scholarly journals Primary Localized Cutaneous Amyloidosis: A Retrospective Study of an Uncommon Skin Disease in the Largest Tertiary Care Center in Switzerland

Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Carole Guillet ◽  
Simona Steinmann ◽  
Julia-Tatjana Maul ◽  
Isabel Kolm
Keyword(s):  
Treatment Efficacy ◽  
Care Center ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Substantial Improvement ◽  
Sufficient Information ◽  
High Potency ◽  
Systemic Involvement ◽  
Topical Corticosteroids ◽  
Uva1 Phototherapy

<b><i>Background:</i></b> Primary localized cutaneous amyloidosis (PLCA) is defined by the deposition of amyloid protein in the skin without systemic involvement. There are four subtypes of PLCA: lichen amyloidosis (LA), macular amyloidosis (MA), biphasic amyloidosis (BA), and nodular amyloidosis (NA). PLCA occurs most frequently in Latin Americans and Asians. Treatment is not standardized. <b><i>Objectives:</i></b> To identify subtypes, demographic and clinical features and treatment efficacy in patients with histopathologically confirmed PLCA. <b><i>Materials and Methods:</i></b> Data of PLCA patients were extracted from the electronic hospital database and included if diagnosis of PLCA was histopathologically confirmed and if sufficient information regarding treatment and follow-up was available. The evaluation of the treatment efficacy was based on a novel score to assess the reduction of itch and skin lesions. <b><i>Results:</i></b> In this retrospective, monocentric study, 37 cases of PLCA diagnosed between 2000 and 2020 were included (21 females) with a mean age of 52 years. LA was the most frequent subtype found in 21 patients (56.8%), followed by MA in 10 patients (28%) and BA in 6 patients (16.2%). No cases of NA were included. 22 patients (59.4%) had skin phototype II or III. Regarding treatment, a combination of UVA1 phototherapy with high-potency topical corticosteroids seemed to show the highest efficacy with complete clearance of symptoms in 4 patients (10.8%). A substantial improvement of symptoms was found in 5 patients (12.7%) treated with high-potency topical corticosteroids alone or in combination either with UVA1 or bath PUVA or monotherapy with UVA1 phototherapy or capsaicin (0.075%) cream. Low-/medium-potency topical corticosteroids alone or in combination with UVBnb (311 nm) phototherapy showed a lower efficacy. <b><i>Conclusion:</i></b> Our data show that PCLA is a rare disease in central Europe but can also be expected in a predominantly Caucasian population. The best treatment response was achieved with a combination of UVA1 phototherapy and high-potency topical corticosteroids.

scholarly journals Profile of Skin Biopsies and Patterns of Granulomatous Skin Diseases in a Tertiary Care Center of Western Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 288-293
Author(s):  
Ajay Kumar ◽  
Saujan Subedi ◽  
Jenny Pun ◽  
Binamra Basnet ◽  
Raja Babu Giri ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Clinical Impression ◽  
Clinicopathological Correlation ◽  
Diagnostic Challenge ◽  
Cross Sectional ◽  
Skin Biopsies

Background: Granulomatous skin diseases are one of the leading causes of morbidity in tropical countries like Nepal. These granulomatous skin lesions often pose diagnostic challenge to clinicians as well as to dermatopathologists. Histopathologic examination of a biopsy specimen represents one of the most informative and cost-effective procedure and may help to avoid other, costlier and invasive diagnostic workup. Materials and Methods: This cross-sectional observational study from October 2018 to October 2019, at department of dermatology, enrolled 142 cases of skin biopsies. Correlation between clinical impression and histopathological findings was evaluated. Results: Out of 13940 dermatology visits/ consultations, 142 (1.01%) skin biopsies were performed. Head, neck and face were the commonest sites of biopsies (29.6%). The most common biopsy technique was incisional type in 70 (50.4%). Histopathology showed granulomatous features in 49 (34.8%) cases, out of which tuberculoid type was the commonest, in 29 (58.0%). Positive clinicopathological correlation was seen in 117/142 (82.4%) for all biopsies and 41/49 (85%) for granulomaous skin lesions. Conclusion: Tuberculoid type was the most common cutaneous granuloma. High clinicopathological correlation in our study supports histopathology as an important tool for diagnosis of granulomatous as well overall skin disorders.

