczema, 8.7% and 8.3% dermatoses of skin appendages and miscellaneous dermatoses found respectively. Nutritional dermatoses was found in 5.9%, nevus 3.8%, papulosquamousdermatoses 3.6%, pigmentary dermatoses 2.67% and both bullous and keratinization each of 0.98% patients. Discussion : In our study most common dermatoses was infection and infestation which mainly occur due to low socioeconomic status, dietary habits, climatic exposure, lack of health awareness and poverty. Bacterial infections were most common in all the age group. The viral wart were common in 6-14 years of age group due to more exposure and enhanced outdoor activities. Conclusion : Our study brings into light the presentation of rural pediatric dermatology patients were commonly of dermatoses like infections, infestations, dermatitis and nutritional disorders.

Disability In Acne Patients - A Hospital Based Study In Rural Population Of Central India

Introduction : Acne vulgaris is chronic inflammatory disease of pilosebaceous unit. It has been found that acne is one of the most common distressing diseases that can affect all aspects of an individual’s health-related quality of life (HRQOL), particularly in feelings and emotions, personal relationships, sports, social life and to get employment opportunity. As per best of our knowledge, there was no study on disability in acne patients in rural population of India. Aim and Objectives : The aim was to assess quality of life of patient having acne vulgaris, with the objectives 1) to assess the impact of acne on the rural patients by executing Cardiff Acne Disability Index formula (i.e. physical, social and psychological aspects of the patient’s life) 2) to observe any relationship between severity of acne vulgaris and its impact on quality of life. Material and Methods : The patients who came to dermatology OPD having acne vulgaris at AVBRH were enrolled. Quality of life of all enrolled patients of acne vulgaris were evaluated by using Cardiff Acne Disability Index questionnaires. The parameters evaluated were aggressiveness, frustration, embarrassment, effect on social life, relation with members of opposite sex, concern for skin appearance, avoidance of changing facility. Acne grading will be done by IADVL grading system. Statistical analysis done with Chi-square (χ²) test. Result : Total 81 patients with Acne vulgaris were included. By using the parameters, we analyze a statistical significant impact on quality of life of acne patients were frustration, embarrassment, effect on social life, relation with members of opposite sex, concern for skin appearance and avoidance of changing facility. Aggressiveness was found to be statistically insignificant. It implies that acne is a disease of mild to moderate severity. There was a significant positive relationship between disease severities with scores of CADI. Conclusion : There was impairment in quality of life due to acne in a rural population.

A point to note in pili torti

International Journal of Trichology / Volume 10 / Issue 2 / March-April 2018 95 3. Fatemi Naieni F, Ebrahimi B, Vakilian HR, Shahmoradi Z. Serum iron, zinc, and copper concentration in premature graying of hair. Biol Trace Elem Res 2012;146:30‐4. 4. Dawber RP. Integumentary associations of pernicious anaemia. Br J Dermatol 1970;82:221‐3. 5. Bhat RM, Sharma R, Pinto AC, Dandekeri S, Martis J. Epidemiological and investigative study of premature graying of hair in higher secondary and pre‐university school children. Int J Trichology 2013;5:17‐21.

Evaluation of effectiveness of syndicate learning in oral medicine and radiology: Cardinal findings in a batch of final-year students

Introduction: Syndicate learning is a form of peer learning involving small groups of 5-6 students working in semi-independent groups toward achievement of a collective goal. Methods: Eighty final Bachelor of Dental Surgery (BDS) students were enrolled. Pre-test was conducted for regular batches posted for clinical posting in Oral Medicine and Radiology. Each batch was randomized into two equal sub-groups. Sub-group A and B were exposed to syndicate and traditional learning methods, respectively. Post-test was carried out. Crossover was done. Pre-test was again conducted. Sub-group A and B were exposed to traditional and syndicate learning, respectively. Post-test was again carried out. Results: In round one, scores of post-test were significantly better than pre-test in both subgroups A (pre-test - 2.40 ± 0.98, post-test - 4.45 ± 0.71) and B (pre-test - 2.47 ± 0.96; post-test; 3.57 ± 0.87). In round two after crossover, scores of post-test were significantly higher in both subgroup A (pre-test-2.30 ± 1.09; post-test-3.72 ± 0.84) and subgroup B (pre-test - 2.37 ± 1.12; post-test - 4.50 ± 0.59). Further, when subgroup A was compared with B, scores of post-test were significantly higher in the syndicate group compared with traditional group, before and after crossover. Conclusions: Syndicate groups can make learning experience more interesting; generate many opportunities for creative interchange of ideas and lively, meaningful participations and discussion among students.

Adult-onset unilateral disabling pansclerotic morphea

Disabling pansclerotic morphea (DPM) is a rare, severe, and mutilating form of morphea, involving the dermis, subcutaneous tissue, fat, muscle, and even bone. It is usually seen before the age of 14 years, with the patient complaining of arthralgia and stiffness at the time of onset. We report a case of unilateral adult-onset DPM with sparing of the face. Within a few months of onset, painful contracture deformities of the hand, elbow, and shoulder joints developed, impairing the patients normal daily activities. We are reporting this case because of the unusual presentation: DPM in an adult, with history of trauma in childhood and rapid onset of complications, is rare.