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A Cross-Sectional Study to Determine the Prevalence of Thyroid Autoimmunity in Patients with Chronic Spontaneous Urticaria 确定慢性自发性荨麻疹患者甲状腺自身免疫患病率的横断面研究
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_55_22
Pallavi Singh, Vidyadhar R Sardesai
Abstract Background: Chronic spontaneous urticaria (CSU) can be a distressing condition for both the patient and the treating doctor due to the lack of a definite underlying etiology. The condition has been found to be associated with autoimmune (AI) conditions, which brings to light possible pathogenesis being shared by AI conditions and chronic urticaria. This can help us understand the condition better as well as have a bearing on the treatment. Thyroid autoimmunity is one such condition which has commonly been associated with chronic urticaria. Objectives: To determine the prevalence of thyroid autoimmunity in patients with CSU. To determine the correlation between thyroid autoantibodies level and the severity and duration of CSU. Materials and Methods: Forty-eight adult patients of CSU were enrolled, in whom thyroid autoimmunity was determined by detecting the levels of anti-thyroid peroxidase (anti-TPO) antibody. Urticaria Activity Score was used to determine the activity of the disease. Results: Nine out of 48 (18.75%) patients showed raised anti-TPO antibody levels. Eight out of those 9 (88.89%) patients were female. No correlation was found between the duration of disease and the antibody levels. A significant association was found between the disease activity and anti-TPO antibody levels. Conclusion: The prevalence of thyroid autoimmunity is higher in patients of CSU compared to the general population. The condition occurs more frequently and with greater severity in the female population.
背景:慢性自发性荨麻疹(CSU)由于缺乏明确的潜在病因,对患者和治疗医生来说都是一种令人痛苦的疾病。该疾病已被发现与自身免疫性疾病(AI)有关,这揭示了AI疾病和慢性荨麻疹可能共有的发病机制。这可以帮助我们更好地了解病情,并对治疗有影响。甲状腺自身免疫就是这样一种情况,通常与慢性荨麻疹有关。目的:了解CSU患者甲状腺自身免疫的患病率。目的:探讨甲状腺自身抗体水平与CSU严重程度及病程的相关性。材料与方法:选取48例成年CSU患者,通过检测抗甲状腺过氧化物酶(anti-thyroid peroxidase, tpo)抗体水平,测定其甲状腺自身免疫水平。使用荨麻疹活动度评分来确定疾病的活动度。结果:48例患者中9例(18.75%)出现抗tpo抗体升高。9例患者中有8例(88.89%)为女性。在疾病持续时间和抗体水平之间没有发现相关性。在疾病活动性和抗tpo抗体水平之间发现了显著的关联。结论:与普通人群相比,CSU患者甲状腺自身免疫的患病率更高。这种情况在女性人群中更为频繁和严重。
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引用次数: 0
How and when to Use Psychotropic Drugs in Psychodermatology 精神皮肤科如何及何时使用精神药物
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_6_22
Sharmishtha S. Deshpande, Sanket Bhailume
Abstract A significant number of patients coming to dermatologists have psychiatric symptoms as predisposing, precipitating, and perpetuating factors. Assessment and treatment of these conditions is complex. However, looking at the number of patients with these problems, dermatologist needs to be well versed with an assessment of these patients and use of some of the psychotropic drugs. Some such drugs are discussed here along with a discussion about the decision to use them. Benzodiazepines such as clonazepam and lorazepam, doxepin, selective serotonin reuptake inhibitor like fluoxetine, escitalopram, and low dose of antipsychotics like risperidone, haloperidol, and olanzapine are discussed. As the patients are often reluctant to visit a psychiatrist, a dermatologist needs to help in allaying the initial anxiety and to provide understanding about the psychiatric conditions and available options for treatment. In long term, liaison with a psychiatrist can be established and joint treatment by both consultants can be continued.
