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3. Clinico virological characterization of hand, foot and mouth disease in a tertiary care hospital, South India

Author

Christi Rajaseker, P Ferdinamarie Sharmila, Malathi Munisamy, Vanathy Kandhasamy, Raja Sundaramurthy, and Rahul Dhodapkar

Subjects
coxsackie virus-a16, coxsackie virus-a6, enteroviruses, hand- foot and mouth disease, human enterovirus-71, Infectious and parasitic diseases, RC109-216
Abstract

Introduction: Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease, caused by enteroviruses (EVs) which can present with typical or atypical lesions. Although the disease is self-limiting, it can also lead to serious complications. In the era of polio eradication, it is important to understand the population dynamics of enteroviruses causing HFMD as one of the circulating strains may become dominant. Methods: It was a collaborative study carried out in the Department of Dermatology and Microbiology of a tertiary care teaching hospital. The throat swabs were collected from 132 suspected HFMD cases. Real-time polymerase chain reaction (PCR) was performed to detect the presence of pan enteroviruses, followed by genotype-specific PCR targeting Human Enterovirus 71 (HEV-71) and Coxsackie virus A16 (CVA-16) and CVA-6 for pan Enterovirus-positive samples. Follow-up samples were collected from 14 children in the 2nd week and subjected to molecular testing to detect enteroviruses. Results: Among 132 children suspected to have HFMD, 44 were girls and 88 were boys, and the majority of them 76.5% (101/132) were under 2 years of age. A history of exposure to a similar clinical presentation was present in 15 children. Of 132 suspected cases, 60 samples (45.5%) were positive for pan Enterovirus. The predominantly circulating genotype was found to be CVA-6 (31.6% [19/60]). There were about 10 cases (16.6%) which had co-infection with both HEV71 and CVA-6. Rash with fever was the most common presentation (57%). In most of the cases with HEV 71, 92.3% (12/13) presented within 3 days of illness to the health-care facility. Of 60 positive cases, 25% (15/60) of children had the atypical distribution of rashes in the face, trunk, genitalia, thigh, neck, and axilla and 16.7% of children (10/60) had the atypical type of lesion either only papular lesions or erythema multiforme. Out of 14 follow-up samples, 13 were negative for EVs; one was positive for pan EV in the 2nd week, however, the patient lost to follow-up after that. Conclusion: HFMD outbreaks in our region were caused by various genotypes of enteroviruses. No severe complications were seen in the affected children. Nearly 30% had atypical presentation either in the form of lesion or site. Robust molecular epidemiological surveillance of HFMD is required to know the strain variations and other emerging genotypes in our setup.

Published
2023
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4. IADVL SIG pediatric dermatology (academy) recommendations on Hemangioma of Infancy (HOI)

Author

Bhumesh K Katakam, Minu J Chiramel, Ram Gulati, Mrinal Gupta, Malathi Munisamy, P S S. Ranugha, and K A Seetharam

Subjects
beta blockers, hemangioma of infancy, lumbar, pelvis, phaces, Dermatology, RL1-803
Abstract

Hemangioma of infancy (HOI) is a benign vascular proliferation. Though resolution is the norm, potential complications make an accurate diagnosis and early management of importance. The Indian association of dermatologists, venereologists and leprologists (IADVL) special interest group (SIG) paediatric dermatology in association with IADVL academy did an extensive analysis of the literature on the clinical features, diagnosis, and management of HOI published between 2010 and 2021. Online meetings were conducted from February 2021 to March 2022 to reach a consensus on these recommendations which are made from an Indian perspective.

Published
2023
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5. Assessment of patients with periorbital melanosis for hyperinsulinemia and insulin resistance

Author

Devinder M Thappa, Laxmisha Chandrashekar, Medha Rajappa, R Usha, K Muthupandi, Palani S Mohanraj, Malathi Munisamy, and Nidhi Singh

Subjects
adipokines, adiponectin, insulin like growth factor-1, insulin resistance, leptin, periobital hyperpigmentation, Dermatology, RL1-803
Abstract

Background: Periorbital melanosis (PM) is one of the most common dermatological condition seen in routine practice. Several cutaneous markers such as acanthosis nigricans have been associated with insulin resistance (IR). However, the association of PM with IR needs to be substantiated. Objective: The objective of the study is to evaluate the association of circulating adipokines and IR with PM. Materials and Methods: In this cross-sectional study, we recruited 100 patients with PM and 100 age- and gender-matched healthy controls. The serum levels of leptin, adiponectin, fasting glucose, fasting insulin, insulin-like growth factor-1 (IGF-1), homeostatic model assessment of insulin resistance (HOMA-IR), and leptin: adiponectin ratio (L/A ratio) were assayed. Results: The serum levels of leptin, fasting glucose, fasting insulin, HOMA-IR, L/A ratio were significantly higher in patients with PM as compared to controls. The serum levels of adiponectin were significantly lower in cases as compared to controls. On multivariate regression analysis, leptin, adiponectin, and HOMA-IR were found to be significant, even after adjusting for BMI, blood pressure and LDL and HDL cholesterol.Conclusion: Our findings suggest that patients with PM have hyperinsulinemia, IR, and elevated L/A ratio. PM as a marker of IR in adults may help in identifying patients early and thus aid in the early prevention and management of the disease.

Published
2021
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6. Recommendations for management of childhood psoriasis

Author

Bhumesh Kumar Katakam, Malathi Munisamy, T Narayana Rao, Minu Jose Chiramel, Maitreyee Panda, Sandeep Gupta, P S S Ranugha, and K A Seetharam

Subjects
childhood psoriasis, co-morbidity, phototherapy, recommendations, systemic, topical., Dermatology, RL1-803
Abstract

Childhood psoriasis is recognized as a potential multisystem disorder and hence it is imperative to optimize disease management to arrest progression, minimize psychological burden and evolution of metabolic syndrome. Clinical practice recommendations are necessary to assist practitioners in appropriate decision making based on available evidence. Owing to the lack of Indian recommendations on childhood psoriasis, the SIG Pediatric Dermatology under IADVL Academy undertook an evidence-based approach based on published literature on the topic, between January 2000 and July 2020 to frame the recommendations.

Published
2021
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7. Recommendations for COVID vaccination for dermatological patients on immunosuppressive/immunomodulatory therapy (IADVL Academy)

Author

Malathi Munisamy, Bhabani S. T. P. Singh, and Deepika Pandhi

Subjects
covid-19, dermatology, guidelines, immunosuppressant, recommendations, vaccination, Dermatology, RL1-803
Abstract

Significant proportion of patients with dermatological disorders are on immunosuppressive or immunomodulatory therapy predisposing them to risk of acquisition of COVID-19 infection. However, the efficacy of COVID-19 vaccination among these patients is a matter of concern due to lack of adequate evidence for their protective effect owing to the drug induced immunosuppressed state. Hence, we from the IADVL academy have framed the recommendations to be followed for COVID-19 vaccination among dermatological patients on immunosuppressive therapy based on available related literature.

Published
2021
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8. Recommendations for pediatric dermatology practice during COVID-19 pandemic

Author

Ram Gulati, Bhumesh K Katakam, P S. S. Ranugha, Mrinal Gupta, T Narayana Rao, Maitreyee Panda, Malathi Munisamy, Minu J Chiramel, Neerja Puri, Sandeep Gupta, Biswanath Behera, and Garima Dabas

Subjects
pediatric dermatology, recommendations, covid19, Dermatology, RL1-803
Abstract

The current scenario of the coronavirus disease (COVID-19) pandemic has resulted in a huge disease burden worldwide affecting people across all age groups. Although children get infected by coronavirus, they are less commonly affected. Only 2% of cases are being reported among patients aged less than 20 years of age and childhood cases constitute around 1–5% of them. Moreover, they are less likely to be seriously affected when compared to adults, with more than 90% of them being either asymptomatic or having mild to moderate disease. This could be attributed to less exposure or sensitivity to COVID-19, varying immune response mechanisms, differences in the expression/function of the Angiotensin Converting Enzyme 2 receptors or higher antibody levels to viruses owing to exposures to multiple respiratory infections, protective role of measles and BCG vaccine, and few associated comorbidities. However, children with certain underlying medical conditions like cardiac or respiratory disease, diabetes, immunodeficiency disorders, cancer or on immunosuppressants may be at a higher risk for developing severe disease.

