Hospital Dermatology Research Articles

Giant and Profuse Xanthogranuloma in a 14-Month-Old Infant at the Dermatology Hospital of Bamako

Juvenile xanthogranuloma (JXG) is a proliferative disease included in the group of non-Langerhansian histiocytoses (NLH) that mainly affects infants and children, and is congenital in 40-70% of cases. This condition is usually a single or few lesions but the profuse form is very rare. We report a case of giant, profuse xanthogranuloma in a 14-month-old infant. A 5-month-old infant was brought to the dermatology department with a rash that had been flaring for more than a month. The infant had no previous history of the disease and the lesions were asymptomatic. Clinical examination revealed firm nodulopapular lesions of normal skin colour, varying in size from 5 mm to 1 cm, scattered over the body. The lesions were most prominent on the neck and trunk. Biopsy of one nodule was concluded to be a juvenile xanthogranuloma. We reassured the parents about the disease and abstained from treatment. After 9 months of evolution, the child was readmitted to dermatology for aggravation of the rash. On examination, turgid nodules of 1-2cm in diameter were observed, profuse on the body. Elsewhere the clinical and biological examination was unremarkable. We report a case of giant diffuse xanthogranuloma in a 14-month-old infant, evident by histological examination. Our observation is peculiar because of its mode of extension and the giant nature of the lesions. It remains to be seen whether the evolution of this disease passes through this turgid stage. Further work is needed to support the pathogenesis of the lesions.

Perceptions of telehealth among inpatient consultative dermatology providers and practice patterns during COVID-19.

Use of inpatient teledermatology increased during the COVID-19 pandemic. We surveyed the Society for Dermatology Hospitalists to better characterize the impact of COVID-19 on teledermatology use by inpatient dermatology providers, particularly on provider perceptions of teledermatology. Prior to the COVID-19 pandemic, 40% (8/20) of surveyed providers had used telehealth at their institution to help perform inpatient consults, while 90% (18/20) adapted use of teledermatology during the pandemic. 80% (16/20) reported that their opinion of teledermatology changed as a result of the COVID-19 pandemic, with the vast majority (87.5%, 14/16) reporting having a more positive opinion. Benefits of teledermatology included efficiency, ability to increase access safely, and ability for clinicians to focus on complex cases. Some providers expressed concerns over the potential implications regarding the perception of dermatology within medicine, limitations of inadequate photos, and breakdowns in communication with consulting teams and patients. Robust algorithms and or utilization criteria of teledermatology may help to mitigate risk, while increasing access to inpatient dermatologic evaluation.

Sweaty Miliary During the Heat Period in A Sub-Saharan Country (Mali)

Considered to be commonplace in our countries, sweaty miliary can be responsible for pruritus with significant socio-professional repercussions. No data are available on this condition in our environment. The aim of this study is to describe sweaty miliary during hot weather in the dermatology hospital of Bamako. This is a descriptive cross-sectional study over a period of 6 months (1 February to 31 July 2019), carried out at the dermatology hospital in Bamako, the study involved all patients received for sweaty miliary without distinction of age, sex or origin and who gave their informed consent. Socio-demographic, clinical and therapeutic variables were collected on a survey form, entered and analysed with Epi Info 7.2.2.6. A total of 93 patients (18 males and 75 females) out of 13,000 patients or a frequency of 0.7%. Median age of patients was 11.31 years. The dominant clinical type was crystalline miliaria (sudamina) in 79.56%. Dermocorticoids and zinc oxide were the most used in the treatment and flattening of the abscess in 8 complicated cases.

Neglected Adult Tinea Capitis in South China: A Retrospective Study in Nanchang, Jiangxi Province, from 2007 to 2021.