相当数量的患者来皮肤科医生有精神症状的易感因素,沉淀和延续的因素。这些疾病的评估和治疗是复杂的。然而,考虑到有这些问题的患者的数量,皮肤科医生需要精通这些患者的评估和一些精神药物的使用。这里讨论了一些这样的药物,并讨论了如何决定使用它们。苯二氮卓类药物,如氯硝西泮和劳拉西泮,多虑平,选择性血清素再摄取抑制剂,如氟西汀,艾司西酞普兰,低剂量抗精神病药物,如利培酮,氟哌啶醇和奥氮平。由于患者通常不愿去看精神病医生,皮肤科医生需要帮助减轻最初的焦虑,并提供对精神状况和可用治疗方案的了解。从长期来看,可以与精神科医生建立联系,并继续进行双方的联合治疗。
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引用次数: 0
Psychological Interventions in Psychodermatological Practice 精神皮肤科实践中的心理干预
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_11_22
Ettappurath N Abdul Latheef, Bishrul N A Hafi
Abstract There is a well-established connection between the skin and the mind. Based on current evidence, many dermatological conditions are triggered or exacerbated by stress. Therefore, intervention needs to target stress, anxiety, and other psychiatric comorbidities which may be secondary to skin conditions or may lead to aggravation of the illness. Psychological interventions should be based on the underlying emotional issues that may affect the way skin problems respond to medical treatment. Before starting the intervention, it is very important to know which psychodermatological conditions will be targeted. In primary psychocutaneous illness (delusion of parasitosis, obsessive-compulsive disorder, dysmorphophobia, etc.) the target is to modify or eliminate the symptoms of illness with specific models and approaches. If stress is playing an active role in the etiology and course of skin conditions (e.g., psoriasis, atopic dermatitis, and urticaria) or it is delaying the improvement, then the aim should be to apply stress reduction techniques. In some skin conditions (pemphigus vulgaris, Hansen’s disease, etc.), the aim of the intervention should be to strengthen the defenses and teach new and better mechanisms to maintain control. The common psychotherapy procedures useful in dermatology practice include psychoeducation, behavior therapy, habit reversal, relaxation procedures, biofeedback, cognitive behavior therapy, hypnotherapy, and group therapy.
皮肤和心灵之间有着根深蒂固的联系。根据目前的证据,许多皮肤病是由压力引发或加剧的。因此,干预需要针对压力、焦虑和其他可能继发于皮肤病或可能导致疾病加重的精神合并症。心理干预应基于可能影响皮肤问题对医疗反应的潜在情绪问题。在开始干预之前,了解将针对哪些精神皮肤病是非常重要的。在原发性精神皮肤疾病(寄生虫妄想、强迫症、畸形恐惧症等)中,目标是通过特定的模式和方法来改变或消除疾病的症状。如果压力在皮肤病(如牛皮癣、特应性皮炎和荨麻疹)的病因和病程中起积极作用,或者它正在延缓改善,那么目标应该是应用压力减轻技术。在某些皮肤状况(寻常性天疱疮、汉森病等)中,干预的目的应该是加强防御,并教授新的更好的机制来维持控制。在皮肤病学实践中常用的心理疗法包括心理教育、行为疗法、习惯逆转、放松疗法、生物反馈、认知行为疗法、催眠疗法和团体疗法。
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引用次数: 0
Clinical and Dermoscopic Features of Eruptive Collagenomas Localized Only on the Neck in a Young Female 年轻女性仅局限于颈部的爆发性胶原瘤的临床和皮肤镜特征
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_92_22
Satyendra Kumar Singh, Vandana Yadav, Chandra Pratap Singh, Atul Mohan
Abstract Eruptive collagenomas are rare nonfamilial connective tissue nevi of unknown etiology and pathogenesis, which are characterized by an abrupt onset of asymptomatic papules, nodules, and plaques on the trunk and extremities. Herein, we report a unique case of eruptive collagenoma in a 29-year-old female, who presented with multiple asymptomatic skin-colored to slightly hyperpigmented papules over the anterolateral aspect of the neck with no systemic involvement. Family history was unremarkable, and the diagnosis was confirmed by histopathological examination which showed thickened homogenized collagen bundles in the superficial dermis. We report this case due to the paucity of cases in Indian literature on eruptive collagenoma in a young female with only neck involvement.
