INTRODUCTION Dengue (Den gay, Dandy) is a mosquito-borne viral illness caused by one of the four serotypes of the dengue virus DENV; (DENV-1 to DENV-4) belonging to the family Flaviviridae. The virus serotypes are closely related but antigenically distinct. Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). In recent decades, the incidence of dengue infection has increased around the world and has become a major international public health concern. The disease is now endemic in more than 110 tropical and subtropical countries. The World Health Organization (WHO) estimates that there may be 50 million dengue infections worldwide every year (1-3). Infection with one serotype of DENV provides lifelong immunity to that serotype but results only in partial and transient protection against subsequent infection by the other three serotypes. It is possible for a person to be infected as many as four times, once with each serotype. It is well documented that sequential infection with different DENV serotypes increases the risk of developing DHF. Ninety percent of DHF infections occur in children less than 15 years of age. There is currently no specific treatment for DENV infection, although several potential vaccines are in development; therefore, the only method of preventing DENV transmission is vector (mosquito) control (4-6). Early clinical features of dengue infection are variable among patients, and initial symptoms are often nonspecific; therefore, specific laboratory tests are necessary for an accurate diagnosis (7-8). According to the US Centers for Disease Control and Prevention (CDC) and the WHO dengue guidelines, the clinical features of DF and DHF are sudden onset of fever, severe headache, myalgias and arthralgias, leucopenia, thrombocytopenia, and hemorrhagic manifestations (8). It occasionally produces shock and hemorrhage, leading to death. Classic DF symptoms include fever, headache, retro-orbital pain, myalgia and arthralgia nausea, vomiting, and often a rash. Some DF patients develop the more serious form of the disease DHF ABSTRACT Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the lifethreatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at NCMC. This retrospective study included 43 patients infected with dengue virus, age 18 years to 70 years. Laboratory and hematological data were included. Peak of infection occurred in Nov. 2018 and least number of cases were recorded in September 2018. Same observation was seen in previous year. Common clinical symptoms were fever, headache and myalgia. Common hematological abnormalities were thrombocytopenia and leucopoenia. All patients survived. There was no case of dengue hemorrhagic fever or dengue s...

Background: Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at NCMC.Methods: This retrospective study included 24 patients infected with dengue virus, aged 19 years to 45 years. Laboratory and haematological data were included.Results Peak of infection occurred in November 2019 and no cases were recorded in October 2019. Common clinical symptoms were fever, joint pains, headache and rash. Common haematological abnormalities were thrombocytopenia. All patients survived. There was no case of dengue hemorrhagic fever or dengue shock syndrome.Conclusions: Significant differences in the clinical profile is possibly because of infection with different serotypes of dengue virus (DENV), concurrent/sequential infection of more than one serotype, and differences in host immune responses associated with host genetic variations.

Background: The COVID-19 pandemic has seen an unprecedented lockdown with restrictions on human movement and interaction, imposed throughout the world to contain the spread of the disease. This gave us the unique opportunity to study the pattern of patients presenting to the dermatology out-patient department during this period.Methods: The study was a retrospective observational study involving the assessment of patient records from 25th March 2020 to 7th June 2020. This period corresponds to the duration of strictly imposed nationwide lockdown which was relaxed with phased resumption from 8th June 2020, termed as unlock 1.Results: A decrease in the absolute as well as proportional number of patients was seen in majority of the cases with a statistically significant proportional decline being seen in cases of allergic contact dermatitis (p-value =0.007), acne (p value <0.001), male pattern hair loss (p value <0.001) and female pattern hair loss (p value <0.001), verrucae (p value=0.01), seborrheic dermatitis (p value <0.001), ephelids (p value <0.001), melasma (p value<0.001), post-inflammatory hyperpigmentation (p value=0.006). However, there were certain disorders whose proportionate representation increased significantly during the lockdown period contrary to prevalent belief. These disorders included urticaria (p value <0.001), herpes zoster (p value <0.001), scabies (p value =0.01), generalized pruritus (p value <0.001) and prurigo (p value <0.001).Conclusions: Disorders like acne, male pattern hair loss, female pattern hair loss, verrucae, seborrheic dermatitis, ephelids, melasma and post-inflammatory hyperpigmentation which do not cause significant morbidity showed a significant decrease in proportional representation. The proportionate representation of disorders like urticaria, herpes zoster, scabies, generalized pruritus and prurigo increased significantly during the lockdown period.

Periorbital neurofibromas can occur either in isolation or in association with neurofibromatosis (NF). Neurofibromas in the periorbital region account for 0.5-2.4% of orbital tumours. Hypertrichosis overlying neurofibromas are rarely reported cases in literature. We report a case of localized hypertrichosis overlying neurofibroma in a 27 year old female with no other features of neurofibromatosis. Neurofibromas can occur as solitary lesions or in association with neurofibromatosis. Our patient had diffuse hypertrichosis on a hyperpigmented macule overlying and around the periorbital neurofibroma.

Background: Psoriasis affects nearly 1% of the world population. It can be a source of significant morbidity and psychological stress to the patient but is not lethal under ordinary circumstances. Patients suffering from the disease feel a lack of empathy on part of care-givers, family members, healthcare professionals as well as society in general. Dermatology life quality index (DLQI) is a questionnaire-based assessment of health related quality of life in patients suffering from skin disorders and has been seen to correlate well with the impact of the disease on a patient. This study was done to understand the impact of psoriasis on the overall well-being of patients using DLQI as the tool of assessment.Methods: The study included 40 cases of psoriasis that were assessed for the severity of the disease based on percentage body surface area involvement. The impact of disease severity and other factors on the quality of life of the patient was assessed using DLQI.Results: Out of 35 patients with BSA involvement <50% (mild and moderate disease), 28.6% (n=10/35) showed a very large or extremely large effect on the quality of life while no patient with a BSA involvement >50% (severe and very severe disease) reported the same. A small, moderate or no effect on the DLQI was seen in 71.4% (n=25/35) of cases from the mild and moderate disease group while 100% (n=5/5) of cases from severe and very severe disease group reported a similar effect. Thus, DLQI was not directly related to the extent of BSA involvement and was dependent on other factors as well.Conclusion: Age had a correlation with the effect of the disease on the quality of life of psoriasis cases. Patients who were younger were more likely to report stress and anxiety related to the recurrences seen with the disease. Patients with lesions on sites that are socially exposed like face, hands, scalp, etc. were more likely to feel embarrassed about their condition. Younger age, female gender, lesions on exposed sites and recently diagnosed patients (<12 months) were factors which had a significant impact on the health-related quality of life of patients. The severity of disease and extent of involvement were not always directly related to extent of impact on the quality of life.