Tinea capitis (TC) in adults is much less frequently diagnosed in comparison to TC in children. In this study, we explored retrospectively adult TC in a specialized dermatology hospital, located in South China, during the years 2007-2021. Among 1037 TC cases, 168 (16.2%) patients were older than 18years. The majority of adults with TC, 77.38% (130/168), were older than 40, with a peak in the age of 51-60years (40/168, 23.81%). Before presenting at our hospital, many of patients did not got proper treatment due to misdiagnosis or simply did not consulted an appropriate clinic. 60.71% (102/168) of the patients reported symptoms lasting for more than 1year and 29.76% (50/168) reported chronic scalp problems of at least 10years. And 27.38% (46/168) of the patients had an immunocompromised status, including long-term use of corticosteroids shampoo, type 2 diabetes mellitus (DM), psoriasis vulgaris, rheumatoid arthritis, systemic lupus erythematosus or bullous pemphigoid. As for clinical presentation, 87.5% (147/168) of the cases presented as black dot type of TC and anthropophilic dermatophytes were the predominant etiology, with Trichophyton violaceum (126), T. tonsurans (15), T. rubrum (8) and T. shoenleinii (6). Grey patch type of TC (3.57%, 6/168) was seldom in Jiangxi Province and zoophilic/geophilic dermatophytes were rare. Our study indicates that anthropophilic Trichophyton species can cause long-lasting TC in adults. Not in all cases, the manifestation had symptom clearly indicating a dermatophyte-related TC. Thus, patients with long-lasting scalp inflammation, also older ones, should be examined for the presence of dermatophyte-related TC.

Hospital Dermatology: analysis of dermatological consultations in a tertiary teaching hospital

BackgroundIn hospital settings, dermatology can offer substantial clinical support for the diagnosis and management of skin conditions, reducing morbidity and mortality. Thus, the study aimed to analyze the profile of referrals and consultations performed by the Dermatology Service of the Santa Casa de Misericordia de Porto Alegre, from August 2018 to January 2020. MethodsThis study is descriptive, quantitative, and retrospective, conducted through data collection and review of medical records and referrals. The variables included were clinical data of referrals, in-patients profiles, dermatological diagnoses, complementary exams, therapeutic conduct, and recommended follow-ups. ResultsA total of 1020 referrals were analyzed, which resulted in 641 consultations (328 men, 313 women). The most prevalent skin disease groups were ‘Dermatitis and Eczema’ (33.1%) and ‘Other infectious skin diseases (21.8%), while the most frequent ICD-10 were ‘Drug eruptions – L27’ (9.9%) and ‘Other and unspecified dermatitis – L30’ (6.6%). Corticoids were the most recommended treatments (27.7%), followed by antifungals (13.1%). ‘Consultation Discharge’ (44%) and ‘Outpatient’ Dermatology follow-up (27%) were the most frequent causes for ending consultation. Study limitationsAmong the study limitations, the authors highlight its retrospective nature, with data analysis based on referrals and medical records, which may present inaccurate or incomplete information. In addition to this, the study may demonstrate a certain degree of subjectivity due to the review and interpretation process conducted by the researchers. However, the definition of objective criteria based on previous studies attenuates such possible bias. Furthermore, considering that the Dermatology teams are composed of a preceptor dermatologist and residents, the established diagnoses were not submitted to third-party verification, except in the cases of skin biopsies and cultures. Thus, the professional’s experience and skills may have influenced the dermatological diagnoses. ConclusionsThese findings underlie the importance of Dermatology in hospital assistance, contributing to the management of a wide range of skin conditions.

