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Gugle, Anil S.
- Comparative Study of Efficacy of Glycolic Acid Peel and Intense Pulsed Light in the Treatment of Melasma
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1 Department of Dermatology, Venerology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital, and Research Centre, Vasantdada Nagar, Adgaon, Nashik-422003, IN
1 Department of Dermatology, Venerology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital, and Research Centre, Vasantdada Nagar, Adgaon, Nashik-422003, IN
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MVP Journal of Medical Sciences, Vol 2, No 1 (2015), Pagination: 39-48Abstract
Background: Melasma, one of the common aesthetically displeasing entities, continues to be a difficult problem to treat. Chemical peeling is one new weapon in the therapeutic armamentarium of melasma. Intense Pulsed Light (IPL) is a noncoherent, broad-spectrum light, ranging from 500 to 1200 nm. Intense Pulsed Light (IPL) treatment is a good option for patients with melasma. Aims and Objective: To compare the efficacy of glycolic acid peel and intense pulsed light in the treatment of melasma. Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and Methods: 60 patients of melasma were recruited in the study. Patients were randomly allocated into two groups: one group (glycolic acid 50%) and another group (IPL) with 30 patients in each group. All the participants were subjected to undergo pre-peel programme of daily application of sunscreens (day time) and 0.025% retinoic acid at bed time for two weeks in GA peel group. 4 peels were carried out at 2 weekly intervals. Four sessions of IPL were done at 3 weeks interval. MASI scoring and coloured photographs (without reavealing identity) of each patient were taken before each peel and at the end of the follow-up period i.e. 2 weeks after 4th sitting in GA peel group and 3 weeks after 4th sitting in IPL group. Side effects, if any, were also recorded. Statistical Analysis Used: SYSTAT version-12. Results: In both the groups there was constant decrease in MASI scores after each sitting as compared to pre-peel scores. However, the comparison of mean MASI scores i.e. both pre-peel and after each peel, between the two groups showed statistically significant difference (p<0.05). Local reactions, such as burning sensation and erythema during the peel were not significant with both the groups. Conclusions: Glycolic Acid (GA) peel (50%) is more efficacious&safe treatment modality in melasma compared to IPL.Keywords
Glycolic Peel, Intense Pulse Light, Melasma.- A Comparative Study of Efficacy, Safety and Relapse Rate of Three Drugs; Systemic Ketoconazole, Systemic Itraconazole and Topical Oxiconazole in the Treatment of Pityriasis Versicolor
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MVP Journal of Medical Sciences, Vol 2, No 2 (2015), Pagination: 76-80Abstract
Aim: The aim of our study was to evaluate the efficacy, safety and relapse rate of systemic Ketoconazole, systemic Itraconazole and topical Oxiconazole in the treatment of pityriasis versicolor. Study design: 94 patients who had pityriasis versicolor were included in the study. The patients were given Ketoconazole, Itraconazole and Oxiconazole randomly and were followed up at the interval of 15 days, 1 month and 3 months for assessement of clinical and mycological cure. Results: In assessment of clinical parameters maximum improvement in scaling, pigmentation and pruritus was seen in Oxiconazole group compared to itraconazole and ketoconazole group. During the study it was observed that rate of clinical cure was maximum in Oxiconazole group (76.67%) as compared to Itraconazole (58.82%) and Ketoconazole group (46.66%). Mycological cure during visit 2 in Oxiconazole group was (83.33%), as compared to (88.2%) Itraconazole group and (88.7%) Ketoconazole group. During visit 3, mycological cure was present in 93.3% cases in Oxiconazole group, 94.1% in Itraconazole group and 93.3% in Ketoconazole group. During visit 4 mycological cure was assessed which showed 88.7% cure rate in Oxiconazole group compared to 88.2% in Itraconazole group and 88.7% in Ketoconazole group. These results suggested presence of relapse in 6.6% cases in both Oxiconazole and Ketoconazole group and 5.9% cases in Itraconazole group. There were no side effects with oxiconazole group while cases treated with ketoconazole and itraconazole had side effects like nausea and urticaria. Conclusion: According to the present study we conclude that topical Oxiconazole therapy was more effective as compared to systemic Itraconazole and Ketoconazole therapy in early improvement of scaling, pigmentation and pruritus secondary to Pityriasis versicolor with no significant side effects.Keywords
Efficacy, Itraconazole, Ketoconazole, Pityriasis Versicolor, Topical Oxiconazole.References
- Morishita N, Sei Y. Microreview of PityriasisVersicolor and Malassezia species. Micopathologica. 2006 Dec; 162(6):373-6.
