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  Citation statistics : Table of Contents
   2017| July-December  | Volume 3 | Issue 2  
    Online since December 28, 2017

 
 
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EDITORIAL
Tranexamic acid in melasma: Why and how?
Shuken Dashore, Katyain Mishra
July-December 2017, 3(2):61-63
DOI:10.4103/ijdd.ijdd_37_17  
  5 65,382 1,299
CASE REPORTS
Topical steroid-dependent face: Response to xylometazoline topical
Sushil Kakkar, Prafulla K Sharma
July-December 2017, 3(2):87-89
DOI:10.4103/ijdd.ijdd_6_16  
Unsupervised and long-term use of fluorinated/potent topical steroids on the face can lead to side effects such as acne, skin thinning, photosensitivity, and a typical clinical presentation of a topical steroid-dependent face (TSDF) with rebound flushing, burning, dryness, and scaling on attempted withdrawal of the potent topical steroid cream. To evaluate the response of a commercially available nasal decongested solution of xylometazoline 0.05% in patients of long-term potent topical steroid abuse on the face. Two patients with a history of long-term, indiscriminate, and unsupervised topical steroid use on the face were asked to use a commercially available nasal decongestant solution, on face. Patients were asked to use the decongestant solution on face, once daily for 2 weeks. Follow-up after 2 weeks demonstrated excellent improvement in flushing and erythema. Side effects reported were transient tingling and stinging sensation. Xylometazoline, being an alpha-adrenergic agonist, presents an effective new option for treatment in patients of flushing and erythema, resulting from long-term topical steroid use on face.
  3 17,398 284
ORIGINAL ARTICLES
Intralesional bleomycin in the treatment of common warts
Mahesh Unni, Vaibhav Tapare
July-December 2017, 3(2):73-76
DOI:10.4103/ijdd.ijdd_26_17  
Background: Warts are one of the most common benign growths in the dermatological outpatient department but are many times tough to treat as they are chronic, resistant, and relapsing to available treatment. A variety of therapeutic modalities have been used with varying degree of success. However, till date, no therapeutic modality had been fully successful. Aim and Objectives: The present study was conducted to evaluate the therapeutic efficacy and safety of intralesional (IL) bleomycin injection in common warts. Materials and Methods: A total of 50 patients of common warts were enrolled in this evaluator blinded randomized placebo-controlled study. Group A consists of patients to be treated with IL bleomycin, and Group B consists of patients to be treated with IL normal saline. A total of 25 patients were enrolled in each group. Patients of both groups were asked to follow-up after 4 weeks for maximum of 4 times, i.e. at 8 weeks, 12 weeks, at the end of 6 months as a final visit, and assessed clinically every time. Results: Out of 87 wart lesions in Group A patients, 81 (93.10%) showed a complete resolution. A progressive clearance of the warts was seen, after the first injection (64%) and second injection (36%), only 6 warty growths (7%) were nonresponders to treatment. However, in Group B, only 4 (5%) showed disappearance within 12 weeks and even after 6 months of follow-up (P < 0.05 by × 2 analysis and risk ratio = 7.67). Conclusion: IL bleomycin injection was significantly safer and effective, with better patient acceptance in treating common warts.
  3 13,663 309
VIVA VOCE
Rituximab in the treatment of skin diseases
Murlidhar Rajagopalan, Resham Vasani
July-December 2017, 3(2):105-109
DOI:10.4103/ijdd.ijdd_31_17  
  2 9,000 512
CASE REPORTS
Squamous cell carcinoma in a psoriasis patient possibly due to long-term methotrexate
Guneet Awal, Manpreet Kaur, Ravika Kanish Budhiraja
July-December 2017, 3(2):84-86
DOI:10.4103/ijdd.ijdd_6_17  
Squamous cell carcinoma (SCC) in a patient of psoriasis is a rare occurrence with paramount clinical significance for selecting the appropriate management options. We report a case of SCC in a 45-year-old male patient of psoriasis on unsupervised methotrexate for over 10 years. This case report highlights the importance of early diagnosis of SCC, carcinogenic potential of methotrexate, and role of acitretin in the management of such patients.
