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Das S, Chandra A, Das A, Senapati S, Chatterjee G, Chatterjee R. Identifying the genetic associations among the psoriasis patients in eastern India. J Hum Genet 2024; 69:205-213. [PMID: 38409498 DOI: 10.1038/s10038-024-01227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/28/2024]
Abstract
Psoriasis is a multifactorial genetic disorder manifested by hyperproliferation and abnormal differentiation of epidermal keratinocytes, along with the infiltration of inflammatory cells into the skin. Although ~80 genetic susceptibility variants were reported in psoriasis, many loci showed population-specific associations, warranting the need for more population-specific association studies in psoriasis. We determined the association of forty single nucleotide polymorphisms (SNPs) among 2136 psoriasis patients and normal individuals from eastern India. We investigated the expression of corresponding genes and evaluated the protein structure stability for the genes with susceptible coding variants. We found fifteen SNPs significantly associated with psoriasis, while additional three SNPs showed significant association when we classified the patients based on the presence of HLA-Cw6 allele. Epistatic interaction between HLA-Cw6 and other associated loci showed significant association with the SNPs at PSORS1 region, along with other five SNPs outside PSORS1. Three genes showed significant differential expression in psoriatic tissues compared to the adjacent normal skin tissues but were not differential when classified the patients based on their genotypes. SNP rs495337 at SPATA2 (Spermatogenesis Associated 2) showed a 1.2-fold increased risk among the HLA-Cw6 patients compared to combined samples. We found significant downregulation of SPATA2 among the patients with risk genotypes and HLA-Cw6 allele compared to the non-risk genotypes. Protein structure stability analysis showed reduced structural stability for all the mutant residues caused by the associated coding variants. Our study evaluated the genetic associations of psoriasis-susceptible variants in India and evaluated the possible functional significance of these associated variants in psoriasis.
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Affiliation(s)
- Shantanab Das
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India
| | - Aditi Chandra
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India
| | - Anamika Das
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India
| | - Swapan Senapati
- Consultant Dermatologist, Uttarpara, Hooghly, West Bengal, 712258, India
| | - Gobinda Chatterjee
- Department of Dermatology, IPGMER/SSKM Hospital, Kolkata, West Bengal, India
| | - Raghunath Chatterjee
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India.
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Ganguly T, Laha S, Senapati S, Chatterjee G, Chatterjee R. Serum miRNA profiling identified miRNAs associated with disease severity in psoriasis. Exp Dermatol 2024; 33:e14973. [PMID: 37926911 DOI: 10.1111/exd.14973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/27/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
Psoriasis vulgaris is a chronic, autoimmune skin disease involving a complex interplay of epidermal keratinocytes, dermal fibroblast and infiltrating immune cells. Differential expressions of miRNAs are observed in psoriasis and the deregulated miRNAs are sometimes associated with disease severity. This study aims to identify miRNAs altered in the serum of psoriasis patients that are associated with the Psoriasis Area and Severity Index (PASI). In order to assess miRNA levels in the serum of psoriasis patients, we selected 24 differentially expressed miRNAs in the psoriatic skin are possibly derived from the skin and immune cells, as well as five miRNAs that are enriched in other tissues. We identified 16 miRNAs that exhibited significantly (p < 0.05) altered levels in the serum of psoriasis patients compared to healthy individuals. Among these, 13 miRNAs showed similar expression pattern in the serum of psoriasis patients as also observed in the psoriatic skin tissues. Ten miRNAs showed an accuracy of greater than 75% in classifying the psoriasis patients from healthy individuals. Further analysis of differential miRNA levels between the low PASI group and the high PASI group identified three miRNAs (miR-147b, miR-3614-5p, and miR-125a-5p) with significantly altered levels between the low severity and the high severity psoriasis patients. Our systematic investigation of skin and immune cell-derived miRNAs in the serum of psoriasis patients revealed alteration in miRNA levels to be associated with disease severity, which may help in monitoring the disease progression and therapeutic response.
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Affiliation(s)
- Torsa Ganguly
- Human Genetics Unit, Indian Statistical Institute, Kolkata, West Bengal, India
| | - Sayantan Laha
- Human Genetics Unit, Indian Statistical Institute, Kolkata, West Bengal, India
| | | | - Gobinda Chatterjee
- Department of Dermatology, IPGMER/SSKM Hospital, Kolkata, West Bengal, India
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Sayers CJ, Cerullo G, Zhang Y, Sanders CE, Chapman RT, Wyatt AS, Chatterjee G, Springate E, Wolverson D, Da Como E, Carpene E. Exploring the Charge Density Wave Phase of 1T-TaSe_{2}: Mott or Charge-Transfer Gap? Phys Rev Lett 2023; 130:156401. [PMID: 37115877 DOI: 10.1103/physrevlett.130.156401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 06/19/2023]
Abstract
1T-TaSe_{2} is widely believed to host a Mott metal-insulator transition in the charge density wave (CDW) phase according to the spectroscopic observation of a band gap that extends across all momentum space. Previous investigations inferred that the occurrence of the Mott phase is limited to the surface only of bulk specimens, but recent analysis on thin samples revealed that the Mott-like behavior, observed in the monolayer, is rapidly suppressed with increasing thickness. Here, we report combined time- and angle-resolved photoemission spectroscopy and theoretical investigations of the electronic structure of 1T-TaSe_{2}. Our experimental results confirm the existence of a state above E_{F}, previously ascribed to the upper Hubbard band, and an overall band gap of ∼0.7 eV at Γ[over ¯]. However, supported by density functional theory calculations, we demonstrate that the origin of this state and the gap rests on band structure modifications induced by the CDW phase alone, without the need for Mott correlation effects.
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Affiliation(s)
- C J Sayers
- Dipartimento di Fisica, Politecnico di Milano, Milan 20133, Italy
| | - G Cerullo
- Dipartimento di Fisica, Politecnico di Milano, Milan 20133, Italy
| | - Y Zhang
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - C E Sanders
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - R T Chapman
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - A S Wyatt
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - G Chatterjee
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - E Springate
- STFC Central Laser Facility, Research Complex at Harwell, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - D Wolverson
- Centre for Nanoscience and Nanotechnology, Department of Physics, University of Bath, Bath BA2 7AY, United Kingdom
| | - E Da Como
- Centre for Nanoscience and Nanotechnology, Department of Physics, University of Bath, Bath BA2 7AY, United Kingdom
| | - E Carpene
- IFN-CNR, Dipartimento di Fisica, Politecnico di Milano, Milan 20133, Italy
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Basu K, Addya S, Mukherjee S, Sengupta M, Pandey R, Chatterjee G, Bandopadhyay M. Clinicopathological Spectrum of Henoch-Schönlein Purpura Vasculitis: An Experience from a Tertiary Care Center. Saudi J Kidney Dis Transpl 2022; 33:693-701. [PMID: 37955461 DOI: 10.4103/1319-2442.389429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis with multiorgan involvement. Renal involvement is the key factor predicting morbidity. We have aimed to analyze the clinicopathological spectrum of HSP vasculitis and HSP nephritis to assess the risk factors associated with kidney involvement. This retrospective study was performed in the department of pathology with collaboration of department of dermatology and department of nephrology of a tertiary care center. All clinical details along with biopsy findings were retrieved. Starting materials of the study were cases of leukocytoclastic vasculitis with only perivascular IgA deposit of more than ++ in the absence of other immunoglobulin and trace complements. To investigate the possible factors that are influential on the development of biopsy-proven HSP nephritis, we divided the whole study population in two groups -group 1: with and group 2: without biopsy-proven nephritis. One-way analysis of variance was carried out during comparative analysis between two groups using IBM SPSS statistics software, version 19 and MedCalc software, version 12.3.0.0. HSP vasculitis comprised 11.6% (n = 19) of total cutaneous vasculitis in 2 years (164 cases) with a mean age of 13.52 ± 8.10 (range: 4-33 years). Three cases developed de novo kidney disease (15.79%). A correlation analysis revealed that predictors were seasonal variation (P = 0.018), severe gastrointestinal involvement (P = 0.03), and subcutaneous edema (P = 0.005). Various clinical and laboratory parameters were associated with renal consequences. Occult nephritis was the most common presentation with crescent as a constant histopathological feature.
