Cr Srinivas

Turban PUVASOL: An Effective Treatment in Alopecia Totalis.

Alopecia areata is characterized by patchy hair loss involving the scalp, eyelashes, and beard. The disease may at times lead to complete baldness of the scalp (alopecia totalis) or of the entire body (alopecia universalis). Alopecia totalis is usually resistant to therapy. We report two cases of alopecia totalis treated with turban psoralen with sunlight exposure (PUVASOL).

Modified Unna Boot and Pinch Grafting for Chronic Non-healing Venous Leg Ulcer

Venous ulcers cause considerable morbidity. A 45-year-old man reported with non healing ulcer since 15 years. Patch tests revealed multiple sensitivity. Infection was first controlled with antibiotics and antiseptics. Dressing with modified Unna’s boot made with zinc oxide 40% and glycerine paste 60% resulted in formation of healthy granulation tissue. Pinch grafting was subsequently done to promote epithelization. We recommend the use of Unna’s paste instead of more expensive synthetic and occlusive and semi occlusive dressing to promote granulation tissue and pinch grafting after bed is ready to hasten epithelization.

Spring-loaded syringe for multiple rapid injections

Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage.

Fractional carbon dioxide, long pulse Nd:YAG and pulsed dye laser in the management of keloids

Background: Keloids are abnormal wound responses characterised by excessive deposition of collagen and glycoprotein. They are both aesthetically and symptomatically distressing for most of the patients. There are reports of keloid management with pulsed dye laser (PDL), fractional carbon dioxide (CO2) laser and neodymium-doped yttrium aluminium garnet (Nd:YAG) laser individually and also in combination of CO2 with PDL and CO2 with Nd:YAG. Here, we discuss a combination of all the 3 lasers as a therapy for keloids. Aim: This study aims to assess the efficacy of fractional CO2 laser, long pulse Nd:YAG laser and PDL in the management of keloids. Materials and Methods: Fifteen patients with keloids were treated by fractional CO2 laser, followed by PDL and long pulse Nd:YAG laser at monthly intervals. Four patients discontinued the study and were lost for follow-up. Photographs were taken at the beginning of the treatment and at the end of five sessions. Clinical improvement was analysed based on a visual analogue scale graded by three blinded observers after assessing the clinical photographs for the improvement in size, colour and aesthetic impression. Results: Of the 11 patients, one patient had excellent improvement, one patient had good improvement, four patients had moderate improvement, two patients had mild improvement and three had no improvement. Conclusion: Lasers may have a synergistic effect when combined with other modalities of treatment but cannot be used as monotherapy in the treatment of keloids.

Effect of oil application, age, diet, and pigmentation on the tensile strength and breaking point of hair

Background: Hair strength depends on various factors such as nutrition, environmental factors, sunlight, oiling, aging, conditioner, etc. Aim: To compare the tensile strength and breaking point of the hair shaft between (1) vegetarian and nonvegetarian. (2) Those who regularly apply and those who do not apply oil. (3) Pigmented and nonpigmented hair, (4) childhood and elderly. Materials and Methods: Hair fibers were mounted in tensile strength testing machine Zwick/Roell Z010 and gradual force was administered. The elongation of hair fiber in mm and the maximum force required to break the hair strand were recorded for each fiber. Results: Elasticity of the childrens hair was more than the elasticity of adult (P = 0.05) although tensile strength in children hair was not statistically significant (>0.05). Similarly, the tensile strength was more among those who regularly consumed nonvegetarian food but the difference was not statistically significant (P > 0.05). There was no statistically significant difference in other groups (P > 0.05). Conclusion: Elasticity in children hair is statistically more than elderly hair although there is no significant change in tensile strength.

Split Skin Grafting for Leg Ulcers Complicating Rheumatoid Arthritis

Leg ulcers as a complication of rheumatoid arthritis are difficult to heal. We present a case responding to treatment with cyclophosphamide and split skin grafting