Indian Journal of Dermatology Venereology & Leprology最新文献

Background Dermoscopy can potentially obviate the need for skin biopsy, particularly at cosmetically sensitive sites such as the face. While dermoscopic features of various skin diseases are well described, information on dermoscopic findings in normal skin is limited. Objectives To study the dermoscopic features of the normal face. Methods Two-hundred subjects without any facial skin disease were included in the study. Dermoscopic findings of different facial sites (forehead, bilateral zygomatic areas, bilateral cheeks, nose and chin) were evaluated using a hand-held dermoscope (Heine Delta 30) by two investigators. Dermoscopic differences between different facial sites, gender and age groups were compared. Results Most (n=156, 78%) subjects had Fitzpatrick skin type IV-VI. A background pseudonetwork was present in a majority at all the sites, except the nose (62-85% vs 41%, p<0.001). An accentuated patchy pseudonetwork was seen most commonly on the cheeks and zygoma (18-21%, p<0.001). Follicles were of uniform size and present at uniform distances in a majority at all sites, but were more commonly variable on the nose (53-70%, p<0.001). Follicular brown pigmentation was seen in 27-37% at all sites, except the forehead (9%, p<0.001). Brown circles around adnexal openings were seen most commonly on the nose (41%, p< .001). A 'dot in circle' morphology was seen most commonly on the zygoma and cheeks (25-30%, p<0.001). Vessels were more commonly seen on the cheeks (48%) and chin (27%) as compared to other sites (p<0.001). The most common vessel pattern was a linear, non-branching one. Focussed or dotted vessels were not seen at any site. White reticular lines were seen almost exclusively on the nose (15%, p<0.001). Accentuated patchy pseudonetwork, follicular plugs and brown circles around adnexal openings were more common in males, while follicular brown pigmentation was statistically significantly more common in females. Accentuated patchy pseudonetwork, follicular plugs, follicular brown pigmentation, brown circles around adnexal openings, vessels, and reticular white lines became more common with advancing age. Limitations Relatively small sample size, smaller proportion of elderly subjects, and a majority of the subjects belonging to darker skin phototypes (V-VI) Conclusion Knowledge of variations in normal dermoscopic findings of the face will help dermatologists in distinguishing abnormal from normal, and improve the interpretation of dermoscopic findings of facial skin lesions.

Background Skin and soft tissue infections (SSTIs) encompass a wide range of conditions, from superficial infections to life-threatening necrotising fasciitis. Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE pathogens) are leading causes of SSTIs and are notable for their antimicrobial resistance. Aim This study aims to determine the prevalence of SSTIs and analyse the resistance patterns of ESKAPE pathogens,providing critical insights for effective treatment strategies. Methods A prospective, observational, cross-sectional study was conducted from January to December 2024 in the Bacteriology section of the Department of Microbiology. A total of 2,300 clinical specimens, including pus, pus swabs, and tissue samples, were processed using standard microbiological techniques. Isolates were identified, and antibiotic susceptibility was assessed following the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Among 2,300 samples, 1,311 (57%) were culture-positive, with ESKAPE pathogens detected in 808 (61.6%) culture-positive isolates. Staphylococcus aureus (59.5%) was the most frequently isolated organism, followed by Pseudomonas aeruginosa (17.8%) and Klebsiella pneumoniae (11.4%). Methicillin-resistant S. aureus (MRSA) was found in 52.2% of isolates. Among Gram-negative bacteria, 15.3% were multidrug-resistant (MDR), but all remained susceptible to colistin. Limitations Conducted at a single centre he study may not capture regional differences in resistance, patient demographics, or healthcare practices, nor assess sustained intervention outcomes or relapses. Conclusion ESKAPE pathogens contribute significantly to SSTIs, posing a challenge due to their resistance mechanisms. The high prevalence of MRSA and MDR Gram-negative bacteria highlights the need for continuous surveillance, rational antibiotic use, and alternative treatment strategies to combat antimicrobial resistance effectively.