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Affiliation(s)
- Keya Basu
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Soma Addya
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Sriranjan Mukherjee
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Rajendra Pandey
- Department of Nephrology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Department of Anatomy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
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Kaur Hora M, Choudhary N, Agrawal S, Gupta S, Gandhi J, De A, Chatterjee G. Evaluation of the Efficacy and Safety Profile of Long-Pulsed 1064 Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser in Hemangioma and Vascular Malformation in Darker Skin Types. Cureus 2022; 14:e25742. [PMID: 35812578 PMCID: PMC9270095 DOI: 10.7759/cureus.25742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction A prospective, interventional study was conducted to evaluate the efficacy and safety profile of long-pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in the treatment of vascular lesions in the darker skin patients of Fitzpatrick skin type IV and V. Materials and method The study was conducted at a tertiary care hospital. Institutional ethical committee permission was obtained before starting the study. Twenty-nine patients presenting with vascular lesions were enrolled in the study. The patients were called once a month for sessions for six months. Clinician Global Impression (CGI) scores were used for evaluation. We followed a “per protocol” analysis. Results Of the 29 patients we enrolled, three dropped out for various logistic reasons, and 26 patients completed their treatment. After six months of follow-up of the 26 patients who completed their treatment, 12 (46.15%) had shown complete healing (CGI = 4, 70%-100% improvement in lesions). The rest of the 14 (53.84%) patients showed good improvement (CG1 = 3, reduction of 50%-70% of lesions). No permanent side effects were noted. Conclusion Long-pulsed 1064 Nd:YAG laser proves to be an effective treatment for hemangioma and vascular malformation in darker skin patients with its major advantages of being a safe, well-tolerated, cost-effective procedure with minimal downtime and minimal side effects.
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Mallick S, Rudra O, Baisya S, Chatterjee G. Nailfold capillaroscopic changes as a marker of interstitial lung disease in systemic sclerosis: A cross-sectional study in a tertiary care hospital in Eastern India. Indian Dermatol Online J 2022; 13:216-220. [PMID: 35287403 PMCID: PMC8917487 DOI: 10.4103/idoj.idoj_393_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/23/2021] [Accepted: 10/30/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Aims: Materials and Methods: Results: Discussion:
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Sahu VK, Datta A, Sarkar T, Gayen T, Chatterjee G. Role of Trichoscopy in Evaluation of Alopecia Areata: A Study in a Tertiary Care Referral Centre in the Eastern India. Indian J Dermatol 2022; 67:127-132. [PMID: 36092210 PMCID: PMC9455090 DOI: 10.4103/ijd.ijd_577_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Alopecia areata is an autoimmune disorder affecting the hair-bearing sites of the body. Trichoscopy has recently been practiced in the diagnosis of alopecia areata. Aim To elicit trichoscopy patterns in alopecia areata and to find out any correlation of trichoscopic findings with disease severity. Methods Trichoscopy was done on clinically diagnosed cases of alopecia areata and on age and sex-matched controls without hair disorders by using a DL1 dermoscope (magnification: ×10). Observed dermoscopic findings were analyzed to find the correlation with disease severity. Results In total, 87 cases and 60 controls were included in the study with the mean age for cases being 25.47 ± 14.07 years. There was male predominance of cases (51; 58.62%). Alopecia in multiple patches was the most common type (42; 48.27%), and scalp was the most common site of involvement (79; 90.8%). Yellow dots (YD), black dots (BD), broken hairs (BH), circle hair (CH), and tapering hairs (TH) or exclamation hair (EH) were found to be statistically significant findings in alopecia areata as compared to controls. Circle hair was significantly associated with total severity of alopecia areata (P = 0.041). Yellow dots had a positive correlation with the number of episodes of alopecia areata (Spearman's rho = 0.273, P = 0.0106) and mean severity of alopecia tool (SALT) score (P = 0.0130). No significant association was noted between trichoscopic findings and disease activity, family history, disease associations, or nail involvement. Conclusion A constellation of trichoscopic findings helps in establishing the diagnosis of alopecia areata obviating the need for biopsy.
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Affiliation(s)
- Vineet K Sahu
- From the Department of Dermatology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Adrija Datta
- Department of Dermatology, IPGME&R, Kolkata, West Bengal, India
| | - Tanusree Sarkar
- Department of Dermatology, Burdwan Medical College and Hospitals, Burdwan, West Bengal, India
| | - Tirthankar Gayen
- Department of Dermatology, IPGME&R, Kolkata, West Bengal, India,Address for correspondence: Dr. Tirthankar Gayen, Madhabpur, Diamond Harbour, South 24 Parganas, West Bengal - 743 331, India. E-mail:
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Das S, Poddar S, Sen S, Chatterjee G. Could it be wolf isotopic response?: Occurrence of dermatophytoses on vitiliginous skin-case series of five cases from a tertiary care centre in India. Indian Dermatol Online J 2022; 13:240-243. [PMID: 35287404 PMCID: PMC8917505 DOI: 10.4103/idoj.idoj_377_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 06/24/2021] [Accepted: 08/02/2021] [Indexed: 11/12/2022] Open
Abstract
Wolf isotopic response is the occurrence of new dermatoses on areas of the skin with previous but still active dermatoses. Vitiligo is an acquired disorder characterized by the loss of functional melanocytes which manifests as circumscribed depigmented macules and patches. Dermatophytoses are superficial fungal infections caused by three genera of fungi (Microsporum, Trichophyton, and Epidermophyton) that have the unique ability to invade and multiply within keratinized tissue (skin, hair, and nail). The appearance of dermatophyte infection on previously present vitiligo lesion is an uncommon example of Wolf response. We describe a case series of five vitiligo patients that presented to our OPD over 1 year period.
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Varghese S, Sriram H, Chatterjee G, Girase K, Rajpal S, Ghogale S, Deshpande N, Badrinath Y, Patkar N, Gujral S, Subramanian P, Tembhare P. Expression pattern of a new marker, GL7 in different stages of B-cell maturation and its utility in B-lymphoblastic leukemia/lymphoma measurable residual disease assessment. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chandra A, Das S, Mazumder S, Senapati S, Chatterjee G, Chatterjee R. Functional Mapping of Genetic Interactions between HLA-Cw6 and LCE3A in Psoriasis. J Invest Dermatol 2021; 141:2630-2638.e7. [PMID: 34029573 DOI: 10.1016/j.jid.2021.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 12/31/2022]
Abstract
Functional studies to delineate the molecular mechanisms of causal genetic variants are the main focus in the post-GWAS era. Previous GWASs have identified >50 susceptibility loci associated with psoriasis. Functional understanding of the biology underlying the disease risk of most of these associated loci is unclear. In this study, we identified a regulatory SNP at the putative enhancer of the LCE3A gene within the epidermal differentiation complex that showed epistatic interaction with HLA-Cw6. The variant allele disrupted signal transducer and activator of transcription 3 binding to the region, thereby regulating the expression of the downstream LCE3A gene. Electrophoretic mobility shift and pulldown assay confirmed the preferential binding of signal transducer and activator of transcription 3 to the DNA with a wild-type allele compared with the DNA with a variant allele. The reporter assay further validated the IL-6‒stimulated phosphorylated signal transducer and activator of transcription 3‒mediated LCE3A activation in the presence of the wild-type allele. Interestingly, the presence of the HLA-Cw6 allele leads to IL-6‒mediated phosphorylation of signal transducer and activator of transcription 3, followed by its nuclear localization in the epidermal keratinocytes of psoriatic skin, suggesting indirect interaction of the HLA-Cw6 allele and a regulatory SNP upstream of the LCE3A gene. This study reflects an interesting approach to dissecting the molecular mechanism underlying the genetic interaction observed between HLA-Cw6 and LCE3A in psoriasis pathogenesis.
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Affiliation(s)
- Aditi Chandra
- Human Genetics Unit, Biological Sciences Division, Indian Statistical Institute, Kolkata, India
| | - Shantanab Das
- Human Genetics Unit, Biological Sciences Division, Indian Statistical Institute, Kolkata, India
| | - Sayani Mazumder
- Human Genetics Unit, Biological Sciences Division, Indian Statistical Institute, Kolkata, India
| | - Swapan Senapati
- Human Genetics Unit, Biological Sciences Division, Indian Statistical Institute, Kolkata, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post Graduate Medical Education & Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| | - Raghunath Chatterjee
- Human Genetics Unit, Biological Sciences Division, Indian Statistical Institute, Kolkata, India.