- Kanwar AJ, Dipankar De. Superficial Fungal Infections. IADVL Textbook of Dermatology. R.G.Valia, Amit R.Valia (Editors). 3rd ed. Vol 1. p. 285-93.
- Giam YC, Rajan VS. Oral ketoconazole-A new treatment for tinea versicolor. Singapore Med J. 1984; 25:157-60.
- Richardson M, Warnock D. Other cutanious fungal infection. Fungal infection diagnosis and management. 3rd ed. Blackwell Publishing; p. 129.
- Jegasothy BV, Pakes GE. Oxiconazolenitrate : pharmacology, efficacy and safety of a new imidazole antifungal agent. ClinTher. 1991; 13:126-41.
- Jain VK, Aggarwal K. Comparative study of ketoconazole and itraconazole in pityriasis versicolor. Indian J Dermatol Venereol Leprol. 1999; 65:267-9.
- Bhogal CS, Singal A, Baruah MC. Comparative efficacy of ketoconazole and fluconazole in the treatment of pityriasis versicolor: a one year follow-up study. J Dermatol. 2001; 28:535-9.
- Gugnani HC. Oxiconazole in treatment of topical dermatomycoses. Current therapeutic research. 54(1):122-5.
- Maytham M, Al-Hilo, Hala K, AL-Obaidi, Ahmed Samir Al- Noaimi, Alwan AI. Therapeutic efficacy of different azole antifungal regimens in treatment of tineaversicolor. International Journal of advanced Biological Research. 2012: 2(4):766-71..
- Mohanty J, Sethi J, Sharma MK. Efficacy of Itraconazole in the treatment of PityriasisVersicolor. Indian Journal Dermatology Venereology Leprology. 2001; 67(5):240-1.
- Silva H, Gibbs D, Arguedas J. A comparison of fluconazole with Ketoconazole, Itraconazole and Clotrimazole in the treatment of patients with Pityriasisversicolor. Current Therapeutic Research. 1998; 59(4):203-14.
- Comparative Study of Efficacy of Topical Minoxidil 5% and Combination of Topical Minoxidil 5%, Topical Azelaic Acid 1.5% and Topical Tretinoin 0.01% on the Basis of Dermoscopic Analysis in Androgenetic Alopecia
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MVP Journal of Medical Sciences, Vol 2, No 2 (2015), Pagination: 90-99Abstract
Background: Androgenetic alopecia (AGA) more commonly known as male pattern baldness affects up to 50% of men worldwide. Tretinoin prolongs anagen phase and increases percutaneous absorption of minoxidil three fold. Azelaic acid is an inhibitor of 5 alpha reductase and could be an effective agent in the treatment of androgen related pathology of human skin. Aims and Objective: 1) To study the efficacy of topical minoxidil 5% in treatment of androgenetic alopecia. 2) To study the efficacy of combination of topical minoxidil 5%, topical azelaic acid 1.5% and topical tretinoin 0.01% in treatment of androgenetic alopecia. 3) To compare the efficacy of foresaid topical preparation in treatment of androgenetic alopecia Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and methods: Topical minoxidil 5 % lotion was used in 23 (50%) patients of the present study. Combination of topical minoxidil 5%, azelaic acid 1.5 % and tretinoin 0.01 % lotion was used in 23 (50 %) patients of the present study. Statistical analysis used: Epi info version 7. Results: There was statistically significant increase in hair number and thickness after treatment in both the groups. The comparison of the increase of hair number and thickness was statistically insignificant. Conclusions: Topical Minoxidil 5% is equally effective to combination of topical Minoxidil 5%, azelaic acid 1.5% and tretinoin 0.01% in treatment of androgenetic alopecia.Keywords
