A comparison study of the clinical efficacy and safety of topical adapalene gel (0.1%) and tretinoin cream (0.025%) in the treatment of acne vulgaris

Background: Adapalene a synthetic retinoid analogue, is an addition to the arsenal of topical retinoids developed for the topical treatment of acne vulgaris. The study was designed to compare the clinical efficacy and safety of topical adapalene gel 0.1% and tretinoin cream 0.025% in the treatment of acne vulgaris.Methods: A total of 80 patients with grade I-III acne vulgaris seen in the out-patient department of a tertiary care center were randomized to 8 weeks of daily treatment with either adapalene gel 0.1% or tretinoin gel 0.025%. Counts of total lesions, inflammatory lesions and non-inflammatory lesions were made at baseline and again at treatment weeks 2, 4, 6 and 8. Global assessment ratings, based on percent lesion reduction from baseline were also made. Side-effects like erythema, burning, pruritus, scaling and dryness were rated on a 0-3 severity scale.Results: Out of 80 patients there were 8 dropouts in the study; the 72 patients who completed the study were evaluated for efficacy and safety. Both adapalene and tretinoin produce dramatic reductions in total, inflammatory and non-inflammatory lesion counts, on an average. Cutaneous side-effects were limited to a mild retinoid dermatitis occurring in both treatment groups however patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin cream.Conclusions: Adapalene gel 0.1% offers comparable efficacy to tretinoin cream 0.025 % cream, but is less irritating. Adapalene gel 0.1% is a safe and effective topical agent in the treatment of mild to moderate acne vulgaris in Indian patients

Skin capillary density in pregnancy induced hypertension and normotensive pregnant participants

Background: Pre-eclampsia is a vascular related disorder of pregnancy, Despite the increasing research efforts in the field, the etiology and pathogenesis of this disorder remain elusive, resulting in failure to develop specific screening, preventive and treatment strategies. Peripheral vasodilatation and angiogenesis are critical components of physiological adaptation in normal pregnancy. Women who have later developed preeclampsia had significant structural capillary density rarefaction early in the pregnancy before the onset of preeclampsia.Methods: Case control, comparative study was carried out at our institute. 30 pregnant participants were recruited in each group after satisfying the inclusion criteria. Data was collected by using dermatoscope (200X magnification). Statistical analysis was done by non-parametric test- Mann-Whitney test as blood pressure was not normally distributed among participants. Spearman’s correlation coefficient was used to make correlation between skin capillary densities and blood pressures.Results: On applying Mann-Whitney test, mean rank for systolic and diastolic blood pressure at 20 weeks for both groups were not significant statistically, mean rank for systolic and diastolic blood pressure between 28-36 weeks of gestation for both groups were significant statistically. After testing, skin capillary density came significantly less in hypertensive group as compare to normotensive pregnant participant of same gestational ages. Spearman’s correlation coefficient came negative for systolic and positive for diastolic blood pressure at 28-36 weeks of gestation.Conclusions: Authors conclude that estimating the skin capillary density provides a potentially useful clinical marker in the prediction of preeclampsia and dermatoscope is an especially attractive clinical tool

A Study of Depression and Quality of Life in Patients of Lichen Planus

The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck’s depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life