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Nag F, Chatterjee G, Ghosh A, De A. Clinico-Etiological Evaluation of Chronic Leg Ulcer in a Tertiary Care Center of Eastern India. Indian J Dermatol 2021; 65:495-499. [PMID: 33487705 PMCID: PMC7810075 DOI: 10.4103/ijd.ijd_62_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: A chronic leg ulcer (CLU) is a significant public health problem. It has various etiologies. Racial, familial, occupational, and social factors may also have an impact on the prevalence of different causes of leg ulcers. Though there are western data on the epidemiology of leg ulcer, similar data are largely unavailable from our part of the world. Aims: We undertook a study in a tertiary care center in eastern India to determine the clinical and etiological pattern of patients with CLU. Materials and Methods: Hundred consecutive patients presenting with CLU, fulfilling the criteria, were included after informed consent. Patients were subjected to proper history taking, clinical examination, routine blood test, and pus for culture and sensitivity test (where needed) along with Ankle Brachial Index (ABI). Results: Among the 100 patients, venous ulcer (34%) was predominant followed by arterial ulcer (14%), mixed arterial and venous ulcer (11%). History of smoking (56%) and obesity (BMI >25) (32%) were the common risk factors in leg ulcer patients. Fifty nine percent of the total CLU were infected and out of this, 86.4% showed growth of microorganisms. Staphylococcus aureus (39%) was the most commonly isolated organism, followed by Pseudomonas aeruginosa (15%). Eleven (24.44%) clinically diagnosed venous ulcer patients showed significantly lower ABI (<0.9) and were diagnosed as mixed ulcer (a venous ulcer with a peripheral arterial disease). Conclusion: Venous ulcer and mixed ulcer are the most common type of CLU.
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Affiliation(s)
- Falguni Nag
- Department of Dermatology, Purulia Government Medical College, Purulia, West Bengal, India
| | | | - Arghyaprasun Ghosh
- Department of Dermatology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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Karmakar S, Basu K, Sengupta M, Chatterjee G, Sarkar S, Bandopadhyay M. Genetic and acquired blistering disorders of pediatric age group: An experience from Eastern India. INDIAN J PATHOL MICR 2021; 64:509-517. [PMID: 34341262 DOI: 10.4103/ijpm.ijpm_314_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Blistering or vesiculobullous disorders in pediatric population are either immunobullous or mechanobullous. Spectrum was analyzed using demographic details, clinical features, histopathology, direct immunofluorescence (DIF) and Immunofluorescence mapping (IFM). Methodology This was a single institution based observational study in children below 18 years. The demographic details were collected using proforma containing particulars of the patient, history, complaints, and other parameters. Punch biopsy of the skin lesion was done. Biopsy samples were examined under light microscope followed by DIF using fluorescent conjugated polyclonal antibody against immunoglobulins IgG, IgM, IgA, and complement C3. The salt-split technique was also used in particular cases. IFM was done using anticytokeratin (CK) 5 & 14, antilaminin 332, anticollagen VII, and anticollagen IV antibodies. Results Out of total 50 cases, linear IgA bullous dermatosis (LABD) was the commonest. The average concordance between clinical and final diagnosis (histopathological examination + DIF) was 87.5% and discordance was 12.5%. The agreement between histopathological examination and DIF was found to be substantially significant (κ = 0.6892). IFM depicted epidermolysis bullosa simplex with reduced CK 14 expression, dystrophic epidermolysis bullosa with reduced Collagen VII expression and junctional epidermolysis bullosa with absent laminin 5 expression. Conclusion The spectrum of bullous lesions in childhood was properly delineated and subcategorization of EB was done. Histopathological examination showed the hallmarks that were conclusive in most of the cases except in LABD and EB. DIF and IFM proved indispensable in those cases. Thus, DIF is not a substitute for histopathology but complementary to it.
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Affiliation(s)
- Subhrojyoti Karmakar
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Sumantra Sarkar
- Department of Pediatric Medicine, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Department of Anatomy, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
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Behra A, Chatterjee G, Chandra A, Chatterjee R. Association of Human Leukocyte Antigen- Cw6 in Psoriasis Patients with Disease Severity and Morphological Patterns: A Cross-control Study in a Tertiary Care Referral Centre in Eastern India. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/50595.15198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Psoriasis is a multifactorial disorder in which genetic and environmental factors play an essential role in disease pathogenesis. The Human Leukocyte Antigen-Cw6 (HLA-Cw6) allele has shown the strongest genetic association with this condition across several populations studied. Aim: To estimate the risk of HLA-Cw6 association with psoriasis compared to the control group and its association with the severity of psoriasis expressed as Psoriasis Area and Severity Index (PASI) score and morphological patterns. Materials and Methods: A cross-control study was conducted from March 2014 to February 2015 in a tertiary care centre in the eastern part of India. All patients who were diagnosed clinically as psoriasis and gave written informed consent were included in the study. Healthy controls were taken to compare the HLA-Cw6 after duly signing the informed consent for detailed history, clinical examination, PASI score, and digital photographs of lesions were taken. A blood sample was taken from patients and the control for HLA-Cw6 typing by sequence- specific Polymerase Chain Reaction (PCR) method. Data was analysed by appropriate statistical test (Chi-square test) using R statistical software. Results: A total of 100 patients with psoriasis and 100 controls were recruited, of which 61 were positive for HLA-Cw6 among the psoriasis group and nine in the control group. Positivity of the HLA-Cw6 allele was significantly higher in psoriasis cases (n=61) compared to normal individuals (n=9) (p-value: 1.79×10-15, OR: 15.8148, 95% CI: 7.15-34.99). It was also observed that HLA-Cw6 positive individuals had a more severe form of the disease, determined by a PASI score >6 (p-value: 0.0494, OR: 2.22, 95% CI: 0.96-5.15), and significant involvement of scalp psoriasis (p-value: 0.0054, OR: 13.125, 95% CI: 1.55-111.42). However, no significant association of HLA-Cw6 was seen with positive family history, nail involvement, and joint pain (arthralgia). Conclusion: The HLA-Cw6 positivity was associated with a more severe form of disease and scalp psoriasis.
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Das AK, Mithal A, Kumar KMP, Unnikrishnan AG, Kalra S, Thacker H, Sethi B, Ghosh R, Mathew A, Chodankar D, Mohanasundaram S, Menon SK, Trivedi C, Naqvi M, Kanade V, Salvi V, Chatterjee G, Rais N, Wangnoo SK, Chowdhury S, Zargar AH, Joshi S. Rationale, study design and methodology of the LANDMARC trial: a 3-year, pan-India, prospective, longitudinal study to assess management and real-world outcomes of diabetes mellitus. Diabet Med 2020; 37:885-892. [PMID: 31691356 PMCID: PMC7216981 DOI: 10.1111/dme.14171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 11/30/2022]
Abstract
AIM India contributes towards a large part of the worldwide epidemic of diabetes and its associated complications. However, there are limited longitudinal studies available in India to understand the occurrence of diabetes complications over time. This pan-India longitudinal study was initiated to assess the real-world outcomes of diabetes across the country. METHODS The LANDMARC study is the first prospective, multicentre, longitudinal, observational study investigating a large cohort of people with type 2 diabetes mellitus across India over a period of 3 years. The primary objective of this ongoing study is to determine the proportion of people developing macrovascular diabetes complications over the duration of the study (36 months ± 45 days) distributed over seven visits; the secondary objective is to evaluate microvascular diabetes complications, glycaemic control and time-to-treatment adaptation or intensification. Overall, 6300 participants (aged 25-60 years) diagnosed with type 2 diabetes for at least 2 years will be included from 450 centres across India. Data will be recorded for baseline demographics, comorbidities, glycaemic measurements, use of anti-hyperglycaemic medications and any cardiovascular or other diabetes-related events occurring during the observational study period. CONCLUSIONS The LANDMARC study is expected to reveal the trends in complications associated with diabetes, treatment strategies used by physicians, and correlation among treatment, control and complications of diabetes within the Indian context. The findings of this study will help to identify the disease burden, emergence of early-onset complications and dose titration patterns, and eventually develop person-centred care and facilitate public health agencies to invest appropriate resources in the management of diabetes. (Trial Registration No: CTRI/2017/05/008452).