scholarly journals Cutaneous manifestations of COVID-19: experience from a tertiary care center for COVID-19 management in South India

2020 ◽  
Vol 7 (1) ◽  
pp. 118
Author(s):  
Olasseri K. R. Mariyath ◽  
Sreekanth Sukumarakurup ◽  
Koyakutty A. Samad ◽  
Keerankulangara Devi ◽  
George Nikhil ◽  
...  
Keyword(s):  
Erythema Multiforme ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Tertiary Care Center ◽  
Cutaneous Manifestations ◽  
Exanthematous Pustulosis ◽  
Isolation Ward

<p class="abstract">Cutaneous manifestations observed in COVID-19 include maculopapular rash, urticaria, pseudo chilblain, vesicles, livedo reticularis, petechiae, erythema multiforme-like, symmetric drug related intertriginous and flexural exanthem (SDRIFE)-like and pityriasis rosea-like lesions. Maculopapular rash involving the trunk and sparing palms and soles is the most common cutaneous manifestation reported in COVID-19 patients. We report cutaneous manifestations in six COVID-19 patients from the corona isolation ward and intensive care unit of a tertiary care center for COVID-19 management in Kerala, South India. The skin lesions observed were urticaria (two patients), atypical maculopapular rash with urticarial and erythema multiforme-like lesions, eruptive pseudoangiomatosis, exaggerated insect bite reaction and acute localized exanthematous pustulosis (ALEP)-like lesions. To the best of our knowledge atypical maculopapular rash with urticarial and erythema multiforme-like lesions, eruptive pseudoangiomatosis and acute localized exanthematous pustulosis-like lesions are not reported in COVID-19.</p>

scholarly journals Clinico-Pathological Profile of Cutaneous Lupus Erythematosus Patients: A Report from A Tertiary Care Center of Chattogram

2021 ◽  
Vol 20 (2) ◽  
pp. 79-84
Author(s):  
Mohammad Rafiqul Mowla ◽  
Deva Pratim Barua ◽  
Shakila Zaman ◽  
Mohammad Ismail Hossain Chowdhury ◽  
Papri Dutta ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Care Center ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Cutaneous Lupus Erythematosus ◽  
Skin Lesions ◽  
College Hospital ◽  
Cross Sectional ◽  
Common Manifestation ◽  
Cutaneous Lupus