爆发性胶原瘤是一种罕见的非家族性结缔组织痣,病因和发病机制尚不清楚,其特征是躯干和四肢突然出现无症状丘疹、结节和斑块。在此,我们报告一个独特的病例爆发性胶原瘤在一个29岁的女性,谁提出了多个无症状的皮肤颜色到轻微色素沉着丘疹在颈部前外侧,没有全身累及。家族史无明显差异,组织病理学检查显示真皮表层胶原束增厚均质。我们报告这一情况,由于缺乏病例在印度文献的爆发性胶原瘤在一个年轻的女性只有颈部受累。
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引用次数: 0
I Am Anxious, I Bleed – A Rare Clinical Case of Facial Hematohidrosis 我焦虑,我流血——一个罕见的面部血汗临床病例
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_81_22
Sahana Srihari, T N Revathi
Abstract Hematohidrosis is a rare clinical condition in which an individual sweats blood from intact, unbroken skin. Psychogenic cause is found to be the most frequent among other causes such as vicarious menstruation and systemic disease. We report a case of a 9-year-old boy who had bloody sweat discharge from the face and pinna of the ears while going to school. Pharmacotherapy with oral propranolol and psychotherapy were followed by a complete remission.
摘要:血汗症是一种罕见的临床状况,其中一个人汗血从完整的,未破损的皮肤。心理原因是最常见的其他原因,如月经代行和全身性疾病。我们报告一个9岁的男孩,他在上学时从脸部和耳廓流出血汗。口服心得安和心理治疗后完全缓解。
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引用次数: 0
Profile of dermatology consultations for inpatients: The scope for telemedicine during the COVID-19 pandemic and beyond 住院患者皮肤科咨询简介:新冠肺炎大流行期间及以后的远程医疗范围
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_20_22
R. Pangti, Somesh Gupta
Background: Attending dermatology consultations for inpatients is an integral part of the role of dermatologists inpatient care. Materials and Methods: A retrospective study was conducted at a large tertiary care hospital when the country, particularly the city, was severely affected by the COVID-19 pandemic. The aim was to study the profile of dermatology referrals for inpatients at the time of the COVID-19 pandemic and assessing the need for telemedicine in these inpatients. Results: A total of 341 dermatology consultations for 288 patients were received. Most of the consultations were from internal medicine (15.3%) and obstetrics and gynecology (8.7%). Around 65% of consultations were for new-onset (≤30 days) skin conditions while around 35% were for chronic (>30 days) conditions. The most commonly seen conditions were superficial fungal infections (14.9%) followed by eczematous disorders (13.2%). On grading the level of urgency of the referrals, 34.4% required an immediate consultation, 41% required it within a week, 12.8% within 2–4 weeks, 8% within 1–3 months, and 3.8% after the pandemic settles. The need for urgent consultation was more in acute cases than in chronic cases (P = 0.00). 62.5% of the consultations could have been done by telemedicine. Conclusion: As a majority of the consultations were for common and straightforward skin conditions and could mostly be done on telemedicine, this study underlines the need for strengthening the telemedicine services for inpatients referrals during this COVID-19 pandemic and even beyond.
