Our study findings indicate that the known frequency of vulvar diseases may represent only a small proportion of actual frequency. Further clinical and population-based research should be carried out with respect to the treatment, follow-up, and true prevalence of these diseases in the community.

Thyroid dermopathy is an uncommon manifestation of autoimmune thyroid disease. About 0.5%–4.3% of patients with history of thyrotoxicosis and 15% of patients with severe Graves’ ophthalmopathy have this cutaneous manifestation. However thyroid dermopathy is almost always associated with ophthalmopathy (96%) and sign and symptoms of hyperth-yroidism. The diagnosis of thyroid dermopathy is based on clinical sign and symptoms, serological thyroid hormone abnormalities supported by skin pathology. Isolated dermopathy is an uncommon manifestation of hyperthyroidism. A 35-year-old male presented with 7 months history of asymptomatic, multiple skin colored nodulo-tumorous growth over anterior aspect of both leg and one erythematous plaque with mild central atrophy on left leg. On examination most of the nodulo-tumorous growth (1 cm × 1 cm to 4 cm × 4 cm) and plaque (3 cm × 4 cm) showed ‘peau d’ orange’ appearance and were firm in consistency, indurated, non-tender with no rise of local temperature. Complete systemic and ophthalmological examination revealed no abnormalities. Abnormal thyroid function test and cutaneous deposition of mucin on histopathology suggested the diagnosis.The case is reported for its uncommon manifestation. Clinical sign should be documented and analysis of skin histopathology should be carried out in patients with suspected thyroid dermopathy.

Vitiligo is an acquired depigmenting disorder having disfiguring consequences. Many treatments have been attempted with varying reports of success. A parallel-group, assessor blinded, randomized, controlled trial was designed to compare the efficacy and adverse effects of narrowband UVB (NBUVB) with oral psoralen UVA (PUVA) therapy in the treatment of vitiligo. Patients aged 13-70 years with vitiliginous lesions involving more than 5% body surface area were eligible for the study. In total, 56 patients were randomized in a 1:1 ratio to oral PUVA or NBUVB phototherapy groups. Patients were assessed for the percentage of repigmentation over the depigmented areas as the primary outcome measure at each visit during the first three months and then monthly within the next three months. The incidence of adverse effects was also noted during the study period as the secondary outcome measure. The median repigmentation achieved at the end of the six-month therapy course was 45% in the NBUVB group and 40% in the oral PUVA group. Focal vitiligo had the best response in both treatment groups. There were lesser adverse effects within the NBUVB (7.4%) than in the PUVA (57.2%) group. Two PUVA patients discontinued therapy due to severe dizziness. There was no significant difference in the mean degree of repigmentation; however, NBUVB carried a greater response rate and might be superior to oral PUVA with better tolerance and color match with the surrounding normal skin, as well as fewer side effects in the treatment of vitiligo.

Chronic renal failure, regardless of its cause, often produces specific dermatological abnormalities, which can develop long before failure manifests clinically. Our aim was to study the clinical pattern of skin and nail changes in chronic renal failure and also study the associations of these changes with age, sex, etiology and duration of the chronic renal failure. A total of 104 diagnosed cases of chronic renal failure were included in the study over a period of 1 year. Equal numbers of age- and sex-matched individuals were taken as controls. The male : female ratio was 1.4:1. The mean duration of chronic renal failure was 19 +/- 20 months. Among cases and controls, 72% and 16% had skin changes, respectively. Xerosis was the most common of the skin changes (28%), followed by hyperpigmentation (20%), pruritus (15%), infectious diseases (5%) and other skin changes (33%) in chronic renal failure patients. Abnormal nail changes were seen in 82% of the cases compared to only 8% of the controls. In the cases, white nail was most common followed by brown and half-and-half nail. Pruritus was significantly higher in the dialysis group whereas the nail changes were significantly higher in the non-dialysis group. The skin and nail changes were common in chronic renal failure and manifested in various forms. Thus, thorough inspection of the integument might reveal markers of occult renal disease.

BackgroundVitiligo is a well-recognized pigmentary disorder of the skin and /or mucous membrane characterized by circumscribed ivory or chalky white macules devoid of identifiable melanocytes. The pathogenesis of vitiligo is complex and still not well understood. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. The role of free radicals and oxidative damage in the pathophysiology of vitiligo has been documented in recent studies. ObjectiveTo evaluate the role of oxidative stress in patients with vitiligo and of healthy controls by measuring levels of the oxidant malondialdehyde (MDA) and antioxidants vitamin C and vitamin E in serum and catalase (CAT) in erythrocytes. MethodA total of 80 clinically diagnosed cases of vitiligo and 80 control subjects were included in the study to assess the activity of MDA, vitamin C and vitamin E in serum and CAT in erythrocytes of patients and controls by using the spectrophotometric assay. ResultThere was statistically significant increase in the levels of MDA in patients with vitiligo compared to the control group (p<0.001). No significant difference was found in the levels of vitamin C (p=0.411) and vitamin E (p=0.771) between the patients with vitiligo and control group. The levels of CAT in the vitiligo patients were found to be significantly lower than those of controls (p<0.001). ConclusionIncreased oxidative stress and decreased catalase have been observed in vitiligo patients and the data suggesting that the free radicals may be involved in the destruction of melanocytes or dysregulation of melanogenesis.