  1 5,836 52
LETTERS TO EDITOR
Imatinib-induced lichen planus resolving with depigmentation
Vrutika Hasmukh Shah, Kinjal Deepak Rambhia, Jayesh Mukhi, Rajesh P Singh
July-December 2017, 3(2):93-94
DOI:10.4103/ijdd.ijdd_25_17  
  1 3,497 60
BRIEF REPORT
Successful use of propranolol in infantile hemangiomas
Rajendra Saoji, Manasi Shirolikar
July-December 2017, 3(2):77-80
DOI:10.4103/ijdd.ijdd_35_17  
Infantile hemangioma (IH) is a benign vascular tumor of the capillary endothelium that exhibits a characteristic clinical course of early rapid growth followed by spontaneous slow involution by the first decade of life. Most IHs regress spontaneously by the end of the 1st year, but some may require urgent medical or surgical intervention if they encroach on vital organs affecting their function; or may cause significant cosmetic disfigurement on the resolution. We report three cases of large IHs over eyelid, vulva, and the tongue which were causing considerable impairment or were cosmetically disfiguring and in whom surgery was difficult due to their anatomic location. In these cases, oral propranolol therapy was initiated with successful outcomes. Propranolol was well tolerated in all these patients without significant side effects.
  - 5,031 150
CASE REPORTS
Intralesional tranexamic acid: Safe and effective way of treatment for melasma
Vani Veggalam, Nataraj Perumalla
July-December 2017, 3(2):81-83
DOI:10.4103/ijdd.ijdd_24_17  
Many studies suggested the use of tranexamic acid (TA) as a treatment modality for melasma, however, there are many limitations in the use of oral and intravenous dosage forms of TA because of adverse effects and contraindications resulted by its thrombolytic property. Topical application of TA is not effective because of its poor penetration through epidermis. Intradermal injections into the localized lesions of melasma regions or intralesional administration of TA were reported to be effective way of treatment for melasma with minimum risk of adverse effects. We report a case of a 40-year-old woman, who was treated with a minimum effective dilution of intradermal TA at localized hyperpigmented regions. The results were noted and analyzed with photographs taken during the treatment and by considering the patient satisfaction scores. The patient showed good improvement at the end of 4 weeks.
  - 21,727 487
A case of type 1 pachyonychia congenita with response to acitretin
Bhagyashree Babanrao Supekar, Kinjal Deepak Rambhia, Jayesh Ishwardas Mukhi, Rajesh Pratap Singh
July-December 2017, 3(2):90-92
DOI:10.4103/ijdd.ijdd_28_17  
An 8-year-old male born of nonconsanguineous marriage presented with multiple raised lesions all over the body, over palms and soles, and thickening of all nails of fingers and toes for 5 years. On examination, there were hyperkeratotic plaques over palms and soles with subungual hyperkeratosis of all finger and toe nails. Oral cavity revealed white hyperkeratotic plaque over buccal mucosa. There were hyperkeratotic papules distributed over dorsum of hands, feet, elbows, knees, trunk, and thighs. Biopsy taken from hyperkeratotic lesion over palms revealed findings suggestive of palmoplantar keratoderma. Considering the clinical features and histopathological examination, a diagnosis of Type 1 pachyonychia congenita was made. After hematological investigations, the patient was started on oral acitretin at a dose of 25 mg thrice a week. There was a marked improvement in the form of reduced hyperkeratosis over palms and soles and subsidence of hyperkeratotic papules and oral lesions, 2 months after treatment with acitretin.
