A clinicoepidemiological study of fixed drug eruptions at a tertiary centre of North India

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls

A clinicoepidemiological study of dermatoses among paediatric population

Background: Alike the normal population, even paediatric population encounters various dermatological conditions. Dermatosis among paediatric population can range from acute conditions, to chronic or recurrent and does carry significant burden on quality of life. It has to be dealt separately from adults as it has different symptoms, requires different treatment as has different prognosis for the same disease as compared to adults. Aim was to study the clinico-epidemiological profile of various dermatoses prevalent among the paediatric population less than 18 years.Methods: This was a prospective study done at a tertiary care centre of Jammu region. Paediatric patients less than 18 years of age attending the dermatology outpatient department were taken up for study. A detailed history was taken from the patient or attendants, detailed clinical examination was done. Also, laboratory investigations like KOH, gram stain, AFB stain, woods lamp, histopathological studies among others were done wherever required. The results were statistically evaluated and inferences drawn.Results: A total of 600 children were taken up for study. Males outnumbered the females with 302 females and 298 males. Maximum no. of patients (36.8%) were in the 6-11 years age group followed by 1-5 years age group (27%). Most common dermatoses seen over all the age groups was infections and infestations (39.1%) followed by eczematous group (16%). However, the pattern of dermatoses did vary in each age group and also was determined by the climate. Many patients had more than one dermatoses.Conclusions: This study was done to assess the burden of dematoses among paediatric population and found that various dermatoses did vary according to various age groups. Infections and infestations formed a major share

A clinicoepidemiological study of dermatoses among paediatric population

Background: Alike the normal population, even paediatric population encounters various dermatological conditions. Dermatosis among paediatric population can range from acute conditions, to chronic or recurrent and does carry significant burden on quality of life. It has to be dealt separately from adults as it has different symptoms, requires different treatment as has different prognosis for the same disease as compared to adults. Aim was to study the clinico-epidemiological profile of various dermatoses prevalent among the paediatric population less than 18 years.Methods: This was a prospective study done at a tertiary care centre of Jammu region. Paediatric patients less than 18 years of age attending the dermatology outpatient department were taken up for study. A detailed history was taken from the patient or attendants, detailed clinical examination was done. Also, laboratory investigations like KOH, gram stain, AFB stain, woods lamp, histopathological studies among others were done wherever required. The results were statistically evaluated and inferences drawn.Results: A total of 600 children were taken up for study. Males outnumbered the females with 302 females and 298 males. Maximum no. of patients (36.8%) were in the 6-11 years age group followed by 1-5 years age group (27%). Most common dermatoses seen over all the age groups was infections and infestations (39.1%) followed by eczematous group (16%). However, the pattern of dermatoses did vary in each age group and also was determined by the climate. Many patients had more than one dermatoses.Conclusions: This study was done to assess the burden of dematoses among paediatric population and found that various dermatoses did vary according to various age groups. Infections and infestations formed a major share

Desert Hedgehog-Primary Cilia Cross Talk Shapes Mitral Valve Tissue by Organizing Smooth Muscle Actin

Non-syndromic mitral valve prolapse (MVP) is the most common heart valve disease affecting 2.4% of the population. Recent studies have identified genetic defects in primary cilia as causative to MVP, although the mechanism of their action is currently unknown. Using a series of gene inactivation approaches, we define a paracrine mechanism by which endocardially-expressed Desert Hedgehog (DHH) activates primary cilia signaling on neighboring valve interstitial cells. High-resolution imaging and functional assays show that DHH de-represses smoothened at the primary cilia, resulting in kinase activation of RAC1 through the RAC1-GEF, TIAM1. Activation of this non-canonical hedgehog pathway stimulates α-smooth actin organization and ECM remodeling. Genetic or pharmacological perturbation of this pathway results in enlarged valves that progress to a myxomatous phenotype, similar to valves seen in MVP patients. These data identify a potential molecular origin for MVP as well as establish a paracrine DHH-primary cilium cross-talk mechanism that is likely applicable across developmental tissue types