Lata Sharma

Glucose Tolerance Studies in Lichen planus

A study of glucose tolerance and insulin response to oral glucose was carried out in 56 consecutive histologically confirmed cases of lichen planus. 30.3% patients showed abnormal glucose tolerance. The pattern of insulin response was similar to that seen in type II diabetes. Insulin/glucose ratio showed the same relationship as seen in type II diabetes. These results reinforce the possibility of glucose intolerance in lichen planus patients. However, no correlation between glucose tolerance abnormalities and duration and distribution of lesions was observed.

Clinicoepidemiological study of pigmented purpuric dermatoses

Background: Pigmented purpuric dermatoses (PPD) are a group of vascular disorders with varied manifestations which cause concern and are resistant to treatment. The literature is still lacking in clinicoepidemiological studies. Aim: To study the epidemiology, etiological, host and environmental factors, clinical manifestations, its variations, and the type prevalent in this part of the world. Materials and Methods: All cases of PPD were selected for the study from Skin and Venereal Disease, Out Patient Department between January 2008 and June 2009. Their history, examination, hematological investigations, and, in a few, histopathology findings were also recorded and data obtained were evaluated statistically. Results: There were 100 cases of PPD of total 55 323 patients (0.18%). There were 79 males and 21 females between 11 and 66 years. They were working as police men, security guards, barber, chemist, teachers, students, farmers, businessmen, and housewives. In a majority, there was a history of prolonged standing in day-to-day work. Purpuric, brownish pigmented, lichenoid or atrophic lesions were seen depending upon the type of PPD on lower parts of one or both lower limbs. Blood investigations were normal. Schambergs disease was seen in ninety five, Lichen aureus in three, lichenoid dermatosis and Majocchis disease in one case each. Discussion: Three clinical types of PPD were diagnosed which may represent different features of the same disease. Cell-mediated immunity, immune complexes, capillary fragility, gravitational forces, venous hypertension, focal infection, clothing, contact allergy to dyes, and drug intake have been incriminating factors in the past. Patients occupation and environmental factors may also be considered contributory in precipitating the disease. Conclusions: The study revealed the problem of PPD in this geographical area, its magnitude, clinical presentation, the type prevalent, and possible aggravating factors to be kept in mind while managing the disease.

Androgenetic alopecia and risk of coronary artery disease.

Background: Androgenetic alopecia (AGA) or male pattern baldness (MPB) has been found to be associated with the risk of coronary artery disease (CAD). The well-known risk factors are family history of CAD, hypertension, increased body mass index (BMI), central obesity, hyperglycemia, and dyslipidemia. The newer risk factors are serum lipoprotein-a (SL-a), serum homocysteine (SH), and serum adiponectin (SA). Aim: Identifying individuals at risk of CAD at an early age might help in preventing CAD and save life. Hence, a comparative study of CAD risk factors was planned in 100 males of AGA between the age of 25 and 40 years with equal number of age- and sex-matched controls. Materials and Methods: Patients of AGA grade II or more of Hamilton and Norwood (HN) Scale and controls were examined clinically and advised blood test. The reports were available for fasting blood sugar (FBS), serum total serum cholesterol (SC) in 64 cases, 64 controls; lipoproteins (high, low, very low density, HDL, LDL, VLDL), serum triglycerides (ST) in 63 cases, 63 controls; SL-a in 63 cases, 74 controls; SH in 56 cases, 74 controls; and SA in 62 cases, 74 controls. Results: In these cases family history (FH) of AGA and CAD was significantly high. The blood pressure (BP) was also found to be significantly high in the cases. The difference of mean serum HDL, LDL, VLDL, ST, SH, and SL-a in cases and controls were statistically significant and with increasing grade of AGA, the risk factors also increased. Conclusion: Patients with AGA appear to be at an increased risk of developing CAD, therefore, clinical evaluation of cases with AGA of grade II and above may be of help in preventing CAD in future.

A clinicoepidemiological study of polymorphic light eruption.

BACKGROUND AND AIMS The prevalence of polymorphic light eruption (PLE) varies between 10-20% in different countries but no such data is available from India, where exposure to sunlight is high. METHODS A clinico-epidemiological study of PLE was done in the skin outpatient department (OPD) of Institute of Medical Sciences Hospital from January to December. RESULTS The ages of the patients varied from 5-70 years. Out of a total of 39,112 OPD cases, 220 cases of PLE (138 females and 82 males) were recorded, giving a prevalence of 0.56% in this study population. The skin type varied between IV and VI in 96% of the cases. Housewives were 81, students 67, office persons 39, farmers 22, businessmen 6 and unemployed 5. DISCUSSION The manifestation of PLE was most common in housewives in areas exposed to the sun. Most of the PLE patients presented with mild symptoms and rash around the neck, forearms and arms which was aggravated on exposure to sunlight. PLE was more prevalent in the months of March and September and the disease was recurrent in 31.36% of the cases. CONCLUSIONS The prevalence of PLE was 0.56%. It was mild in nature and only areas exposed to the sun were involved.

Thyroid function tests in cases of polymorphic light eruption: A case-control study

Background: Polymorphic light eruption (PLE) has been found to be associated with thyroid function abnormalities. Aim: To study clinicoepidemiological features of PLE and to study and compare thyroid function tests (TFTs) in cases of PLE. Materials and Methods: The study included 100 cases of PLE and age- and sex-matched controls attending a skin outpatient department. The clinical and epidemiological features were recorded. Both cases and controls were tested for thyroid-stimulating hormone (TSH). In case of abnormality in TSH, triiodothyronine (T3) and tetraiodothyronine (T4) levels were estimated. Results: TFT was abnormal in 25 cases and 7 controls. TSH was elevated in 24 cases and 6 controls and decreased in 1 case and 1 control. T3 and T4 were decreased in 18 cases and 6 controls and elevated in 1 each in case and control. Hypothyroidism was significantly high among cases than controls. Discussion: TFT abnormality was significantly higher among cases than controls. Hypothyroidism has a significant association with PLE. Genetic basis or immune dysfunction may be the cause of both the diseases. PLE may be considered as a clinical presentation of thyroid function disorder and vice versa. Conclusion: Cases of PLE should be examined clinically for thyroid disorder and also tested for TSH or TFT to find any association and prevent serious consequences.