Arpita Jain

Combination of Microdermabrasion and 5‐Fluorouracil to Induce Repigmentation in Vitiligo: An Observational Study

BACKGROUND Treatment of resistant vitiligo is challenging. A few well‐researched studies have shown variable results with surgical and other therapeutic strategies. OBJECTIVE To evaluate the usefulness of a less‐painful method of repigmentation of vitiligo patches. PATIENTS AND METHODS Forty vitiligo patches in 22 consecutive patients with resistant vitiligo presenting at a vitiligo clinic of a university teaching medical school in New Delhi, India, were treated with microdermabrasion followed by topical 5% 5‐fluorouracil (5‐FU). RESULTS One‐third of the patches showed more than 50% repigmentation, and one‐fourth showed more than 75% repigmentation. Gratifying results were obtained in seven patches after a single session. CONCLUSION Microdermabrasion is adjunctive with topical 5% 5‐FU in the treatment of resistant vitiligo patches. Further well‐controlled randomized trials are required to validate the observations of the study. The authors have indicated no significant interest with commercial supporters.

Specific Pregnancy Dermatoses in 1430 females from Northern India.

BACKGROUND The specific dermatoses of pregnancy represent a heterogenous group of ill-defined pruritic skin diseases, unique to pregnancy and post partum period. OBJECTIVE The aim of our study was epidemiological and clinical evaluation of various specific dermatoses of pregnancy. METHODS All patients visiting our antenatal clinic were screened for various pruritic skin conditions and those with specific pregnancy dermatoses were identified and evaluated. RESULTS Out of 1430 patients screened, nearly 5% (70 cases) patients had specific dermatoses of pregnancy. Intra hepatic cholestasis was the commonest specific pregnancy dermatoses. CONCLUSION Specific dermatoses of pregnancy can be diagnosed primarily on the basis of clinical features. All of these, except intra hepatic cholestasis, do not have any effect on normal course of pregnancy.

Mucocutaneous manifestations in children with human immunodeficiency virus infection

Skin is one of the most frequently involved organs in human immunodeficiency virus (HIV) infection, and mucocutaneous manifestations may be one of the earliest markers of AIDS. The prevalence of cutaneous abnormalities in HIV approaches nearly 90%. Mucocutaneous manifestations may also act as a prognostic marker of HIV infection. Children are increasingly being affected by HIV infection and it is important to realize the presence of the infection early in the disease process as their immune status is not mature enough to handle the stress of various infections. Skin manifestations can serve as early markers and prognostic indicators of HIV infection. This review highlights the epidemiology, transmission, pathogenesis, and the mucocutaneous manifestations of HIV infection in children.

Current status of acquired syphilis: A hospital-based 5-year study.

INTRODUCTION Prevalence of sexually transmitted infection shows regional variations. Though a rising trend of prevalence of viral STI s has been observed, syphilis still continues to remain a commonly diagnosed STI. AIM To study the current status of acquired syphilis in a tertiary care hospital. MATERIALS AND METHODS Retrospective analysis of all the cases of acquired syphilis registered in our hospital from 2005 to 2009 was done. Complete epidemiological, clinical, and investigational data were recorded and assessed. OBSERVATION Total of 570 cases attended the STI clinic from year 2005 to 2009. 42 (7.36%) cases were diagnosed as syphilis. There were 32 (74%) males and 11 (26%) were females. 25 (60%) were married. Only two patients were less than 15 years of age. Primary syphilis was diagnosed in 21 (50%), secondary in 10 (24%), and latent in 11 (26%) cases. Two (9.5%) of primary syphilis showed multiple chancre. Concomitant primary chancre and lesions of secondary syphilis were seen in 2 (20%) patients. Secondary syphilis presented as condyloma lata (50%), maculo-papular rash (40%), and lues maligna in one patient who was HIV positive. Mixed infection was diagnosed in eight patients of which herpes genitalis was the commonest. Two patients were serologically positive for HIV. CONCLUSION Incidence of syphilis had shown a constant trend over last 5 years. In lieu of change in trends of sexual practices, condyloma was the commonest presentation of secondary syphilis. Pustular syphilis was observed in association with HIV and could be a marker of the immune-deficient state.

Sexually transmitted diseases among men who have sex with men: A retrospective analysis from Suraksha clinic in a tertiary care hospital

BACKGROUND Men who have sex with men (MSMs) are a vulnerable population for spread of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). Apart from being important for HIV transmission, they tend to have a different distribution patterns of STDs. Few Indian studies have looked into this aspect. OBJECTIVE We retrospectively analyzed the available data on MSM from Suraksha clinic of a tertiary care hospital in a metropolitan city from 2004 to 2010. MATERIALS AND METHODS A total of 75 MSM constituting 11.4% of the total 660 patients visited our Suraksha clinic in these 6 years. The clinical and behavioral profile of each patient along with the pattern of STDs was evaluated. OBSERVATIONS AND RESULTS 75% of the MSMs were promiscuous; one-third of them indulging in only homosexual activities. Syphilis was the most common STD, followed by condyloma acuminata, herpes genitalis, and gonorrhea. On comparing the data on the STD profiles of the heterosexual males, predisposition toward bacterial STDs among MSMs was observed. CONCLUSION Identification of MSMs is important as most of them are bisexual and promiscuous, thereby playing a role in spread of STDs in vast number of partners. The profile of STDs also differs in MSM, which makes it all the more important to identify them.

Contact dermatitis in nurses and paramedicals in a tertiary care hospital of northern India.

HFMD is generally a benign self-limiting disease. However, mortalities, mostly from pulmonary and central nervous system complications, had been reported from outbreaks of the disease from enterovirus 71.[9] Besides one patient who had pneumonitis, none of our patients had systemic complications and all recovered uneventfully. The cases of HFMD are usually divided into two groups, namely “more severe” cases (cases with fatality, with sequelae, cases requiring hospitalization of 7 days or longer) and “less severe” cases.[10] All the patients of the present series belonged to the “less severe” group. Generally, no laboratory studies are necessary for the diagnosis of HFMD.[1,7]

Atypical cutaneous sporotrichosis in an immunocompetent adult: Response to potassium iodide

Cutaneous sporotrichosis, also known as “Rose Gardeners disease,” caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

Isolated distal cutaneous thrombosis: An unusual presentation and an interesting etiology

A middle-aged hypertensive male, with a fatty liver and chronic alcohol intake, relocated to a high altitude of 2100 m above sea level; in the first winter season, he developed bluish skin lesions over the tip of the nose, margins of both ear lobes, both knees, and subungual location. Systemic examination was unremarkable. Skin biopsy showed thrombi in dermal vessels without any evidence of vasculitis; immunofluorescence was negative. Investigations revealed mild elevation in plasma homocysteine levels, weakly positive antinuclear antibodies and elevated antiphospholipid antibodies, methylene tetrahydrofolate reductase C677T heterozygosity, and protein S deficiency. The patient received prednisolone for 2 weeks, aspirin and pentoxyphylline for 3 months, and continues to be on folic acid and vitamin B6. After 3 months, antiphospholipid antibodies and antinuclear antibody levels were normal. Isolated distal cutaneous thrombosis is an uncommon entity and precipitation by extreme cold in a hypertensive male with three thrombophilic states - one transient, one hereditary, and one acquired - is fascinating.

Ascher syndrome: a case report.

Abstract:  Ascher syndrome is a rare disease described by Ascher, an ophthalmologist from Prague, in 1920. We report a case of an 8‐year‐old child, who presented with recalcitrant recurrent swelling of bilateral upper eyelids, probably a forme fruste of Ascher syndrome.