Background : Nearly all epidemiologic studies have involved patients with Systemic Lupus Erythematosus (SLE). Few authors have investigated the characteristics of patients with Cutaneous Lupus Erythematosus (CLE). We aim to describe the epidemiologic, clinical, and immunologic characteristics of a series of patients diagnosed with CLE. Materials and methods : This is a descriptive retrospective cross-sectional study carried out using the register records of total 218 patients attending the ‘Lupus Clinic’ in Chittagong Medical College Hospital during the period 2010 and 2020. The disease activity and damage of CLE were assessed according to the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). Results : There were 187 females (86%) and 31 males (14%) with the female: male ratio being 6.1:1. The mean age was 28 ± 10.06 (mean ± SD) ranging between 11 and 65 years. The Chronic Cutaneous Lupus Erythematosus (CCLE) patients accounted 154 (71%) followed by Acute Cutaneous Lupus Erythematosus (ACLE) 46 (21%) and Subacute Cutaneous Lupus Erythematosus (SCLE) 18 (8%). On the basis of CLASI score, 91 (42%) patients were in mild form, 85 (39%) in moderate form and 42 (19%) in severe state. In LE specific skin lesions, common manifestation was photosensitivity 198 (91%) followed by discoid rash 154 (71%) and maculo-papular lupus rash 55 (25%). Oral ulcer was seen in 49 (22%) patients and malar rash in 46 (21%) patients. Other observed LE specific skin manifestations were papulo squamous rash 11 (5%), Toxic epidermal necrolysis like lesions 7 (3%) and lichenoid lesions 6 (3%). Among LE nonspecific skin lesions, common manifestation was nonscarring alopecia 123 (56%) followed by Raynaud’s phenomenon 17 (8%) livedo reticularis 17 (8%) Vasculitis 15 (7%) Periungual telangiectasia 7 (3%) erythema multiforme 6 (3%) and leg Ulcer 5 (2%). Antinuclear Antibody (ANA) 132 (61%) was the most common autoantibody followed by anti-ds DNA 91 (42%) anti-Sm antibody 2 (1%) anti-phospholipid antibodies 9 (4%) and anti-RNP 3 (1%). Hematological manifestations were seen in 161 (73.85%) where erythrocyte sedimentation rate was the most common hematological abnormality 161(73.85%) followed by lymphopenia 126 (57.80%) leucopenia 113 (51.80%) thrombocytopenia 107 (49.10%) anemia 92 (42%) monocytopenia 37 (16.97%). Conclusions: CCLE was the most common subtypes of CLE. Patients with different subtypes of CLE have distinct clinical and pathological characteristics. The onset or concurrence of SLE mandates the involvement of other disciplines depending on organ involvement. In the absence of consensus on a definition that makes it possible to differentiate cutaneous forms of LE from SLE, the dermatologist’s role in the correct diagnosis and classification of such patients is fundamental. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 79-84

scholarly journals Histopathological pattern of cutaneous disorders in tertiary care center in Shahjahanpur district of India

2020 ◽  
Vol 8 (7) ◽  
pp. 2531
Author(s):  
Amar Singh ◽  
Astha Pant
Keyword(s):  
Histopathological Examination ◽  
Care Center ◽  
Health Centre ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Cutaneous Tuberculosis ◽  
Younger Age ◽  
Common Group ◽  
Skin Biopsies ◽  
Patient Presentation

Background: Histopathological examination is most commonly needed and used investigation in dermatology. The main objective of this study is to share our experience with skin lesions from a tertiary health Centre by describing the histopathological patterns of 675 consecutive cases.Methods: The study was retrospective and was conducted in those patients who attended the OPD. A total of 675 cases were sent for histopathological examination. Further they were classified into various histological categories based on the site and pattern of involvement. Inclusion criteria involves all skin biopsies sent for histopathology examination, exclusion criteria was none.Results: Most common histopathological entity was infectious disease with 22.52% cases leading in this study. Out of which Hansen disease is on top with 16.29% which was followed by cutaneous tuberculosis with 3.70% (25) cases. Second most common group was of psoriasiform reactions with 9.77% cases. In this group most common disorder was psoriasis vulgaris with 5.92% (40) cases. Third and fourth most common group were spongiotic dermatitis and lichenoid dermatitis which presented with 9.18% and 9.03% cases with a minimal difference of 1 case.Conclusions: A huge diversity in skin lesions was noticed in our study ranging from nonspecific dermatitis to malignant melanoma conditions. There was a younger age predominance regarding the patient presentation. Hansen’s disease still remains a single entity in India for which skin biopsy are required.

scholarly journals Pigmented Lesions of Skin: A Histopathologic Experience at a Tertiary Care Center in Central Nepal

2021 ◽  
Vol 17 (1) ◽  
pp. 1-9
Author(s):  
Binita Goyal ◽  
Suman Rai ◽  
Mamata Sedhain ◽  
Pratigya Subedi
Keyword(s):  
Cell Carcinoma ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Care Center ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Pigmented Lesions ◽  
Pigmented Skin Lesions

