Background: Data on clinical and epidemiologic profile on pediatric alopecia is relatively scarce. Aims and Objectives: We aimed to study the clinical, epidemiological, and dermoscopic profile of ...children presenting with alopecia, and assess the responsiveness to different treatment modalities in a real-life setting. Materials and Methods: This cohort study involved analyzing children presenting with hair loss during the study period. After a detailed history, clinical, and trichoscopic examination, treatment offered to patients and follow-up response to treatment along with relapse of symptoms were noted. Results: Around 119 children were included. Nearly 90% were of acquired etiology. The most common cause of alopecia was alopecia areata (AA) in 85 (71%) patients followed by tinea capitis 9 (7.5%), lichen planopilaris 4 (3.3%), and other less common causes. In patients of AA, dermoscopy showed the presence of black dots in 68% cases, exclamation mark hair in 54% of patients followed by off-white dots, yellow dots, and vellus hair. Patients with an acute course and black dots on dermoscopy responded better to treatment. Relapse was common in patients with early age of onset and longer disease duration. Conclusions: Hair loss is frequently seen in pediatric dermatology clinics. Dermoscopy of pediatric AA shows scarce yellow dots while off-white dots are more frequent; the presence of black dots is a good prognostic indicator.
Cutaneous reactions to tattoos can be attributed either to trauma or to the exogenous pigment introduced into the skin. Red pigment is associated with a high sensitizing potential and is the most ...frequently implicated pigment inducing various types of histological reactions. Herein, we describe a patient with red tattoo pigment-induced granulomatous dermatitis that histologically revealed a very rare granuloma annulare–like reaction.
Background: Congenital ichthyoses are a rare Mendelian group of disorders affecting the integument with a heterogeneous clinical presentation amongst which scaling is a constant feature. There is ...scanty epidemiologic data regarding the clinical profile and histologic patterns of inherited ichthyosis from resource-poor countries. Aims and Objectives: The study was aimed at assessing the clinic-epidemiologic characteristics associated with the different forms of non-syndromic congenital ichthyosis. Materials and Methods: This was a retrospective chart review of ichthyosis patients that presented between July 2016 and Jun 2020. Details including demographic profile, clinical characteristics along with any relevant investigations done were included. Results: During the study period of 4 years, 107 patients with congenital non-syndromic ichthyosis were seen. The most frequent diagnosis was of common ichthyoses, followed by autosomal recessive congenital ichthyosis, epidermolytic ichthyosis and erythrokeratoderma, in decreasing order. Conclusion: Important clinical findings like erythema and the type of scales as well as histological differences including an absent or reduced granular layer in ichthyosis vulgaris can help differentiate among the clinical phenotypes of inherited non-syndromic ichthyosis especially in resource-poor settings. Also, there is a high prevalence of vitamin D deficiency and hence a need for screening for the same in all patients of congenital ichthyosis including the milder phenotypes.
Nodulocystic acne is a severe type of acne that is known to improve after treatment with isotretinoin. Melnik has hypothesized a unifying concept on the mechanism of acne pathogenesis involving ...altered expression of Forkhead box O transcription factor (
) and role of isotretinoin in improving acne via modulating this pathway.
To evaluate the pathway proposed by Melnik in acne pathogenesis by analysing the difference in the expression of
, peroxisome proliferator-activated receptor (
), and androgen receptor (AR) between acne patients and non-acne controls and the effect of treatment with isotretinoin on change in expression of these genes in acne patients.
The gene expression of
was non significantly higher in acne patients as compared to controls. After treatment with isotretinoin, a significant decrease in
expression in acne patients at mRNA (
= 0.05) level was observed. There was a significant decrease in grade 3 positivity of
at protein level (
= 0.0009). A decrease in androgen receptor positivity (
= 0.055) at protein level was also observed.
Reduction in
expression appears to be an important mechanism of action of isotretinoin in acne.