Serum Concentrations of Thelper2-derived Cytokines in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Some immunological and genetic factors are believed to be involved in the pathogenesis of SJS/TEN, including T helper 1 and T helper 2 (Th2)-derived cytokines. AIM: This study aims to evaluate the serum levels of Th2-derived cytokines in SJS/TEN, compare to those of erythema multiforme (EM) patients, and the relation between them and the progress of SJS/TEN. METHODS: This was a sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. 48 SJS/TEN patients, 43 EM patients, and 20 healthy controls (HCs) participated. Serum interleukin (IL)-4, IL-5, and IL-13 levels were measured by using the fluorescence covalent microbead immunosorbent assay (FCMIA) (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann-Whitney U test was used to compare the serum IL levels of the two groups. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05. RESULTS: 19 SJS patients (39.5%) and 29 TEN patients (60.5%) participated in our study. The mean age was 49.3, range of 19–77 years (47.9% males; 52.1% females). The most common causative drugs were traditional medicine (29.1%), and allopurinol (12.5%). On the day of hospitalization, the serum level of IL-4 in the SJS/TEN group was 3 ± 7.5 pg/mL, statistically significantly higher than that in the HCs group (p < 0.05), but not higher than that in the EM group (p > 0.05); serum levels of IL-5 and IL-13 in the SJS/TEN group were 4.5 ± 9.8 pg/mL and 1.6 ± 0.6 pg/mL, respectively, similar to those in the EM and HCs groups. On the day of re-epithelialization, in SJS/TEN patients, the serum level of IL-5 was 1 ± 2.8 pg/ml, statistically significantly lower than that on the day of hospitalization (3 ± 7.5 pg/mL) with p < 0.05. Regarding serum levels of IL-4 and IL-13, there was no difference between the two- time points. CONCLUSION: The serum concentrations of Th2-derived cytokines (IL-4, IL-5, and IL-13) were not higher in the SJS/TEN group than in the EM group and there was no significant change in the clinical progression of SJS/TEN, except the serum level of IL-5.

Dermatoses in geriatric diabetic patients and its association with socioeconomic condition – A cross-sectional observational study in a tertiary care hospital in Eastern India

Background: Diabetes mellitus can have varied cutaneous manifestations. Aims and Objectives: This study aims to explore the plethora of dermatoses among the geriatric diabetic population and evaluate their association with the socioeconomic conditions of the patients. Materials and Methods: This is a cross-sectional observational study carried out on 300 diabetic patients aged 60 and above in department of dermatology of a tertiary care hospital in Eastern India. Data were collected in a pre-designed proforma, and all findings were recorded. Results: Three hundred diabetic patients aged 60 and above were evaluated; 42% were male, 58% were female. About 61.33% belonged to lower socioeconomic status (SES), 24% to middle, and 14.67% to upper SES. Xerosis (66%) and generalized pruritus (44%) were the most common skin manifestations. Among the infective dermatoses, fungal infections (49.3%) were the most common followed by bacterial (29.3%). There was statistically significant correlation of diabetic dermatoses with SES, female gender, obesity, increased intake of junk food, active smokers for more than 10 years, living singly, sedentary lifestyle, and hypertension. Conclusion: An in-depth knowledge of diabetic dermatoses in the elderly and the role of SES and demographic parameters accounting for their increased prevalence has not been sufficiently studied among the Indian population. This study will shed some light on the same and bring in awareness among the doctors and policymakers alike to enhance the health-care needs of the elderly.

The Results of the Hospitalized Treatment of Kerion Celsi

BACKGROUND: Kerion celsi is quite common in children, accounting for a relatively high rate in the form of a scalp fungus, caused by Trichophyton or Microsporum fungi. Clinical manifestations include painful crusty lesions covered with follicular pustules and systemic symptoms. Treatment requires a combination of several methods. AIM: This study was conducted to describe the results of inpatient treatment of kerion celsi. METHODS: This is a cross-sectional descriptive study on 25 in-patients with kerion celsi at the National Hospital of Dermatology from January 2017 to December 2017. RESULTS: The results showed that male patients accounted for 64%, female patients accounted for 36%; 4–7 years old accounted for 52%. The mean number of days of in-patient treatment was 9.9 days. All patients received systemic antifungals in combination with topical antifungals and systemic antibiotics. There were 24/25 patients with incisions, drainage, and pus cleaning. The rate of lesion clearing after 2–4 weeks was 13%, after 4–6 weeks was 34.8%, and over 6 weeks was 52.2%. After 6 months, all patients had hair regrowth. The rate of patients with scars after treatment was 69.6%. CONCLUSION: Antifungal therapy along with incision, and cleaning of pus gives gcood results in the treatment of kerion celsi, the most common complication is scarring.

