Search

Background: Though higher doses of terbinafine are often prescribed to treat dermatophyte infections, it is unknown if such doses are more effective than the conventional dose because comparative data are unavailable. Aim: To compare the efficacy and safety of a once-daily dose of oral terbinafine 250 mg with 500 mg along with topical clotrimazole in the treatment of tinea infections. Methods: A randomised, assessor-blinded, comparative study was carried out. Each group of subjects were administered either 250 mg or 500 mg oral terbinafine once daily for four weeks, along with topical clotrimazole. Clinical improvement was assessed after two weeks and again after four weeks from treatment initiation. Result: A total of 60 patients with tinea corporis and cruris were randomised into two groups receiving either 250 mg (group A) or 500 mg (group B) oral terbinafine, along with clotrimazole cream in both groups. Baseline clinical parameters such as lesional activity (papules, vesicles and pustules), degree of erythema, scaling and severity of itching were comparable between both treatment arms. At the first and second follow-ups, no significant differences were found in the clinical parameters between the two groups. At the end of two weeks 13.8% of group A and 14.3% of group B and after 4 weeks 25.9% of group A and 33.3% of group B participants became KOH negative (P = 1.00 and 0.76, respectively). No significant difference in culture negativity was reported at the end of therapy (four weeks) between the two treatment arms (P = 0.78). Overall cure rates were 20% and 33.3% in the two treatment arms respectively at the end of the study (P = 0.82). Conclusion: Oral terbinafine 250 mg daily yielded a poor cure rate in tinea cruris and corporis after 4 weeks of treatment and an increased dose of 500 mg did not have any additional benefit. [ABSTRACT FROM AUTHOR]

Byline: Arindam. Sett, Samiksha. Pradhan, Karan. Sancheti, Dibyendu. Basu, Adrija. Datta, Lekha. Biswas, Sayan. Das, Subhasis. Pal, Nidhi. Gupta, Amrita. Sil, Nilay. Das Background: Acanthosis nigricans has been associated with [...]

Background: Nodular skin lesions are a common diagnostic dilemma because of overlapping clinical features. Histopathology remains the gold standard for diagnostic confirmation. Aims and objectives: The aim of this article is to analyze the clinico-epidemiology and histological spectrum of nodular skin lesions along with clinico-pathological correlation. Materials and methods: A cross- sectional study was conducted including 114 new patients with cutaneous nodules. Each patient was subjected to detailed clinical examination and histopathological examination to obtain the final diagnosis and degree of histomorphological concordance. Results: Neoplastic disorders accounted for 42.9% of the skin nodules among 114 patients (mean age 33.2 ± 11.9 years; M: F 1.7:1), followed by miscellaneous (30.7%), infective (19.3%), and deposition (7%) disorders. The most common cause was lipoma (19.3%), followed by prurigo nodularis (12.3%), leprosy (11.4%), and neurofibroma (9.6%). Most common site was trunk, and pruritus is the commonest symptom. Multiple clinical differentials were considered for almost one-third of patients owing to overlapping clinical features, and histology provided the final diagnosis. On clinico-pathological correlation, 72.8% of the cases showed histopathological concordance, whereas the remaining cases were histologically discordant (7%) or inconclusive (20.2%). Conclusion: Neoplastic disorders (benign> malignant) are the most common cause of nodular skin lesions. In addition to detailed clinical examination, histopathology is necessary to confirm the diagnosis and rule out differentials. Considerable histopathological correlation can be obtained for skin nodules if performed appropriately. [ABSTRACT FROM AUTHOR]

Background: Childhood alopecia areata (AA) is a common cause of dermatologic consultation; however, data is scarce in the present set-up. Objectives: To evaluate the clinico-epidemiological profile of childhood AA along with dermoscopic correlation. Methods: We conducted a cross-sectional study including 50 new cases of childhood AA for 1 year. Dermoscopy was performed in each child and findings recorded. Results: Childhood AA was more common in girls (M: F 1:1.4), mean age being 11.1 ± 3.7 years. Scalp was commonest site of involvement in 86% cases, while 32 (64%) children had mild disease (<25% involvement). Localized circumscribed patch was the commonest presentation in 37 (74%) children, while sisaipho was the least (2%). A positive family history of AA was noted in 5 (10%) children. Twenty-four children (48%) provided a history of atopic disorders, while 30% had a positive family history of atopy. Stress was the commonest precipitating factor in 13 (26%) subjects. Nail involvement was observed in 19 (38%) children (pitting >thinning), while systemic associations like vitiligo and thyroid dysfunction were present in 26% and 24% cases, respectively. Dermoscopy revealed yellow-dots to be the commonest finding in 44 (88%) cases, followed by short vellus hair and black dots in 76% and 28% children, respectively, while exclamation-mark hair was rare. Conclusion: Female gender, younger age, nail involvement, and presence of concomitant atopy, vitiligo, and thyroid dysfunction were associated with severe disease, but not statistically significant (p > 0.05). Regression model failed to detect any risk factors for severe AA. Dermoscopy is an important non-invasive tool for evaluating childhood AA. [ABSTRACT FROM AUTHOR]

Porokeratosis is a heterogeneous disorder of keratinization usually inherited in an autosomal dominant pattern. It usually affects the trunk and extremities. Lesions exclusively present over face are rare and not well-documented. We present a case of linear porokeratosis along the blaschkoid lines over the face in a 9-year-old girl. [ABSTRACT FROM AUTHOR]