Soumya Jagadeesan

Methicillin-resistant Staphylococcus aureus colonization and disease severity in atopic dermatitis: A cross-sectional study from South India

BACKGROUND Colonization by methicillin-resistant Staphylococcus aureus (MRSA) in atopic dermatitis is little studied but has therapeutic implications. It may have a role in disease severity given the additional virulence factors associated. AIMS Our aims were to record the proportion of patients with MRSA colonization in atopic dermatitis and to ascertain if any association exists between MRSA colonization and disease severity. METHODS An observational cross-sectional study involving children aged≤12 years with atopic dermatitis attending the outpatient department of Government Medical College, Kottayam was conducted. Socio-demographic data, exacerbating factors and risk factors for hospital care-associated MRSA were documented. Extent of atopic dermatitis was recorded using a standardized scale (Eczema Area Severity Index, EASI). Skin swabs were taken from anterior nares and the worst affected atopic dermatitis sites for culture and sensitivity. RESULTS Of the 119 subjects recruited during the study period (November 2009-April 2011), Staphylococcus aureus was isolated from 110 (92.4%) patients and MRSA from 30 (25.21%) patients. A total of 18 patients with MRSA had risk factors for healthcare associated-MRSA. The patients whose cultures grew MRSA were found to have significantly higher EASI score when compared to those patients colonized with methicillin sensitive Staphylococcus aureus (P < 0.01). Presence of Staphylococcus aureus, early age of onset, presence of food allergies, seasonal exacerbation and inadequate breastfeeding did not seem to influence disease severity. CONCLUSIONS There is a high degree of prevalence of MRSA (25.2%) in atopic dermatitis and presence of MRSA is associated with increased disease severity. Further studies are needed to validate these findings.

What's up dermatology? A pilot survey of the use of WhatsApp in dermatology practice and case discussion among members of WhatsApp dermatology groups.

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Use of vegetable oils in dermatology: an overview.

Vegetable oils have been used for a wide variety of purposes since time immemorial; however, their principle use remains as skin moisturizers, especially in neonates and children. Because of their considerable efficacy and a low side effect profile and bearable cost, these oils are hugely popular as moisturizers among the common people in countries such as India. A wide variety of oils have been used, and newer ones are coming up with each passing day. This article focuses on the different types of vegetable oils and their varied uses in dermatology.

Successful treatment of generalized granuloma annulare with pentoxifylline

218 Indian Dermatology Online Journal | Volume 8 | Issue 3 | May‐June 2017 Many viruses including HHV6 and HHV7 have been proposed as causative agents for pityriasis rosea, although there is no conclusive evidence. Here, we presented a case of pityriasis rosea coexisting with oral HSV1 infection. Our case is unique because purpuric pityriasis rosea has not been associated with HSV1 previously. Consequently, we suggest that HSV1 may play role in the etiopathogenesis of the disease, and antiviral therapy may be the treatment of choice for extensive and resistant lesions.

Imatinib-induced Extensive Hyperpigmentation in a Case of Chronic Myeloid Leukemia.

Imatinib, a tyrosine kinase inhibitor, is well known to cause hypopigmentation because of its inhibitory effect on melanocytes. Herewith we report a case of chronic myeloid leukemia who developed extensive hyperpigmentation following imatinib therapy.

Mycobacterium chelonae infection complicating traumatic and surgical wounds: A case series

Mycobacterium chelonae is a rapidly growing non-tuberculous mycobacterium. The skin and soft tissue infections due to this organism are steadily on the rise and need to be delineated specifically as most of these are not responsive to routine antituberculosis treatment. Here, we report 3 different presentations caused by Mycobacterium chelonae in traumatic and surgical wounds. Mycobacterium chelonae can complicate surgical or traumatic wounds.This infection may also present as injection site abscesses. Diabetics on insulin injections are especially at risk. A high index of suspicion is necessary in long standing culture negative lesions for clinching the diagnosis. PCR can be helpful in confirming the diagnosis.

A survey on the pattern of dermoscopy use among dermatologists in India.

Introduction and Background: Dermoscopy is being increasingly used for improving dermatological diagnosis. Use of dermoscopy in the early recognition of skin malignancies, especially melanoma, is well established. Of late, its use in general clinical dermatology is growing with the recognition of new and specific patterns in conditions such as hair disorders, inflammatory disorders, and infections/infestations. This cross-sectional survey aims to assess the common patterns of dermoscopy use by Indian dermatologists. Methods: This was across-sectional survey. An online questionnaire was used to collect data. The questionnaire focused on the frequency of dermoscopy use by Indian dermatologists, reasons for using it or not, and the training they had received on dermoscopy. Results: Of the total 150 valid responses, eighty two (54.7%) participants reported that they were using dermoscopy routinely in their clinical practice. Lack of familiarity and lack of proper training were the important reasons cited for not using dermoscopy regularly. Among the dermatologists using dermoscopy, consensus on effectiveness was highest for hair disorders. Conclusions: Dermoscopy use by dermatologists in India is mainly in the context of inflammatory dermatosis and hair disorders rather than skin tumors. Lack of familiarity with the technique appears to be main factor limiting the use of dermoscopy in India. Limitations: Small sample size is the major limitation of this study. It is possible that a large number of dermatologists who do not use dermoscopy might not have responded to the survey, there by affecting the results and their interpretation.

Arthropathy in dermatology: A comprehensive review

Dermatology and rheumatology are two specialties that deal with significant overlap. In this context, it is important that the dermatologists acquaint themselves with conditions presenting with arthropathy. As the first step, it is essential to know whether the origin of musculoskeletal symptom is articular or extra-articular; inflammatory or noninflammatory; acute or chronic; oligo- or poly-articular. This will help in narrowing down the differential diagnoses as well as in better correlation with the cutaneous symptoms. In this review, we discuss the skin and articular manifestations of common inflammatory and noninflammatory arthropathies including rheumatoid arthritis, spondyloarthropathies, connective tissue disorders, vasculitis, crystal arthropathies, infective arthritis, arthritis associated with degenerative, endocrine and metabolic conditions, etc. We have also added a section on the common cutaneous features associated with the treatment of rheumatologic diseases. A basic understanding of the joint pathologies and associated skin changes will help a long way in the better management of these conditions.

Ichthyosis congenita, harlequin type: A case report and a brief review of literature

Harlequin ichthyosis (HI) is the most severe type of congenital ichthyosis, and it is extremely rare. It is inherited in an autosomal recessive fashion. Although previously thought to be lethal, recently there have been increased reports of prolonged survival, following improved supportive care and judicious use of systemic retinoids. We report a new case of HI in an infant born of a consanguineous marraige who succumbed on the 5th day of birth despite intensive supportive care, a short review of literature regarding the condition is also presented.

Cytodiagnostic copper pennies in chromoblastomycosis.

145 Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India A 45-year-old male agriculturist presented to the dermatology outpatient clinic with asymptomatic slowly progressive exophytic lesions over the left lower limb since 4 years. Examination revealed multiple verrucous plaques and nodules with scaling and a few black dots on the surface of some lesions [Figure 1]. He gave a history of trauma a few years back while farming, preceding the onset of lesions.