Sister Marie Joseph Nodule in a Polypathological Patient: Study of an Observation at the Dermatology Hospital of Bamako (Mali)

Summary: Sister Mary Joseph nodule is a metastatic localization with a generally abdominal-pelvic origin and secondary to a primary adenocarcinoma in 90% of cases. We report an observation of Sister Mary Joseph nodule revealing a primary adenocarcinoma of the colon in a young adult with multiple pathologies. Observation: A 57-year-old patient, followed for hepatitis B, HIV1+, and benefiting from a therapeutic regimen (Tenofovir+Lamivudine+Dolutegravir) since 2019 and later a hyperthyroidism of incidental discovery. For one year he has had a firm nodular ulceration measuring 07 cm in its longest axis, with a reddish-pink appearance and whitish deposits, a haemorrhagic ooze on contact, and located at the umbilicus. Also, a tongue laden with whitish coatings that are easily removed with a tongue depressor and the inner surface of the cheeks and palate are erythematous. Bilateral exophthalmos abolished vocal vibrations in both lung bases; two hard left inguinal adenopathies adhering to the deep plane, painless, 3 cm in diameter each. He also described episodes of alternating constipation and diarrhoea accompanied by abdominal pain, coughing, physical asthenia and weight loss (40% loss in 2 years). Anatomopathology of a fragment of the nodule revealed a well-differentiated adenocarcinoma whose tumour cells were of colorectal origin and expressed CK20 and CK8/18. Colonoscopy revealed a multilobed polyploid tumour of the ascending colon and histology concluded that it was a liberkuhnian adenocarcinoma. A chest CT scan revealed pulmonary and abdominal-pelvic metastases and the diagnosis of a Sister Mary Joseph nodule revealing a colonic and metastatic adenocarcinoma was made. The patient was referred to the oncology department for palliative care after the surgical opinion. Conclusion: The nodule of Sister Marie Joseph is a cutaneous metastasis revealing a cancer of the abdominopelvic sphere. This rare and characteristic tumour deserves to be known by practitioners .......

A Study of Nailfold Capillaroscopy in Different Morphological Variants of Psoriasis in a Tertiary Care Hospital

Abstract Background: Psoriasis is a chronic skin disease. Nailfold capillaroscopy (NFC) is a method to analyze nail changes in autoimmune disorders and is gaining popularity as a bedside tool for studying the capillaroscopic changes of psoriasis. Aim: The aim was to assess the nail fold capillaroscopic parameters in controls versus psoriasis patients and to assess the nail fold capillaroscopic parameters in various morphological types of psoriasis patients. Materials and Methods: A cross-sectional observational study of NFC was conducted on 100 patients and 100 controls who attended the outpatient department of dermatology of a tertiary care hospital in Central India from June 2022 to October 2022. Nail fold of little fingers of both hands was studied by the Universal Serial Bus (USB) Digital Microscope and photographed. Results: This study was conducted on 100 patients of psoriasis and 100 controls. The mean age of patients was 50.77 ± 11.33 years with a male-to-female ratio of 1.27. The most common type of psoriasis was chronic plaque psoriasis, and erythrodermic psoriasis was the least common. Majority of 51 patients were having a Psoriasis Area and Severity Index score of >3–15 suggestive of moderate psoriasis. Capillary morphology in 89% of psoriasis cases was inverse U-shape, while remaining 11% had bizarre morphology. There was a significant difference (P < 0.011) in capillary density between psoriasis patients and controls. Only 6% of patients had irregular and haphazard capillary distribution, compared to 94% of patients who had regular and parallel capillary distribution. Other parameters of NFC such as subpapillary plexus, ramified/bushy capillaries, and hemorrhage were also studied. Conclusion: Psoriasis is characterized by microvascular abnormalities which can be studied by a novel technique of nailfold capillaroscopy.