Published
2021
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9. Mucocutaneous adverse reactions of cancer chemotherapy and chemoradiation

Author

Sheikh Naveed, Devinder Mohan Thappa, Biswajit Dubashi, Jagadeesan Pandjatcharam, Malathi Munisamy, and Nidhi Singh

Subjects
Adverse cutaneous reactions, cancer, chemoradiation, chemotherapy, Dermatology, RL1-803
Abstract

Background: With the introduction of newer anti-cancer agents, the adverse effects have become more rampant which call for concern in the treatment of patients with cancer. Hence, the assessment and management of dermatological adverse effects of anti-cancer therapy have become a significant part of the care of patients with cancer and require proper and close collaboration between the dermatologists and the oncologists. Aims: To assess the frequency and pattern of mucocutaneous adverse reactions to cancer chemotherapy and chemoradiation and grade them according to their severity and to identify hematological and biochemical changes related to cancer chemotherapy-induced mucocutaneous adverse reactions. Materials and Methods: This was a descriptive study done among 226 patients in an Indian tertiary care hospital, who presented with mucocutaneous adverse reactions to either chemotherapy alone or combination of chemotherapy and radiation to dermatology, medical oncology and radiotherapy outpatient departments. Detailed history and examination were undertaken. Visual analog score (VAS) was employed to quantify pain and pruritus. Correlation of various biochemical and hematological parameters with chemotherapy-induced adverse reactions was attempted and grading of adverse reactions was done based on the severity scale of Common Terminology Criteria for Adverse Events (CTCAE). Results: The common cutaneous adverse reactions observed in our study were nail changes (194 patients; 85.84%), followed by skin changes (191; 84.51%), hair changes (159, 70.35%), mucosal changes (34, 15.04%), and other miscellaneous manifestations. Grade 1 manifestations comprised of 49.91% of total manifestations followed by Grade 2 (45.45%) and Grade 3 (5.64%). In addition to bleomycin, other chemotherapeutic agents also had been shown to produce flagellate dermatitis in our study. Conclusion: Nail changes, skin changes, hair changes and mucosal changes occurred frequently as a significant side effect of chemotherapy, which a physician should be aware of, while selecting a chemotherapeutic drug.

Published
2019
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10. Association between psychiatric morbidity, coping, and quality of life in psoriasis: A cross-sectional study

Author

Vaditya Lakshmi Momini, Vikas Menon, and Malathi Munisamy

Subjects
asia, coping, depression, gender, psoriasis, Medicine
Abstract

Background: Psychological factors are key determinants of outcomes in psoriasis. Little is known about burden of psychological morbidity, coping styles of patients with psoriasis, and relationship between coping styles, psychiatric morbidity, and quality of life (QoL) in this group. Methods: A cross-sectional, comparative study was carried out on cases with psoriasis and apparently healthy age- and gender-matched controls (n = 72 each). Both groups were compared on depression, anxiety, QoL, and coping preferences using standard measures. Multiple linear regression (MLR) analysis was used to assess predictors of depression and anxiety in psoriasis. Results: Cases with psoriasis had less schooling (P < 0.001) and belonged to lower socioeconomic class (P = 0.005). They also preferentially used emotion-focused coping strategies (P = 0.007) compared to controls and scored higher on depression and anxiety and had poorer QoL across all domains (P < 0.001 for all comparisons). In MLR analysis, female gender (B = 3.04, 95% confidence interval [CI] = 1.22–4.86, P = 0.001), lower QoL (B = −0.06, 95% CI = −0.12–−0.01, P = 0.033), and higher anxiety (B = 0.68, 95% CI = 0.45–0.91, P < 0.001) were the predictors of depression while higher depression (B = 0.57, 95% CI = 0.39–0.76, P < 0.001) predicted anxiety in psoriasis. Conclusion: Significantly, higher psychiatric morbidity, poorer QoL, and maladaptive coping are present in patients with psoriasis when compared with controls. Gender appears to be an important moderator in the relationship between psoriasis and depression.

Published
2019
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11. Dermoscopy in Vitiligo

Author

Thappa, Devinder Mohan, Chandrashekar, Laxmisha, Malathi, Munisamy, Handog, Evangeline B., editor, and Enriquez-Macarayo, Maria Juliet, editor

Published
2017
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12. Pubertal Acne

Author

Thappa, Devinder Mohan, Malathi, Munisamy, Kumanov, Philip, editor, and Agarwal, Ashok, editor

Published
2016
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13. Cutaneous manifestations in disorders of hepatobiliary system

Author

Shashi K Godara, Devinder M Thappa, Biju Pottakkatt, Abdoul Hamide, Jagadisan Barath, Malathi Munisamy, and Minu J Chiramel

Subjects
Hepatitis, liver disorders, skin changes, Dermatology, RL1-803
Abstract

Background: Hepatobiliary diseases are associated with various mucocutaneous changes that are directly and indirectly associated with these diseases. There is a dearth of studies from India dealing with cutaneous manifestations in liver disorders. Aim: This study was conducted to know the spectrum of cutaneous changes and their correlation with liver function tests in patients with disorders of hepatobiliary system. Methods: This was a descriptive study conducted among in patients and outpatients with primary hepatobiliary disorders at a tertiary care center in South India. Detailed history taking and examination was done. Visual analog score (VAS) and 5D itch score was employed to quantify pruritus. Correlation of liver function tests with pruritus and comparison of skin changes in the major disease groups was attempted. Results: A total of 303 patients were recruited. Hepatic mass/malignancy followed by nonalcoholic liver disease were the most common diagnoses. Icterus followed by pruritus were the most common cutaneous complaints. The mean VAS and 5D itch scores among the patients with pruritus were 4.7 ± 1.9 and 13.6 ± 4.9. The most common mucocutaneous findings observed were icterus (241 patients; 79.5%), ichthyosis/xerosis (172 patients; 56.7%), pallor (131 patients; 43.2%), excoriations (118 patients; 38.9%), hyperpigmented palmar creases (118 patients; 38.9%), clubbing (113 patients; 37.2%), and pedal edema (85 patients; 28%).There was statistically significant correlation between serum bilirubin levels and pruritus. Conclusion: The common mucocutaneous manifestations associated with primary hepatobiliary disorders were icterus, ichthyosis/xerosis, pallor, excoriations, hyperpigmented palmar creases, clubbing, and pedal edema.

Published
2017
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14. Is the Ratio of Antibodies Against Oxidized LDL to Oxidized LDL an Indicator of Cardiovascular Risk in Psoriasis?

Author

Medha Rajappa, Devinder Mohan Thappa, Laxmisha Chandrashekar, Malathi Munisamy, and G. Revathy

Subjects
Psoriasis, Oxidized Low Density Lipoprotein, Oxidative Stress, Cardiovascular Disease, Medicine
Abstract

Objectives: Psoriasis is a chronic inflammatory skin disease. Chronic inflammation results in increased oxidative stress and oxidizes lipoproteins, increasing their atherogenicity. This study sought to estimate the levels of oxidized low-density lipoprotein (ox-LDL) and antibodies against oxidized LDL (anti-ox-LDL) and compute the ratio of anti-ox-LDL/ox-LDL as a single composite parameter to assess the oxidative lipoprotein burden as an indicator of cardiovascular risk in patients with psoriasis. Methods: This cross-sectional study included 45 patients with psoriasis. All patients were given a psoriasis severity index score and their ox-LDL and anti-ox-LDL estimated using ELISA. Results: The results of this study show an elevation in the ratio of anti-ox-LDL to ox-LDL in patients with psoriasis, which initiate and perpetuate the pathogenesis of psoriasis and its comorbidity, atherosclerotic cardiovascular disease. Conclusions: Our results suggest that an elevated ratio of anti-ox-LDL/ox-LDL can serve as a composite parameter reflecting the total oxidative lipoprotein burden and cardiovascular risk in psoriasis patients.

