Shrutakirthi D Shenoi

EFFICACY OF DEXAMETHASONE PULSE THERAPY IN PROGRESSIVE SYSTEMIC SCLEROSIS

Background. Systemic sclerosis is a disease of unknown etiology for which no specific treatment is effective. Pulse therapy with corticosteroids has been tried for various autoimmune disorders with minimal side effects. We undertook this study to determine the efficacy of dexamethasone pulse therapy in progressive systemic sclerosis (PSS).

Sensitivity to various ingredients topical preparation following prolonged use

63 selected patients, with features suggestive of allergic contact dermatitis and histories of prolonged use of numerous topical preparations, or of exacerbation or spread of dermatitis following the use of such preparations, were studied with respect to age, sex, and site. All were patch tested with 45 different allergens supplied by Chemotechnique Diagnostics AB, Malmo, Sweden. In addition, relevant topical preparations were tested, as is. Van der Bend Square Chambers were used for patch testing.

Photochemotherapy (PUVA) in psoriasis and vitiligo

Phototherapy with photochemotherapy (PUVA) is a well-known and well-studied modality for the treatment of psoriasis, which involves systemic or topical administration of chemicals known as psoralens and administration of ultraviolet light in increasing dosages after requisite time gap. PUVA is also used in the treatment of widespread vitiligo with moderately good results, though it is being surpassed by ultraviolet B (UVB), which is equally or slightly more efficacious with fewer side effects. PUVA induces repigmentation by varying mechanisms such as stimulation of melanogenesis, immunomodulation and activation of growth factors, though the exact mechanism is still speculative. There are various studies evaluating the efficacy of PUVA in psoriasis as well as in vitiligo, either alone or in combination with other immunosuppressants like azathioprine and calcipotriene.

Phototherapy in vitiligo: Assessing the compliance, response and patient's perception about disease and treatment

Context: Vitiligo is a chronic, benign, but emotionally frustrating autoimmune disorder of depigmentation, with an incidence of 0.25-2.5% in India, the treatment of which is equally frustrating to the patient, as well as the doctor. Phototherapy is the first line treatment in many cases, which needs to be given at frequent sittings for long periods of time. As there is no satisfactory, short term treatment, many vitiligo patients, though enthusiastic in the beginning, become defaulters after a few weeks or months. Aims: This study was conducted to assess the compliance to phototherapy (PUVA and NB-UVB), determine the reasons for non-compliance, to calculate the overall response to phototherapy and to know about the patients’ perception about improvement of lesions. Materials and Methods: All files of the patients who attended phototherapy for Vitiligo in the department for a period of 4 years from January 2007 were analyzed and the patients were contacted via mail or telephone and were made to answer questionnaire regarding their disease. Conclusions: At the end of this retrospective questionnaire based study we concluded that only a quarter of the patients underwent regular phototherapy, among which the younger patients and those with widespread disease and facial lesions were more compliant. Educational status and sex had no impact on default status.

Results of patch testing with dental materials

Patients and Methods 31 patients (19 male, 12 female), aged between 18 and 62 years, were patch tested from January 1990 to July 1998 with 12 dental allergens (Chemotechnique Diagnostics AB, Sweden). All had lesions of the buccal mucosa and/ or lips suspected of allergic aetiology, except for 1 dental student with vesicular lesions on the fingertips. Readings were made after 2 days and reactions >π were considered positive, as per ICDRG recommendations.

Ichthyosis follicularis with alopecia and photophobia (IFAP) syndrome.

A 12-year-old boy born of a nonconsanguineous marriage presented with dry rough skin and photophobia since birth. His growth and developmental milestones were normal and there was no history of any neurological problem, hearing deficit or scarring around the hair follicles. Cutaneous examination revealed diffuse thinning of scalp hair with loss of eyebrows and eyelashes and a sandpapery texture of the skin all over the body, suggestive of ichthyosis follicularis with alopecia and photophobia syndrome.

Contact sensitivity to calcium hypochlorite

Eusol (an abbreviation for Edinburgh University solution), consisting of aqueous boric acid and calcium hypochlorite, is widely used in the management of open wounds left to heal by secondary intention ( 1 ).

Laptop induced erythema Ab Igne

Erythema ab igne is a reticular, pigmented dermatosis caused by prolonged and repeated exposure to infrared radiation that is insufficient to produce a burn. The use of laptop computers has increased manifold in the recent past. Prolonged contact of the laptop with the skin can lead to the development of erythema ab igne. We present a case of erythema ab igne secondary to laptop use in an Indian student.

Clinical evaluation of patients patch tested with plant series: A prospective study

Background: Plants are ubiquitous in nature and are essential for human life, though some do have detrimental effects. In India, there are various indigenous and foreign plants that are well known to cause dermatitis, Parthenium hysterophorus being the foremost. Aims of the Study: To study the clinical features of patients presenting with plant dermatitis and evaluate plant allergen series patch test results. Materials and Methods: 50 patients with suspected plant dermatitis were evaluated regarding evolution of dermatitis, precipitating factors and contact with various plants. 31 patients (62%) complained of photo sensitivity and 24 (48%) had involvement of sun-exposed areas. Our provisional diagnoses included allergic contact dermatitis in 16, air borne contact dermatitis in 9, phytophotodermatitis in 7, photodermatitis in 6, airborne contact dermatitis to other causes in 4, phytodermatitis in 3. Patients were patch tested with Indian standard series of allergens as well as plant allergen series consisting of common allergenic plants of local flora in and around Manipal and also with plants strongly suspected by the patient. 35 tested positive with maximum positives (26 patients, i.e., 52%) to Parthenium hysterophorus (Compositae). Results: The result of patch testing was correlated with the history and clinical examination and relevance established. Conclusions: Majority of the patients with clinically suspected plant dermatitis belonged to 3rd or 4th decade and Parthenium was the leading plant allergen Sensitization to Leguminosae plants and Hopea ponga, seen in 9 cases, have not been reported earlier in literature.

Cutaneous dirofilariasis presenting as an eyelid swelling

Dirofilariasis is a common filarial infection occurring in domestic and wild animals as a result of arthropod bites. However, it can be transmitted to humans after mosquito bites. Here, we report a case of a 54-year-old lady who developed an unilateral eyelid swelling secondary to Dirofilaria repens.