Isolation of Bacteria Causing Secondary Bacterial Infection In TheDry l ,esions Of Cutaneous Leishmaniasis

Abstract Cutaneous loishrnaniasts (CL) is a parasitic disease characterized by single or multiple lesions,. Sc ontlay bacterial infection is one of the complications of the Jiscase that Can increase the titute destruction and the resultant sear. To determine effectively the u3cidence of real tamaindary bacterial infection in the dry type, of cutaneous leishmaniasis ,we designed the current study. This was a crusts-sectional study performed in the outpatient clinic of dermatology and vencriology nt Unit Teaching Hospital. A total of 37 patients with etinica3 diagnosis of Cutaneous leishmaniasis (dry type) were, carolled in this study. Samples were taken from all patients. The skin areas surrounding the lesions were thoroughly cleaned using cotton wool moistened with alcoholic iodine. After appropriate cleaning, the samples were collected aseptically by scraping of sterile swabs of the lesions All the samples were transferred uo Mac Cunkeys agar and blood agar_ After 24 hours incubation (aerobically& en aerobically) at 37 tIC, the species atilt bacteria were determined. Then site samples were transferred to Mueller-Hinton agar or nutrient agar for sensitivity test. After 24 hours incubation at 37 °C, the diameters of the inhibition zones were measured to determined the sensitivity Among the 37 patients with Cutaneous leislununiasis the results of the culture were positive in 12 patients (32.4%). 11 of them (91.6%) have more than one lesion and 9 patients (75%) of them were less than 5 years old. and 3 patients (25%) were more than 5 years old_ Bacteria isolated from the lesions were Staph. aureus in II patients (91.6%)( and all were sensitive to Rifampicin) and E.Coli in one patient (LI%) which was sensitive to Amikacin & Norlioxacini The incidence of secondary bacterial infection with a dry type of Cl., was (32.4%), (91.6%) of them had multiple lesions, and (75%) were less than 5 years old, The most common bacterial isolate was Staphylouocus ttureus

Retrospective analysis of 71 patients with cutaneous sporotrichosis

To summarise 71 cases of cutaneous sporotrichosis in Zhejiang over the past 9 years and analyse clinical and epidemiological characteristics. This was a retrospective review of patients with cutaneous sporotrichosis attending the Department of Dermatology of the Hangzhou Third People's Hospital between 2013 and 2022. The male-to-female ratio was 1.15:1 among the 71 patients, with a mean age of 55.90 years (±2.02) and an age range of 3 to 94 years. The disease duration was unknown for 17 patients. The intermediate course for the remaining 54 patients lasted 11.90 months, ranging from 1 to 120 months. Thirty-four patients were involved in mixed occupations, 28 were farmers, 4 were housewives, 3 were manufacturing workers, and 2 were carpenters; 23.95% of cases had a history of trauma. The most common clinical manifestation was fixed cutaneous (69.01%), followed by lymphocutaneous (29.58%) and disseminated cutaneous (1.41%). There were 72 affected sites; the upper limbs (69.44%) were affected the most, followed by the face (16.67%) and lower limbs (12.50%). Forty-nine patients showed open lesions (69.01%), 15 showed mixed lesions (21.13%), and seven showed closed lesions (9.86%). Seventy-one patients were confirmed by biopsied tissue or tissue fluid culture. Forty-four patients underwent direct microscopy; of these, 18 (40.91%) were positive and 26 were negative. Molecular analysis confirmed that all fungal strains were Sporothrix globosa. Fifty-nine patients underwent histopathological examination, of whom 18 (18.64%) were positive for periodic acid-Schiff (PAS) staining. Eighteen patients were lost to follow-up; the remaining patients were cured. Consistent with the epidemiological situation of sporotrichosis in other areas of China, S. globosa is the primary pathogen in the Zhejiang province. The primary clinical form of sporotrichosis is fixed cutaneous. Susceptible subjects are mainly middle-aged and elderly rural populations, and males are affected more than females. Patients with cutaneous sporotrichosis do not commonly have a history of obvious trauma. Direct microscopy is important for the diagnosis of sporotrichosis, and itraconazole is a safe and effective treatment option.