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Affiliation(s)
- A. K. Das
- Pondicherry Institute of Medical Sciences (PIMS)PuducherryIndia
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- Chowpatti Medical CentreMumbaiIndia
| | - S. K. Wangnoo
- Apollo Hospital Education and Research FoundationNew DelhiIndia
| | | | - A. H. Zargar
- Center for Diabetes & Endocrine CareSrinagarIndia
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Das NK, De A, Naskar B, Sil A, Das S, Sarda A, Chatterjee G. A Quality of Life Study of Patients with Leprosy Attending the Dermatology OPD of a Tertiary Care Center of Eastern India. Indian J Dermatol 2020; 65:42-46. [PMID: 32029939 PMCID: PMC6986124 DOI: 10.4103/ijd.ijd_729_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Leprosy is a chronic infectious disease caused by Mycobacterium leprae affecting the skin, peripheral nervous system, and other tissues. The disease is associated with social stigma, and the patients sometimes suffer social discrimination because it often leads to visible physical deformities. Hence, leprosy may have severe impact on the quality of life (QoL) of patients. AIMS AND OBJECTIVES The aim of this study was to assess the effect of leprosy on the QoL of the affected patients and to find out whether there is some association with certain demographic and clinical factors. MATERIALS AND METHODS The Dermatology Life Quality Index (DLQI) questionnaire was used to assess the QoL of 114 patients with leprosy who attended dermatology outpatient department of a tertiary care center of eastern India. This was a cross-sectional study. RESULTS Among a total of 114 patients, leprosy had no impact on the QoL of 15 (13.16%) patients. There was a mild impact in 23 (20.18%) of the patients. There was moderate impact in 37 (32.46%) of the patients. The disease had severe impact in the QoL of 39 (34.21%) patients. None of the patients had a very severe impact. Several of the clinical aspects such as nerve involvement, systemic features, deformity, disability grade, and type of leprosy have significant impact on QoL. Among the demographic factors, gender had some effects on QoL. CONCLUSION Leprosy adversely affects the QoL of those affected. Although it is considered a social disease, at least in our part of the country, demographics have minimal effect on the QoL. Rather, important clinical aspects such as systemic features, nerve involvement, reaction, deformity, and disability have profound impact on the QoL of the patients.
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Affiliation(s)
- Nirmalya K Das
- From the Department of Dermatology, IPGMER, Kolkata, West Bengal, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Biswanath Naskar
- From the Department of Dermatology, IPGMER, Kolkata, West Bengal, India
| | - Amrita Sil
- Department of Pharmacology, Rampurhat Government Medical College, Rampurhat, West Bengal, India
| | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Aarti Sarda
- Department of Dermatology, Wizderm Specialty Skin and Hair Clinic, Kolkata, West Bengal, India
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Biswas P, Pal D, De A, Chatterjee G, Ghosh A, Das S, Das PK, Sarda A, Sen S. Clinicopathological Study of Primary Cutaneous Amyloidosis in a Tertiary Care Center of Eastern India Reveals Insignificant Association with Friction, Scrubbing, and Photo-Exposure: How valid is the "Keratinocyte Hypothesis"? Indian J Dermatol 2019; 64:28-33. [PMID: 30745632 PMCID: PMC6340246 DOI: 10.4103/ijd.ijd_149_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction: Primary cutaneous amyloidosis (PCA) can be classified into four principal categories: macular amyloidosis, lichen amyloidosis, biphasic, and nodular amyloidosis. Some unusual variants such as widespread diffuse hyperpigmentation without papules, poikiloderma like involvement, lesions following Blaschko's line, etc., have also been reported. However, not much data are available regarding the demography, epidemiology, clinical patterns, and distribution and histopathological findings, especially from the eastern part of India. Aims: We conducted a cross-sectional, institution-based study to evaluate clinicopathological pattern and factors of PCA in eastern India. Materials and Methods: We recorded clinical and histopathological findings of 100 consecutive patients of PCA presenting to a tertiary care institution of Kolkata in eastern India. Results: We found female patients of PCA outnumber male (M:F =1:1.9) with majority of patients being young adults (56%) between 20 and 40 years of age. More than half (54%) of the patients were pruritic. The severity of pruritus is significantly more associated with lichenoid and biphasic variants over macular amyloidosis. Positive family history was recorded in 17% of cases. Macular variant was the most common variant constituting 48% of the total PCA. We also found that the association with history of friction and scrubbing and photo-exposure were statistically insignificant. However, duration of the disease has statistically significant association with the disease morphology. Congo red stain showed these deposits as reddish orange substance in 28 patients out of 64 patients’ samples on which Congo red could be performed. Conclusion: Our study revealed that many concepts of pathogenesis of PCA including friction and photoexposure might have lesser importance. However, morphological types were significantly associated with the duration of the disease and symptom severity.
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Affiliation(s)
- Projna Biswas
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Dayamay Pal
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | | | - Arghyaprasun Ghosh
- Department of Dermatology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Pijush Kanti Das
- Department of Obstetrics and Gynecology, Calcutta Medical College, Kolkata, West Bengal, India
| | - Aarti Sarda
- Department of Dermatology, Wizderm Skin and Hair Clinic, Kolkata, West Bengal, India
| | - Sumit Sen
- Department of Dermatology, IPGMER, Kolkata, West Bengal, India
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Chandra A, Senapati S, Roy S, Chatterjee G, Chatterjee R. Epigenome-wide DNA methylation regulates cardinal pathological features of psoriasis. Clin Epigenetics 2018; 10:108. [PMID: 30092825 PMCID: PMC6085681 DOI: 10.1186/s13148-018-0541-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/29/2018] [Indexed: 02/05/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory autoimmune skin disorder. Several studies suggested psoriasis to be a complex multifactorial disease, but the exact triggering factor is yet to be determined. Evidences suggest that in addition to genetic factors, epigenetic reprogramming is also involved in psoriasis development. Major histopathological features, like increased proliferation and abnormal differentiation of keratinocytes, and immune cell infiltrations are characteristic marks of psoriatic skin lesions. Following therapy, histopathological features as well as aberrant DNA methylation reversed to normal levels. To understand the role of DNA methylation in regulating these crucial histopathologic features, we investigated the genome-wide DNA methylation profile of psoriasis patients with different histopathological features. Results Genome-wide DNA methylation profiling of psoriatic and adjacent normal skin tissues identified several novel differentially methylated regions associated with psoriasis. Differentially methylated CpGs were significantly enriched in several psoriasis susceptibility (PSORS) regions and epigenetically regulated the expression of key pathogenic genes, even with low-CpG promoters. Top differentially methylated genes overlapped with PSORS regions including S100A9, SELENBP1, CARD14, KAZN and PTPN22 showed inverse correlation between methylation and gene expression. We identified differentially methylated genes associated with characteristic histopathological features in psoriasis. Psoriatic skin with Munro’s microabscess, a distinctive feature in psoriasis including parakeratosis and neutrophil accumulation at the stratum corneum, was enriched with differentially methylated genes involved in neutrophil chemotaxis. Rete peg elongation and focal hypergranulosis were also associated with epigenetically regulated genes, supporting the reversible nature of these characteristic features during remission and relapse of the lesions. Conclusion Our study, for the first time, indicated the possible involvement of DNA methylation in regulating the cardinal pathophysiological features in psoriasis. Common genes involved in regulation of these pathologies may be used to develop drugs for better clinical management of psoriasis. Electronic supplementary material The online version of this article (10.1186/s13148-018-0541-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aditi Chandra
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India
| | | | - Sudipta Roy
- MDDC, Lansdowne Place, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, IPGMER/SSKM Hospital, Kolkata, West Bengal, India
| | - Raghunath Chatterjee
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India.
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Majumdar B, De A, Ghosh S, Sil A, Sarda A, Lahiri K, Chatterjee G, Das S. "Turban PUVAsol:" A Simple, Novel, Effective, and Safe Treatment Option for Advanced and Refractory Cases of Alopecia Areata. Int J Trichology 2018; 10:124-128. [PMID: 30034192 PMCID: PMC6028997 DOI: 10.4103/ijt.ijt_95_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Alopecia areata (AA) is an autoimmune characterized by nonscarring loss of scalp and/or body hairs. Topical PUVA has been reported to have good effect in AA. The modification of topical PUVA which we call, "Turban PUVA-sol," is a method of localized immunotherapy using psoralen solution followed by sun exposure. Aims We aim to study the therapeutic role and side effect profile of turban PUVA in the treatment of advanced and refractory AA. Methodology Fifteen consecutive patients of alopecia subtotalis (at least 70% of scalp hair loss), totalis, and universalis, attending the dermatology outpatient department of a tertiary care hospital in eastern India were subjected to "Turban PUVA-sol" after duly signed consent. Alternate day therapy was given. Results At the end of 10 months of study, 2 (13%) out of fifteen patients were lost to follow-up for some unknown reasons. The severity of alopecia tool scores showed a significant (P = 0.0002) decrease posttreatment. Correlation between the severity of alopecia and grade of improvement showed a rho value of -0.453. In the remaining thirteen patients, using physician global assessment (PGA), 4 (26%) showed good response, 4 (26%) showed moderate response, 3 showed mild (20%) response, and 2 patients (13%) showed negligible response. Three out of four patients who showed good improvement in PGA showed more than 80% of new hair growth. Side effects are minimal with some patients complaining of mild irritation and scaling. Conclusion We found topical Turban PUVAsol to be a very cost-effective and safe treatment option for AA.
