Sanjeev Handa

Vitiligo: Clinical Findings in 1436 Patients

We retrospectively analyzed the clinical and epidemiological profiles of patients with vitiligo attending the pigmentary dermatoses clinic. One thousand four hundred and thirty‐six patients were seen between 1989 and 1993. Males constituted 54.5% of the group and females 45.5%. Mean age of the patients was 25 years, and average disease duration at the time of hospital visit was 3.7 years.

Epidemiology of Childhood Vitiligo: A Study of 625 Patients from North India

Abstract: To study the clinical and epidemiologic profile of childhood vitiligo, we retrospectively analyzed the data of children with vitiligo attending the pigmentary clinic of our center. Of the 625 children seen over 10 years, 357 (57.1%) were girls and 268 (42.9%) were boys. As compared to adult patients with vitiligo, this sex difference was found to be statistically significant (p < 0.001). The mean age of onset of the disease was 6.2 years. Vitiligo vulgaris (generalized vitiligo) was the most common type, followed by focal, segmental, acrofacial, mucosal, and universal, in that order. The most frequent site of onset was the head and neck, followed by the lower limbs, trunk, upper limbs, and mucosae. Leukotrichia was present in 77 patients (12.3%), while Koebner phenomenon was observed in 71 patients (11.3%). Halo nevi were observed in 29 patients (4.4%). Seventy‐six patients (12.2%) had a family history of vitiligo. Eight patients (1.3%) had an associated autoimmune disease. These associated disorders were alopecia areata in two patients, and diabetes mellitus, thyroid disease, Addison disease, polyglandular syndrome, and pemphigus vulgaris in one patient each.

Psychiatric morbidity in vitiligo: prevalence and correlates in India

Background Vitiligo, a common pigmentary disorder, is recognized to be associated with a high psychiatric morbidity, yet compared to other dermatological disorders like leprosy, psoriasis, etc., it has not been subjected to detailed evaluation of its psychological consequences. The data from the developing countries on this aspect in particular is meager.

Epidemiology of childhood psoriasis: a study of 419 patients from northern India.

Background  We undertook this study in order to determine the pattern and prevalence of childhood psoriasis in northern India and to highlight the differences and similarities with previous studies.

Childhood lichen planus: a study of 87 cases

Aims We undertook this study to analyze the clinical profile of childhood lichen planus (LP) prevailing in north India, and to highlight differences from and similarities with adult LP.

Safety and efficacy of glycolic acid facial peel in Indian women with melasma.

Abstract

Methotrexate in childhood psoriasis.

Abstract: We treated childhood psoriasis with methotrexate (MTX) in seven children (4 boys, 3 girls) over 7.5 years. Their ages and duration of disease varied from 3.5 to 16 years (mean 12.14 yrs) and 4.8 months to 5 years (mean 2.2 yrs), respectively. Psoriatic erythroderma was seen in three patients, generalized pustular psoriasis in two, recalcitrant psoriasis and psoriatic arthropathy in one each. Pre‐MTX liver biopsy performed in 4 children showed grade I changes. Methotrexate was given in a single weekly oral dose of 3.75 to 25 mg (mean 16.6 mg). The duration of treatment necessary to control the disease varied from 6 to 10 weeks (mean 7.9 wks). Total duration of MTX therapy was 31.2 to 46.4 weeks (mean 38.8 wks). Posttherapy disease‐free interval ranged between 14.4 and 16.8 weeks (mean 15.5 wks). Follow‐up after withdrawal of MTX was 16 to 28 weeks (mean 22.3 wks). Total cumulative MTX dose ranged from 390 to 960 mg (mean 683.6 mg). Side effects were nausea and vomiting in three patients.

Comparative efficacy of cetirizine and fexofenadine in the treatment of chronic idiopathic urticaria

objectives: Antihistamines are the first line of therapy for chronic idiopathic urticaria (CIU). The present study was designed considering the lack of reports comparing the efficacy and safety of commonly prescribed cetirizine and fexofenadine in the treatment of CIU. methods: A total of 116 patients, aged 17 to 65 years, with CIU (urticarial wheals for at least two days per week for six consecutive weeks before entry) were enrolled in this randomised double‐blind study. Study period was 28 days with patient visits on days 14 and 28 for investigator evaluation of the clinical response. Patient evaluation was on the basis of an analogue scale. Final response to treatment was judged as symptom free, partial improvement, and no improvement. results: Ninety‐seven patients (52 cetirizine, 45 fexofenadine) completed the study. The response to treatment in both the groups at the end of treatment period was as follows; symptom free {cetirizine 27(51.9%), fexofenadine 2(4.4%)}, partial improvement {cetirizine 19(36.5%), fexofenadine 19(42.2%)}, no improvement {cetirizine 6(11.5%), fexofenadine 24(53.3%)}. Side effects noted were mild with no significant difference between the two. conclusion: Cetirizine seems to have therapeutic advantage over fexofenadine in the treatment of CIU.

Lichen planus in childhood: a report of 17 patients.

Abstract: Lichen planus is a dermatosis of unknown origin with a very limited frequency in children. Over a period of one and a half years we observed 17 cases of childhood lichen planus. The classic form of the disease as seen in adults was the most common in these children; unlike adults, however, mucosal and nail involvement was uncommon. The natural history of the disease was similar to that in adults.

Psychiatric morbidity in vitiligo and psoriasis: a comparative study from India.

In a tertiary‐care teaching hospital in India, dermatology outpatients with vitiligo (N=113) and psoriasis (N=103) were studied for psychiatric morbidity. The two groups were similar with regard to education, locality, religion, and attitude to appearance (ATT). Psoriasis cases were older, more often male, and more often married. The General Health Questionnaire (GHQ) assessed psychiatric morbidity rates at 33.63% and 24.7% for vitiligo and psoriasis, respectively. The ICD‐10 psychiatric diagnoses in GHQ positive cases were: adjustment disorder (56% vs 62%), depressive episode (22% vs 29%) and dysthymia (9% vs 4%) in vitiligo and psoriasis, respectively. The Comprehensive Psychopathological Rating Scale (CPRS) assessed that depression, anxiety, and total psychopathology levels were similar in the two GHQ positive subgroups. Significant correlations were noted between psychopathology (GHQ, CRPS), dysfunction as per Dysfunction Analysis Questionnaire (DAQ), and behavior change as per Impact of Skin Disease Scale (IMPACT), and all were more prominent in vitiligo.