A retrospective study of 129 patients with plasma cell balanitis

AbstractBackgroundPlasma cell balanitis (PCB) is a chronic inflammatory dermatosis of the glans penis and prepuce, typically presenting as discrete shiny bright red plaques. Research on PCB is scarce, with case reports and small series. The aetiology, incidence and prevalence of PCB remain unclear. Circumcision is considered as the treatment of choice. Topical treatments such as topical corticosteroids, calcineurin inhibitors, fucidic acid and imiquimod have been widely used, but they lack evidence of efficacy.ObjectivesThe objective of this study was to investigate the clinical profiles, treatment methods and outcomes of PCB patients in a relatively large cohort.MethodsWe concluded a retrospective study of 129 patients with the diagnosis of PCB between 1 January 2003 and 31 December 2018 at Tampere University Hospital (TAYS) dermatology department.ResultsThe majority of patients were treated with topical treatments only, while 31 patients (24%) eventually underwent circumcision. The most used and most effective topical treatments were tacrolimus (0.03% or 0.1%) and clobetasol propionate. Those treated with circumcision had a shorter follow‐up time (median 8 months vs. 47 months, p = 0.002) and were more likely to reach remission (46% vs. 16%, p = 0.002) compared with those treated with only topical treatments. Patients with more severe symptoms were more often treated with several topical treatments and to undergo circumcision, and they were more likely to ultimately reach remission. The follow‐up time was longer among patients with a histopathologic diagnosis than with a clinical diagnosis (median 16 months vs. 6 months, p = 0.01).ConclusionsTopical treatments are rarely curative, but among them tacrolimus and topical corticosteroids show the strongest evidence of efficacy. The rate of remission is significantly better among those circumcised, and it is to be considered already at an early stage. Further studies are needed to find the best care management for PCB.

Profile of Skin Tumors at Dr. Zainoel Abidin General Hospital Dermatology and Venerology Outpatient Clinic in 2017 – 2021 : A Retrospective Study

Background: Skin tumors are swellings caused by proliferation or failure of cell death mechanisms. Based on the type of growth, skin tumors are divided into benign tumors and malignant tumors. Purpose: To investigate the incidence of skin tumors in Dr. Zainoel Abidin General Hospital outpatient clinic. Methods: This study is a descriptive study with total sampling. The diagnosis of skin tumors is assessed based on medical records filled by Dr. Zainoel Abidin General Hospital Dermatovenerologist in January 2017-September 2021. Result: The results showed patients diagnosed with benign skin tumors had as many as 360 subjects and malignant tumors had as many as 4 samples. The majority of women are affected by benign and malignant skin tumors. Based on the age of benign tumors dominated by the age of 22-45 years while in malignant tumors dominated by 45-64 years. The majority of the sample comes from Banda Aceh, based on where the most of them reside. Based on the size of lesions, benign tumors are dominated by lesions that are less than 0.5 cm in size, while malignant tumors are dominated by lesions that are larger than 0.5 cm in size. Based on the presence and absence of recursion the entire dominant sample has no recursion. Based on the physical treatment in benign tumors are dominated by electrocautery action while malignant tumors are the same number between general surgery and FNAB. Conclusion: most of the skin tumors found in Dr. Zainoel Abidin General Hospital dermatology and venerology outpatient clinic are benign

Determination of Serum 25-Hydroxyvitamin D Levels in Patients with Alopecia Areata.