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Affiliation(s)
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | | | - Amrita Sil
- Department of Pharmacology, IPGMER, Kolkata, West Bengal, India
| | - Aarti Sarda
- Wizderm specialty skin and hair clinic, Kolkata, West Bengal, India
| | - Koushik Lahiri
- Wizderm specialty skin and hair clinic, Kolkata, West Bengal, India
| | | | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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Ahar R, Aggarwal I, Samanta A, Ghosh A, Chatterjee G, Sharma N. Palmer Freckling as a New Clinical Marker: Clinico-epidemiological Study of 26 Cases of Neurofibromatosis Type-1. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/32125.11478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ghosh A, Ahar R, Chatterjee G, Sharma N, Jadhav SA. Clinico-epidemiological Study of Congenital Ichthyosis in a Tertiary Care Center of Eastern India. Indian J Dermatol 2017; 62:606-611. [PMID: 29263534 PMCID: PMC5724308 DOI: 10.4103/ijd.ijd_411_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Congenital ichthyoses comprises various specific genetic diseases and can range from mild to very severe presentation. Furthermore, these may be associated with various syndromes. There is scanty data regarding the demographic profile and clinical features of patients with congenital ichthyosis in India. Aims and Objectives The aim is to evaluate the epidemiology and clinical characteristics of various types of congenital ichthyoses. Materials and Methods The study was conducted for 1 year from April 2013 to March 2014. Patients were evaluated for epidemiological profile and clinical features. Results During the study of 1 year, 106 patients of congenital ichthyoses were identified. The most common of the various ichthyoses was ichthyosis vulgaris, followed by lamellar ichthyosis, X-linked recessive ichthyosis. One case of Netherton syndrome and one of ichthyosis hystrix were also identified. Conclusion Various types of congenital ichthyoses present with different clinical features which range from mild to severe. These present with significant psychological stress to both patients and their families. Furthermore, all these diseases have significant implications of transmission to their offspring.
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Affiliation(s)
- Arghyaprasun Ghosh
- Department of Dermatology, Venereology and Leprosy, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Rahul Ahar
- Department of Dermatology, Venereology and Leprosy, Shridev Suman Subharti Medical College, Dehradun, Uttarakhand, India
| | - Gobinda Chatterjee
- Department of Dermatology, Venereology and Leprosy, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Neha Sharma
- Department of Dermatology, Venereology and Leprosy, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Shruti Alhad Jadhav
- Department of Dermatology, Venereology and Leprosy, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Affiliation(s)
- Gobinda Chatterjee
- Department of Dermatology, Venereology and Leprosy, Institute of Post Graduate Medical Education & Research (IPGME&R) & Seth Sukhlal Karnani Memorial (SSKM) Hospital, Kolkata 700 020, West Bengal, India
| | - Atul Jain
- Department of Dermatology, Venereology and Leprosy, Institute of Post Graduate Medical Education & Research (IPGME&R) & Seth Sukhlal Karnani Memorial (SSKM) Hospital, Kolkata 700 020, West Bengal, India
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Kalia A, Gandhi T, Chatterjee G, Swami P, Dhillon H, Bi S, Chauhan N, Gupta SD, Sharma P, Sood S, Ganesh S, Mathur U, Sinha P. Assessing the impact of a program for late surgical intervention in early-blind children. Public Health 2017; 146:15-23. [PMID: 28404468 DOI: 10.1016/j.puhe.2016.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Many blind children in the developing world are unable to obtain timely treatment due to lack of financial and medical resources. Can public health programs that identify and treat such children several years after the onset of blindness enhance their quality of life? The notion that visual development is subject to an early 'critical period' argues against this possibility. However, there are inadequate empirical data from humans on this issue. To address this need, we examined the quality of life of children living in India and who were treated for early-onset blindness (before one year of age), due to cataracts or corneal opacities. STUDY DESIGN Survey study. METHODS As part of an ongoing scientific effort named Project Prakash, we screened over 40,000 children in rural northern India to identify those suffering from early-onset blindness. They were provided eye surgeries in a tertiary care ophthalmic center in New Delhi. We subsequently surveyed 64 Prakash children, ranging in age from 5 to 22 years and obtained their responses on a multi-dimensional quality of life questionnaire. RESULTS Nearly all of the subjects indicated that their quality of life had improved after treatment. Children reported marked enhancement in their mobility, independence, and safety, and also in social integration. Surprisingly, we found no significant correlations between quality of life metrics and factors such as age at treatment, gender, time since treatment, and pre-surgery and post-surgery acuity. CONCLUSIONS A key question for public health policy makers is whether a program of surgical intervention for older blind children is likely to be beneficial, or if the resources are better spent on rehabilitation via vocational training and assistive devices. The marked improvements in quality of life we find in our data strongly argue for the provision of surgical care regardless of a child's age.
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Affiliation(s)
- A Kalia
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, USA.
| | - T Gandhi
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, USA; Department of Electrical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - G Chatterjee
- Computer Vision and Pattern Recognition Unit, Indian Statistical Institute, Kolkata, India
| | - P Swami
- Center for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - H Dhillon
- Community Outreach Department, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - S Bi
- Community Outreach Department, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - N Chauhan
- Community Outreach Department, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - S D Gupta
- Community Outreach Department, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - P Sharma
- Department of Pediatric Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - S Sood
- Lexington High School Lexington, USA
| | - S Ganesh
- Department of Pediatric Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - U Mathur
- Department of Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - P Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, USA
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Affiliation(s)
- Tirthankar Gayen
- Department of Dermatology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Ishad Aggarwal
- Department of Dermatology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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De A, Hasanoor Reja AH, Aggarwal I, Sen S, Sil A, Bhattacharya B, Sharma N, Ansari A, Sarda A, Chatterjee G, Das S. Use of Fine Needle Aspirate from Peripheral Nerves of Pure-neural Leprosy for Cytology and Polymerase Chain Reaction to Confirm the Diagnosis: A Follow-up Study of 4 Years. Indian J Dermatol 2017; 62:635-643. [PMID: 29263539 PMCID: PMC5724313 DOI: 10.4103/ijd.ijd_115_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Pure neural leprosy (PNL) still remains a diagnostic challenge because of the absence of sine qua non skin lesions of leprosy and a confirmatory diagnostic method. The authors had earlier described a simple yet objective technique of combining fine needle aspiration cytology (FNAC) coupled with a multiplex polymerase chain reaction (PCR) in a pilot study, wherein the technique showed promise of a reliable diagnostic tool. In the pursuit of further evidence, the authors carried out a 4-year study with PNL cases to find the efficacy and reliability of the said method in a larger sample size. Aim: This study was conducted to find the efficacy, reliability, and reproducibility of FNAC coupled with multiplex PCR and Ziehl-Neelsen (ZN) staining in identifying the cases of PNL. Materials and Methods: All cases that were suspected to be suffering from PNL, following evaluation by two independent observers were included in the study and were subjected to FNAC from the affected nerve, and the aspirates were evaluated for cytology, ZN staining, and multiplex PCR for Mycobacterium leprae genome. In addition, serum anti-PGL1 levels were also performed in all the study subjects. Fifteen non-PNL cases were also included in the control arm. Results: A total of 47 cases were included in the test arm and subjected to FNAC. Conventional ZN staining could demonstrate acid-fast bacilli (AFB) in only 15 out of 47 cases (31.91%) while M. leprae DNA could be elicited in 37 (78.72%) cases by the multiplex PCR. Only 13 (27.65%) out of 47 cases showed anti-PGLI-1 antibody positivity. On cytological examination of the nerve aspirates, only 11 (23.40%) cases showed epithelioid cells whereas nonspecific inflammation was seen in 26 (75.60%) cases. Conclusion: The results of this study conducted over a larger sample size corroborate with the findings of our pilot study. In a resource poor set up, FNAC in combination with ZN staining and multiplex PCR is a rapid, simple, and easily performed test, which can give a reproducible and objective diagnosis in cases of PNL.
