Background
Umbilical granuloma is an overgrowth of granulation tissue following the separation of umbilical cord. Treatment options for this common entity are limited and have side effects such as chemical burns. In this study, we present a novel modification of the salt application method to treat infants with umbilical granuloma.
Methods
Seventeen infants were recruited in our study after institutional ethics committee approval and consent from the parents. The area of application was cleaned, and common table salt was carefully applied over the lesion. The granuloma was then occluded with surgical adhesive tape for 24 hours. Cases were followed up the next day to remove the occlusive tape and for assessment of improvement.
Results
All seventeen cases responded well to this approach with complete resolution of lesions at 24 hours. Small clotlike shrunken tissue was found at the site of granuloma, which was easily scraped off during gentle cleansing. No major complication or recurrence was noted in 3 months of follow‐up.
Conclusion
Complete resolution of umbilical granuloma can be achieved with a single, clinic‐based application of salt under occlusion for 24 hours. Salt causes shrinkage of granuloma inside occluded hyperosmolar chamber by desiccant effect. The salient features of this method include ease of application, low cost of treatment, accurate one‐time physician‐controlled application, and complete and rapid resolution without complication.
Following the outbreak of COVID-19 pandemic, health care workers are involved in screening, investigations, admission, ward rounds, and even performing life-resuscitating procedures. 1 Dermatology residents, young faculties, and consultants are not used to handling long hours of duty and stressful environment. 2 We evaluated the mental health status of front-line dermatologists combating the pandemic. This was a cross-sectional, observational study. Dermatologists engaged in direct patient contact through clinical services at outpatient department, designated COVID wards, and fever clinics were included. Those involved in administrative duties and other departmental engagements were excluded. An online semistructured ques
Background:
Recent years have seen an alarming rise in the prevalence of recalcitrant and relapsing dermatophyte infections in India associated with lack of clinical response to standard antifungal regimens.
Aims and Objectives:
A study was undertaken to identify the antifungal susceptibility patterns of dermatophyte species isolated from lesions of dermatophytoses in patients examined at our center.
Materials and Methods:
A total of 85 patients with clinically diagnosed dermatophytoses were subjected to skin scrapings for potassium hydroxide mount (microscopic examination) and culture using Sabouraud's agar medium containing chloramphenicol and cycloheximide (incubated at 30°C). Antifungal susceptibilities [minimum inhibitory concentration-90 (MIC-90)] of the identified dermatophytes were tested for seven systemic and topical antifungal agents (terbinafine, griseofulvin, itraconazole, fluconazole, sertaconazole, ketoconazole, and clotrimazole) using Clinical and Laboratory Standards Institute broth microdilution method (M38-A).
Results:
Trichophyton rubrum
(50%) and
Trichophyton mentagrophytes complex
(47.2%) were the two major species isolated. Isolates of both showed downy and granular forms (61.11%, 38.89% and 32.35%, 67.65%, respectively). The overall
in-vitro
susceptibility profiles (MIC-90 ranges in μg/mL) of the seven drugs for
T. rubrum
and
T. mentagrophytes complex
respectively were as follows: terbinafine (0.008–0256, 0.016–0.256), griseofulvin (0.03-1, 0.06–1), itraconazole (0.125-2, 0.25–2), fluconazole (0.125–1, 0.25–32), sertaconazole (0.03-1, 0.03-1), ketoconazole (0.06–1, 0.125–1), and clotrimazole (0.03–2, 0.06–1).
Conclusions:
This study indicates a rising proportion of
T. mentagrophytes complex
with increased proportion of granular form (
T. mentagrophytes var. mentagrophytes
). This study represents the current antifungal susceptibility profile of dermatophytic infections in a tertiary care medical center in western India with rising MICs to terbinafine and itraconazole.
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