Androgenetic Alopecia, Azelaic Acid, Minoxidil, Tretinoin.- Study of Homologous Autoimplantation Therapy for Treatment of Multiple Warts in Patients Attending the Dermatology out Patient Department
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MVP Journal of Medical Sciences, Vol 2, No 2 (2015), Pagination: 110-117Abstract
Introduction: Warts are benign tumours that commonly involve skin and other epithelial tissues. There is no single treatment modality that is 100% effective. In multiple warts, especially on face, palms, and soles destructive procedure are inappropriate and impractical. Homologous autoimplantation is a simple technique, which helps in inducing cell mediated response, causing clearance of warts. Aims and objectives: To evaluate the effect of homologous autoimplantation therapy in treatment of multiple warts. To study the untoward effects of this treatment. Material and methods: A total of 49 patients of viral warts were included in study. Homologous autoimplantation of wart was done and regular follow up was done to see the result. Results: Out of 49 patients, in 24 patients there was good response, 14 showed moderate response, 5 showed poor response and in 6 patients there was no response. Conclusion: Homologous autoimplantation is an easy, minimally invasive technique which clears multiple, recurrent and recalcitrant warts.Keywords
Homologous Autoimplantation, Warts.References
- Drake LA, Ceilley RI, Cornelison RL, Dobes WL, Dorner W, Goltz RW, et al. Guidelines of care for warts: Human papilloma viruses. J AM AcadDermatol. 1995 Jan; 32(1):98-103.
- Srivastava PK, Bajaj AK. Autowart injection therapy for recalcitrant warts. Indian J Dermatol. 2010 Oct-Dec; 55(4): 367-9.
- Lipke MM. An Armamentarium of Wart Treatments. Clin Med Res. 2006 Dec; 4(4):273-93.
- Sterling JC, Handfield-Jones S, Hudson PM. British Association of Dermatologists. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001 Jan; 144(1):4-11.
- Androphy EJ, Lowy DR. ‘Warts’, in Klaus Wolff, Lowell A. Goldsmith, Amy S. Paller, David J. Leffell. Fitzpatrick’s Dermatology in General Medicine. 7th ed. Vol. 2. United States of America: The McGraw-Hill Companies; 2008. p. 1914-23.
- Shivkumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatolvenerolleprol. 2009 Nov-Dec; 75(6):593-5.
- Viac J, Thivolet J, Hegary MR, Chardonnet Y, Dambuyant C. Comparative study of delyed hypersensitivity skin reaction and antibodies to human papilloma virus. ClinExpimmunol. 1997; 29(2):240-6.
- Nischal KC, et al. A novel modification of autoimplantation therapy for the treatment of multiple recurrent and palmoplantar warts. J Cutanaestsurg. 2012 Jan-Mar; 5(1):26-9.
- Kuykendall-Ivy TD, Johnson SM. Evidence-based review of managementof nongenital cutaneous warts. Cutis. 2003 Mar; 71(3):213-22.
- Viac J, Thivolet J, Chardonnet Y. Specific immunity in patients sufferingfrom recurring warts before and after repetitive intradermal tests withhuman papilloma virus. Br J Dermatol. 1977 Oct; 97(4):365-70.
- Venugopal SS, Murrell DF. Recalcitrant Cutaneous warts treated with recombinant quadrivalent human papilloma virus vaccine (types 6, 11, 16and 18) in a developmentally delayed, 31-year-old white man. ArchDermatol. 2010 May; 146(5):475-7.
- Kreuter A, Waterboer T, Wieland U. Regression of Cutaneous warts ina patient with WILD syndrome following recombinant quadrivalent humanpapilloma virus vaccination. Arch Dermatol. 2010 Oct; 146(10):1196-7.
- Briggaman RA, Wheeler CE Jr. Immunology of human warts. J Am Acad Dermatol. 1979 Oct; 1(4):297-304.