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Affiliation(s)
- Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | | | - Ishad Aggarwal
- Department of Dermatology, IPGMER, Kolkata, West Bengal, India
| | - Sumit Sen
- Department of Dermatology, IPGMER, Kolkata, West Bengal, India
| | - Amrita Sil
- Department of Pharmacology, IPGMER, Kolkata, West Bengal, India
| | | | - Nidhi Sharma
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Asad Ansari
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Aarti Sarda
- Department of Dermatology, KPC Medical College, Kolkata, West Bengal, India
| | | | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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Raj HJ, Majumdar B, Jain A, Maiti PK, Chatterjee G. A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management. J Clin Diagn Res 2016; 9:WC01-4. [PMID: 26816977 DOI: 10.7860/jcdr/2015/16199.6963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/30/2015] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country. AIM The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents. MATERIALS AND METHODS Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features. RESULTS Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment. CONCLUSION A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses.
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Affiliation(s)
- Hirak Jyoti Raj
- Assistant Professor, Department of Microbiology, IPGME&R , Kolkata, India
| | - Banashree Majumdar
- Post Graduate Trainee, Department of Dermatology, IPGME&R , Kolkata, India
| | - Atul Jain
- Post Graduate Trainee, Department of Dermatology, IPGME&R , Kolkata, India
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Gangopadhyay A, Ghosh A, Biswas S, Singha J, Aggarwal I, Chatterjee G. Darier's Disease in Gastric Malignancy: An Unusual Paraneoplastic Phenomenon. Indian J Dermatol 2015; 60:423. [PMID: 26288448 PMCID: PMC4533578 DOI: 10.4103/0019-5154.160535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Darier's disease is an autosomal dominant genodermatosis resulting from ATP2A2 gene mutation. A 62-year-old male presented at our outpatient (OPD) with sudden-onset numerous dirty, warty papules over the head, neck, and back since 2 months. Histopathology of the skin lesions revealed acantholytic dyskeratosis suggestive of Darier's disease. He was referred to the gastroenterology department for some gastrointestinal (GI) symptoms where he was diagnosed with adenocarcinoma of the stomach and was subsequently operated. On his next visit to our department for follow-up, we found a marked diminution of the skin lesions in the absence of any specific treatment. In view of the above finding, we concluded that paraneoplastic dermatosis in the form of Darier's disease occurred in this patient. Paraneoplastic Darier's disease with gastric adenocarcinoma is not yet described in dermatology literature and is hence reported here.
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Affiliation(s)
- Anusree Gangopadhyay
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Arghyaprasun Ghosh
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Saugato Biswas
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Joydeep Singha
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ishad Aggarwal
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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De A, Reja AHH, Biswas S, Bhattacharya B, Chatterjee G, Basu K, Sarda A, Chowdhury N. Unique TTC Repeat Base Pair Loss Mutation In Cases of Pure Neural Leprosy: A Survival Strategy of Mycobacterium Leprae? Indian J Dermatol 2015; 60:351-5. [PMID: 26288401 PMCID: PMC4533531 DOI: 10.4103/0019-5154.160478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Genomic reduction helps obligate intracellular microbes to survive difficult host niches. Adaptation of Mycobacterium leprae in cases of pure neural leprosy (PNL) in the intracellular niche of peripheral nerves can be associated with some gene loss. Recently, a stable but variable number of tandem repefzats (TTC) have been reported in strains of M. leprae. FolP and rpoB genes are the two common mutation sites which deal with the susceptibility of the bacteria to drugs. Aim: We attempted to find if genomic reduction of M. leprae in context of these TTC repeats or mutations in folP1 and rpoB can be the reason for the restriction of M. leprae in the nerves in PNL. Materials and Methods: DNA extracts taken from fine needle aspiration of affected nerves of 24 PNL cases were studied for tandem repeats with 21TTC primer in multiplex-PCR. Mutations were also studied by PCR Amplification of SRDR (Sulphone Resistance Determining Region) of the folP1 and multiple primer PCR amplification refractory mutation system (MARS) of the rpoB. Results: Of the 24 PNL, only 1 patient showed mutation in the rpoB gene and none in the folp1 gene. Studying the mutation in TTC region of the M. leprae gene we found that all the cases have a loss of a few bases in the sequence. Conclusion: We can conclude that there is consistent loss in the bases in the TTC region in all cases of pure neural Hansen and we postulate that it may be an adaptive response of the bacteria to survive host niche resulting in its restriction to peripheral nerves.
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Affiliation(s)
- Abhishek De
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Abu Hena Hasanoor Reja
- Department of Biochemistry, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Supratik Biswas
- Department of Biochemistry, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Basudev Bhattacharya
- Department of Biochemistry, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Aarti Sarda
- Department of Dermatology, KPC Medical College, Kolkata, West Bengal, India
| | - Nidhi Chowdhury
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
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Ghosh A, Aggarwal I, De A, Samanta A, Chatterjee G, Bala S, Biswas P, Chowdhary N. Zinc-responsive acral hyperkeratotic dermatosis-A novel entity or a subset of some well-known dermatosis? Indian J Dermatol 2015; 60:136-41. [PMID: 25814700 PMCID: PMC4372904 DOI: 10.4103/0019-5154.152507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND We are reporting a series of interesting cases, which presented to us with psoriasiform lesions distributed over the acral regions of the body. The cases are unusual because they were resistant to conventional treatment modalities like topical corticosteroids, tacrolimus and oral methotrexate but showed significant improvement on oral zinc therapy. MATERIALS AND METHODS Ten patients with characteristic clinical features of distinctive hyperkeratotic plaque in the acral areas, who were resistant to treatment by different modalities including potent topical steroids and oral methotrexate, were included for detailed investigations. A proper history was taken and relevant laboratory investigations were done which included blood count, urine, liver function, renal function, hepatitis-C virus serology and serum zinc levels. Patients were followed up every 2 weeks. Histopathological examinations of the lesional tissue were done at baseline and after 6 weeks of therapy. Patients were given oral zinc daily and no other treatment during the 6 weeks course. RESULTS All our patients were non-reactive to hepatitis-C. Of the ten patients only one patient (10%) showed low titer of serum zinc, another (10%) showed higher zinc level, while the rest of the patients had normal zinc level. Five of our patients had chronic renal failure, one had Grave's disease and the remaining had no associated systemic illness. Histopathology mostly showed hyperkeratosis, acanthosis, prominent granular layer, spongiosis and dermal infiltrate. After 6 weeks of follow up, all patients showed rapid and remarkable therapeutic response with zinc. CONCLUSIONS We here report a series of patients, discernible because of their uniform clinical presentation of acral hypekeratotic plaques and in showing a noticeable response to zinc. Clinical, histopathological and laboratory investigations were done to rule out diseases of similar morphology including psoriasis, acral necrolytic erythema and lichen simplex chronicus. Authors understand that further studies with greater number cases and more detailed investigations are required to establish exact etio-pathogenesis and nomenclature of this distinct subset of patients.
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Affiliation(s)
- Arghyaprasun Ghosh
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Ishad Aggarwal
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Abhishek De
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Ayan Samanta
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Sanchaita Bala
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Projna Biswas
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Nidhi Chowdhary
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
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De A, Surana TV, Biswas S, Reja AHH, Chatterjee G. Isolated tenosynovitis as a sole manifestation: the great mimicker still continues to surprise us. Indian J Dermatol 2015; 60:213. [PMID: 25814736 PMCID: PMC4372940 DOI: 10.4103/0019-5154.152577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A middle aged male presented with non-tender cystic swelling over left distal forearm since 1 year. No other cutaneous abnormality could be found except mild paresthesia of the overlying skin and equivocal thickening of the ipsilateral ulnar nerve. Routine investigation was within normal limits. Detailed workup of the patient including MRI of the lesion suggested the diagnosis as tenosynovitis with a soft tissue mass. Fine needle aspiration cytology from the cyst showed foamy macrophages and acid fast bacilli; while PCR of the aspirate confirmed the etiological agent as M. leprae. We, thus, report a unique case of isolated tenosynovitis as a sole manifestation of pure neural leprosy which is extremely rare in world literature.
