Search

Introduction: Melasma is an acquired symmetric hypermelanosis characterized by irregular light to greyish brown macules on sun exposed skin, usually face. It is more seen in women and is more prevalent in individuals with skin type IV, V and VI. The exact etiology of melasma is not known therefore various treatment modalities have been employed. These include topical depigmenting agents like hydroquinone, azelaic acid, retinoids, chemical peels, low and high fluence lasers, yet none have proven to being fully beneficial in our study, we aim at comparing the therapeutic efficacy of 35% glycolic peel and triple combination cream in the treatment of melasma. Materials and Methods: It is a hospital based study. 60 diagnosed cases of melasma were randomly enrolled equally to two groups P and Q. Group P patients given serial 35% Glycolic acid peel and group Q patients given Triple combination cream to be applied topically once at night daily. Followed up on 4th, 8th and 12th week. At each visit clinical response to treatment was calculated using MASI score. Results: At 4th, 8th and 12th week post treatment evaluation, Triple combination cream had an overall superiority to serial 35% glycolic acid peel as a topical hypopigmenting agent. Conclusion: The results of the study show that Triple combination cream is a better hypopigmenting agent with rapid rate of clinical improvement when compared to 35% glycolic acid peel. Keywords: Melasma, Triple combination cream, 35% Glycolic acid peel.

BACKGROUND AND OBJECTIVES: Alopecia Areata refers to a common usually reversible condition in which patchy loss of hair occurs characterized by presence of mononuclear cell infiltrates developing in and around anagen hair follicles and causing circumscript hair loss. Alopecia Areata has an auto immune pathogenesis mediated by helper T-cells. Since tacrolimus suppresses helper T-cell activity its effect on alopecia areata was studied. METHODS: The study was conducted in the dermatology OPD department in Fr. Muller Medical College Hospital, Mangalore. A total of 50 cases of alopecia areata were taken up for the study. The period of study was from October 2004 - April 2006, the study included 33 males and 17 females. An informed consent was obtained from all the patients. Hair root examination, VDRL, haemogram, Liver Function Test (LFT), Renal Function Test (RFT) and other relevant investigations were done. Focal sepsis was ruled out in all patients. Tacrolimus 0.03% cream was applied once daily and reviewed once in two weeks for twelve weeks. Qualitative data wise score analysis was done by using Friedman's test, Mean, Standard Deviation, Chi-Square test and 'p' value (test of significant) was noted. Response was graded as failure, poor, good and excellent objectively. RESULTS: 6 (12%) patients with scalp involvement had poor response. 20 (40%) patients of alopecia areata on scalp, 5 (10%) patients on face and 2 (4%) patients each on eyebrow and moustache showed good response. 2 (4%) patients with ophiasis pattern also showed good response. 8 (16%) with scalp and 5 (10%) on face had excellent response. None of the patients had any cutaneous or systemic side effects to 0.03% tacrolimus cream during the study period. INTERPRETATION AND CONCLUSION: 10 (20%) patients had associated personal history of atopy and 8 (16%) patients showed exclamatory mark hair. 6 (12%) patients who poorly responded to 0.03% tacrolimus cream had nail pitting. Topical tacrolimus is effective and could be the other modality in treating alopecia areata, however higher strength (0.1%) may give a better result. Being non-irritant topical therapy it could be a treatment modality of choice in children. Absence of cutaneous side effects makes it suitable for use on the face.

Vitiligo is an acquired de-pigmenting skin condition that results from destruction of melanocytes. There are very few studies from south India regarding the efficacy and safety of narrowband ultraviolet B (UVB) photo therapy in vitiligo which lead to the This prospective open non randomized study was conducted at a tertiary healthcare centre of south India between January 2011 and December 2011to determine the efficacy and safety of narrowband ultraviolet B (UVB) photo therapy in vitiligo. A total of 62 patients of vitiligo attending the dermatology outpatient department were enrolled in the study. Patients were treated with narrow band UVB phototherapy. Majority of our patients (29%) were in the age group of 31-40 years. Duration of vitiligo varied from 4 months to 18 years, with a mean of 6.2 years. Percentage of body surface area involved by vitiligo varied from 2-80% with a mean of 12.8%. Out of the various body sites, the most satisfactory repigmentation was seen on the face and the least was on the extremities. At the end of 6 months percentage area of re-pigmentation varied 60-90% on the face, 10-95% on upper limb, 15-90% on the trunk and 15-80% on lower limbs. Out of 62 patients, all had itching, which responded to oral antihistaminic. The phototoxic reactions were mild which were treated with topical steroid. This study emphasized the utility of narrow band UVB phototherapy as an effective modality of therapy for vitiligo.

PurposeThe purpose of this paper is to develop a flexible, as well as a rigid, polyurethane (PU) product using polyols derived from renewable resource for suitable application.Design/methodology/approachCardanol is converted into corresponding glycidyl ether by reacting it with epichlorohydrin. The resulting glycidyl ether is hydrolysed to the corresponding diol in the presence of a heteropolyacid, which acted as a catalyst. The diol obtained is used for synthesising PU's by reacting it with various mole ratios of toluene diisocyanate (TDI) and isophorone diisocyanate (IPDI) and their physicomechanical, chemical and morphological properties are studied.FindingsThe polyol selected for the present paper has unique structural characteristics such as C15 chain length, which contributes to flexibility, and an aromatic ring, which imparts rigidity in the final application of resulting PU. By choosing optimum ratio of NCO/OH, it is possible to obtain a system, which can be used for the development of a flexible as well as a rigid polymer for suitable application.Research limitations/implicationsThe cardanol and dodecatungstosilic acid used are of a particular grade and of a particular manufacturer. Furthermore, it could be obtained from different sources and of different grades. The spectral studies done are purely qualitative. Gloss is tested for the samples at 600, whereas other angles can also be used.Practical implicationsThe method developed provided a simple and practical solution to improve performance characteristics of PU resins, which also proves to be cost effective.Originality/valueThe PU product developed due to its enhanced coating properties can be used in various surface‐coating applications.