Background: Atopic dermatitis (AD) is an itchy, chronic or chronically relapsing, inflammatory skin condition. Aims: To study the effectiveness of probiotic supplementation (Bacillus clausii) in ...achieving clinical remission, preventing relapse and its effect on immunological profile in children with AD. Methods: In this randomized controlled study, 114 children with AD were randomized into two groups (57 each): Group A received conventional treatment, along with Bacillus clausii (Strains O/C, N/R, SIN and T) suspension available as Enterogermina® at the dose 2 billion spores/5 ml twice daily for 8 weeks and Group B receiving conventional treatment only. Baseline and follow-up SCORAD were assessed at 0, 4, 8, 12, 16, 20 and 24 weeks. Serum IL-17A levels were measured at baseline and 12 weeks. Results: There was no significant difference in mean SCORAD between the two groups at baseline, 12 weeks (p = 0.21) and 24 weeks (p = 0.26). The two groups did not differ significantly in terms of the number of patients who achieved SCORAD 90 (p = 0.19), SCORAD 75 (p = 0.59), and those who relapsed (p = 0.5). IL-17A levels were not significantly different between the two groups at baseline and 12 weeks (p = 0.7). There was no statistically significant correlation between IL-17A levels and AD severity. Limitations: Lack of double-blinding, lack of the use of placebo and a short follow-up period were the limitations of the present study. Conclusion: Administration of the probiotic Bacillus clausii in addition to conventional treatment does not offer any additional benefit in inducing remission or prevention relapse in AD.
Hot Topics in Paediatric Dermatology Thakur, Vishal; De, Dipankar
Indian journal of paediatric dermatology,
04/2019, Letnik:
20, Številka:
2
Journal Article
Background: Despite the excellent clinical efficacy of oral propranolol in the management of infantile haemangiomas (IHs), there is a need to further evaluate other beta blockers that may be equally ...efficacious but result in lesser adverse effects. We compared the efficacy and short-term safety of atenolol, a hydrophilic cardio-selective beta blocker, with propranolol, in the treatment of IHs. Materials and Methods: Sixty patients with complicated and/or cosmetically significant IHs were randomised into two groups, oral propranolol group (2 mg/kg/day) and the oral atenolol (1 mg/kg/day) group, respectively, for 9 months. Patients were assessed clinically, by the use of Doppler ultrasonography (USG) and measurement of serum hypoxia-inducible factor 1 alpha (HIF-1α). Results: Twenty-two of 30 patients achieved complete clearance in the propranolol group (0.73; 95% CI = 0.54 to 0.87) compared with 13 of 25 patients in the atenolol group (0.52; 95% CI = 0.31 to 0.72). The mean time to achieve Physician Global Assessment Score 5 (PGA5) (25.00 ± 8.87 weeks) was significantly lesser in the propranolol group versus the atenolol group (31.69 ± 7.01 weeks; log-rank = 0.04). The two groups were comparable in terms of adverse effect profile, degree of volume reduction in USG and reduction in HIF-1α levels. Conclusions: Propranolol (2 mg/kg/day) is better than atenolol (1 mg/kg/day) in inducing complete clinical clearance of IH although the results need to be reproduced in larger studies.
ClinicalTrials.gov Identifier: NCT03237637
In this article, a new coupled inductor-based high voltage gain dc-dc converter with continuous input current and reduced semiconductor stresses (with respect to the competitive topologies) is ...presented. The coupled inductor windings are used in the voltage multiplier cells to increase the boost factor of the converter. The proposed topology achieves a high efficiency due to: 1) soft switching of the main and auxiliary switches along with the power diodes; 2) active clamp circuit based coupled inductor leakage energy recycling to the output; 3) improved output-side power diodes reverse recovery performance because of a reduced falling current rate due to the presence of leakage inductance; 4) lower on -state resistance and lower conduction losses in the semiconductor switches because of the reduced voltage rating of the switches. The performance of the converter is evaluated analytically to demonstrate efficiency improvement, reduced semiconductor stress, and high voltage gain capabilities. Furthermore, a detailed comparative study is presented. The proposed topology is found to be superior compared to recent state of art configurations. Through simulation studies and experimentation on a 250 W prototype, the proposed concept is validated.
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