Pregnancy is associated with complex of endocrinological, immunological, metabolic, and vascular changes that may influence the skin and other organs in various ways. Pregnancy is a period in which more than 90% women have significant and complex skin changes that may have great impact on the woman's life. The dermatoses of pregnancy represent a heterogeneous group of skin diseases related to pregnancy and/or the postpartum period. The dermatoses of pregnancy can be classified into the following three groups: Physiologic skin changes in pregnancy, pre-existing dermatoses affected by pregnancy, and specific dermatoses of pregnancy. Though most of these skin dermatoses are benign and resolve in postpartum period, a few can risk fetal life and require antenatal surveillance. Most of the dermatoses of pregnancy can be treated conservatively but a few require intervention in the form of termination of pregnancy. Correct diagnosis is essential for the treatment of these disorders. This article discusses the current knowledge of various skin changes during pregnancy and the evaluation of the patient with pregnancy dermatoses with special emphasis on clinical features, diagnostic tests, maternal and fetal prognosis, therapy, and management.
Background:Sexually transmitted infections (STIs) promote Human immunodeficiency virus (HIV) transmission by augmenting HIV infectiousness and susceptibility. In our society, especially in rural areas, males are common visitors to STI clinic than females who are generally traced as a contact. This difference may be due to the asymptomatic nature of infections in females, lower awareness among women of need for availing medical facilities, or their frequent consultation in gynecological clinics instead of STI clinics.Aim:To determine the prevalence, clinical profile, and the pattern of STIs in males and the prevalence of HIV infection in them at a rural-based tertiary care center.Materials and Methods:A retrospective study of male cases attending STI clinic between January 2008 and December 2009 was carried out. Diseases were diagnosed on the basis of clinical morphology of the lesion, and HIV and Venereal disease research laboratory (VDRL) testing was done in all cases.Results:Of 23 433 male patients presenting at the Skin/VD department, 201 were diagnosed to have STI. Most common age group affected was 25 to 44 years (59.7%). Incidence of STI was high among married individuals (77.2%). Herpes genitalis was most common STI in 49 (24.37%) cases. Viral infections (herpes genitalis, genital warts, and molluscum contagiosum) accounted for 62.2% of cases. Prevalence of HIV in STI was 2.48%.Conclusions:The persistent and recurrent nature of viral infections is responsible for their increasing trend in the current STI scenario. HIV and STIs are perfect examples of epidemiologic synergy as they are core transmitters of each other. STI being higher in married individuals further underlines the importance of contact tracing, counseling, and prompt management of the partners.
Background: ACDRs (Adverse cutaneous Drug Reactions) is a major problem in drug therapy and is one of the leading causes of morbidity and mortality in health care. Aims & Objective: To study the clinical pattern, most common offending drugs & relation between absolute eosinophil count & various ACDRs. Materials and Methods: The prospective observational study was carried out from April 2010 to March 2011 in the Dermatology department at a rural based tertiary care hospital in all patients irrespective of age and sex suspected of having drug reactions seen during the period of one year after taking their written consent. Results: Out of total 100 cases (51 males and 49 females), most common affected age group was 21-30yrs and most common presenting complaint was itching (37%). The most common ACDRs were maculopapular rash (25%) followed by fixed drug eruptions (23%) and urticaria (22%). Antimicrobials were the most common drug group incriminated in 54% followed by NSAIDs in 23% and anticonvulsants in 11%. Diclofenac, AKT, phenytoin and ciprofloxacin were the commonest incriminated drugs. Using the WHO guidelines for causality assessment, 9 were certain, 70 were probable and 21 were possible cases. Eosinophilia (AEC>500) was seen in 20% (15/74) cases. Conclusion: Physicians are expected to be well informed with common drug eruptions to diagnose them at the earliest, stop the offending drug and initiate the treatment at the earliest & also the patients should be counseled & educated regarding the importance of carrying the drug list.
Introduction:Vitiligo is an acquired depigmentary condition caused by inactivation or destruction of melanocytes in epidermis and hair follicle. Worldwide incidence of 1% has been reported; similar to various dermatological clinics in India. Widespread prejudice, ignorance, taboos, lack of scientific appraisal, and confusion of vitiligo with leprosy makes it an immense psychological stress.Aim:To know the clinical profile of vitiligo patient with associated cofactors.Materials and Methods:Total 1,010 patients of vitiligo attended in outpatient department at Shree Krishna Hospital (SKH) and Matar camp, Gujarat over 1 year period from August 2011 to July 2012 were included in this study. Detail history and clinical examination of patients were done.Results:Out of 1,010 patients 57.3% were females and 42.7 % were males. Most cases developed vitiligo by 2nd decade of life. Progressive course was found in 60.9 % of patients. Vitiligo vulgaris (57.8%) was most common morphological type. Most common site of onset (41.5%) and involvement (75.7%) was lower limb. Family history was present in 20.4%.Conclusions:Vitiligo constitutes important dermatological disease especially in India. The data suggest that local epidemiological behavior of vitiligo need not be the same across different regions. Vitiligo differs substantially in various clinical aspects.
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