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Affiliation(s)
- Abhishek De
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Trupti V Surana
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Saugato Biswas
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Abu Hena Hasanoor Reja
- Department of Biochemistry, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
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Saha A, Halder C, Sen S, Chatterjee G. Hemilateral proteus syndrome: An unusual hamartomatous disorder with significant cerebellar tonsillar herniation. Indian J Dermatol 2015; 60:202-4. [PMID: 25814719 PMCID: PMC4372923 DOI: 10.4103/0019-5154.152538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pradhan R, De S, Choudhary N, Mukherjee S, Chatterjee G, Ghosh A, Chatterjee M, Chatterjee S. Can systemically generated reactive oxygen species help to monitor disease activity in generalized vitiligo? A pilot study. Indian J Dermatol 2014; 59:547-51. [PMID: 25484381 PMCID: PMC4248488 DOI: 10.4103/0019-5154.143506] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Generalized vitiligo is a disease with unpredictable bursts of activity, goal of treatment during the active phase being to stabilize the lesions. This emphasizes the need for a prospective marker for monitoring disease activity to help decide the duration of therapy. Aims and Objectives: In the present study, we examined whether reactive oxygen species (ROS) generated in erythrocytes can be translated into a marker of activity in vitiligo. Materials and Methods: Level of intracellular ROS was measured flow cytometrically in erythrocytes from venous blood of 21 patients with generalized vitiligo and 21 healthy volunteers using the probe dichlorodihydrofluorescein diacetate. Results: The levels of ROS differed significantly between patients and healthy controls, as well as between active versus stable disease groups. In the active disease group, ROS levels were significantly lower in those being treated with systemic steroids than those that were not. ROS levels poorly correlated with disease duration or body surface area involved. Conclusion: A long-term study based on these findings can be conducted to further validate the potential role of ROS in monitoring disease activity vitiligo.
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Affiliation(s)
- Richeek Pradhan
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Soumita De
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Nidhi Choudhary
- Department of Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Shibabrata Mukherjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Arghyaprasun Ghosh
- Department of Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Mitali Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Suparna Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
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Reja AHH, De A, Biswas S, Chattopadhyay A, Chatterjee G, Bhattacharya B, Sarda A, Aggarwal I. Use of fine needle aspirate from peripheral nerves of pure-neural leprosy for cytology and PCR to confirm the diagnosis: a pilot study. Indian J Dermatol Venereol Leprol 2014; 79:789-94. [PMID: 24177611 DOI: 10.4103/0378-6323.120731] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The diagnosis of pure neural leprosy (PNL) remained subjective because of over-dependence of clinical expertise and a lack of simple yet reliable diagnostic tool. The criteria for diagnosis, proposed by Jardim et al., are not routinely done by clinicians in developing country as it involves invasive nerve biopsy and sophisticated anti-PGL-1 detection. We conducted a study using fine needle aspiration cytology (FNAC) coupled with Ziehl Neelsen staining (ZN staining) and Multiplex-Polymerase Chain Reaction (PCR) specific for M. leprae for an objective diagnosis of pure neural leprosy (PNL), which may be simpler and yet reliable. AIM The aim of the study is to couple FNAC with ZN staining and multiplex PCR to diagnose pure neural leprosy patients rapidly, in simpler and yet reliable way. METHODS Thirteen patients of PNL as diagnosed by two independent consultants were included as case, and 5 patients other than PNL were taken as control in the study. Fine needle aspiration was done on the affected nerve, and aspirates were evaluated for cytology, ZN staining and multiplex-PCR. RESULTS Out of the 13 cases where fine needle aspiration was done, M. leprae could be elicited in the nerve tissue aspirates in 5 cases (38.4%) with the help of conventional acid-fast staining and 11 cases (84.6%) with the help of multiplex PCR. On cytological examination of the aspirates, only 3 (23%) cases showed specific epithelioid cells, whereas 8 (61.5%) cases showed non-specific inflammation, and 2 (15.3%) cases had no inflammatory cells. CONCLUSION Our study demonstrates that in the field of laboratory diagnosis of PNL cases, FNAC in combination with ZN staining for acid-fast bacilli (AFB) and Multiplex-PCR can provide a rapid and definitive diagnosis for the majority of PNL cases. FNAC is a less-invasive, outdoor-based and simpler technique than invasive nerve biopsy procedure. Thus, this study may enlighten the future path for easy and reliable diagnosis of PNL.
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Affiliation(s)
- Abu Hena Hasanoor Reja
- Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Sen S, Sinhamahapatra P, Choudhury S, Gangopadhyay A, Bala S, Sircar G, Chatterjee G, Ghosh A. Cutaneous manifestations of mixed connective tissue disease: study from a tertiary care hospital in eastern India. Indian J Dermatol 2014; 59:35-40. [PMID: 24470658 PMCID: PMC3884926 DOI: 10.4103/0019-5154.123491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Context: Mixed connective tissue disorder is an uncommon disease. Some scientists are reluctant to recognize it as a separate entity. Some others have defined this ailment. Cutaneous features of this condition are unique. Researchers from India have described these features to relate to those described in the studies from other parts of the globe. Aims: This study aims to delineate the skin manifestations of clearly defined mixed connective tissue disease (MCTD) patients, to compare them with those established as overlap syndrome, and to relate them with studies from other parts of the globe. Settings and Design: Successive patients who fulfilled the specific criteria for MCTD presenting in the skin outpatient department of a tertiary care hospital in eastern India were clinically examined from 2009 for 3 years. Materials and Methods: The number of participants was 23 and the dermatological features of these were compared with 22 patients with overlap syndrome. The antibody to uridine-rich U1 ribonucleoprotein was measured for all patients. Statistical Analysis Used: SPSS (Version 17) and MedCalc (Version 11.6). Results: The Male: Female ratio among the MCTD patients was 1:6.67 and that of the overlap syndrome was 1:10. Twenty patients of the MCTD group presented with synovitis as against only seven in the overlap group. Raynaud's phenomenon was present in some of the subjects. Puffy fingers were rare in our study. Facial numbness was reported by four of those suffering from MCTD. Antinuclear antibody (ANA) was essentially of a speckled pattern in this disease Conclusions: Cutaneous indicators of MCTD are distinct from overlap syndrome. Knowledge of these manifestations prevalent in a region may lead to early diagnosis of the disease.
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Affiliation(s)
- Sumit Sen
- Department of Dermatology, Venereology and Leprosy, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Pradyot Sinhamahapatra
- Department of Rheumatology, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Supriyo Choudhury
- Department of Pharmacology, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Anusree Gangopadhyay
- Department of Dermatology, Venereology and Leprosy, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Sanchaita Bala
- Department of Dermatology, Venereology and Leprosy, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Geetabali Sircar
- Department of Rheumatology, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Gobinda Chatterjee
- Department of Dermatology, Venereology and Leprosy, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
| | - Alakendu Ghosh
- Department of Rheumatology, The Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Salt Lake City, Kolkata, India
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Abstract
Ichthyosis hystrix is a term used to describe an ichthyosiform dermatosis which is characterized by hyperkeratotic spiny scales mainly over extensor aspects of limbs with palmoplantar keratoderma and occasionally associated with deafness and neurological deficit. It is a rare autosomal dominant form of ichthyosis and very few cases are reported in literature. We are presenting a 46 years-old-male patient of ichthyosis hystrix with unusual presentation. He had lesions mainly over the face and scalp with palmoplantar keratoderma and significant nail changes.