Background: A thorough knowledge of the skin changes, physiological as well as acquired, in neonates is of prime importance for the dermatologist as well as paediatrician.Methods: A total of 430 randomly selected live-born neonates delivered and admitted to the postpartum ward or to the Neonatal Intensive Care Unit and neonates attending the Dermatology Outpatient Department of a tertiary care institute were included in this study after taking written informed consent. A detailed assessment of history was performed and a detailed dermatological examination of each neonate was carried out. Laboratory procedures were performed to confirm diagnosis if required. Data was analyzed using SPSS ver. 20.Results: Most common physiological skin change observed was Mongolian spot (65.35%) followed by Erythema Toxicum Neonatorum (51.63%), Epstein’s pearls (46.97%) and Sebaceous gland hyperplasia (45.81%). Lanugo hair was seen in 16.74% neonates. Among congenital skin lesions, Salmon patch was seen in 15.58% of the neonates whereas congenital melanocytic nevi are seen in 4.19% of the neonates. Diaper dermatitis was the most common acquired skin manifestation seen in 5.81% of cases. Conclusions: Neonates are prone to suffer from a wide range of dermatological problems, physiological as well as pathological. These manifestations are unique to the neonates. A detailed history and awareness of the clinical presentation facilitates the confirmation of the diagnosis.

Background Itolizumab, a humanized monoclonal antibody to CD6, is a novel therapeutic agent evaluated in chronic plaque psoriasis. Objective We sought to assess the safety and efficacy of itolizumab in moderate to severe chronic plaque psoriasis. Methods A total of 225 patients were randomized (2:2:1) to 2 different itolizumab arms (A or B; A = 4-week loading dose of 0.4 mg/kg/wk followed by 1.6 mg/kg every 2 weeks; B = 1.6/mg every 2 weeks) or placebo. At week 12, the placebo arm was switched to 1.6 mg/kg itolizumab every 2 weeks. The primary end point was the proportion of patients with at least 75% improvement in Psoriasis Area and Severity Index score at week 12. Results At week 12, 27.0% in arm A ( P = .0172 vs placebo), 36.4% in B ( P = .0043 vs placebo), and 2.3% in the placebo arm had at least 75% improvement in Psoriasis Area and Severity Index score. At week 28, the proportion with at least 75% improvement in Psoriasis Area and Severity Index score was comparable: 46.1%, 45.5%, and 41.9% for A, B, and placebo, respectively. In weeks 1 to 12, the incidence of all adverse events was comparable across arms (A, 43%; B, 38%; placebo, 47%) and the incidence of infections was not greater than placebo (11.1%, 8.9%, and 18.6% for A, B, and placebo). Limitations No active comparator is a limitation. Conclusions Itolizumab is an effective and well-tolerated novel biological therapy in moderate to severe psoriasis.

Context: Hair plays an important role in one's personality and builds confidence. Now-a-days, chemical hair relaxers are used very commonly in the society. We document the adverse effects reported by the sample that have used any one of the professional chemical hair relaxers. Aim: To study the adverse effects reported by the sample who underwent repeated chemical hair relaxing. Settings and Design: Cross-sectional questionnaire based study done on a sample taken from a medical college and hospital campus in Mangalore. Materials and Methods: The sample was restricted to females and to those who underwent it more than once. A questionnaire was given to a sample of 90, which matched our criteria. Statistical Analysis: SPSS software 17. Results: Adverse effects reported by the sample after undergoing the procedure were found to be a high 95.56%, out of which the following are the common adverse effects reported; frizzy hair in 67%, dandruff in 61%, hair loss in 47%, thinning and weakening of hair in 40%, greying of hair 22%, and split ends in only 17%. Conclusions: Very few studies have been conducted on the adverse effects of hair straightening products in India. From our study, it can be stated that most of the samples had adverse effects, which was as high as 95.56%. Hence from the details elicited from this study, we can conclude that, usage of chemical hair relaxers does cause adverse effects and is “not a myth.” Thus, it is necessary to make available a less harmful chemical hair relaxer to the society.

Foot dermatitis refers to the predominant involvement of feet in the eczematous process. This study is undertaken to determine the clinical pattern and causative agent in foot eczema and to evaluate the role of patch testing in determining the causative agent of foot eczema. Data was collected from 50 patients with foot eczema, who attended the out-patient department. The patch test was performed using Indian standard series. Patch test was positive in 88% of the patients. The most common site affected was the dorsal aspect of the foot (48%) and scaly plaque was the predominant morphological pattern. The highest number of patients (24%) showed positive reactions to mercaptobenzothiazole (MBT) and the lowest (4%) to neomycin sulfate. Rubber and rubber chemicals have been reported worldwide to be the most common sensitizer causing foot eczema. Thus, patch test has a major role in finding out the cause of foot eczema.