Alopecia Areata is a common non scarring alopecia with autoimmune etiology. In several previous studies, an insufficient level of 25 hydroxyvitamin D had been correlated with various autoimmune diseases. The current study aimed to determine the level of serum 25 hydroxyvitamin D in patients with alopecia areata. A cross-sectionalstudy was conducted on 35 patients with alopecia areata who visited the outpatient department of Dermatology of KIST Medical College and Teaching Hospital, Nepal. A prior approval of the institute review committee was taken. Convenience sampling technique period for 3 months (March 2022-May 2022) was used to include the participants (informed consent was taken; in minors parental consent was prepared). The serum levels of 25 hydroxyvitamin D was estimated using Abbott Architect i1000 SR analyser. In this study, Alopecia Areata was common in the age group of 16-30 years (Mean age: 31.65 ± 11.92 Years). The average duration of the disease in Alopecia Areata patients was close to 1 year. This study indicated a lower concentration of 25 hydroxyvitamin D in half of the studied AA patients (51.4%).The number of patches, Severity of Alopecia Tool scoring, serum 25 hydroxyvitamin D level, and age were found to be statistically insignificant with the disease activity. However, a significant positive correlation was found between the Severity of Alopecia Tool score and the number of patches. Although low levels of serum 25 hydroxyvitamin D may be seen among subjects with alopecia areata; No statistical correlation was observed. Hence, a larger study of similar nature is needed in the future to elucidate the exact correlation.

Teledermatopathology on the ADOI platform and beyond.

In September 2021 on the platform of the Italian Association of Hospital Dermatologists (ADOI; https://www.adoi.it/) a monthly on-line live session of teledermatopathology was started involving collegial discussion among experienced Italian pathologists about challenging melanocytic tumors using the virtual microscope [...].

Psychosocial Status and Quality of Life among Vitiligo Patients

Vitiligo is a chronic skin disorder that may have negatively affect on patients’ self-esteem, body image, social state and quality of life. Aim: The aim of the present study was to assess the relationship between psychosocial status and quality of life among patients’ vitiligo. Design: A descriptive correlational research design was utilized to achieve the aim of this study. Setting: The study was conducted in laser unit at Benha Dermatology Hospital and in phototherapy unit at Benha University Hospital Governorate. Subject: A convenience sample of 100 patients’ vitiligo was included from the above settings for conduction of this study. Tools: Five tools used for data collection. Tool I - A structured interviewing questionnaire was used to collect data about socio demographic and clinical characteristics of the studied sample. Tool II - Self-esteem Scale. Tool III - Body image scale, Tool IV - Social problems scale, Tool V - Quality of life scale. Results: More than half of studied sample had low level of self-esteem and quality of life. While more than half of studied sample had moderate negative body image. Also, half of studied sample had moderate level of social problems. Conclusion: There was a highly statistically significant positive correlation between total body image, total social problems and quality of life. Recommendation: Stress management and assertiveness training program should be given to patients’ vitiligo to relieve the psychosocial problems and enhance coping patterns.

COMORBID CONDITIONS IN PSORIASIS

Psoriasis is a chronic dermatosis of a multifactorial nature with a dominant role in the development of genetic factors, characterized by hyperproliferation of epidermal cells, impaired keratinization, and inflammation in the dermis. Currently, its prevalence in the population is from 0.1 to 7%, and among people hospitalized in dermatological hospitals – from 25 to 40%. In the scientific literature, the issue of considering psoriasis as a systemic disease is widely discussed, which includes damage not only to the skin, but also to other organs and systems. Thus, the indicated problems of combined pathology are relevant, require further in-depth study and search for evidence-based solutions that will improve the quality of medical care for patients with both psoriasis alone and its combined course.

