Mary Jacob

DIAGNOSTIC EVALUATION OF THE LUPUS BAND TEST IN DISCOID AND SYSTEMIC LUPUS ERYTHEMATOSUS

Background. The usefulness of the lupus band test (lbt) in the diagnosis of cutaneous lupus erythematosus remains controversial. The study was done to determine the sensitivity, specificity, and predictive value of the lbt in discoid lupus erythematosus (dle) and systemic lupus erythematosus (sle).

Pain in multiple leiomyomas alleviated by nifedipine.

&NA; We have confirmed the usefulness of nifedipine in the treatment of pain present in lesions of multiple skin leiomyomata. Our patient, a 28‐year‐old woman, had hundreds of skin lesions, proven histologically to be leiomyomata. Nifedipine (10 mg) three or four times daily was remarkably effective in diminishing pain that was more marked in the winter season.

Clinicopathologic profile of normocomplementemic and hypocomplementemic urticarial vasculitis: a study from South India

Background  This study aims to study the clinical and histopathological characteristics of hypocomplementemic and normocomplementemic urticarial vasculitis (HUVS and NUV) among dermatology clinic attendees in a tertiary care hospital in South India.

Pathomechanics of congenital and acquired hallux varus: a clinical and anatomical study.

Hallux varus was observed in 69 feet among patients from a rural Indian population. This included three types of congenital hallux varus. The congenital “primary” type was the commonest and was not associated with any other foot deformity. Among the acquired forms was idiopathic hallux varus of middle age, which developed spontaneously in unshod persons and progressed gradually. Hallux varus following chronic arthritis was part of a consistent pattern of foot deformities in which the first ray collapsed in a zig-zag manner in two planes. Although the development of hallux varus is often due to intrinsic muscle imbalance, hallux varus secondary to chronic arthritis seems to occur as a result of both intrinsic and extrinsic muscle imbalance associated with midtarsal and subtalar arthritis. Muscular factors contribute to progression of the deformity also. No anatomical basis for a racial prediliction for the deformity was noted. Failure to use footwear could account for the higher incidence of hallux varus in India.

The Clinical Profile of Children in India with Pigmentary Anomalies along the Lines of Blaschko and Central Nervous System Manifestations

Abstract:  The aim of this study was to describe the clinical profile of children with congenital pigmentary anomalies along Blaschko lines and the associated manifestations in the central nervous system. Twenty‐six children aged 12 years or less (14 boys and 12 girls), with hypopigmentation and hyperpigmentation along Blaschko lines and central nervous system manifestations were included during the period June 2001 to December 2003. Detailed physical, cutaneous, and systemic examinations were carried out. Relevant investigations included histopathology, karyotyping, electroencephalogram, computerized tomography scans, and magnetic resonance imaging of the brain whenever possible. Twenty children had hyperpigmentation along the lines of Blaschko, four had hypopigmentation, and two had a combination of the two. Eight children had diffuse involvement. Of these, two each had hypomelanosis of Ito, incontinentia pigmenti and linear and whorled nevoid hypermelanosis. The remaining 20 patients could not be categorized as any of the described entities. The majority (92.3%) of patients manifested skin and central nervous system disorders before the age of 2 years. Hyperpigmentation along Blaschko lines was significantly higher in patients with central nervous system manifestations (p = 0.01). Developmental delay was the most frequent central nervous system presentation. Multiple systems were affected, including the eyes. Histology was useful to distinguish incontinentia pigmenti from other types of nevoid hyperpigmentation.

Randomised double blind controlled trial of 2% ketoconazole cream versus 0.05% clobetasol 17‐butyrate cream in seborrhoeic dermatitis

To the Editor: This is the report of a study comparing 2% ketoconazole versus 0.05% clobetasone 17-butyrate in patients with seborrhoeic dermatitis involving the face and trunk. Subjects Adult patients with seborrhoeic dermatitis of the face and trunk attending the dermatology clinic in a tertiary hospital in India. Patients on chlorpromazine, cimetidine, alphamethyl-dopa, INAH, steroids, infants, and subjects with Parkinsonism or AIDS were excluded. Design Randomised double blind control trial (RCT). Patients were assessed for severity of dermatitis using criteria given in Table 1. A stratified blocked random method was used to allocate the recruited patients into two groups according to severity. Intervention Patients were provided with identical tubes containing either 2% ketoconazole cream or 0.05% clobetasone 17-butyrate cream to be applied twice daily to the affected sites except scalp for 4

SKIN LESIONS IN HIV-POSITIVE AND HIV-NEGATIVE PATIENTS IN SOUTH INDIA

Background. Various dermatologic conditions have been reported to occur with increased frequency in human immunodeficiency virus (HIV)‐positive individuals, but there are only a few studies comparing the prevalences of skin diseases in HIV‐positive patients with those in matched HIV‐negative controls.

Linear IgA bullous dermatosis in South India

Background A study of five cases of linear IgA dermatosis (LABD) in a referral hospital in South India is presented.

A comparison of economic aspects of hospitalization versus ambulatory care in the management of neuritis occurring in lepra reaction

Neuritis is one of the important causes of deformities and disabilities in leprosy. Neuritis has been managed both in the field and in hospital. This study was done to compare the economic aspects of cost of ambulatory vs in-patient management of neuritis in leprosy. The quality of life of the affected patients and the clinical improvement in the 2 groups were also studied. Twenty six patients fulfilling the study criteria were randomized into the ambulatory and in-patient group (13 in each group). The primary outcome examined was cost, in various categories; the secondary outcomes included pre- and post-treatment comparison of Quality of Life (QOL) scores and tests of sensory and motor function. The direct and indirect medical costs incurred by patients in the hospitalized group were higher than those patients in the ambulatory group. The difference in the direct medical costs between the two groups was Rs. 9110.5, and the extra direct non medical costs incurred by patients in the hospitalized group was Rs. 888.50 because of more frequent visits of family members. A greater percentage of ambulatory than in-patients returned to work in </= 15 days (53.8% vs 15.3%), and the mean duration before returning to work was 19.5 days ambulatory patients compared to 66.8 days for in-patients group. The QOL scores and motor and sensory function tests showed no significant difference between groups. Although the sample size was small, these preliminary results suggest that substantial cost minimization by ambulatory care is possible without significantly affecting the quality of life or peripheral nerve function.

Basal cell carcinoma arising in a localized linear verrucous epidermal naevus

dermatitis or bacterial and mycological infections (1). BTXA has been used recently to treat focal hyperhidrosis (gustatory sweating, palmo-plantar and axillary hyperhidrosis) (4, 5). There are no data available for the treatment of stump hyperhidrosis. We used BTXA for stump hyperhidrosis in a dosage comparable to that used in palmar hyperhidrosis, i.e. 100 U of Botox. The treatment was very effective not only for focal hyperhidrosis of the stump but it also showed a preventive effect on the associated eczema. In another study with tap water iontophoresis for hyperhidrotic hand eczema, it could be demonstrated that effective treatment of hyperhidrosis is an important factor for prolongation of disease-free interval in atopic eczema and contact dermatitis (9). Further studies should be performed to investigate this positive side-effect of hyperhidrosis treatment.