Floresgrace2405

Maculopapular rash was the most common (42.5%) type of cutaneous eruptions and ethambutol, the most common (45%) offending drug followed by other first line anti-tubercular drugs. Ten (25%) patients developed multiple drug hypersensitivity on re-challenging. Multiple drug hypersensitivity was seen in 10 (25%) patients. Conclusion Drug reaction to ATT is like a double-edged sword as stopping ATT and starting treatment of reaction with systemic steroids can further aggravate the condition with increased risk of disseminated and multidrug resistant tuberculosis. Re-challenge with ATT not only find out the culprit drug but also helps to restart a safer alternate ATT regimen. Limitations Small sample size, lack of proper hospital records due to which some patients were missed and the fact that re-challenge was not performred in mild lichenoid type rash.Background and aims Melanonychia can be a manifestation of benign or malignant pathology and often poses a diagnostic challenge on clinical examination. Even with distinguishing dermoscopic features (nail plate), it can be quite difficult to determine the nature of pigmentation as complete assessment of nail bed and matrix is still not possible. Intraoperative dermoscopy (IOD) can serve as a useful tool to appreciate the bed and matrix changes. The aim here is to study the intraoperative dermoscopic features in patients with melanonychia and correlate with histopathology. Methods 20 consecutive patients with melanonychia were recruited. Inclusion criteria was melanonychia of sudden onset, progressive nature, irregular width/color/symmetry on dermoscopy, positive Hutchinson sign, solitary nail involvement or associated nail dystrophy. Preoperative dermoscopy was performed and recorded. Patients were planned for nail matrix biopsy, during which IOD was performed over nail matrix and bed after removal of the nail plate. Images were recorded and analyzed and correlated with the histopathology. Results Out of 20 patients, 12 were females and 8 males. On IOD-histopathological correlation, 2 patients were found to have melanoma of the nail unit, 5had nail lichen planus, 9 had benign melanocytic nevi, and 4 had fungal melanonychia. IOD revealed fine, parallel and regular lines of pigmentation localized to proximal nail bed and matrix in all patients with benign melanonychia, while dark thick bands with irregular borders, dots, globules, streaks and structureless areas in the two patients with melanoma. Fungal melanonychia revealed an unremarkable nail bed and matrix on IOD. Conclusion Intraoperative dermoscopycan help in determining the nature of melanonychia and obviate the need to perform biopsy in certain cases. It can also aid in delineating the most suitable site for biopsy, along with grossly assessing the extent of involvement in case of malignancy.Background Pityriasis versicolor (PV) is the most common chronic superficial infection of the stratum corneum, reported in 40-60% of the tropical population. After the description of the new Malassezia species, only a few studies have been conducted from India. Aims Molecular identification, quantification of Malassezia species implicated with PV and correlation to its clinical presentation. Materials and methods The subjects include 50 PV patients, who attended the dermatology outpatient department of our hospital and 50 healthy individuals. Same size area of the skin was sampled from lesional and non-lesional sites in the patient group and from forehead, cheek, and chest of healthy individuals. Malassezia spp. isolated were identified by conventional method and confirmed by ITS2 PCR-RFLP and sequencing of D1/D2 region of 26S rDNA. Results Eighty percent of patients presented with hypopigmented lesions and 20% with hyperpigmented lesions. From PV lesions, the most frequently isolated species was M. furfur (50%), followed by M. globosa (27.3%), mixture of M. furfur and M. globosa (15.9%), M. sympodialis (4.5%), and M. slooffiae (2.3%). Higher Malassezia density was found in lesional area as compared to non-lesional area of PV patients and in healthy individuals (P 0.0001). Conclusion Although M. furfur was the most prevalent species isolated from both patients and controls, significantly higher isolation of M. globosa from the lesional area compared to non-lesional area indicates its possible role along with M. furfur in causing PV.Background The association between lichen planus (LP) and cardiovascular disease (CVD) risk factors has been demonstrated in previous reports. However, the evidence of CVD risk factors in Indian patients with LP is limited. Objective To compare CVD risk factors in LP patients and healthy controls. Methods We performed a cross-sectional study on 122 subjects, 61 LP patients, and 61 controls who visited the outpatient clinic of the dermatology department of a tertiary care hospital. Patients with skin diseases known to be associated with CV risk, pregnant, and lactating women were excluded from the study. CVD risk factors were compared between LP cases and controls using anthropometric measures, hemodynamic and metabolic parameters, and inflammatory marker (ESR). Results The proportion of metabolic syndrome (MS) was significantly higher in LP patients than the controls (29.5% vs. 9.8%, odds ratio [OR] 3.83; 95% confidence interval [CI] 1.40-10.50; P = 0.006). The proportion of dyslipidemia was also significantly higher in LP patients (70.5% vs. 42.6%; P = 0.002). LP patients had a high proportion of obesity (P = 0.004), hypertension (P = 0.004), impaired fasting glucose (P = 0.025), and raised ESR (P = 0.006) as compared to controls. A multivariate regression model demonstrated that dyslipidemia and obesity were significantly associated with LP even after controlling for confounders such as age, gender, sedentarism, dietary habits, alcohol, and impaired fasting glucose. There was no significant association between the extent of LP and the proportion of MS or dyslipidemia. Conclusion The present study found a significant association of LP with individual CVD risk