A CLINICO-ETIOLOGICAL STUDY ON BALANOPOSTHITIS

Background: Balanoposthitis is a relatively common condition affecting both pediatric patients and adults. In adults, uncircumcised males with diabetes mellitus are at the highest risk, with higher prevalence. Although majority of patients will respond to changes in hygiene and empiric therapy, about one in ten will show recurrence needing further evaluation and more targeted management. Aims And Objectives: To study the clinical features in patients of Balanoposthitis, and to determine the etiological agents by microbiological spectrum and the risk factors associated with it. Materials And Methods: The present hospital based cross-sectional study was conducted for a period of 18 months on 75 patients with clinically diagnosed balanoposthitis visiting outpatient and inpatient under the Department of Dermatology, Venerology and Leprosy of Basaveshwar teaching and general hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. A pre-designed semi-structured proforma, which was internally validated was used to collect the necessary information on all the needed variables. Demographic details were recorded and a detailed history of symptoms, history of external application, and history of systemic illness was obtained. The systemic and genital examination was done. Subpreputial discharge was collected on swabs and sent for KOH mount, bacterial and fungal culture. Results: In the present study, the mean age was estimated to be 44.60 ± 10.49 years. Majority were married (90.7%), had completed just high school education (90.7%). On enquiring whether any topical agents were applied in the past, only 10.7% had agreed to it. Subpreputial discharge was found to be the most common clinical feature (72.0%), followed by erythema (54.7%). The involvement of preputial skin was observed in about 44.0% cases. Herpes genitalis was evident in 5.3% cases, while syphilis was present in only 1 individual, and 3 other subjects were positive for HIV infection. The only complication was non-retractable prepuce, which was appreciated in about 9.3% cases. About 74.1% of the subjects showed positive for KOH Mount. However, among them, only 35 individuals were found to be positive on fungal culture. Staphylococcus aureus was the most common bacteria (25.9%), followed by staphylococcus epidermis (22.2%). Diabetes mellitus was regarded as commonly associated risk factor (74.7%). The commonest infectious etiology was observed to be bacterial infection (73.3%), followed by fungal infection (46.7%). The commonest non-infectious etiologies were observed to be adverse drug reaction and irritant contact. Conclusion: Subpreputial discharge was found to be the most common clinical feature followed by erythema, fissures over preputial skin and ulcer. Bacterial and fungal infection were common infectious etiologies while adverse drug reaction and irritant contact were non-infectious etiologies causing Balanoposthitis. Co-morbidities such as diabetes mellitus and hypertension were regarded as the risk factors associated with Balanoposthitis.

Médicaments responsables de toxidermie chez des enfants de phototype foncé à Dakar

IntroductionToxidermia in the paediatric population accounts for 35 to 36% of adverse drug reactions in children [1]. In 2% of cases, they can affect the vital and/or functional prognosis [2]. The aim of this work was to determine the drugs responsible of toxidermia in pediatric population in a hospital environment in Dakar. MethodologyThis was a cross-sectional, observational, descriptive study, over a period of 10 years, of children seen in the 3 dermatological university hospitals of reference in Dakar. ResultsWe collected 116 cases, representing a hospital incidence of 0.08%. The sex ratio was 1.23. The mean age of the patients was 7 years. The types of toxidermia were Stevens Johnson/Lyell syndrome in 42.2%, EPF in 11.2%, EMP in 10.3%, urticaria in 8.6%. Mucosal involvement was found in 50.9%. Complications were hydro-electrolytic disorders in 22.4%, infection in 7.7% and hypothermia in 1.7%. The incriminated drug classes were antibiotics in 41.4%, antiepileptics in 17.2%, non steroidal anti-inflammatory drugs in 15.5%, analgesics in 15.5% and antimalarials in 8.6%. Traditional plants were incriminated in 7.7% of cases. ConclusionAntibiotics and antiepileptics are the most common drugs involved in children toxidermia in Dakar. Stevens Johnson/Lyell syndrome is the most frequent clinical form.