  - 3,704 74
LETTERS TO EDITOR
Brimonidine “Rebound:” Worsening of rosacea following topical application of brimonidine gel
Sujata Mehta Ambalal
July-December 2017, 3(2):94-96
DOI:10.4103/ijdd.ijdd_18_17  
  - 18,004 110
A case of pediatric cutaneous mastocytosis successfully treated with imatinib mesylate
Rameshwar Gutte, Bhushan Madke, Ashish Bakshi
July-December 2017, 3(2):96-97
DOI:10.4103/ijdd.ijdd_16_17  
  - 4,035 76
MANAGING A SIDE-EFFECT
Prevention and management of thalidomide toxicity
Bhavana Ravindra Doshi, Nagbhushan Shreyans Chougule, BS Manjunathswamy
July-December 2017, 3(2):100-104
DOI:10.4103/ijdd.ijdd_38_17  
Thalidomide is a drug whose efficacy been reported in numerous conditions which can be attributable to its various mechanism of actions. Hence it would be prudent to know its side effects and its subsequent management so as to use it effectively. The current article reviews side effects of thalidomide and discusses methods of prevention and management of thalidomide toxicity.
  - 6,254 213
ORIGINAL ARTICLES
A study of fixed-drug reactions at a rural-based tertiary care center, Gujarat
Rita V Vora, Rochit R Singhal, Rahulkrishna S Kota, Bharat M Gajjar
July-December 2017, 3(2):69-72
DOI:10.4103/ijdd.ijdd_33_16  
Context: Adverse cutaneous drug reactions (ACDRs) are very common due to a wide variety of drugs available in markets. Fixed-drug reaction (FDR) is a type of ACDR that dermatologists are facing frequently nowadays. There is a need to identify various drugs responsible for FDR and to ensure the safety of the patients with proper counseling. Aim and Objective: The aim and objective was to study the demographic details, clinical patterns, and the offending drugs causing FDR. Setting and Design: This was a cross-sectional, observational study. Materials and Methods: The study was carried out from April 2010 to March 2015 in the Department of Dermatology at a rural-based tertiary care center of Gujarat, India, after taking approval from the hospital's research ethical committee. A detailed history taking and thorough clinical examination were done for all the patients having FDR and were recorded in a predesigned pro forma. Analysis was done using frequencies, proportions, and Chi-square test. All the patients were educated regarding ACDRs and given a list of drugs causing FDR to avoid recurrence. Results: A total of 59 patients were studied for FDR among which 32 (54.23%) were males and 27 (45.76%) were females. Fever (20.34%) was the most common illness for which patients had taken the culprit drug. Antimicrobials (26 [44.07%]) were the most common group of drugs causing FDR followed by nonsteroidal anti-inflammatory drugs (21 [35.59%]). As a single molecule, diclofenac was the most common drug causing FDR followed by metronidazole 5 (8.47%) and cotrimoxazole, fluconazole, and ciprofloxacin 4 (6.78%) each. The most common complaint following intake of the culprit drug was pigmented patch (31 [52.54%]) followed by blisters (13 [22.03%]). Conclusion: FDR is one of the important ACDRs seen in patients. Antimicrobials are the most common group while diclofenac is the most common drug causing FDR.
  - 5,203 112
REVIEW ARTICLE
Bepotastine besilate: A novel anti-histamine
Kiran Godse, Neeti Kumari
July-December 2017, 3(2):64-68
DOI:10.4103/ijdd.ijdd_22_17  
Oral bepotastine is a nonsedative second-generation antihistamine with an action on other inflammatory mediators. It also acts as a mast cell stabilizer and leukotrienes inhibitor. Its distribution in the brain is very limited. We explored the currently available literature on bepotastine besilate to assess the pharmacodynamics and pharmacokinetics of the drug and its role in pruritus and urticaria. Bepotastine is generally well tolerated in the elderly population and pediatric patients. Safety of bepotastine in children >2 years of age, pregnant and lactating females is not known. Bepotastine has got very minimal side effect. In comparison to many other second-generation antihistamines, it has got the quicker onset of action, and it maintains its efficacy over the time. It is a promising agent in the treatment of urticaria, allergic rhinitis, and pruritus associated with different skin disorders.
  - 19,147 780
TABLE
Erythroderma: How to know if it is drug induced?
Sudip Das, Nidhi Sharma
July-December 2017, 3(2):98-99
DOI:10.4103/ijdd.ijdd_39_17  
  - 9,151 413
WHATS IN NEWS
News from regulatory corner: Safety communication and recent drug approvals
Shuken Dashore
July-December 2017, 3(2):110-111
DOI:10.4103/2455-3972.221749  
  - 2,980 86