DRESS Syndrome Secondary to Carbamazepine Therapy Presenting with Bilateral Acute Anterior Uveitis and Angle Closure Glaucoma

Purpose: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, lifethreatening multi-system adverse drug reaction characterized by febrile skin rash, hematologic abnormalities, and involvement of internal organs. We report a case of DRESS syndrome in a child presenting with primary ophthalmic manifestations. Case Report: An 11-year-old boy presented with severe pain and diminished vision in both eyes six weeks after starting carbamazepine therapy for seizure disorder. Ocular examination revealed features of bilateral acute anterior uveitis, acute onset myopia, and angle closure glaucoma secondary to uveal effusion. Additionally, the patient was febrile with a generalized maculopapular rash, and blood investigations revealed eosinophilic leukocytosis. A diagnosis of carbamazepine-induced DRESS syndrome was made, and carbamazepine therapy was discontinued. Treatment with cycloplegics, topical, and systemic steroids resulted in prompt clinical recovery. Conclusion: Ophthalmologists should be aware that hypersensitivity to anticonvulsants, such as carbamazepine, can present with bilateral uveitis and uveal effusion along with systemic symptoms. Prompt diagnosis and treatment can prevent vision loss and life-threatening complications. Patients should be counselled about potential adverse effects of anticonvulsants before therapy

Practicality in Using Diphenyl Cyclo Propenone for Alopecia Areata

Diphenyl cyclo propenone (DPCP) is used as a topical immunomodulator in alopecia areata. It is a potent allergen. The process of procuring, dilution and application limits its wider use. This short communication aims to make the DPCP application easy to use

Single-Hair Follicular Unit Transplant for Stable Vitiligo

Follicular unit transplant (FUT) is one of the surgical procedures which has been recently used to repigment a stable vitiligo patch. Single-hair FUT was done for a 30-year-old male with stable vitiligo patch on the upper lip. Repigmentation was noted in 4 weeks and complete pigmentation seen at 8 weeks. No recurrence was noted at the end of 6-month follow-up with excellent colour match. This case is presented to highlight the effectiveness of FUT in focal vitligo patch with leukotrichia

Controversies in hair transplantation

Hair transplantation being a relatively new field, several aspects raise issues and controversies. The issues refer to both ethics and evidence and how practitioners and the community need to deal with them. This article deals with few of such diverse issues as follicular unit transplantation versus follicular unit excision, safe donor area, platelet-rich plasma, and minimum qualification for performing hair transplantation

Assembling a hand-held trichotillometer and determination of epilation force in normal individuals

Aim: To assemble a simple, inexpensive hand-held trichotillometer and to determine the epilation force (EF) required to pluck the anagen hair and telogen hair from four regions of the scalp in healthy volunteers. Materials and Methods: A simple hand-held trichotillometer was assembled by modifying a laboratory spring balance, and the instrument was calibrated after attachments. EF was measured in 30 healthy individuals on four regions of the scalp. Results: A total of 30 volunteers were included in the study, among them 15 were males and 15 were females. A total of 1200 hairs were examined. The mean EF in our study was 70.15 grams (g). The mean EF required to pluck the anagen hair was 86.61 g and telogen hair was 53.69 g. Conclusion: The assembled- hand held trichotillometer is a simple and reliable device. Tricotillometer is a useful device to measure the EF in various physiological and pathological conditions and may have diagnostic, prognostic, and therapeutic value in various hair diseases

Outcomes of staple closure of the donor area during hair transplant by follicular unit transfer

Background: Donor area closure in hair transplantation by follicular unit transfer (FUT) is being done by various techniques. This study aims to assess the outcomes of staple closure for donor area in FUT. Aim: To study the outcome, efficacy and complications of staples in donor area closure for FUT. Materials and Methods: A total of 50 consecutive patients who underwent staple closure for donor area in FUT were included in the study and their data were collected retrospectively. Patients were followed up one year after the surgery and photographic documentation of the scar at the donor site was done. Objective measurement of the width of the scar was done for all the patients. Results: The average length of the donor area was 22 cm. The average width of the scar was 1.82 mm. There was no infection or tissue necrosis at the staple closure site in any of the patients. Conclusion: Staple closure resulted in cosmetically acceptable scar, but post operative discomfort was the major limitation. The potential to conserve the hair follicles along the line of closure makes using staples worthwhile if conservation of follicles is the goal

DRESS Syndrome Secondary to Carbamazepine Therapy Presenting with Bilateral Acute Anterior Uveitis and Angle Closure Glaucoma

Purpose: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, lifethreatening multi-system adverse drug reaction characterized by febrile skin rash, hematologic abnormalities, and involvement of internal organs. We report a case of DRESS syndrome in a child presenting with primary ophthalmic manifestations. Case Report: An 11-year-old boy presented with severe pain and diminished vision in both eyes six weeks after starting carbamazepine therapy for seizure disorder. Ocular examination revealed features of bilateral acute anterior uveitis, acute onset myopia, and angle closure glaucoma secondary to uveal effusion. Additionally, the patient was febrile with a generalized maculopapular rash, and blood investigations revealed eosinophilic leukocytosis. A diagnosis of carbamazepine-induced DRESS syndrome was made, and carbamazepine therapy was discontinued. Treatment with cycloplegics, topical, and systemic steroids resulted in prompt clinical recovery. Conclusion: Ophthalmologists should be aware that hypersensitivity to anticonvulsants, such as carbamazepine, can present with bilateral uveitis and uveal effusion along with systemic symptoms. Prompt diagnosis and treatment can prevent vision loss and life-threatening complications. Patients should be counselled about potential adverse effects of anticonvulsants before therapy