Estimating the Frequency of Hanifin and Rajka’s Minor Criteria among Paediatric Atopic Cases at a Tertiary Care Hospital in Western Tamil Nadu, India- A Cross-sectional Study

Introduction: Atopic Dermatitis (AD) is a common relapsing inflammatory disorder, among the paediatric population clinically, characterised by pruritus and recurring eczematous skin lesions and a host of other cutaneous changes. Diagnosis is done on the basis of clinical findings with the usage of Hanifin and Rajka’s criteria which includes 4 major and 23 minor criteria. Geographical, climatic factors and other population factors have been reported to influence the occurrence of minor criteria. Aim: To estimate the frequency of Minor criteria among paediatric atopic dermatitis in Western Tamil Nadu, India. Materials and Methods: This cross-sectional observational study was done by including 110 atopic children attending Paediatric and Dermatology Outpatient Departments (OPD) of KMCH IHSR, Coimbatore, Western Tamil Nadu, India, between March 2022 to August 2022. The clinical and ophthalmological findings were documented. Categorical variables were presented as frequency and percentages, Continuous variables were presented as Mean±Standard deviation. The data was entered in excel and was analysed using statistical package for social sciences (SPSS) version 27. Results: Among the total study population of 110, 53 (48.2%) were males and the rest 57 (51.8%) were females. The mean age was 24.73±5.18 years with a range of 2-15 years. Early age of onset was seen in 73.6% of study population. Hyperlinear palms were found in 70% of the study patients. 68.2% had Dennie Morgan infraorbital fold, 64.5% had xerosis, 61% had pityriasis alba and 60% had a family history of atopy. Conclusion: Certain minor manifestations of AD like xerosis, icthyosis, hyprerlinear palms, and perifollicular accentuation were more common in the present study. Western Tamil Nadu having a tropical semi-arid climate tempered by higher altitude could explain the differences noted in the frequency of certain minor criteria.

Trichoscopic Diagnosis and Management of a Case of Scalp Dysesthesia with Lichen Simplex Chronicus

Scalp dysesthesia (SD), a variant of cutaneous dysesthesia syndrome is an underrecognized cause of scalp pruritus. It usually presents with itch, pain, burning, or stinging sensation over localized or diffuse area of the scalp without any objective findings. Trichoscopy, a rapid and in-office procedure, could aid in the early clinical diagnosis of this condition and initiate management. We report a case of SD in an elderly male diagnosed with the aid of trichoscope, evaluated and treated successfully.

Disseminated histoplasmosis as a presenting manifestation in an HIV patient - A case report from South India

Histoplasmosis has heterogenous clinical presentation ranging from mild and self-limiting respiratory disease to disseminated forms with high mortality. In progressive disseminated histoplasmosis (PDH), patient presents with fever, lymphadenopathy, hepatosplenomegaly, adrenal enlargement, hemophagocytic lymphohistiocytosis and non-specific mucocutaneous lesions, usually in late stage of HIV. Cutaneous involvement is upto 25% in PDH which are papules, plaques, nodules and ulcers. Forty-two year old male, recently diagnosed as HIV positive presented with complaints of multiple painful ulcerated lesions over face, neck, tongue, arms, trunk & genitalia. Skin Biopsy was suggestive of histoplasmosis. Patient showed excellent response with amphotericin B and itraconazole. Since histoplasmosis is relatively uncommon, there should be a high-index of suspicion when an HIV patient presents with disseminated skin lesions.

Prevalence and patterns of latex glove allergy among healthcare workers in a tertiary care center in South India - A cross-sectional study

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