- Study of Serum Alkaline Phosphatase Levels among Psoriasis Patients and Comparative Group in Tertiary Care Institute
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Affiliations
1 Department of Dermatology, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
1 Department of Dermatology, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
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MVP Journal of Medical Sciences, Vol 5, No 2 (2018), Pagination: 211-215Abstract
Background: Psoriasis is a chronic relapsing autoimmune skin disease of unknown etiology, characterised by complex alterations in epidermal growth and differentiation. Oxidative stress is a known risk factor for exacerbation of psoriasis. Serum alkaline phosphatase level is a marker of oxidative stress in body. Aims and Objectives: To study and compare serum alkaline phosphatase levels in cases of psoriasis. Materials and Methods: Serum Alkaline Phosphatase levels were evaluated in 100 cases of psoriasis and controls. Results: There was no statistically significant difference between serum alkaline phosphatase levels among cases and controls. Conclusion: Serum alkaline phosphatase levels, as a marker of oxidative stress is not significantly raised in cases of psoriasis.Keywords
Alkaline Phosphatase, Oxidative Stress, Psoriasis.References
- Nickoloff BJ, Nestle FO. Recent insights into the immunopathogenesis of psoriasis provide new therapeutic opportunities, J. Clin. Invest. 2004; 113:1664−75.
- Dogra S, Yadav S. Psoriasis in India: Prevalence and pattern, Indian J. Dermatol. Venerol. Leprol. 2010; 76:595−601.
- Bedi TR. Clinical profile of psoriasis in North India, Indian J. Dermatol. Venereol. Leprol. 1995; 61:202−5.
- Kaur I, Handa S, Kumar B. Natural history of psoriasis: A study from the Indian subcontinent, J. Dermatol. 1997; 24:230−4.
- Malligarjunan H, Gnanaraj P, Subramanian S, Elango T, Dayalan H. Clinical efficacy of propylthiouracil and its influence on prolactin in psoriatic patients, Clin. Biochem. 2011 Oct; 44(14-15):1209−13. Epub. 2011 Jul 28. https://doi.org/10.1016/j.clinbiochem.2011.07.009.
- Smith AE, Kassab JY, Rowland Payne CME, Beur WE. Bimodality in age of onset of psoriasis in both patients and relatives, Dermatology. 1993; 186:181−86.
- Pavithran K, Karunakaran M, Aparna P, Raghunatha S. PsoariasisIn: Valia RG, Valia AR. EDS. Disorders of keratinization. IADVL textbook of dermatology. Third edition. Volume 1, reprint. Bhalani publishing house; 2012. 30, p. 1021−56.
- Gudjonsson JE, Elder JT. Psoriasis. In: Goldsmith LA, Katz SI, Gilchrest, Paller AS, Leffell DJ, Wolff K. Eds. Fitzpatrick Dermatology in General Medicine. Eighth edition. Volume I; 2008. 18, p. 197−231.
- Griffiths CEM, Barker JNWN. Psoriasis In: Tony B, Stephen B, Neil C, Christopher G. editors. Rook textbook of dermatology, Eighth edition. Volume 1, Wiley-Blackwell; 2010. 20, p. 1−20.
- Peter Cm, Kerkhof vd, Nestle FO. Psoriasis In: Bolognia JL, Jorizzo JL, Schaffer JV, Eds. Dermatology, Third edition. Elsevier; 2008. p. 135−56.
- Smith CH, Anstey AV, Barker JN et al. British Association of Dermatologists guidelines for use of biological intervention in psoriasis, Br J Dermatol. 2005; 153:486−97.
- David H. Vroon, Zafar Israili. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd Edition.
- Oxidative Medicine and Cellular Longevity. 2016 (2016). Article ID 8490643, p. 7.
- Bhatnagar M, Bapna A, Khare A K. Serum proteins, trace metals and phosphatases in psoriasis, Indian J. DermatolVenereol. Leprol. 1994; 60:18−2
- Franck H, Ittel T. Serum osteocalcin levels in patients with psoriatic arthritis: An extended report, Rheumatol Int. 2000; 19(5):161−4
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- Sheikh G, Masood Q, Majeed S, Hassan I. Comparison of levels of serum copper, zinc, albumin, globulin and alkaline phosphatase in psoriatic patients and controls: A hospital based case control study, Indian Dermatol. Online J. 2015 Mar-Apr; 6(2):81−3. https://doi.org/10.4103/2229-5178.153006.
