and other aspects of factitious wealing (dermographism). Br J Dermatol 1971;85:331-5. 4. Kaplan A.P., Clinical practice: Chronic urticaria and angioedema. N Engl J Med 2002;346:175-9. 5. Mathews CN, Kirby JD, James J, Warin RP. Dermographism: reduction in wheal sizeby chlorpheniramine and hydroxyzine. Br J Dermatolol 1973;88:279-82. 6. Ryan TJ, Shim-Young N, Turk JL, Delayed pressure urticaria. Br J Dermatol 1968;80:485-90. 7. Godse KV. Diagnosis of delayed pressure urticaria. Indian J Dermatol Venereol Leprol 2006;72:155-6. 8. Sukan M. The problems in sexual functions of vitiligo and chronic urticaria patients. J Sex Marital Ther 2007;33:55-64. 9. Estes SA, Yung CW. Delayed pressure urticaria: an investigation of some parameters of lesions induction. J Am Acad Dermatol 1981;5:25.
Objectives: The objectives are as follows: (1) To document the clinical profile and demography of patients attending a tertiary referral institution with chronic folliculitis of leg and (2) to document the bacteriological profile of pustular lesions of chronic folliculitis. Materials and Methods: After obtaining clearance from institutional research and ethics committees, consecutive patients who attended our tertiary care center with clinically diagnosed chronic folliculitis of the leg from December 1, 2016, to November 30, 2017, were included in this cross-sectional study. The data regarding patient characteristics and clinical profile of disease were collected using a preset pro forma. Pus culture and sensitivity study was carried out in all patients who had pustules at presentation. The association between duration of disease and extent of disease and duration of disease and clinical grading was evaluated by Pearson’s Chi-square analysis. Results: The study population comprised 39 (78%) males and 11 (22%) females with male to female ratio of 3.5:1. Study participants ranged in age from 16 to 67 years. In 15/24 (62.5%) patients who manifested pustules, pus culture isolated pathogenic bacteria, Staphylococcus aureus, sensitive to cloxacillin in 14 (58.3%) and methicillin-resistant S. aureus in one (4.2%). Limitations: A study conducted in a tertiary referral center not reflecting the disease profile in the community was the major limitation. Conclusion: Staphylococcus aureus sensitive to common antibiotics like cloxacillin being the most common pathogen isolated from pustular lesions signifies the need for more prospective studies with a large sample size to evaluate the role of environmental factors and individual’s immune system in maintaining the inflammation in chronic folliculitis of the leg.
Background: Detection of peripheral nerve thickening and nerve function impairment is crucial in the diagnosis and the management of leprosy. Aims and objectives: (1) To document the cross-sectional area, echotexture and blood flow of peripheral nerves in healthy controls and leprosy cases using high-resolution ultrasound, (2) to compare the sensitivities of clinical examination and high-resolution ultrasound in detecting peripheral nerve thickening in leprosy. Methods: Peripheral nerves of 30 leprosy patients and 30 age- and sex-matched controls were evaluated clinically and by high-resolution ultrasound. When the cross-sectional area of a peripheral nerve on high-resolution ultrasound in a leprosy patient was more than the calculated upper bound of the 95% confidence interval for mean for that specific nerve in controls, that particular peripheral nerve was considered to be enlarged. Results: Cross-sectional areas more than 7.1 mm2 for the radial nerve, 8.17 mm2 for ulnar, 10.17 mm2 for median, 9.50 mm2 for lateral popliteal and 11.21mm2 for the posterior tibial nerve were considered as nerve thickening on high-resolution ultrasound. High-resolution ultrasound detected 141/300 (47%) nerves enlarged in contrast to the 60 (20%) diagnosed clinically by palpation (P < 0.001). Clinical examination identified thickening in 31/70 (44.3%) nerves in cases with impairment of nerve function and 29/230 (12.6%) in the absence of nerve function impairment. High-resolution ultrasound detected thickening in 50/70 (71.4%) nerves with impairment of function and in 91/230 (39.6%) nerves without any impairment of function. Limitation: A single-centre study design was the major study limitation. Conclusion: High-resolution ultrasound showed greater sensitivity than clinical examination in detecting peripheral nerve thickening in leprosy cases. High-resolution ultrasound, may therefore improve the sensitivity of the diagnostic criterion of peripheral nerve enlargement in the diagnosis and classification of leprosy.
A patient with linear IgA bullous dermatosis is reported, the disease being unresponsive to dapsone at a dose of 25 mg/kg per day; however, the addition of co-trimoxazole controlled the condition and the patient has been in remission for 2 vears.
Background: Individuals with HIV/AIDS are prone for psychiatric/psychological morbidities. Many studies have reported significantly higher prevalence of depression in people living with HIV/AIDS (PLWHA's) when compared to general population. However, there are only very few studies looking at the prevalence of depression in patients on antiretroviral therapy (ART). Objectives: To estimate the prevalance and factors associated with depression among clinically stable PLWHAs. Materials and Methods: We used a cross-sectional study design to estimate the prevalence of depression and factors associated with it among clinically stable PLWHAs with CD4 cell count >400 cells/mm3 and on ART for >2 years. We assessed 100 PLWHAs and diagnosed depression using ICD-10 diagnostic criteria. Results: The prevalence of depression was 30% in this sample. Female gender, lack of family support, and HIV-positive status of the spouse were associated with depression in this study. Multiple logistic regression analysis showed lack of family support significantly associated with depression. High prevalence of depression and its association with stressful life circumstances even in individuals stable on ART points toward need for psychosocial interventions to improve metal health and well-being of these patients.
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