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   2022| July-September  | Volume 16 | Issue 3  
    Online since September 15, 2022

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Intralesional MMR versus intralesional bleomycin in the treatment of digital warts: A randomized comparative study and review of the literature
Arunima Ray, Ishan Agrawal, Bikash R Kar
July-September 2022, 16(3):73-79
Introduction: Warts are benign hyperkeratotic viral infections poorly responsive to most treatment modalities. Commonly used destructive methods can cause the scarring of the digits. Intralesional agents are preferred in digital warts. Individual efficacy has been assessed, but previously intralesional bleomycin and immunomodulator measles, mumps, and rubella (MMR) vaccine have not been compared. Objectives: To assess the effectiveness and safety of intralesional bleomycin versus intralesional MMR vaccine in the treatment of digital warts. Materials and Methods: All consenting adults with ≤5 digital warts were randomly divided into two groups by chit method: group A got intralesional MMR vaccine and group B got intralesional bleomycin monthly for 3 months with follow-up at the fourth month. Clearance and reduction in wart sizes and side effects were noted. Results: Totally 45 patients completed the study, and with single injection, clearance in group B was significantly higher than in group A (P = 0.001, Chi-square test). Necrosis, eschar formation, and residual pain were seen in group B. Overall, there was no significant difference in clearance rates at three injections (P = 0.198, chi-square test). Conclusion: Intralesional MMR vaccine and intralesional bleomycin are both effective in treating digital verrucae. Faster clearance is seen with intralesional bleomycin, with more side effects such as necrosis, eschar, and pain, controlled with oral analgesics.
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Retrospective analysis of cases with Stevens-Johnson syndrome/toxic epidermal necrolysis: A case series of 20 patients
Kifayat Mammadli, Aslı Bilgiç, Hatice Deniz İlhan, Oguz Dursun, Murat Yılmaz, Erkan Alpsoy
July-September 2022, 16(3):80-86
Background: Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) are rare, acute, severe cutaneous hypersensitivity reactions usually triggered by medications. They are classified by the extent of the detached skin surface area. Objective: We aimed to retrospectively evaluate the sociodemographic, clinical, therapeutic, and prognostic characteristics of SJS/TEN cases diagnosed between January 2015 and December 2020 in our centre. Materials and Methods: All the data regarding patient characteristics were obtained retrospectively. The SCORe of Toxic Epidermal Necrolysis (SCORTEN) was used to predict disease severity and mortality rates. Results: Out of 20 patients (14 females, 6 males), eight (40%) were evaluated as TEN, three (15%) as SJS/ TEN overlap, and nine (45%) as SJS. The mean age was 39.2 ± 27.92 years. A higher frequency of systemic antibiotic use was found in cases of SJS/TEN overlap or TEN compared to SJS cases during patients’ follow-up after the diagnosis (P = 0.006). The most common responsible drug was allopurinol (25%). While the estimated mortality in patients with SCORTEN values of 4 and 5 was 58.3% and 90.0%, the mortality observed in our cohort was 50% and 100%, respectively. In terms of complications, ocular problems were the most common ones. Ophthalmic sequelae were observed in 15 patients during the follow-up period, the most common belonging to the cornea. Conclusion: In conclusion, early diagnosis, immediate discontinuation of suspected drugs, and good clinical care are among the most crucial treatment steps in the treatment of SJS/TEN. In addition, multidisciplinary management of the disease is vital in preventing the development of long-term sequelae in survivors.
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The comparative study to determine the efficacy of 0.05% tazarotene gel versus 0.1% adapalene gel in patients of facial acne vulgaris
Ashish Deshmukh, Sanmitra Aiholli, Bhargav N Naik
July-September 2022, 16(3):87-91
Introduction: Acne vulgaris is one of the most common skin disorders that present to Dermatology clinics. The majority of the patients suffer from mild-to-moderate acne, for which topical retinoids form the mainstay of treatment. Aims and Objectives: The aim of this article is to study and determine the efficacy and tolerability of 0.05% tazarotene gel against 0.1% adapalene gel in facial acne vulgaris. Materials and Methods: Eighty-two facial acne vulgaris patients were randomly divided into two groups. Group A was given 0.05% tazarotene gel, and group B received 0.1% adapalene gel to be applied overnight for a period of 8 weeks. Lesion counting and photographs were recorded every 15 days. Results: The mean difference on first follow-up from baseline for tazarotene and adapalene was 6.80 ± 6.42 and 1.48 ± 10.44, and the P-value was 0.013. The final follow-up visit values were 34.77 ± 23.73 and 25.48 ± 13.04, with a P-value of 0.051. The mean percentage change from baseline to last follow-up for tazarotene and adapalene was 60% and 51%, respectively, which were statistically significant for both groups (P < 0.05). More patients in the tazarotene group developed cutaneous side effects such as erythema and burning sensation than those in the adapalene group (P < 0.05). conclusion: About 0.05% tazarotene gel has better efficacy than 0.1% adapalene, though associated with more side effects. It can be used as a topical adjunct or as monotherapy in mild-to-moderate facial acne vulgaris.
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Zosteriform eruptive vellus hair cyst: A rare entity with an uncommon presentation
Shreya Poddar, Tirthankar Gayen, Gobinda Chatterjee
July-September 2022, 16(3):98-100
Eruptive vellus hair cyst (EVHC) represents a rare developmental anomaly of vellus hair follicles. The infrequency with which it is encountered makes it a formidable diagnostic challenge. Herein, we report a case of zosteriform EVHC in a 23-year-old male who presented to our dermatology clinic with asymptomatic, brown-black colored, follicular papules for 15 years. This case highlights a unique presentation of an uncommon entity.
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Association between initial findings leading to Behçet’s disease diagnosis and further organ involvements
Irem Yanatma, Gulbahar Sarac, Hulya Cenk, Selami Arslan, Imge Durmaz, Gonca Ay
July-September 2022, 16(3):92-97
Objectives: Studies show that the symptoms are clustered in certain ways in Behçet’s disease (BD), which causes involvement of multiple organs. We aimed to investigate the association between clinical findings at onset and further organ involvements, which may occur during follow-up. Materials and Methods: A total of 363 patients diagnosed with BD in accordance with the International Criteria for BD (ICBD) between 2003 and 2019 at the Inonu University were included in the study, and all the first findings were compared with further organ involvements. Results: A statistical significance was detected between erythema nodosum like lesions and both pulmonary (P = 0.002) and vascular (P = 0.022) involvements. The frequency of neurological involvement was higher in patients with papulopustular/pseudo-follicular lesions (P = 0.043). Gastrointestinal involvement was detected in 33.3% of the patients with herpetiform aphthae. The frequency of ocular involvement was significantly higher in patients with a negative pathergy test result (P = 0.013). Conclusion: The clinical clusters in BD may provide a predictive value about the disease course for clinicians. Although it has been shown that there is an association between some clinical findings and involvements which are mentioned before, this is one of the most comprehensive studies according to us. The clinical clusters in BD may provide a predictive value about the disease course for clinicians. Although it has been shown that there is an association between some clinical findings and involvements in the literature, this is one of the most comprehensive studies as far as we know.
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An unusual hyperkeratotic mucous cyst
Harsimran Kaur Gujral, Akansha Anil Chadha, Atul M Dongre, Chitra Shivanand Nayak
July-September 2022, 16(3):101-102
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