[Show abstract][Hide abstract] ABSTRACT: Alopecia areata (AA) is a nonscarring, autoimmune hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common site affected is the scalp in the form of solitary or multiple patches of alopecia. Histopathology is characterized by an increased number of telogen follicles and presence of inflammatory lymphocytic infiltrate in the peribulbar region. Corticosteroids are the most popular drugs for the treatment of this disease. This review precisely outlines the etiologic and pathogenic mechanisms, clinical features, diagnosis and management of alopecia areata.
[Show abstract][Hide abstract] ABSTRACT: Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the 'idiopathic' forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.
Indian Journal of Dermatology 11/2011; 56(6):622-8. DOI:10.4103/0019-5154.91817
[Show abstract][Hide abstract] ABSTRACT: Leprosy remains an important public health and social issue in South Asia, particularly in India. Its presence in childhood is an immense social burden because of the associated disabilities and widely prevalent misconceptions regarding communicability and treatment potential. The prevalence of leprosy among children suggests a possible gap in the national programmes aimed at leprosy elimination. This article reports a 10-year retrospective study of childhood leprosy in a tertiary care hospital setting (2000-2009) along with an analysis of selected socio-epidemiologic correlates. We stress the importance of early detection and the application of appropriate prophylactic measures in susceptible children.
Tropical Doctor 05/2011; 41(3):163-5. DOI:10.1258/td.2011.100477 · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A patient co-infected with leprosy and Human Immunodeficiency Virus (HIV)-type 1 who developed type 2 lepra reaction in the absence of antiretroviral therapy is presented. The reaction responded only after initiating anti retroviral therapy (ART) despite normal CD4+ counts. The present report suggests that type 2 reactions in leprosy and HIV co-infected patients may not always be the typical manifestation of immune reconstitution inflammatory syndrome (IRIS) and stresses the importance of considering concomitant HIV infection in refractory lepra reactions. Extensive research is required into the manifestations of HIV in leprosy patients.
[Show abstract][Hide abstract] ABSTRACT: Leprosy is a chronic disabling disease and there are areas of high endemicity in India. Case findings and management strategies suffer a setback when disease manifestations are not picked up in time by health-care providers. This article attempts to estimate the annual incidents of leprosy and to study the confounding factors which may potentially cause delays in diagnosis in an office-based, tertiary health-care setting.
Tropical Doctor 11/2010; 41(1):28-30. DOI:10.1258/td.2010.100107 · 0.48 Impact Factor