factors as well as MS.Context Facial melanoses decreases the quality of life (QoL). Melasma is the commonest cause but there are various other etiologies for facial pigmentation. Aims To study the clinical profile of patients with facial melanoses and the psychological burden in these patients. Settings and design All patients having patchy or diffuse facial pigmentation attending the OPD in a tertiary care hospital for a period of 1 year were included in this hospital based cross-sectional study. Subjects and methods The type, extent, and distribution of the pigmentation was noted and tabulated in all patients. All patients were explained about Skindex-16 questionnaire and asked to complete it. Statistical analysis used Student t-test (two tailed, independent) was used to find the significance of study parameters on continuous scale between two groups. Chi-square/Fisher Exact test was used to find the significance of study parameters on categorical scale between two or more groups. Correlation was performed using Spearman corrélation. Results The total number of cases studied was 238 of which 186 (78.2%) were females and 52 (21.8%) were males. The most common diagnosis was melasma seen in 73% of cases. Other conditions noted were phototanning (5.8%), post-inflammatory hyperpigmentation (5.8%), Lichen planus pigmentosus (4.2%), freckles (3.7%), and Nevus of Ota (1.6%). Skindex-16 score against different grades of pigmentation showed that the mean Skindex-16 score was higher in severe cases but there was no statistically significant difference between the groups. Conclusions The extent and severity of facial pigmentation and the decrease in the QoL are not proportional.Brown-black pigment network is the hallmark dermoscopic feature of melanocytic lesions. Several non-melanocytic disorders also exhibit a pigment network as one of their main or useful dermoscopic diagnostic features. This article presents a compilation of such disorders to the readers describing their essential dermoscopic features with an emphasis on the characteristics of the pigment network exhibited by them.Juvenile localized scleroderma (morphea) is the predominant scleroderma in childhood which affects the skin and may extend to the underlying fascia, muscle, joints and bone. The assessment of activity and damage can be done with a validated instrument like LoSCAT. Disease classified as "low severity" which includes superficial plaque morphea can be treated with topical mid potent- potent steroids, tacrolimus, calcipotriol or imiquimod in combination with phototherapy. Methotrexate is recommended for linear, deep and generalized morphea. Steroids are effective in the early inflammatory stage and used in combination with methotrexate. Methotrexate is continued for at least 12 months after adequate response is achieved. Mycophenolate mofetil is given in cases where methotrexate is contraindicated or for those who do not respond to methotrexate. There are also reports of improvement of disease with ciclosporine and hydroxychloroquine. In severe cases, recalcitrant to standard therapy there may be a role for biologics, JAK inhibitors, and IVIG. Supportive measures like physiotherapy and psychiatric counseling are also important in the management of morphea. Orthopedic surgery and other measures like autologous fat transfer may be advocated once the disease is inactive.Background This study aimed to construct prognostic model by screening prognostic miRNA signature of bladder cancer. Methods The miRNA expression profile data of bladder cancer (BC) in The Cancer Genome Atlas (TCGA) were obtained and randomly divided into the training set and the validation set. selleck inhibitor Differentially expressed miRNAs (DEMs) between BC and normal control samples in the training set were firstly identified, and DEMs related to prognosis were screened by Cox Regression analysis. Then, the MiR Score system was constructed using X-Tile based cutoff points and verified in the validation set. The prognostic clinical factors are selected out by univariate and multivariate Cox Regression analysis. Finally, the mRNAs related to prognosis were screened and the biological pathway analysis was carried out. Results We identified the 7-miRNA signature was significantly associated with the patient's Overall Survival (OS). A prognostic model was constructed based on the prognostic 7-miRNA signature, and possessed a relative satisfying predicted ability both in the training set and validation set. In addition, univariate and multivariate Cox Regression analysis showed that age, lymphovascular invasion and MiR Score were considered as independent prognostic factors in BC patients. Furthermore, based on MiR Score prognostic model, several differentially expressed genes (DEGs), such as WISP3 and UNC5C, as well as their related biological pathway(s), including cell-cell adhesion and neuroactive ligand-receptor interaction, were considered to be related to BC prognosis. Conclusion The prognostic model which was constructed based on the prognostic 7-miRNA signature presented a high predictive ability for BC.Obligate human pathogenic Neisseria gonorrhoeae are the second most frequent bacterial cause of sexually transmitted diseases. These bacteria invade different mucosal tissues and occasionally disseminate into the bloodstream. Invasion into epithelial cells requires the activation of host cell receptors by the formation of ceramide-rich platforms. Here, we investigated the role of sphingosine in the invasion and intracellular survival of gonococci. Sphingosine exhibited an anti-gonococcal activity in vitro. We used specific sphingosine analogs and click chemistry to visualize sphingosine in infected cells. Sphingosine localized to the membrane of intracellular gonococci. Inhibitor studies and the application of a sphingosine derivative indicated that increased sphingosine levels reduced the intracellular survival of gonococci. We demonstrate here, that sphingosine can target intracellular bacteria and may therefore exert a direct bactericidal effect inside cells.