An observational study of cutaneous manifestations in internal malignancy at tertiary care centre

Introduction: Skin is the largest organ in the human body and mirrors the changes in the organism it envelops. Internal malignancies can cause various specific and non-specific cutaneous manifestations along with hair, nail and oral mucosal changes. Some of the changes are detected early indicating a strong association with cancer, while some occur in later stage indicating dissemination or immunosuppression. The present study is an effort to know pattern of dermatosis associated with internal malignancies so that early diagnosis and interventions can be done. Aim: To determine the pattern of specific and non-specific dermatosis associated with internal malignancy. Methods and Material: Patients of internal malignancies with skin lesions attending dermatology and oncology department during July 2020 to June 2021 were recruited in the study after taking written informed consent. A detailed history of skin lesions and malignancies were taken. Clinical examination (skin/hair/nail) was carried out and photographs were taken. Relevant investigations were carried out. Frequency and percentage of dermographic data and dermatosis associated with internal malignancies were calculated. Results: The study included 150 patients with maximum number of patients 78 (52%) in 41-60 years of age group with female: male ratio of 1.2:1. Most common internal malignancy was breast carcinoma in 43 (28.67%) cases. Specific dermatosis were seen in 5 (3.33%) cases and non-specific dermatosis in 121 (80.66%) cases. Specific dermatosis were vasculitis, necrolytic migratory erythema, lymphocytoma cutis, growth and cutaneous metastasis with 1 (0.67%) patient each. Most common non-specific dermatosis was herpes zoster in 17 (11.33%) cases. Conclusion: The study was useful in understanding the various specific and non specific dermatosis associated with internal malignancies and thereby helping the physician to manage the conditions

Clinical audit of radiofrequency electrocautery procedure at dermatology department of a tertiary care teaching center

Background: Radiofrequency (RF) surgery is an office-based procedure in the treatment of various skin conditions. It has the advantage of having both cut and coagulation modes, making the surgery easy, fast, effective, and cheaper, and causes minimal collateral thermal damage, resulting in rapid healing and esthetically pleasant scars. Objective: The present study was a clinical audit done with the aim to improve the quality of practice for RF electrocautery in the outpatient department (OPD) setup. Materials and Methods: This was a prospective clinical audit of patients coming to skin OPD requiring electrocauterization from August 2019 to October 2019. To assess and monitor the patients going for electrocautery, a pro forma was filled about the indication of electrocautery. Requirements and guidelines followed or not during pre- and postoperative preparation were also tabulated. During the procedure, details such as type of electrode, mode and power of electrocautery, wiping of electrode between each use, continuous activation of foot switch, and waiting period between two passages were also noted. Ratios, proportions, and percentages were used to describe the data. Results: A total of 30 patients were enrolled of which 24 were male (80%) and 6 were female (20%). The most common indication was skin tags seen in 21 participants (70%), followed by warts in 6 (20%) and seborrheic keratosis in 3 (10%) patients. Proper counseling and explanation were done in all the patients (100%). Each cautery was performed with clean surroundings (100%). During the procedure, 24 patients (80%) were given injectable local anesthetics. The electrode used was a long sharp tip electrode in all the procedures and the most common power of instrument used was 0.5 (70%). After each use, wiping of electrode was done in 24 (80%) patients. Three patients were on aspirin (10%) and one had a keloidal tendency (3.33%) which was missed while taking history. Conclusion: Educational interventions among doctors as well as students should be carried out to sensitize them about the standard guidelines of using electrocautery for better results