Published
2016

15. Papillomatous plaque in an infant

Author

Irene Mathews, Malathi Munisamy, Krishana Kumar Govindarajan, Bheemanathi H. Srinivas, and Bhawna A. Badhe

Subjects
Pediatrics, Perinatology and Child Health, Dermatology
Published
2023
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16. Is Patch Test Necessary in Children to Solve the Clinical Conundrum of Foot Eczema

Author

Aravind, Sivakumar, Malathi, Munisamy, and Laxmisha, Chandrashekar

Subjects
Foot Diseases, Dermatitis, Allergic Contact, Eczema, Irritants, Humans, Immunology and Allergy, Rubber, Dermatology, Allergens, Patch Tests, Child, Coloring Agents, Dermatitis, Atopic
Abstract

Foot eczema in children is a commonly encountered condition but is associated with diverse etiology, thereby posing a diagnostic challenge. These include atopic eczema, juvenile plantar dermatoses, irritant contact dermatitis, and allergic contact dermatitis. Because of the diverse etiology, it is often difficult to distinguish between the conditions clinically, thereby warranting patch testing for the correct diagnosis.The study was conducted to determine the frequency of positive patch tests among children with foot eczema and to compare them with children with and without atopy.This was a prospective observational study done on 86 children aged 4 to 17 years presenting with foot eczema in whom patch testing was done using Indian standard series and footwear series and patients' own footwear.The clinical diagnosis of foot eczema in our study was allergic contact dermatitis (37%), followed by atopic eczema (30%), juvenile plantar dermatoses (17%), and lichen simplex chronicus (15%). Patch test positivity was present in 36% of the cases with clinical relevance in 65% of the cases. The common allergens were rubber allergens and disperse dyes. Of the children who were patch tested, highest patch test positivity rates were seen in allergic contact dermatitis (50%) and juvenile plantar dermatoses (53%). No significant differences were observed with regard to patch test positivity or relevance between children with and without atopy.The diagnosis of foot eczema in children cannot be made on clinical grounds alone, and patch testing should be recommended in children with any morphological pattern of foot eczema irrespective of presence or absence of atopy, especially in those with long-standing and recalcitrant disease with frequent exacerbations.

Published
2022
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19. Utility of high‐frequency ultrasound in assessing cutaneous edema in venous ulcer patients

Author

Malathi Munisamy, Shakthi Pragasam, Devinder Mohan Thappa, and Rashmi Kumari

Subjects
medicine.medical_specialty, Dermatology, 01 natural sciences, Varicose Ulcer, 010309 optics, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Edema, 0103 physical sciences, Cutaneous edema, medicine, Humans, Skin, Ultrasonography, business.industry, Leg Ulcer, Ultrasound, Pathogenic factor, Echogenicity, Percentage reduction, Compression therapy, Venous Insufficiency, Radiology, medicine.symptom, business, High frequency ultrasound
Abstract

Background High-frequency ultrasound (HFUS) using a 20 MHz probe is a non-invasive assessment tool. Its utility in dermatology for diagnosis of disease or for monitoring of treatment response in various dermatological conditions is still being explored. Edema secondary to venous hypertension is the main pathogenic factor in the development of venous leg ulcers. However, there is no objective method for assessment of degree of edema. In this study, we explore the utility of high-frequency ultrasound in assessing cutaneous edema and for monitoring its improvement with compression therapy among patients with venous ulcer. Materials and methods Twenty patients with venous ulcer were enrolled in the study. Measurement of cutaneous edema was done at baseline and after 2 weeks of compression therapy in all patients. The 3 levels of measurement were dorsum of foot (low site, L1), 4 cm proximal to the medial malleolus (middle site, L2), and the medial aspect of the calf between the medial malleolus and the knee (upper site, L3). Results Baseline subepidermal low echogenic band (SLEB) measurements were 2.46 ± 0.69 mm, 2.94 ± 0.65 mm, and 2.66 ± 0.64 mm at L1, L2, and L3, respectively. There was a significant reduction in SLEB measurement after compression therapy ( p values 0.008, 0.002, and 0.003 at L1, L2, and L3, respectively). The mean percentage reduction in SLEB at level of medial malleolus (mid level - 29.61 ± 12.24) was higher than the other 2 sites (L1-22.45 ± 15.83 and L3 were 27.57 ± 12.34). Conclusion Cutaneous ultrasound aids in accurate assessment of level and severity of edema. Hence, it can be utilized in trials to objectively assess the adequacy of treatment for patients with venous insufficiency.

Published
2021
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22. Recommendations for management of childhood psoriasis

Author

P S S Ranugha, T Narayana Rao, Sandeep Gupta, Maitreyee Panda, KA Seetharam, Minu Jose Chiramel, Bhumesh Kumar Katakam, and Malathi Munisamy

Subjects
medicine.medical_specialty, business.industry, Dermatology, systemic, medicine.disease, Clinical Practice, Childhood psoriasis, RL1-803, recommendations, Medicine, Co morbidity, Pediatric dermatology, Disease management (health), Metabolic syndrome, business, Intensive care medicine, Symposium Article: IADVL SIG Pediatric Dermatology (IADVL Academy), co-morbidity, childhood psoriasis, phototherapy, topical
Abstract

Childhood psoriasis is recognized as a potential multisystem disorder and hence it is imperative to optimize disease management to arrest progression, minimize psychological burden and evolution of metabolic syndrome. Clinical practice recommendations are necessary to assist practitioners in appropriate decision making based on available evidence. Owing to the lack of Indian recommendations on childhood psoriasis, the SIG Pediatric Dermatology under IADVL Academy undertook an evidence-based approach based on published literature on the topic, between January 2000 and July 2020 to frame the recommendations.

Published
2021

23. Effect of vitamin D supplementation on clinical outcome and biochemical profile in South Indian population with vitamin D-deficient chronic urticarial – A randomized double-blind placebo controlled trial

Author

Laxmisha Chandrashekar, Medha Rajappa, Archana Mony, Sandhiya Selvarajan, Malathi Munisamy, and Jayaprakash Sahoo

Subjects
0301 basic medicine, Vitamin, medicine.medical_specialty, Urticaria, Vitamin D-binding protein, Clinical Biochemistry, Placebo-controlled study, Systemic inflammation, Placebo, Biochemistry, Gastroenterology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, law, Internal medicine, medicine, Vitamin D and neurology, Humans, Vitamin D, Inflammation, biology, business.industry, Biochemistry (medical), C-reactive protein, General Medicine, Vitamin D Deficiency, 030104 developmental biology, chemistry, 030220 oncology & carcinogenesis, Dietary Supplements, biology.protein, medicine.symptom, business
Abstract

Background Chronic urticaria (CU) is a debilitating inflammatory skin disease. Prior studies have shown reduced concentrations of vitamin D in CU and there are limited reports of potential beneficial role for vitamin D supplementation in the treatment of subjects with CU. We assessed the effect of vitamin D supplementation in vitamin D deficient CU patients on the clinical outcome and inflammatory markers in South Indian patients with CU. Methods This randomized controlled trial involved 120 vitamin-D deficient CU patients. Urticaria activity score (UAS7) and autologous plasma skin test (APST) status was assessed in all cases. CU patients were supplemented with vitamin D with a dose of 60,000 IU fortnightly for a period of 12 weeks and those in the placebo arm received matched placebo. Five milliliters of blood was drawn from all study subjects at baseline and after 12 weeks for assessing inflammatory markers. Results We observed a significant reduction in UAS7 scores after 12 weeks in the vitamin D treated group in comparison to that of placebo. We also noted a significant reduction of the inflammatory cytokines in the vitamin D treated group. Conclusion Supplementation with vitamin D among patients with vitamin D deficient CU significantly decreases disease severity which is probably mediated through reduction of systemic inflammation.

Published
2020
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26. Is vitiligo associated with systemic aquaporin-3 deficiency?

Author

Kalai Selvi Rajendiran, Medha Rajappa, Laxmisha Chandrashekar, and Malathi Munisamy

Subjects
vitiligo, aquaporin-3, Aquaporin, Vitiligo, Dermatology, medicine.disease_cause, chemistry.chemical_compound, Disease severity, medicine, Immunology and Allergy, oxidative stress, In patient, skin and connective tissue diseases, Internal medicine, PI3K/AKT/mTOR pathway, Original Paper, integumentary system, business.industry, medicine.disease, Malondialdehyde, RC31-1245, chemistry, Aquaporin 3, RL1-803, Immunology, business, Oxidative stress
Abstract

Introduction Recent studies on pathomechanisms of vitiligo have focused on the abnormality of keratinocytes that affect the melanocytes. Aquaporin-3 (AQP3) was implicated as a mechanism for keratinocyte apoptosis owing to the relationship between the PI3K/AKT pathway and the E-cadherin-catenin complex. Aim Based on this evidence, we undertook a cross-sectional study to assess the skin and blood AQP-3 levels in patients with non-segmental vitiligo in comparison to controls and to correlate these levels with malondialdehyde (MDA) levels and total antioxidant status (TAS) in the skin and blood of patients with non-segmental vitiligo and also with their disease activity. Material and methods Thirty-six patients with non-segmental vitiligo and 36 controls were included in this study. AQP3, TAS and MDA levels were assayed both in skin as well as in circulation. Results We observed that skin and plasma aquaporin and TAS were lowered and MDA levels were increased in patients with non-segmental vitiligo as compared to controls. There was a significant negative correlation of skin and plasma aquaporin levels with disease activity. We also observed the local and systemic AQP3 deficiency to correlate with the local and systemic oxidative stress in vitiligo. Conclusions Our results demonstrate a systemic and local AQP3 deficiency in vitiligo correlating with the disease severity and oxidative stress which might have therapeutic implications.