Introduction Pigmented skin lesions refer to lesions that are brown, black or blue in color. These are not always melanocytic in origin. Keratinocytic, vascular or reactive pigmentation in other lesions can also appear pigmented. The main aim of the study was to see the histopathological spectrum and objective was to compare clinical and histopathological diagnoses in pigmented skin lesions. Methods This descriptive study was carried out on 43 pigmented skin lesions that were biopsied over a 1 and half year period from Jan 2018 to June 2019 in College of Medical Sciences and Teaching Hospital. Results Age of the patient ranged from 10 to 88 years and mean±SD was 42.02±19.73 years. There were 21 (48.8%) males and 22 (51.2%) females with a male female ratio 0.9:1. Melanocytic nevus was the most common histopathological diagnosis (11 cases, 25.6%). Reactive pigmentation was seen in 20 (46.5%) cases. Malignant cases comprised 6 (14.0%) cases which included 2 (4.7%) cases of melanoma, 2 (4.7%) cases of pigmented basal cell carcinoma and 1 (2.3%) case each of basaloid squamous cell carcinoma and trichoblastic carcinoma each. Clinicopathological agreement could be seen in 32 (74.4%) cases. However, malignancy was clinically suspected in only half of histologically diagnosed cases. Conclusions Melanocytic nevi were the most common pigmented lesions diagnosed. Not all pigmented lesions are melanocytic in origin. Malignant tumors can sometimes appear deceptively benign and also tumors other than melanoma can be pigmented. Hence, histopathological examination remains the gold standard in diagnosing these conditions and guiding appropriate management. Keywords: melanocytic; melanoma; nevus; pigmented.  

Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study

2020 ◽  
Vol 24 (3) ◽  
pp. 240-248
Author(s):  
Valérie Johnson Girard ◽  
Ashley Hill ◽  
Emma Glaser ◽  
Marie-Thérèse Lussier
Keyword(s):  
Quality Improvement ◽  
Adverse Effects ◽  
Patient Experience ◽  
Care Center ◽  
Phase 1 ◽  
Tertiary Care ◽  
Patient Communication ◽  
Coding System ◽  
Topical Corticosteroids ◽  
Before And After

Background Patients are often non-adherent to topical corticosteroids (TCS). This may be in part due to poor communication between patients and dermatologists. Objectives This quality improvement (QI) study aims to describe dermatologist–patient communication about TCS treatments and to compare communication before and after the implementation of an educational intervention. Methods This QI study assesses the communication between dermatologists and new dermatology outpatients receiving a TCS prescription in a tertiary care center. The QI intervention is 2-pronged, consisting of an educational pamphlet for patients and a communication workshop for the dermatology team. Encounters were audiotaped, and communication was analyzed using a coding system (MEDICODE). Phase 1 recordings happened preintervention and reflect the usual dermatologist–patient communication in this practice setting and phase 2 recordings were postintervention. Results Phase 1 reveals that dermatologists frequently address informational medication themes, such as naming the medications and informing patients about their proper use. They less frequently discuss patient experience themes, such as goals of treatment, adverse effects of treatments, and exploring patients’ emotions about medications (such as anxiety, fears, etc.). After the intervention, there was more frequent discussion of patient experience themes without increasing consultation length. But, in both phases, physicians address most themes as a monolog with little verbal input from patients. Conclusions Our study raises awareness regarding dermatologists’ communication patterns about TCS, identifying specific areas for improvement, such as discussions of adverse effects, and explicitly addressing patients’ attitudes and emotions. This is an essential step to foster a sense-making of TCS for patients.

scholarly journals Histopathological study of non-neoplastic skin lesions in a tertiary care center

2020 ◽  
Vol 6 (6) ◽  
pp. 395-400
Author(s):  
Dr. Sridevi Vijayasankar ◽  
◽  
Dr. Lionel Rohit Mathew ◽  
Dr. Ezhilvizhi Alavandhar ◽  
Dr. C.S. Vijayalakshmi ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Histopathological Study ◽  
Tertiary Care Center

EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari
Keyword(s):  
Burn Injury ◽  
Low Voltage ◽  
Care Center ◽  
Tertiary Care ◽  
The Body ◽  
Electrical Injury ◽  
Age Group ◽  
Electric Circuits ◽  
Medical College ◽  
Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

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