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Affiliation(s)
- Projna Biswas
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
| | - Abhishek De
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
| | - Sampreeti Sendur
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
| | - Falguni Nag
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
| | - Archana Saha
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
| | - Gobinda Chatterjee
- Departments of Dermatology, Institute of Post Graduate Medical Education Research, Kolkata, India
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Bala S, Sen S, Chatterjee G, Gangopadhyay A. Atypical erythema nodosum leprosum as the presenting feature in multibacillary leprosy: a case report. Indian J Dermatol 2014; 59:94-5. [PMID: 24470672 PMCID: PMC3884940 DOI: 10.4103/0019-5154.123519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sanchaita Bala
- Department of Dermatology, IPGMER and SSKM Hospitals, Kolkata, India. E-mail:
| | - Sumit Sen
- Department of Dermatology, IPGMER and SSKM Hospitals, Kolkata, India. E-mail:
| | - Gobinda Chatterjee
- Department of Dermatology, IPGMER and SSKM Hospitals, Kolkata, India. E-mail:
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Choudhary N, Aggarwal I, Dutta D, Ghosh AGS, Chatterjee G, Chowdhury S. Acquired perforating dermatosis and Addison's disease due to disseminated histoplasmosis: Presentation and clinical outcomes. Dermatoendocrinol 2013; 5:305-8. [PMID: 24194970 PMCID: PMC3772918 DOI: 10.4161/derm.22677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/19/2012] [Accepted: 10/26/2012] [Indexed: 11/19/2022]
Abstract
Acquired perforating dermatosis (APD) is a rare disorder characterized by transepidermal elimination of contents from dermis with minimal disruption of surrounding structures, believed to be due to altered expression of dermal proteins. Its occurrence in patients with systemic mycosis has never been reported. We report a 60-y gentleman who presented with features of adrenal insufficiency (nausea vomiting, hypotension and increased pigmentation) for 4 mo, multiple hyperpigmented pruritic nodules with central keratinous plug over extensor surface of both lower limbs along with hepatosplenomegaly of one month duration. Investigations revealed low cortisol (2.3 μg/dl; normal: 5–34 μg/dl), elevated ACTH (68 pg/ml; normal: 5–15 pg/ml), enlarged bilateral adrenals with hepatosplenomegaly on CT. Methanamine silver staining of fine needle aspiration from the adrenals and bone marrow aspiration showed numerous oval yeast cells suggestive of histoplasma. Histopathology of biopsy of one of the skin nodules revealed transepidermal elimination process characterized by invagination of epidermis with extrusion of collagen bundles suggestive of APD. Patient improved with hydrocortisone replacement and there was clinical improvement with resolution of skin lesions following amphotericin-B and itraconazole therapy. This is probably the first reported case of APD in a patient with disseminated histoplasmosis who had presented with Addison’s disease.
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Affiliation(s)
- Nidhi Choudhary
- Department of Dermatology, Venereology & Leprosy; IPGMER & SSKM Hospital; Kolkata
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Gangopadhyay A, Sen S, Naskar B, Chatterjee G. Anti scl-70 antibody positive systemic sclerosis in a patient with lung cancer: a paraneoplastic or a purely coincidental phenomenon? Indian J Dermatol 2013; 58:400-1. [PMID: 24082191 PMCID: PMC3778786 DOI: 10.4103/0019-5154.117326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Anusree Gangopadhyay
- Department of Dermatology, IPGMER and SSKM Hospital, 240, AJC Bose Road, Kolkata, India. E-mail:
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Abstract
Large plaque parapsoriasis (LPP) is an idiopathic, chronic scaly dermatosis classified within parapsoriasis group of diseases, occurring commonly in middle aged patients of all races and geographic regions. LPP and its variants are closely related to the patch stage of mycosis fungoides. The two types of LPP mostly described are the poikilodermatous and retiform parapsoriasis. We are reporting an ichthyosiform LPP for its rarity.
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Affiliation(s)
- Falguni Nag
- Department of Dermatology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Chatterjee G, Kalia A, Gandhi T, Sinha P. Global motion coherence performance after extended congenital blindness: stretching the window. J Vis 2013. [DOI: 10.1167/13.9.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kalia A, Lesmes L, Dorr M, Gandhi T, Chatterjee G, Bex P, Sinha P. Development of Contrast Sensitivity Following Extended Congenital Blindness. J Vis 2013. [DOI: 10.1167/13.9.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Germine L, Hartshorne J, Wilmer J, Chabris C, Chatterjee G, Nakayama K. Heterogeneity in cognitive maturation and aging: Why there is no such thing as an adult control. J Vis 2013. [DOI: 10.1167/13.9.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Nag F, Ghosh A, Surana TV, Biswas S, Gangopadhyay A, Chatterjee G. Inflammatory linear verrucous epidermal nevus in perineum and vulva: a report of two rare cases. Indian J Dermatol 2013; 58:158. [PMID: 23716825 PMCID: PMC3657235 DOI: 10.4103/0019-5154.108078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Falguni Nag
- Department of Dermatology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Nag F, De A, Hazra A, Chatterjee G, Ghosh A, Surana TV. Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country. Int Wound J 2012; 11:546-9. [PMID: 23170845 DOI: 10.1111/iwj.12003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 10/12/2012] [Accepted: 10/22/2012] [Indexed: 11/29/2022] Open
Abstract
Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries.
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Affiliation(s)
- Falguni Nag
- Department of Dermatology, IPGMER & SSKM Hospital, Kolkatta, West Bengal, India
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Ghosh S, Chakraborty R, Chatterjee G, Raychaudhuri U. Study on fermentation conditions of palm juice vinegar by response surface methodology and development of a kinetic model. Braz J Chem Eng 2012. [DOI: 10.1590/s0104-66322012000300003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chatterjee G, Germine L, Novick A, Nakayama K, Wilmer J. Poorer face recognition in left-eye amblyopes. J Vis 2012. [DOI: 10.1167/12.9.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Hamartomatous, circumscribed swellings of the extremities make an interesting study. Presentations are manifold and the naevi are not always present from birth. Excessive growth of hairs leads to remarkable appearance of such swellings. A young woman presented to the dermatology department, complaining of tenderness over 4th finger of her left hand. The defect was present for the last couple of years and was typified by visible hyperhidrosis on gentle tapping. Counseling of the affected lady made her agree for a skin biopsy. The histopathology revealed it to be of the nature of eccrine angiomatous hamartoma. Blood vessels were scarce. Eccrine ducts were plentiful without other associated anomalies. The deformity was removed by simple excision with good result.
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Affiliation(s)
- Sumit Sen
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India.
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Abstract
Stenotrophomonas maltophilia is a recently described organism which was mainly reported either in nosocomial setup, or in immunosuppresed individuals. This was rarely reported as cutaneous pathogenic organism causing cellulitis-like lesion, paronychia, mucocutaneous ulcers and ecthyma gangrenosum in immunocompromised individuals. Here we describe a case of leg ulcer caused by S. maltophilia in an immuno-competent patient. The infection was possibly community acquired as the patient had no exposure to hospital environment. The bacillus was sensitive to cotrimoxazole and levofloxacin, and the patient was successfully treated with cotrimoxazole. Our case is unique not only because it is probably the first ever case of leg ulcer caused by S. maltophilia, but also because of its unusual occurrence in immunocompetent patient.
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Affiliation(s)
- Falguni Nag
- Department of Dermatology, IPGMER & SSKM Hospital, Kolkata, India.
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Mathison J, Corrow S, Platt M, King K, Ziegler R, Chatterjee G, Nakayama K, Yonas A. Developmental Prosopagnosia: A childhood case study. J Vis 2011. [DOI: 10.1167/11.11.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ghosh SK, Bandyopadhyay D, Chatterjee G, Ghosh A, Sarkar S, Sarkar S. Mucocutaneous changes in tuberous sclerosis complex: a clinical profile of 27 Indian patients. Indian J Dermatol 2011; 54:255-7. [PMID: 20161858 PMCID: PMC2810693 DOI: 10.4103/0019-5154.55636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disease resulting in a wide array of clinical manifestations, primarily affecting the skin and central nervous system. Mucocutaneous features play a very important role in the recognition of this syndrome. Aims: To review the prevalence and patterns of cutaneous manifestations in tuberous sclerosis, in a group of patients from eastern India. Methods: Observational clinical study on twenty-seven consecutive patients of tuberous sclerosis collected during a period of four years. Results: Most were between 10–20 years of age; the male to female ratio was 2:1. Family history was found in two-thirds. The classical triad of tuberous sclerosis was present in only nine (33.3%) patients. Adenoma sebaceum was the most common cutaneous feature (100%), followed by hypomelanotic macules (92.6%), connective tissue nevi (66.6%), and Koenen's tumors (33.3%). Oral mucosal fibromas were seen in six (22.22%) patients. Fibromatous plaque over forehead and scalp was seen in three patients. Limitation of the study was small size of study sample. Conclusion: Prominent mucocutaneous changes are extremely common manifestation of TSC, which may provide crucial diagnostic clues for primary care physicians.
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Affiliation(s)
- Sudip Kumar Ghosh
- Departments of Dermatology, Venereology and Leprosy, R.G.Kar Medical College, Kolkata, India
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