Published
2021

29. A Novel Desensitization Protocol for Infliximab Hypersensitivity in a 13-Year Old Patient with Pustular Psoriasis

Author

Saibal Das, Chandana Shajil, Jerene Mathews, Alphienes Stanley Xavier, Sapan Kumar Behera, Sandhiya Selvarajan, and Malathi Munisamy

Subjects
030203 arthritis & rheumatology, Pharmacology, Pediatric intensive care unit, Pediatrics, medicine.medical_specialty, Future studies, business.industry, medicine.medical_treatment, Pustular psoriasis, Toxicology, medicine.disease, Infliximab, Hypersensitivity reaction, 03 medical and health sciences, 0302 clinical medicine, Psoriasis, Medicine, 030211 gastroenterology & hepatology, Pharmacology (medical), business, medicine.drug, Desensitization (medicine)
Abstract

Background: Drug hypersensitivity reactions to infliximab have been reported in pediatric patients. At times, these patients may need infliximab administration in spite of hypersensitivity. However, only a few reports of desensitization protocols are available in the literature in pediatric patients. Case Report:We report a case of immediate hypersensitivity reaction to intravenous infliximab in a 13-year-old child suffering from pustular psoriasis who eventually underwent a 14 step desensitization protocol for the administration of infliximab in a pediatric intensive care unit. Results and Conclusion:Although our desensitization protocol was safe and effective, we recommend the entire desensitization procedure to be performed under the supervision of experienced personnel in a pediatric intensive care unit. Future studies with larger sample size are needed to confirm our findings.

Published
2019
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32. IDDF2020-ABS-0212 Esophageal cancer in plummer vinson syndrome: is lichen planus a missing link?

Author

Abdoul Hamide, Pazhanivel Mohan, K Senthamizh Selvan, and Malathi Munisamy

Subjects
medicine.medical_specialty, business.industry, Cancer, Esophageal cancer, medicine.disease, Gastroenterology, digestive system diseases, stomatognathic diseases, Plummer–Vinson syndrome, medicine.anatomical_structure, Internal medicine, Cohort, medicine, Sex organ, Oral lichen planus, Esophagus, business, Prospective cohort study
Abstract

Background Esophageal cancer is the sixth leading cause of cancer-related mortality worldwide. The risk factors are variable and are based on ethnicity, geographic location and pathological type. The well-established factors include alcohol, tobacco, dietary factors, nutritional deficiencies, environmental carcinogen exposure and chronic irritation of the esophagus. Although Plummer Vinson syndrome (PVS) and Lichen planus (LP) are known independent risk factors, they have never been reported together to cause esophageal squamous cell cancer (ESCC). Hence this association was studied in our cohort of PVS. Methods We reviewed patients with ESCC and PVS from 2013 to 2020 to study their demographic and clinico-pathological characteristics. All these patients underwent dermatological examination for the presence of lichen planus. Results A total of 170 patients were diagnosed with esophageal webs during this period. Nine patients with PVS were diagnosed with ESCC. Six patients had cancer along with webs at the time of diagnosis while three developed ESCC during follow up after endoscopic dilation of webs. There was a female preponderance (Male: Female=1:8) with a mean age of 50 years. ESCC was located in the upper esophagus in two, mid esophagus in three, and lower esophagus in four patients. There was no history of alcohol consumption or tobacco use in any of the patients. Histologically, ESCC was well-differentiated in one and moderately differentiated in 8 patients. Oral LP was observed in four patients, genital LP in one patient, oral and genital LP in one patient. Histological evidence of esophageal lichen planus was observed in one out of four patients who underwent mucosal biopsies. Conclusions ESCC occurred in 5.3% of patients with PVS, more than half of whom had associated oral lichen planus. The coexistence of PVS and mucosal LP can increase the predisposition to ESCC, especially in women without conventional risk factors. However, this association needs to be proven in larger prospective studies so as to develop surveillance strategies in regions where PVS, LP and ESCC are highly prevalent.

Published
2020
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34. Interleukin-9 serves as a key link between systemic inflammation and angiogenesis in psoriasis

Author

M. Priyadarssini, Malathi Munisamy, G. Priyadarshini, P.S. Mohan Raj, H.S. Midde, Sandeep Kumar Singh, and Medha Rajappa

Subjects
Oncology, Adult, Male, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Dermatology, Systemic inflammation, Proinflammatory cytokine, Cohort Studies, 030207 dermatology & venereal diseases, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Reference Values, Psoriasis, Internal medicine, medicine, Humans, Interleukin 9, Inflammation, Neovascularization, Pathologic, business.industry, Interleukin-17, Interleukin-9, Patient Acuity, Interleukin, Dermatology Life Quality Index, Middle Aged, medicine.disease, Vascular endothelial growth factor, chemistry, 030220 oncology & carcinogenesis, Case-Control Studies, Quality of Life, Methotrexate, Female, medicine.symptom, business, medicine.drug
Abstract

Background Psoriasis is a T helper cell-mediated chronic immune-mediated inflammatory disease affecting mainly the skin, although systemic pathological effects are also observed. Cytokine-mediated interaction between T lymphocytes and keratinocytes lead to excessive proliferation of keratinocytes, which in turn leads to formation of a proinflammatory milieu and finally to psoriatic plaque formation. Aim To measure interleukin (IL)-9, IL-17 and vascular endothelial growth factor (VEGF) levels in patients with psoriasis compared with controls, and to evaluate the effect of methotrexate (MTX) monotherapy on the aforesaid cytokine levels in psoriasis. Methods This cohort study included 54 patients with psoriasis and 54 age- and sex-matched healthy controls (HCs). IL-9, IL-17 and VEGF levels were measured by using commercially available ELISA kits. Patients with psoriasis who were on MTX monotherapy were followed up for a period of 3 months. Results Patients with psoriasis had increased levels of IL-9, IL-17 and VEGF at baseline, compared with the HC group. After 3 months of MTX monotherapy, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI) and levels of cytokines (IL-9, IL-17 and VEGF) were significantly decreased compared with baseline. PASI and DLQI at baseline also showed a positive correlation with IL-9, IL-17 and VEGF. Conclusion Our results suggest the existence of a proinflammatory milieu in psoriasis, with increased levels of IL-9, IL-17 and the proangiogenic growth factor VEGF, showing an increasing trend with increasing disease severity and impaired quality of life (QoL). MTX treatment helps to reduce levels of IL-9, IL-17 and VEGF, thereby limiting disease progression and improving QoL in psoriasis.

Published
2020

36. An investigation of vitamin D status in alopecia areata

Author

Medha Rajappa, Malathi Munisamy, Venkata Krishna Vamsi Gade, Laxmisha Chandrashekar, and Archana Mony

Subjects
medicine.medical_specialty, Alopecia Areata, Systemic inflammation, Gastroenterology, General Biochemistry, Genetics and Molecular Biology, vitamin D deficiency, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Blood serum, Internal medicine, Vitamin D and neurology, Humans, Medicine, Vitamin D, Hematology, integumentary system, biology, business.industry, C-reactive protein, Case-control study, General Medicine, Alopecia areata, Vitamin D Deficiency, medicine.disease, C-Reactive Protein, 030220 oncology & carcinogenesis, Disease Progression, biology.protein, medicine.symptom, business
Abstract

Alopecia areata (AA) is a type of non-scarring, recurrent patchy loss of hair in hair-bearing areas and is mostly of autoimmune origin. Previous studies have suggested that some autoimmune diseases were found to be associated with vitamin D deficiency. The current study was designed to assess the levels of serum 25-hydroxy vitamin D and C-reactive protein in AA, as compared with controls and to further identify the association between vitamin D levels and disease severity in patients with AA. This cross-sectional study included 45 patients with AA and 45 healthy volunteers. Clinical and anthropometric parameters were recorded, according to a pre-designed proforma. Serum 25-hydroxy vitamin D and high-sensitivity C-reactive protein were estimated using ELISA kits. The severity of AA was determined using Severity of Alopecia Tool (SALT) score. We observed a significant rise in systemic inflammation as seen by elevated high-sensitive C-reactive protein levels and lowered 25-hydroxy vitamin D levels in patients with alopecia areata, compared to controls (p = 0.001). The levels of 25-hydroxy vitamin D showed a significant negative correlation with disease severity, while hs-CRP levels showed a significant positive correlation with disease severity (ρ = - 0.714, p = 0.001 and ρ = 0.818, p = 0.001). Our results suggest significant systemic inflammation and vitamin D deficiency in alopecia areata, more so with increasing disease severity. This gains particular importance in the treatment of alopecia areata in future, as supplementing vitamin D to AA patients would result in reducing the disease severity and inducing remission.