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- An Observational Study of Dermatological Manifestations in Patients of Chronic Renal Failure Undergoing Hemodialysis
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Authors
Affiliations
1 PG Resident, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422002, Maharashtra, IN
2 Associate Professor, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Professor and Head, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Senior Resident, Department of Dermatology, Venerology and Leprology, Dr. Vasantrao Pawar Institute of Medical Sciences and Research, Nashik – 422003, Maharashtra, IN
1 PG Resident, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422002, Maharashtra, IN
2 Associate Professor, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Professor and Head, Department of Dermatology, Venereology and Leprology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Senior Resident, Department of Dermatology, Venerology and Leprology, Dr. Vasantrao Pawar Institute of Medical Sciences and Research, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 6, No 2 (2019), Pagination: 120–125Abstract
Background: Chronic Renal Failure (CRF) patients develop myriad of cutaneous findings. Novel cutaneous changes are being described since the introduction of hemodialysis, which prolongs the life expectancy, and thus more time for the skin changes to develop. Aims & Objectives: We aimed to evaluate the prevalence of dermatologic manifestations among the patients suffering from Chronic Renal Failure (CRF) who are on hemodialysis. Methods: 93 patients with CRF receiving hemodialysis were evaluated for skin, hair and nail changes. Results: All the enrolled patients experienced some skin problem. The most prevalent cutaneous manifestation was xerosis (54.8%), followed by pallor (21.5%), pruritus (19.35%) and dyspigmentation (18.3%). Other dermatologic manifestations included Kyrle’s disease (5.4%); fungal (5.4%), bacterial (6.5%) and viral (3.2%) infections and purpura (9.7%). Recorded nail changes were half and half nail (21%), koilonychia (39.78%), onychomycosis (1.08%), onychorrhexis (6.45%), splinter hemorrhages (1.08%), and Beau’s lines (2%). Hair changes included sparse hair (18.28%), and brittle and lustreless hair (11.83%). Oral cavity manifestations were enlarged tongue with teeth indentations (23.65%). Conclusions: CRF is associated with multiple skin, hair and nail manifestationsKeywords
Dyspigmentation, Koilonychia, Onychomycosis, Pruritus, Xerosis.References
- Udaykumar P, Balasubramanian S, Ramalingam KS, Lakshmi C, Srinivas CR, Mathew AC. Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian J Dermatol Venereol and Lepr. 2006; 72:119–25. https://doi.org/10.4103/0378-6323.25636 PMid:16707817
- Hegab D, Mourad B, Okasha K, Rizk S. Prospective study on prevalence of dermatological changes in patients under hemodialysis in hemodialysis units in Tanta University hospitals, Egypt. Clinical, Cosmetic and Investigational Dermatology. 2014 Nov; 313–17. https://doi.org/10.2147/CCID.S70842 PMid:25419152 PMCid:PMC4235205
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- Chanda GM, Chintagunta SR, Arakkal G. Dermatological manifestations in chronic renal failure patients with and without hemodialysis: A study at a tertiary care centre. J NTR Univ Health Sci. 2017; 6:8–14
- Singh G, Verma AK, Singh G, Singh SJ. Cutaneous changes in chronicrenal failure. Indian J Dermatol Venereol and Leprol. 1992; 58:320–22.
- Sultan MM, Mansour HH, Wahby IM, Houdery AS. Cutaneous manifestations in Egyptian Patients with Chronic Renal Failure on regular hemodialysis. J Egypt Women Dermatol Soc. 2010; 7:49–55.
- Hajheydari Z, Makhlough. Cutaneous and mucosal manifestations in patients on maintenance hemodialysis: A study of 101 patients in Sari, Iran. Iranian Journal of Kidney diseases. 2008; 2:86–90.
- Falodun O, Ogunbiyi A, Salako B,George AK. Skin changes in patients with Chronic Renal Failure. Saudi J Kidney Dis Transpl. 2011; 22(2):268272
- Kolla PK, Desai M, Pathapati RM, Valli BM, Pentyala S, Reddy GM, et al. Cutaneous manifestations in patients with Chronic Kidney Disease on maintenance Hemodialysis. ISRN Dermatology. 2012:1–4. https://doi.org/10.5402/2012/679619 PMid:22830039 PMCid:PMC3398619
- Khanna D, Singal A, Kalra OP. Comparison of cutaneous manifestations in chronic kidney disease with or without dialysis. Postgrad Med J 2010; 86:641–4. https://doi.org/10.1136/pgmj.2009.095745 PMid:21037238