背景:参加住院患者的皮肤科会诊是皮肤科医生住院护理不可或缺的一部分。材料和方法:当国家,特别是城市受到新冠肺炎大流行的严重影响时,在一家大型三级护理医院进行了回顾性研究。目的是研究新冠肺炎大流行时住院患者的皮肤科转诊情况,并评估这些住院患者对远程医疗的需求。结果:共接受了341次皮肤科会诊,共288名患者。大多数咨询来自内科(15.3%)和妇产科(8.7%)。约65%的咨询是针对新发(≤30天)皮肤病,约35%的咨询是关于慢性(>30天)疾病。最常见的情况是浅表真菌感染(14.9%),其次是湿疹性疾病(13.2%)。在对转诊的紧急程度进行分级时,34.4%的患者需要立即会诊,41%的患者需要在一周内会诊,12.8%的患者在2-4周内会诊、8%的患者在1-3个月内会诊,3.8%的患者在疫情结束后会诊。急性病例比慢性病例更需要紧急会诊(P=0.00)。62.5%的会诊可以通过远程医疗完成。结论:由于大多数咨询是针对常见和直接的皮肤状况,并且大多数可以通过远程医疗进行,本研究强调了在新冠肺炎大流行期间甚至之后加强住院转诊的远程医疗服务的必要性。
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引用次数: 0
Drug reaction with eosinophilia and systemic symptoms syndrome with toxic epidermal necrolysis: Overlap in an HIV seropositive male with diffuse large “B” cell lymphoma – A rare case report 嗜酸性粒细胞增多和全身症状综合征伴中毒性表皮坏死松解的药物反应:HIV血清阳性男性弥漫性大“B”细胞淋巴瘤的重叠——一例罕见病例报告
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_94_21
N. Bhatt, V. Belgaumkar, R. Chavan, N. Deshmukh
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction with varied presentations. We report a rare case of DRESS syndrome with toxic epidermal necrolysis (TEN) overlap associated with non-Hodgkin lymphoma (NHL). A 52-year-old male with retroviral disease presented with fever and diffuse skin peeling with mucosal erosions. The patient was on antitubercular therapy (ATT) for 1 month for suspected tubercular cervical lymphadenitis. He had facial edema, extensive skin tenderness, and denudation with a positive Nikolsky's sign, icterus, hepatosplenomegaly and multiple enlarged immobile nontender cervical, and axillary and inguinal lymph nodes. Investigations showed leukocytosis with hepatic and renal dysfunction. Skin histopathology was consistent with TEN. Based on Registry of Severe Cutaneous Adverse Reaction criteria, a diagnosis of ATT-induced DRESS with TEN overlap was made. Cervical lymph node biopsy and immunohistochemistry confirmed diffuse large B-cell NHL. ATT was withheld and the patient was treated with systemic steroids and assessed for initiation of chemotherapy. The profound immunological dysregulation in individuals with retroviral disease leads to varied clinical presentations, increasing the chances of diagnostic errors, and culminating in challenging scenarios. Therefore, seemingly innocuous symptoms and signs warrant thorough evaluation. Sound clinical acumen and prompt investigations for unusual causes such as malignancies can improve outcomes by aiding accurate diagnosis as well as avert untoward complications such as DRESS syndrome/TE.
嗜酸性粒细胞增多和全身症状(DRESS)综合征的药物反应是一种严重的药物诱导的超敏反应,表现多种多样。我们报告了一例罕见的DRESS综合征,其中毒性表皮坏死松解症(TEN)重叠与非霍奇金淋巴瘤(NHL)相关。一名患有逆转录病毒疾病的52岁男性出现发烧和弥漫性皮肤剥落伴粘膜侵蚀。患者因疑似结核性颈淋巴结炎接受了为期1个月的抗结核治疗。他有面部水肿,广泛的皮肤压痛,伴有Nikolsky征阳性的剥脱,黄疸,肝脾肿大,多发性肿大,不动的非末端颈部、腋窝和腹股沟淋巴结肿大。调查显示白细胞增多伴肝肾功能障碍。皮肤组织病理学与TEN一致。根据严重皮肤不良反应登记标准,诊断ATT诱导的具有TEN重叠的DRESS。颈淋巴结活检和免疫组织化学证实弥漫性大B细胞NHL。ATT被扣留,患者接受全身类固醇治疗,并评估是否开始化疗。逆转录病毒疾病患者的严重免疫失调导致不同的临床表现,增加了诊断错误的机会,并最终导致具有挑战性的情况。因此,看似无害的症状和体征值得彻底评估。良好的临床敏锐性和对恶性肿瘤等异常原因的及时调查可以通过帮助准确诊断来改善结果,并避免DRESS综合征/TE等不良并发症。
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引用次数: 0
An image-based scoring system as an alternative to face-to-face examination for acne vulgaris to deliver follow-up care: A comparative study 基于图像的评分系统作为面对面检查寻常痤疮的替代方案,以提供后续护理:一项比较研究