Published
2018
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41. Xanthoma Disseminatum Presenting with Hoarseness

Author

Behera, Biswanath, Malathi, Munisamy, Thappa, Devinder-Mohan, Vamanshankar, Hemanth, Parida, Pradipta-Kumar, and Gochhait, Debasis

Subjects
Hoarseness, Vocal cord, Case Report, lcsh:Otorhinolaryngology, lcsh:RF1-547, Xanthoma
Abstract

Introduction: Xanthoma disseminatum (XD) is a rare, benign, non-Langerhans cell histiocytic disorder with unknown etio-pathology. It manifests with multiple, grouped, red-brown to yellow papules and nodules involving the skin, mucous membranes, and internal organs with a predilection for flexures and the face. Case Report: We report a patient who presented with disseminated xanthomatous papules and nodules involving the face, neck, trunk, axilla, groin, and oral cavity, along with hoarseness of voice. Video laryngoscopy revealed multiple yellowish nodules over the base of the tongue, vallecula, laryngeal surface of the epiglottis, ary-epiglottic folds, interarytenoid region, and subglottic region. Histopathology was suggestive of xanthoma disseminatum and the patient was treated with tablet acitretin 25mg daily for three months without any response. Following this, the patient was prescribed tablet thalidomide 100 mg daily without any significant improvement at the end of two months. Conclusion: Xanthoma disseminatum is a very rare form of non-Langerhans cell histiocytosis that classically presents with cutaneous xanthomas, mucosal xanthomas, and diabetes insipidus. Hoarseness of voice due to lesions involving the larynx is a rare symptom. Because the disease has punctated, numerous relapses and causes morbidity to the patient, its multisystem manifestations have to be known. Therefore, xanthoma disseminatum has to be kept in mind as a differential diagnosis for hoarseness of voice.

Published
2017

42. Dysphagia in an elderly woman with diabetes mellitus: What is your call?

Author

Pazhanivel Mohan and Malathi Munisamy

Subjects
Diagnostic Challenge, Pediatrics, medicine.medical_specialty, business.industry, Lichen Planus, Gastroenterology, medicine.disease, Dysphagia, Diagnosis, Differential, Esophagus, Diabetes Mellitus, Type 2, Diabetes mellitus, Medical Illustration, medicine, Humans, Female, medicine.symptom, Deglutition Disorders, business, Aged
Published
2020
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43. Atypical discoid eczema-like presentation of Hailey-Hailey disease

Author

Balasundaram Mithin Kumar, Arunachalam Narayanan, Nachiappa Ganesh Rajesh, Sushmitha Dharanisankar, Logamoorthy Ramamoorthy, and Malathi Munisamy

Subjects
medicine.medical_specialty, Hailey–Hailey disease, business.industry, Discoid eczema, medicine, Presentation (obstetrics), medicine.disease, business, Dermatology
Published
2021
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46. Abstracts from the 4th World Congress of the International Dermoscopy Society, April 16-18, 2015, Vienna, Austria

