Yashpal Manchanda

Nail Changes in Childhood Psoriasis: A Study from Kuwait

Abstract:u2002 Psoriasis is a widespread skin disorder in which nail involvement can be seen in up to two‐thirds of those affected. Childhood psoriasis is a distinct entity and the literature focused on nail changes associated with childhood psoriasis is scant. Our objectives were to evaluate the frequency of nail involvement in childhood psoriatic patients, assess the types of nail changes in childhood psoriasis, and compare our clinical findings with the few reports available in the literature. Two hundred and one consecutive new patients with childhood (ageu2003≤u200316u2003years) psoriasis of both sexes were selected for the study of nail changes. The diagnosis of psoriasis was made on clinical grounds. Each patient underwent a thorough dermatologic examination with special attention paid to the nail changes. If a clinical suspicion of fungal infection of the nails existed, further mycologic investigations were performed. We found the prevalence of nail changes to be 37.81% (boysu2003>u2003girls) in children who had psoriasis. Nail pitting was found to be the most common manifestation (61.84%) followed by onycholysis (30.26%), subungual hyperkeratosis (13.16%), and discoloration of the nail plate (7.90%). Nail involvement had no relationship to the type of psoriasis, patients sex, or duration or extent of disease.

Long‐Term Results of Split‐Skin Grafting in Combination with Excimer Laser for Stable Vitiligo

BACKGROUND Some cases of focal or segmental vitiligo are refractory to medical treatment, and surgical management is the treatment of choice. Postsurgical exposure to ultraviolet B rays can lead to faster and better cosmetic results. OBJECTIVE To determine the long‐term results of combination therapy with split‐skin‐thickness grafting and 308‐nm excimer laser for the management of stable focal or segmental vitiligo. PATIENTS AND METHODS Seventeen patients (8 female, 9 male) with stable focal or segmental vitiligo not responding to nonsurgical modalities were treated with split‐skin‐thickness grafting and postgrafting with 32 sessions of 308‐nm excimer laser, beginning 2 weeks after surgery. The patients were followed up every year for evaluation of results. RESULTS All seventeen (100%) patients showed repigmentation, and overall results were graded as excellent in 12 patients and good in the other five at the end of excimer laser therapy. Final evaluation done at the end of 1 year revealed excellent results in all 17 patients. Two patients developed new vitiligo lesion on other parts of the body during follow‐up. None of the patients developed depigmentation of the transplanted skin. CONCLUSION Combination treatment with split‐skin‐thickness grafting and postsurgical exposure to 308‐nm excimer laser in patients with stable focal or segmental vitiligo can lead to fast, cosmetically good, long‐lasting results.

Treatment of Old World cutaneous leishmaniasis with dapsone, itraconazole, cryotherapy, and imiquimod, alone and in combination

Backgroundu2002 Cutaneous leishmaniasis (CL) is a major public health problem. The currently available therapies are expensive, not freely available, toxic, and not always curative. A simple, effective, noninvasive therapeutic approach is required for the treatment of CL.

Tattooing in the Gulf region: A review of tattoo practices and response to treatment with the Q-switched ruby laser

Abstract Background: Data regarding tattoo practices in the Gulf region and response to treatment are almost non-existent in the medical literature. Objective: To study the profile of patients with permanent tattoos in the Arab world, and to evaluate their response to Q-switched ruby laser treatment. Methods: A total of 468 consecutive patients with permanent tattoos consulting us for tattoo removal were recruited in the present study. Before starting the treatment each patient was given a set of questionnaires to answer. The patients were then treated with the Q-switched ruby laser, with a time interval of 8 weeks between each laser session, until complete clearance or up to a maximum of 10 sessions. Results: A total of 292 patients out of 348 patients achieved excellent lightening to complete clearance of tattoo pigment after an average of six sittings (range 2–10 sittings). Female patients with fair complexions and amateur tattoos on the face responded best. Seventy-eight (22.4%) patients developed pigmentary changes. Conclusion: More females than males had tattoos, and at a very young age and mostly on the advice of their parents. The majority of patients wanted to remove the tattoos because of religious reasons. The Q-switched ruby laser seems to be highly effective in removing amateur blue-black tattoos in patients with colored skin.

Angiolymphoid hyperplasia with eosinophilia associated with hepatitis C antibodies

Angiolymphoid hyperplasia, for a long time, has been confused with Kimuras disease. In the recent past, various workers have tried to differentiate these two entities. Various new differences in immunohistochemistry have been found, which have not yet been included in the dermatology literature. In this case report, we have presented a middle-aged man complaining of recurrent nodular lesions on the right ear for 8 years. On examination there were multiple firm 0.5-2.0 cm size, erythematous to violaceous nodules located in and around the right ear. Regional lymph nodes were not involved, and there were no systemic complaints. Histopathological examination from the excision biopsy of one of the nodules revealed features classical of angiolymphoid hyperplasia with eosinophilia. Immunohistochemical stains carried out on the biopsy specimen revealed predominantly T-cell type of infiltrate. All routine investigations were within normal limits, and serum immunoglobulin E was marginally raised. He had positive anti-hepatitis C virus antibodies, an association not so far reported in the literature.