BACKGROUND The Thyroid Hormone (TH) is a key element in the endocrine control of epidermal development and function. Clinical evidence suggest that TH is involved in epidermal proliferation and differentiation, hair growth and wound healing besides affecting the function of dermal fibroblasts. Cutaneous signs of thyroid disease can be caused by the thyroid malady itself or be due to a primary cutaneous disease that has an associated risk of thyroid disease. Primary diseases of the skin, such as vitiligo or lichen sclerosus et atrophicus are associated with an increased prevalence of Autoimmune Thyroid Disease (AITD). This is a prospective crosssectional and comparative study carried out in the outpatient departments of Dermatology and Endocrinology at Osmania General Hospital during the period from November 2012 to August 2014 to study the cutaneous disorders associated with thyroid dysfunction. MATERIALS AND METHODS A total of 65 cases of who presented to OPDs of DVL and Endocrinology at OGH, who were previously diagnosed to have thyroid dysfunction were included in the study. Another 65 age and sex matched control group was taken who presented to the general OPD with non-thyroid disorders. The patients were examined clinically to look for the evidence of thyroid dysfunction manifesting in the skin and appendages in the form of textural and pigmentary changes and other associated conditions. Hair microscopy was done to rule out hair shaft disorders. Hair pull test was done to know the percentage of hairs in telogen and anagen. The skin findings in the patients and the control group were compared statistically. Chi square test was applied and p value was calculated. All the patients were subjected to laboratory investigations to evaluate the status of thyroid dysfunction. Thyroid profile (T3, T4 and TSH) was done in every case. Reference values for TSH (0.3-5.2 mIU/L), T4 (5.0-12.5 g/dL), T3 (0.8-1.9 ng/mL). Selected cases were further investigated by anti-TPO, Fine needle aspiration cytology and ultrasonography of the thyroid. RESULTS Dry coarse skin 20 (62.5%), diffuse hair loss 17 (53.1%), swelling of face and hands 10 (31.25%), pruritus 9 (28.1%) were the common symptoms among the hypothyroid group. In the hyperthyroid group swelling in the neck 13 (65%), flushing 12 (60), pruritus 11 (55%) and diffuse hair loss 8 (40%) were the frequent symptoms. The percentage of symptoms reported were more in the study group in contrast to the controls. Among the associated skin disorders, chronic idiopathic urticaria, vitiligo, alopecia areata were observed with increased frequency in patients with thyroid disorders when compared to controls and had a statistically significant association (p < 0.05). CONCLUSION When compared for the presence of each dermatosis, pruritus, diffuse hair loss, hyperpigmentation, xerosis, flushing, goitre, hyperhidrosis, chronic urticaria, vitiligo, alopecia areata were found to be significantly higher in the patient group with thyroid diseases than in the control group. There is a convincing...

A 3 year old girl was brought by her parents to the DVL OP. Osmania general hospital with the complaints of painful fissures and diffuse thickening of palms and soles since 10 months of her age. She was normal at birth except for presence of woolly hair, thickening of palms and soles started at 10 months of age, which was progressive and lead to formation of fissures. She was put on symptomatic treatment. Carvajal syndrome is very rare disease, so early diagnosis is important to avoid cardiac complications. (Summary)

BACKGROUNDThe kidneys and the skin are two important organs whose blood supply far exceeds their demand, the former for maintaining the milieu interior and the latter for rendering man homoeothermic. Changes of the skin are frequently seen in patients with kidney disease and in those who are undergoing dialysis. A number of diseases are characterised by distinctive cutaneous and renal manifestations. MATERIALS AND METHODSThis study spanned a course of 6 months from January 2011 to June 2011. During this period 82 patients admitted in the Nephrology ward of Osmania General Hospital for dialysis as well as those patients referred to the Dermatology Outpatient Department from the Nephrology Department were screened for evidence of cutaneous manifestations of kidney disease. Of these, 50 patients who had the presence of skin manifestations were selected and studied, both sexes and all age groups were included in the study. RESULTSOut of 50 patients in the age group of 1-70 years, (66%) maximum number of patients were observed between 3rd to 5th decade while least number in 1st and 2nd decade. Youngest Patient studied -Male, 7 Years. Oldest patient studied -Male, 69 Years. Xerosis or dryness of the skin was seen in 28 patients. 14 patients out 50 showed pallor. Pruritus was seen in 12 patients. Purpura was seen in 3 patients. Perforating dermatoses was seen in 3 patients. Fungal infections were seen in 9 patients. Bacterial infections were seen in 5 patients. Viral infections were seen in 4 patients. Scabies was seen in 2 patients. Sparse scalp hair was reported in 7. Specific nail changes were seen in 19 patients. CONCLUSIONSAmong the various cutaneous manifestations, xerosis and pigmentary changes topped the list of prevalence with Xerosis 56%, Pallor 28%. Pruritus was seen in 24% of patients. Nearly, 6% had perforating dermatosis. The Prevalence of hair abnormalities in our study was 14%. Prevalence of nail changes were seen in 38% of cases. Cutaneous infections were seen in 36% of patients.

Contact Dermatitis (CD) is an altered state of skin reactivity induced by exposure to an external agent. According to the mechanism of elicitation, the following types of contact reactions may be distinguished: Allergic Contact Dermatitis (ACD), Irritant Contact Dermatitis (ICD), Phototoxic and Photo Allergic Contact Dermatitis and Immediate Type Contact Reactions or Immune Contact Urticaria. ACD is a delayed-type hypersensitivity reaction that is elicited when the skin comes in contact with a chemical to which an individual has previously been sensitised. Patch testing remains the gold standard for diagnosing ACD. This study focuses on identifying the allergens causing ACD of hands and feet. METHODStudy was conducted in Osmania General Hospital, Hyderabad, over a period of 12 months' duration. Patients suspected to have contact dermatitis were subjected to patch testing. Based on the history, clinical signs and symptoms, a total of 50 patients were shortlisted in 12 months' duration. RESULTOur study showed that the most common allergen showing patch test positivity in both males and females were metals like chromates followed by cosmetics and others. Patients showed significant improvement in their dermatitis after avoidance of the offending agent. CONCLUSIONPatch test is the method of choice and the "gold standard" in the detection of contact allergy and allergic contact dermatitis.