Author

Michael A. Marchetti, Alexandros Stratigos, Claudia Jaeger, Nanja van Geel, Erika Varga, Rachel M Bowden, Nebojsa Pesic, Lauren A. Penn, Francesca Farnetani, Irena Walecka, Otto S. Wolfbeis, Anna Pogorzelska-Antkowiak, Małgorzata Zadurska, Miriam A. Jesús Silva, Mari Grönroos, Fabrizio Ayala, Claudia Sprincenatu, Ausilia Maria Manganoni, Jhonatan Rafael S. Pinheiro, Vincent Descamps, Era C. Murzaku, Josephine Rau, Christian Landi, Josep Malvehy, Othon Papadopoulos, Renato Talamini, Savitha L. Beergouder, Adrian Ballano Ruiz, Karina Scandura, Flavia Persechino, Yunxian Tian, Mark Berneburg, Iara Drakensjö, Luis Javier Del pozo, Elizabeth Lazaridou, Marwah A. Saleh, Wei Zhang, Dalal Mosaad, Aida Carolina Medina, Alka Lalji, Robabeh Abedini, FZ Debagh, Ligia Brzezinska-Wcislo, Nurşah Doğan, Naglaa Ahmed, Tamerlan Shaipov, Ritta Khoury, Lidija Kandolf-Sekulovic, Aldo Bono, Luis Angel Vera, Naotomo Kambe, Jaka Rados, Sergio Talarico, Milvia Maria S. E. S. Enokihara, Iris Zalaudek, Malgorzata Maj, Francesca Specchio, Paloma Arribas, Nazan Emiroglu, Andreea Ioana Popescu, Irina Sergeeva, Virginia Chitu, Michael Kirschbaum, Sergio Yamada, Niken Wulandari, Rotaru Maria, Lore Pil, Lieve Brochez, Anthony Azzi, Vasiliy Y. Sergeev, Raimonds Karls, Zeynep Topkarci, Tanja Planinsek Rucigaj, Osvania Maris, Graham J. Mann, Timótio Dorn, Lubomir Drlik, Pilar Iranzo, Sara Minghetti, Michael Noe, Ahmet R Akar, Jesus Cuevas Santos, Laura Raducu, Salim Ysmail-Dahlouk, Laura Mazzoni, Sidharth Sonthalia, Neşe Çallı Demirkan, Yaei Togawa, Branislava Gajic, Ayelet Rishpon, Chih-Hsun Yang, Barbara Boone, José Luis López-Estebaranz, Markus Albert, George Evangelou, André L.M. Oliveira, Ioana Gencia, Nada Vuckovic, Rosa Perelló, Ana Maria Draganita, Michel Colomb, Ayse Cefle, Hongguang Lu, Annarosa Virgili, Hayriye Saricaoglu, Esther A.W. Wolberink, Michael Russu, Elisabeth Arnoult-Coudoux, Caroline Nicaise-Bergère, Aleksandra M Ignjatović, Necmettin Özdemir, Kristīne Zabludovska, Cemal Bilaç, Jose Luis Lopez Estebaranz, Marie-Christine Lami, Harold S. Rabinovitz, Izabel Bota, Damien Grivet, Dimitrije Brasanac, Andrei Jalba, Joep Hoevenaars, Sofie De Schepper, Deniz Duman, Vladimir Vasku, Anna Belloni Fortina, Rosa Cristina Coppola, Marion Chavez-Bourgeois, Hoon-Soo Kim, Zamira Barragan, Julia Welzel, Thomas Ruzicka, Patricia V. Cristodor, Pierfrancesco Zampieri, Michael Lanthaler, Marc Haspeslagh, Jürgen Christian Becker, Gamze Erfan, Tanja Maier, Hui Mei Cheng, Mauro Enokihara, Ana Arance, Emel Dikicioglu Cetin, Pranaya A. Bagde, Mona M. Elfangary, Stefano Cavicchini, Alicia Barreiro, Odivânia Krüger, Mariana Petaccia Macedo, Itziar Erana Tomas, Elimar Elias Gomes, Monika Vrablova, Marcio Lorencini, Javier Alcántara González, Giuseppe Micali, Kerstin Kellermann, Mauricio Mendonca do Nascimento, Elisabeth Mt Wurm, Elena Sánchez-Largo Uceda, Yury Sergeev, Céleste Lebbé, Manfred Fiebiger, Gisele Gargantini Rezze, Antonio Graziano, Ana Pampín, Márcia Ferreira Candido, Martine Bagot, Jan Lapins, Nahide Onsun, Daniela Göppner, Katie Lee, Josef Schröder, Gisele G Rezze, Reyes Gamo, Mauricio Soto-Gamboa, Giovanni Pellacani, Maria Luiza P. Freitas, Mizuki Sawada, Hyun-Chang Ko, Ramon M Pujol Vallverdú, Jin gyoon Park, Peter Weber, Alberto Mota, Theofanis Spiliopoulos, Renata B. Marques, Daiji Furusho, Barbora Divisova, Pascale Guitera, Johan Heilborn, Alexandr Fedoseev, Athanasios Kyrgidis, Zakia Douhi, Mariame Meziane, Florent Grange, Alister Lilleyman, Juliana C. Marques-Da-Costa, Mitsuyasu Nakajima, Camilla Reggiani, Marina Meneses, Anna Sokolova, Zoe Apalla, Leo Čabrijan, Tim Lee, Piergiacomo Calzavara-Pinton, Tomas Fikrle, Georgios Chaidemenos, Braun Ralph, Aikaterini Patsatsi, Ekin Şavk, Marcela Pecora Cohen, Ioannis Efstratiou, Gurol Acikgoz, Pietro Quaglino, Nati Angelica, Luc Thomas, Edileia Bagatin, Kedima C. Nassif, Dimitrios Sotiriadis, Regina Fink-Puches, Anna Maria Wozniak, Salvador González, Agnieszka Buszko, Fezal Ozdemir, Banu Yaman, Vishnu Moodalgiri, Anne Grange, Robert J Meier, Davorin Loncaric, Fatmagül Keleş, Renato Marchiori Bakos, Sergio Chimenti, Sebastian Podlipnik, Pınar Incel Uysal, Devinder M Thappa, Nida Kaçar, Emel Bulbul Baskan, Erna Snellman, Pietro Rubegni, J. Kreusch, Hae Jin Pak, Danijela Dobrosavljevic Vukojevic, Bengü Nisa Akay, Holger A. Haenssle, Horacio Cabo, Anna Rammlmair, Fred Godtliebsen, Chiara Ferrari, Hiroshi Sakai, Christina Kemanetzi, Åsa Ingvar, Jitka Suchmannova, Zlata Janjic, Samira Zobiri, Haishan Zeng, Emine Böyük, Antonello Felli, Je-Ho Mun, Pablo Fernández Peñas, Ercan Caliskan, Satish S. Udare, Borna Pavičić, Max Hundeiker, Cristel Ruini, A. Hakan Cermik, Ülker Gül, Auro ra Parodi, Timothy P. Wu, Bernardo Gontijo, Ivan Klyuzhin, Gabriela Turcu, Sylvia Aidé Martínez-Cabriales, Francisco Alcántara Nicolás, Inge A. Krisanti, Sandra Cecilia García-García, Meriem Benfodda, Nika Madjlessi, Paraskevi Karagianni, Gizem Yağcıoğlu, Didem Dizman, Danielle I. Shitara, Nilda Eliana Gomez-Bernal, Mirna Šitum, Natalia Ilina, Job Van Der Heijden, Małgorzata Kwiatkowska, Bota Izabel, Ismini Vassilaki, Irene Potouridou, Jorge Luis Rosado, Lukas Prantl, María-José Bañuls, Fernando N. Barbosa, Seitaro Nakagawa, Jana Dornheim, Hitoshi Iyatomi, Rifat Saitburkhanov, Çiğdem Çağlayan, Natalie Ong, Stefano Gardini, Temeida Alendar, Zrinka Rendić-Miočević, Ryuhei Okuyama, Wafae Bono, Olga Warszawik-Hendzel, Danica Tiodorovic-Zivkovic, Alise Balcere, Ramazan Kahveci, Sebastian Gehmert, Herbert M. Kirchesch, Fernando Javier Pinedo, Raul Niin, Dan Savastru, Andreas Blum, Valeria Coco, Alexander C. Katoulis, Yosuke Yamamoto, Mumtaz Jabeen, Louise De Brot Andrade, Lidia Rudnicka, Pierre Wolkenstein, Fatma Pelin Cengiz, Woo-il Kim, Rainer Hofmann-Wellenhof, Tine Vestergaard, Maria Valeria B. Pinheiro, Ana Filipa Pedrosa, Caroline M. Takigami, Nilgün Bilen, Feroze Kaliyadan, Lotte Themstrup, Awatef Kelati, Katrien Vossaert, Burak Sezen, Natalia Jaimes, Olga Zhukova, Peter Jung, Nidhi Singh, Uxua Floristan, Ivette Alarcon, Michel Baccard, Flávia V. Bittencourt, Nicolas Dupin, Neslihan Şendur, Flavia Boff, Lydia Garcia Gaba, João Pedreira Duprat Neto, Caius Solovan, Byung Soo Kim, Anamaria Jović, Toshitsugu Sato, Antoni Bennassar, Ilkka Pölönen, Svetlana Rogozarski, Agnieszka Kardynał, Harald P.M. Gollnick, Anastasia Trigoni, Harvey Lui, Hiroshi Koga, Dai Ogata, Zeynep N. Saraçoğlu, Nilton B Rodrigues, Ketty Peris, Vanessa da Silva, Akira Hamada, Monica Corazza, Azmat A. Khan, Cengizhan Erdem, Victor Desmond Mandel, Sabina Zurac, Laura Elena Barbosa-Moreno, Filomena Azevedo, Matsue Hiroyuki, Philippe Saiag, Kara Shah, Stephen W. Dusza, Margaret Song, Francesca Giusti, Lidija Zolotarevski, Romain Vie, Rutao Cui, Aylin Okçu Heper, Kerstin Wöltje, Kyoko Tonomura, Charlotte H. Vuong, Moira Ragazzi, Marta Andreu Barasoain, Stephan Schreml, Branka Marinović, Mona R E Abdel Halim, Selimir Kovacevic, Noriaki Kamada, Adriana Garcia-Herrera, Ayse S. Filiz, Helena Collgros, Joan A. Puig-Butille, Ulvi Loite, Meng-Tsan Tsai, Nele Degryse, Philipp Tschandl, Seiichiro Wakabayashi, Korina Tzima, Kari Nielsen, Edith Arzberger, Alain Archimbaud, Makiko Miyamoto, Steffen Emmert, Katharine Hanlon, Stefano Astorino, Andre Sobiecki, Trevino A Pakasi, Giovanni Ghigliotti, Arzu Karataş Toğral, Sara Bassoli, Mahdi Akhbardeh, Martina Ulrich, Mirna Bradamante, Gökhan Uslu, Ross Flewell-Smith, Mauro Alaibac, Bettina Kranzelbinder, Steven Gazal, Nina Malishevskaya, Mikhail Ustinov, Noora Neittaanmäki-Perttu, Olga Simionescu, Saime Irkoren, Mahsa Ansari, Mustafa Turhan Sahin, Priit Kruus, Jana Janovska, Vesna Gajanin, Giovanni Ponti, Alon Scope, Ozkan Kanat, Cesare Massone, Thomas Schopf, Karolina Hadasik, Magnus Karlsson, Ayça Tan, Ignacio Gómez Martín, Armand Bensussan, Dilara Tüysüz, Saleh M. H. El Shiemy, Ine De Wispelaere, Malou Peppelman, Kenan Aydogan, Christian Teutsch, Ryszard A. Antkowiak, Nathalie De Carvahlo, Fatma Shabaka, Matthias Karasek, Christina Fotiadou, Wael M. Saudi, Matthias Weber, Maria Saletta Palumbo, Elisa Benati, Hana Helppikangas, Mariana Grigore, Leonard Witkamp, Rajiv Kumar, Stella Atkins, Eugene Y. Neretin, Dirk Berndt, Piet E.J van Erp, Alessandro Testori, David Duffy, Steluta Ratiu, Tara Bronsnick, Christoph