Cutaneous manifestations of mixed connective tissue disease: Study from a tertiary care hospital in Eastern India

Abstract

Context:Mixed connective tissue disorder is an uncommon disease. Some scientists are reluctant to recognize it as a separate entity. Some others have defined this ailment. Cutaneous features of this condition are unique. Researchers from India have described these features to relate to those described in the studies from other parts of the globe.Aims:This study aims to delineate the skin manifestations of clearly defined mixed connective tissue disease (MCTD) patients, to compare them with those established as overlap syndrome, and to relate them with studies from other parts of the globe.Settings and Design:Successive patients who fulfilled the specific criteria for MCTD presenting in the skin outpatient department of a tertiary care hospital in eastern India were clinically examined from 2009 for 3 years.Materials and Methods:The number of participants was 23 and the dermatological features of these were compared with 22 patients with overlap syndrome. The antibody to uridine-rich U1 ribonucleoprotein was measured for all patients.Statistical Analysis Used:SPSS (Version 17) and MedCalc (Version 11.6).Results:The Male: Female ratio among the MCTD patients was 1:6.67 and that of the overlap syndrome was 1:10. Twenty patients of the MCTD group presented with synovitis as against only seven in the overlap group. Raynaud's phenomenon was present in some of the subjects. Puffy fingers were rare in our study. Facial numbness was reported by four of those suffering from MCTD. Antinuclear antibody (ANA) was essentially of a speckled pattern in this diseaseConclusions:Cutaneous indicators of MCTD are distinct from overlap syndrome. Knowledge of these manifestations prevalent in a region may lead to early diagnosis of the disease.

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

“…A summary of NDM prevalence reported across studies stratified by the geographical location, as well as by the sampling method used (all studies vs. repeated sampling), is shown in Table 1 4–77 . Although the adoption of repeated sampling can increase the diagnostic confidence in a case of NDM onychomycosis, ruling out isolation of the facultatively pathogenic agent as a random contaminant, we did not find significant differences in the predominant NDM strain detected from studies with repeated and unrepeated sampling procedures except in North America 7–13 …”

A case of autoimmune hypothyroidism presented as overlap syndrome of mixed connective tissue disorder

“…4,[6][7][8] Individuals who express human leukocyte antigen (HLAs), HLA-DR4 or HLA-DQB1, are genetically predisposed. 9 Specific nature of HLA associations that occur in relationship with MCTD differ with the ethnicity of populations studied and it may account in part to the variability of cutaneous features. 10 MCTD more common among woman.…”

Towards Early Diagnosis of Mixed Connective Tissue Disease: Updated Perspectives

“…During follow-up, any of the typical clinical features of SSc can occur, from puffy hands to sclerodactyly, acrosclerosis, calcinosis, ulcers and digital necrosis. 18 RP is present in almost all MCTD patients from the first assessment onwards, whereas fibrotic changes of the skin became more common during follow-up, reaching a prevalence of about 90%. 19 Oral ulcers, discoid lesions, panniculitis and the classical SLE malar rash are also common in MCTD.…”