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_24_22
S. Shetty, Ruta Joshi, A. Kombettu, Chethana Gurumurthy, G. Kanthraj
Background: AV is a chronic disease with flares and remissions requiring regular follow-ups. Image-based lesion counting (LC) is useful when in-person consultations are not possible, like the COVID-19 pandemic. Objective: The aim of this study is to validate the proposed scoring system for teledermatology consultation and compare it with face to face. Materials and Methods: The face was divided into three zones which was further divided by drawing the imaginary lines from fixed points. AV (Grade 1 and 2) lesions were counted by co-investigator in person at baseline, first, and second follow-up visits. The images of the same were evaluated and scored by the principal investigator. Acne scores obtained were compared and statistically analyzed. Results: Two hundred cases were enrolled. Mean acne scores for in-person were 945.37, 647.57, and 550.81 and for teledermatology 1044.99, 718.79, and 654.36 for baseline, 1st, and 2nd follow-up, respectively. The mean decrease from baseline, 1st and 2nd follow-up, independent sample t-test and correlation analysis was significant in both groups (P = 0.001). Limitations: AV grade 3 and 4 are not included. Conclusion: During the 1st follow-up, a decrease in acne scores was observed, along with consistency in the scores between the evaluators. Image-based lesion counting is a promising approach. The proposed scoring system can be used for both modes of consultation-face-to-face and teledermatology.
背景:AV是一种慢性疾病,发作和缓解需要定期随访。当无法进行住院会诊时,如新冠肺炎大流行,基于图像的病变计数(LC)是有用的。目的:本研究的目的是验证所提出的远程皮肤科会诊评分系统,并将其与面对面的评分系统进行比较。材料和方法:将面部分为三个区域,通过从固定点绘制假想线来进一步划分。AV(1级和2级)病变由联合研究者在基线、第一次和第二次随访时亲自计数。由主要研究者对相同的图像进行评估和评分。对获得的痤疮评分进行比较和统计分析。结果:入选病例200例。在基线、第一次和第二次随访中,亲自治疗的平均痤疮得分分别为945.37、647.57和550.81,远程皮肤科的平均痤疮评分分别为1044.99、718.79和654.36。与基线、第一次和第二次随访、独立样本t检验和相关性分析相比,两组的平均下降均显著(P=0.001)。限制:不包括AV 3级和4级。结论:在第一次随访中,观察到痤疮评分下降,评估者之间的评分一致。基于图像的病变计数是一种很有前途的方法。所提出的评分系统可用于面对面咨询和远程皮肤科两种模式。
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引用次数: 0
Undiagnosed Diabetes Mellitus Type 2 Unmasked by Herpes Zoster with Dissemination: Report of Two Cases 未确诊的2型糖尿病伴带状疱疹传播:附2例报告
Pub Date : 2023-01-01 DOI: 10.4103/cdr.cdr_22_22
P. Kamboj, Preema Sinha, M. Madakshira, D. Shahi
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引用次数: 0
Cardiovascular risk in patients with alopecia areata:a cross-sectional study 斑秃患者的心血管风险:一项横断面研究
Pub Date : 2023-01-01 DOI: 10.5114/dr.2023.128016
A. Waśkiel-Burnat, W. Dorobek, M. Kotowska, M. Starace, B. M. Piraccini, M. Olszewska, L. Rudnicka
{"title":"Cardiovascular risk in patients with alopecia areata:\u0000a cross-sectional study","authors":"A. Waśkiel-Burnat, W. Dorobek, M. Kotowska, M. Starace, B. M. Piraccini, M. Olszewska, L. Rudnicka","doi":"10.5114/dr.2023.128016","DOIUrl":"https://doi.org/10.5114/dr.2023.128016","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77747799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical Dermatology Review
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