Rinner, Soo-Han Woo, Federica Ferrari, Gabriela Garbin, Eduardo Nagore, Claus Duschl, Caterina Longo, Daniel Alcala-Perez, Helmut Beltraminelli, Sarah Hedtrich, David C McLean, Bojana Spasic, Martin Laimer, Malgorzata Pawlowska-Kisiel, Bohdan Lytvynenko, Heba I. Nagy Abd El-Gawad, Jean-Luc Perrot, Daška Štulhofer Buzina, Dimitrios Rigopoulos, Christian Hallermann, Jeffrey Keir, Adriana Martín Fuentes, Franz Trautinger, Walter L. G. Machado, Emese Gellén, Tatjana Ros, Gabriella Emri, Pinar Y. Basak, Nilay Duman, Reinhart Speeckaert, Peter Komericki, Maciel Zortea, Raphaela Kaestle, Lucía Pérez Carmona, Masaru Tanaka, Ionela Manole, Calin Giurcaneanu, Cristina Carrera, Jianhua Zhao, Marsha Mitchum, Isil Kilinc Karaarslan, Michael Muntifering, Alice Casari, Nicole Basset-Seguin, Seok-Kweon Yun, Vesna Mikulic, Albert Brugués, Kim-Dung Nguyen, Reshmi Madankumar, Joo-Ik Kim, Anna Skrok, Nicolle Mazzotti, Aomar Ammar-Khodja, Alina Avram, Laxmisha Chandrashekar, Dilek Biyik Ozkaya, Refika F. Artuz, Joanna Czuwara-Ladykowska, Hana Szakos, Dejan M Nikolic, Katarzyna Żórawicz, Georg Duftschmid, Natalia Pikelgaupt, Jorge Ocampo-Candiani, Irdina Drljevic, Canten Tataroglu, Esther Jiménez Blázquez, Philippe Gain, Simonetta Piana, Yunus Bulgu, Lars Dornheim, Bruno Labeille, Helmut Schaider, Nitul Khiroya, Sofia Theotokoglou, Christian Morsczeck, Kalliopi Armyra, Serap Öztürkcan, Shricharit h Shetty, Ozlem Su, Susana Puig, Lina Ivert, Katia Ongenae, Hirotsugu Shirabe, Ardalan Benam, Gustav Christensen, Veronika Paťavová, Adria Gual, Laura Pavoni, Mihaita Viorica Mihalceanu, Slobodan Jesic, Abdurrahman Bugra Cengiz, Jerome Becquart, Yasutomo Mikoshiba, Mattia Carbotti, Marcelo O. Samolé, Margherita Raucci, Sven Lanssens, Maria João M. Vasconcelos, Valeriy Semisazhenov, Fabio Facchetti, Monia Maccaferri, Vincenzo Panasiti, Camila M. Carvalho, Elena Tolomio, Ercan Arca, Celia Badenas, Sonia Segura Tigell, Francesco Lacarrubba, Ruzica Jurakic Toncic, Uday Khopkar, Uwe Seidl, Clóvis Antônio Lopes Pinto, Alice Marneffe, Zhenguo Wu, Josefin Lysell, Malgorzata Olszewska, Marta Ruano Del Salado, Alina Gogulescu, Tarl W. Prow, Christine Fink, Jean-Marie Tan, Milana Ivkov Simic, Mahshid S. Ansari, Stamatina Geleki, Sondang P. Sirait, Flavia Baderca, Marcella N. Silva, Andra Pehoiu, Joost Koehoorn, Ajay Goyal, Maria Dirlei Ferreira de Souza Begnami, Hui-bin Lu, Hoda A. Moneib, Maria Antonietta Pizzichetta, Scott Menzies, Gulsel Anil Bahali, Vesna Tlaker Zunter, Elfrida Carstea, Ines Chevolet, Septimiu Enache, Aysun Şikar Aktürk, Clara Kirchner, Greg Canning, Dina M. Shahin, Incilay Kalay Tugrul, Kristina Opletalova, Lars Hofmann, Mario Santinami, Anna Elisa Verzì, Asunción Vicente, Nathalia Delcourt, null Mernissi, Duru Tabanlıoglu Onan, Dorothy Polydorou, Irma Korom, Sara Moreno Fernández, Salim Gallouj, Annamari Ranki, Riina Hallik, Saduman Balaban Adim, Erietta Christofidou, Gustavo D. C. Dieamant, Vincenzo De Giorgi, Gregor B.E. Jemec, Kajsa Møllersen, Monisha lalji, Georgiana Simona Mohor, Hans-Jürgen Schulz, Justin R Sharpe, Karinna S. Machado, Efterpi Demiri, Mohammed I. AlJasser, Jelena Stojkovic-Filipovic, Harald Kittler, José M. A. Lopes, Adriana Diaconeasa, Patricia Serrano, Alfonso D’Orazio, Luca Mazzucchelli, Riccardo Bono, Oliver Felthaus, Juan Garcias-Ladaria, Zeljko Mijuskovic, Zsuzsanna Bago-Horvath, Alin Laurentiu Tatu, Christine Prodinger, Roland Blum, Demetrios Ioannides, Nadem Soufir, Diego Serraino, Ahmed M. Sadek, Leticia Calzado Villareal, Elliot Coates, Mariana Costache, Machuel Bruno, Bengu Gerceker Turk, Liliana Gabriela Popa, Han-Uk Kim, Lisa Hoogedoorn, Efstratios Vakirlis, Monika Kotrlá, Gabriel Salerni, Ela Comert, Salvatore Zanframundo, Zsuzsanna Lengyel, Francisco Jose Deleon, Maryam Sadeghi Naeeni, Georgios Kontochristopoulos, Ana Carolina Cherobin, Michiyo Matsumoto-Nakano, Gabriela Fortes Escobar, Maria Concetta Fargnoli, Ayse Oktem, Petra Fedorcova, Slavomir Urbancek, Hyunju Jin, Frédéric Cambazard, Tracey Newlove, Nataliya Sirmays, Cliff Rosendahl, Tamara Micantonio, Shirin Bajaj, Masa Gorsic, Ana Carolina L. Viana, Valentin Popa, Hubert Pehamberger, Anna Maria Carrozzo, Valentina Girgenti, Phil McClenahan, Beata Bergler-Czop, Alex Llambrich, Özgür Bakar, David Polsky, Krishnakant B. Pandya, Andrea Maurichi, Isabelle Hoorens, Paola Sorgi, Marianne Niin, Serena Magi, Malathi Munisamy, Zlatko Marušić, Cristina Mangas, Hakan Yesil, Miriam Potrony, Safaa Y. Negm, Maria T. Corradin, Stefania Seidenari, Işıl Bulur, Evelin Csernus, Gemma Tell-Marti, Alix Thomas, Juliana Casagrande Tavoloni Braga, Marco Manfredini, Karime M. Hassun, Celia Levy-Silbon, Lali Mekokishvili, Cem Yildirim, Hanna Eriksson, John H. Pyne, Angel Pizarro, Hakim Hammadi, Alessandro Borghi, Mariana A. Cordeiro, Fatima Zohra, A. Tülin Güleç, Ivan Ruiz Victoria, Joanna N. Łudzik, Radwa Magdy, Hisashi Uhara, Grażyna Kamińska-Winciorek, Llúcia Alòs, Pegah Kharazmi, Keisuke Suehiro, Lucian Russu, Zorica Đorđević Brlek, Sandrine Massart-Manil Massart-Manil, Moon-Bum Kim, Noha E. Hashem, Domenico Piccolo, Francesca Cicero, Jan Szymszal, Verena Ahlgrimm-Siess, Marian Gonzalez Inchaurraga, Ignazio Stanganelli, Danica Tiodorovic Zivkovic, Bugce Topukcu, Katharina Jaeger, Michael J. Inskip, Sara M. Mohy, Assya Djeridane, Véronique Del Marmol, Isil Kilinc, Nehal Yossif, Geon-Wook Kim, Oleksandr Litus, Ivana Ilić, Richard A Sturm, Mustafa Tunca, Anndressa da Matta, Elisabeth Jecel, Danijela Ćurković, Giuseppe Argenziano, Lynlee L. Lin, Elena Sotiriou, Mikela Petkovic, Suzana Kamberova, Sara Ibañes del Agua, Alan Cameron, Judit Oláh, Marc Nahuys, Leila Jeskanen, Zrinjka Paštar, Anna Wojas-Pelc, Ingela Ahnlide, Romana Čeović, Geoffrey Cains, Gilles Thuret, Mary Thomas, Marios Fragoulis, Drahomira Jarosikova, Manfred Beleut, Ferda Artüz, Brigitte Lavole, Francesco Todisco Grande, Carine Dal Pizzol, Erika Richtig, Nathalie Teixeira De Carvalho, Hans Peter Soyer, Amer M Alanazi, Vesna Sossi, Manal Bosseila, Monica Sulitan, Biancamaria Scoppio, Zrinka Bukvić Mokos, Marie-Jeanne P. Gerritsen, Mariano Suppa, Danielle Giambrone, Christoph Sinz, Jernej Kukovic, Martina Bosic, Adriana Rakowska, Eleni Mitsiou, Kely Hernandez, Ashfaq A. Marghoob, Daniel Boda, Alessandro Di Stefani, Luciana Trane, Leo Raudonikis, Akane Minagawa, Itaru Dekio, Athanassios Kyrgidis, Magdalena Wawrzynkiewicz, Katharina T Weiß, Chie Kamada, Lamberto Zara, Cristian Navarrete-Dechent, Serkan Yazici, Frédéric Renard, Leonie Mathemeier, Nissrine Amraoui, Mariana Fabris, Mariola Wyględowska-Kania, Nikolay Potekaev, Elisa Cinotti, Sedef Şahin, Peter van de Kerkhof, Silvana Ciardo, Sara Izzi, Paolo Piemonte, William V. Stoecker, Giampiero Mazzocchetti, Pasquale Frascione, Louise Lovatto, Ayşegül Yalçınkaya Iyidal, Jennifer A. Stein, Selçuk Yüksel, Daniela Ledić Drvar, Stine F. Pedersen, Dimitrios Sgouros, Meriem Bounouar, Balachandra S Ankad, Rahul Bute, Julia Brockley, Paula Aguilera-Otalvaro, Sumiko Ishizaki, Daniela Kulichova, Ilias Papadimitriou, Yeser Genc, Tanja Batinac, Jadran Bandic, Jean-Michel Lagarde, Göksun Karaman, Philipp Babilas, Mari Salmivuori, Lieven Annemans, Lennart K Blomqvist, Karel Pizinger, Duncan Lambie, Alexander Michael Witkowski, Meltem Uslu, Irena Savo, Martin Gosau, Raphaela Kastle, Olli Saksela, Pedro Zaballos, Esther De Eusebio Murillo, Hu Hui-Han, Sanda Mirela Cherciu, Claudia Artenie, Elvira Moscarella, Richard Johns, Ozlem Erdem, Valérie Vuong, Basma Birqdar, Jela Tomkova, Kasturee Jagirdar, Vassilios Lambropoulos, Moshira S. Bahrawy, Seong-Jin Kim, Su Chii Kong, Helen Schmid, Tetsuya Tsuchida, Michele Tonellato, Laura Berbegal, Lumír Pock, Iustin Hancu, Babar K Rao, Juliette Jegou, Lajos Kemény, Teresa Deinlein, Usha N. Khemani, Davive Guardoli, Juliana Arêas de Souza Lima Beltrame Ferreira, Tatiana Cristina Moraes Pinto Blumetti, Adhimukti T. Sampurna, Alexandru Telea, Ana Maria Forsea, Gionata Marazza, Lidija Kandolf Sekulovic, Marta Kurzeja, Marija Buljan, Fatima Zohra Mernissi, Alba Maiques-Diaz, Roger González, Dimitrios Kalabalikis, María Gabriela Vallone, Vanessa P. Martins Da Silva, Gemma Flores-Pons, Giuseppe Bertollo, Rolland Gyulai, Giuliana Crisman, Secil Saral, Simon Nicholson, Aimilios Lallas, Willeke Blokx, Marc A. L. M. Boone, and Oana Sindea

Subjects
Oncology, business.industry, RL1-803, Genetics, Medicine, Library science, Environmental ethics, Dermatology, business, Molecular Biology
Published
2015
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47. Research on psoriasis in India: Where do we stand?

Author

Devinder Mohan Thappa and Malathi Munisamy

Subjects
medicine.medical_specialty, Biomedical Research, business.industry, lcsh:R, MEDLINE, India, lcsh:Medicine, General Medicine, medicine.disease, General Biochemistry, Genetics and Molecular Biology, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Editorial, Family medicine, Psoriasis, medicine, Humans, 030223 otorhinolaryngology, business
Published
2017

49. Comprehensive lipid tetrad index, atherogenic index and lipid peroxidation: Surrogate markers for increased cardiovascular risk in psoriasis

Author

Devinder Mohan Thappa, Medha Rajappa, Laxmisha Chandrashekar, S Sunitha, Malathi Munisamy, G. Revathy, and M. Priyadarssini

Subjects
Adult, Male, medicine.medical_specialty, Lipoproteins, Dermatology, Systemic inflammation, medicine.disease_cause, Lipid peroxidation, chemistry.chemical_compound, Risk Factors, Psoriasis, Internal medicine, medicine, lcsh:Dermatology, Humans, oxidative stress, Dyslipidemias, Framingham Risk Score, business.industry, psoriasis, Middle Aged, lcsh:RL1-803, Atherosclerosis, Malondialdehyde, medicine.disease, Lipids, psoriasis area severity index, Cross-Sectional Studies, Infectious Diseases, Endocrinology, chemistry, Dyslipidemia, Cardiovascular Diseases, Female, lipids (amino acids, peptides, and proteins), Framingham risk score, Lipid Peroxidation, medicine.symptom, business, Biomarkers, Oxidative stress, Lipoprotein
Abstract

Background and Objectives: Recently, the concept of psoriatic march has come to the fore, in which chronic cutaneous inflammation in psoriasis leads to systemic inflammation which, in conjunction with increased oxidative stress, triggers a cascade of events resulting in increased cardiovascular risk in patients with severe psoriasis. We, therefore, decided to study the levels of some biochemical cardiovascular risk markers: lipid peroxidation (malondialdehyde), lipoprotein (a), lipid indices and atherogenic index, in patients with psoriasis and their association with disease severity. Methods: Fortyfive patients with psoriasis and 45 age and gender-matched healthy controls were included in this cross-sectional study. Disease severity was assessed by the Psoriasis Area Severity Index (PASI). Serum malondialdehyde, lipoprotein (a) and fasting lipid profile were estimated in all study subjects. Lipoprotein ratios were computed using standard formulae. Atherogenic index was calculated as ratio of lipoprotein (a)/high-density lipoprotein. Results: In psoriasis, we observed significantly higher levels of malondialdehyde, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, lipoprotein (a), lipid ratios, atherogenic index and comprehensive lipid tetrad index, compared to controls. These levels were directly proportional to disease severity. Serum levels of malondialdehyde correlated positively with serum lipoprotein (a), comprehensive lipid tetrad index and atherogenic index. Limitations: Different morphological types of psoriasis were not included and follow-up post-therapy was not done. A larger sample size would have validated the results further. Conclusion: Our results indicate that psoriasis, especially the severe variants, are associated with increased oxidative stress and dyslipidemia, which correlate positively with atherogenic index and hence, an increased cardiovascular risk.

Published
2015

50. Study of fine-needle aspiration microbiology versus wound swab for bacterial isolation in diabetic foot infections

Author

K M Abdulbasith, Maanasa M Bhaskar, Raj Kumar Nagarajan, and Malathi Munisamy

Subjects
microorganism, Diabetic foot infections, Microbiological culture, wound swab, Biopsy, Fine-Needle, Culture, Student IJMR, India, lcsh:Medicine, General Biochemistry, Genetics and Molecular Biology, Diabetic wound, Specimen Handling, Microbiology, Diabetes Mellitus, medicine, Sensitivity pattern, Humans, diabetic foot infections, medicine.diagnostic_test, business.industry, culture - diabetic foot infections - fine-needle aspiration microbiology - microorganism - wound swab, lcsh:R, Bacterial Infections, General Medicine, Microbiological Techniques, Isolation (microbiology), Diabetic Foot, fine-needle aspiration microbiology, Fine-needle aspiration, Sample collection, business
Abstract

Background & objectives: Proper identification of the infection causing microbe in diabetic foot infections (DFIs) is essential for starting appropriate treatment. The objectives of this study were to compare fine-needle aspiration microbiology (FNAM) with wound swab as methods of sample collection in isolating microorganisms causing DFIs and also to compare the microbiological profile and sensitivity pattern of the infecting organisms. Methods: This study was conducted targeting all consecutive patients with DFIs with perfusion, extent, depth, infection and sensation (PEDIS) grade 2, 3, and 4 infections admitted in the department of Surgery of a tertiary care hospital in south India during July to August 2017. A superficial wound swab and an FNAM were collected from all the patients. These swabs are analyzed using standard microbiological techniques. Results: Eighty patients with DFI were included. Bacterial culture using FNAM samples yielded growth in 58.75 per cent samples, whereas wound swab samples yielded growth in 93.8 per cent cultures done. Measure of agreement between the two techniques using Kappa statistics was 0.069 (P=0.28). Interpretation & conclusions: In diabetic wound infections, wound swabs were sufficient to identify organisms in all grades of infection. However, in deeper infections (grade 3 and 4), FNAM would be a reliable investigation than wound swab.

Published
2020
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