DOCSLIB.ORG

Pityriasis Rubra Pilaris

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pityriasis Rubra Pilaris Ϣ Σήϟ΍ ϦϤΣήϟ΍ Ϳ΍ ϢδΑ 1 Papulosquamous Dermatoses Rania AlSaied MD 2 Pityriasis Rubra Pilaris 3 It is a chronic papulosquamous disorder of unknown etiology characterized by reddish orange scaly plaques, palmoplantar keratoderma, and keratotic follicular papules. The disease may progress to erythroderma with distinct areas of uninvolved skin, the so-called islands of sparing. 4 Griffiths divided PRP into 5 categories: classic adult type, atypical adult type, classic juvenile type, circumscribed juvenile type, and atypical juvenile type. More recently, an HIV-associated type has been added to this classification system. 5 Pathophysiology The etiology is unknown. A familial form of the disease exists, with an autosomal dominant inheritance pattern; however, most cases are sporadic. One hypothesis is that PRP may be related to an abnormal immune response to an antigenic trigger. Case reports have described PRP occurring after streptococcal infections. 6 Mortality/Morbidity Patients with PRP can have painful and disabling palmoplantar keratoderma. Nail dystrophy and shedding may be present. However, most of the morbidity associated with PRP is associated with the erythroderma 7 Sex , Age PRP occurs equally among men and women The familial form of PRP typically begins in early childhood and has an autosomal dominant inheritance pattern. The acquired form of PRP has a bimodal age distribution, with peaks in the first and fifth decades of life, but it can begin at any age. 8 History The familial form of PRP has a gradual onset, whereas the acquired form has an acute onset. The disease typically spreads in a craniocaudal direction. Patients first notice redness and scales on the face and the scalp. This is often followed by redness and thickening of the palms and the soles The lesions may expand and coalesce to cover the entire body. 9 Physical Skin PRP is characterized by orange-red or salmon-colored scaly plaques with sharp borders, which may expand to involve the entire body Often, areas of uninvolved skin, referred to as islands of sparing, are present. Follicular hyperkeratosis is commonly seen on the dorsal aspects of the proximal phalanges, the elbows, and the wrists 10 11 12 Palmoplantar keratoderma occurs in most patients and tends to have an orange hue. Painful fissures may develop in patients with palmoplantar keratoderma. Pruritus, although not a major symptom, may occur in the early stages of the disease. 13 Nails Nail changes include distal yellow- brown discoloration, subungual hyperkeratosis, longitudinal ridging, nail plate thickening, and splinter hemorrhages. Nail pitting is not typical. 14 Histologic Findings Histologic features are not pathognomonic, but they are useful to rule out other possible papulosquamous and erythrodermic disorders. Features on light microscopy include hyperkeratosis with alternating orthokeratosis and parakeratosis forming a checkerboard pattern in the stratum corneum, focal or confluent hypergranulosis, follicular plugging with perifollicular parakeratosis forming a shoulder effect, thick suprapapillary plates, broad rete ridges, narrow dermal papillae, and sparse superficial dermal lymphocytic perivascular infiltration 15 Medical Care Topical medications Topical corticosteroids may provide some patient comfort, but they are believed to have little long- term therapeutic effect. Emollients reduce fissuring and dryness, providing some patient comfort. Petroleum jelly or one of the many proprietary emollients may be used. 16 Systemic therapy More severe cases may require: Systemic retinoids Immunosuppressants like Azathioprine Methotrexate Cyclosporin 17 Complications PRP can cause painful and disabling palmoplantar keratoderma. Nail dystrophy and shedding may occur. Erythroderma is a reaction pattern of the skin that can occur in the setting of several different skin disorders, most commonly including psoriasis, eczema, lymphoma, drug reactions, and PRP. It is characterized by generalized erythema and scales, hair loss, and onycholysis. 18 Prognosis Each type of PRP has its own prognosis. In general, the familial form of the disease may be persistent throughout life, and the acquired form of the disease may resolve spontaneously within 1-3 years. 19 Pityriasis Rosea 20 Background Pityriasis rosea (PR) is a common benign papulosquamous disease . Pityriasis denotes fine scales, and rosea translates as rose colored or pink. PR can have a number of clinical variations. Its diagnosis is important because it may resemble secondary syphilis. 21 Pathophysiology PR has often been considered to be a viral exanthem. Its clinical presentation supports this concept. PR has been linked to upper respiratory infections, it can cluster within families and close contacts, and it has an increased incidence in individuals who are immunocompromised. As with viral exanthems, the incidence may increase in the fall and the spring. 22 recent work demonstrated human herpesvirus (HHV)ƛ7 viral DNA in both the lesions and the plasma in patients with PR. 23 Sex PR is more common in women than in men. One study found it to be twice as common in women as in men. Age PR commonly develops in children and young adults, although any age group can be affected. Most patients are aged 10-35 years. 24 History The history should include questions about close contacts with similar eruptions. This finding is uncommon because most cases of PR are sporadic, as PR is thought to reflect a weakly contagious disease. A history of medication intake should be obtained because several medications have been shown to cause a similar exanthem. 25 The disease typically begins with a solitary macule that heralds the eruption (called the herald spot/patch), which is usually a salmon-colored macule. This initial lesion enlarges over a few days to become a patch with a collarette of fine scale just inside the well-demarcated border. 26 Within the next 1-2 weeks, a generalized exanthem usually appears, although it may occur from hours to months after the herald patch. This secondary phase consists of bilateral and symmetric macules with a collarette scale oriented with their long axes along cleavage lines. This phase tends to resolve over the next 6 weeks, but variability is common. Pruritus is common, usually of mild-to-moderate severity, and it occurs in 75% of patients. 27 Physical The herald patch is usually a single pink patch, 2-10 cm in diameter, on the neck or the trunk with a fine collarette scale. It is observed in more than 50% of patients, and it may occur as multiple lesions or in atypical locations. 28 About 1-2 weeks after the herald patch is seen, the generalized eruption appears, although it has been known to occur from hours to 3 months later. It consists of salmon-colored macules or patches, 0.5- 1.5 cm in diameter, with a collarette scale, often described as having a cigarette paperƛlike appearance. The long axes of the lesions are oriented in a parallel fashion along cleavage lines, giving the classic Christmas tree pattern. These secondary lesions most commonly occur on the trunk, the abdomen, the back, and the proximal upper extremities. 29 30 31 D.D Lichen Planus Nummular Dermatitis Psoriasis, Guttate Seborrheic Dermatitis Syphilis Tinea Corporis Drug induced PR like eruptions: captopril, levamisole, omeprazole, Barbiturates, aspirin, ketokonazole 32 Lab studies One must be careful to rule out syphilis. A screening rapid plasma reagin (RPR) test or a VDRL test should be ordered for appropriate individuals. 33 Histopathology It shows superficial perivascular dermatitis Focal parakeratosis in mounds, hyperplasia, and focal spongiosis are observed in the epidermis. The epidermis may show exocytosis of lymphocytes, variable spongiosis, mild acanthosis, and a thinned granular layer. In the dermis, extravasated red blood cells are a helpful finding along with a perivascular infiltrate of lymphocytes, histiocytes, and eosinophils. A number of monocytes are also commonly present. 34 35 Treatment Emollients Antihistamines ( if there is pruritus) UVB phototherapy ( for persistent PR) 36 Complications The main morbidity is from pigmentary changes, which are possible with the healing lesions. Both postinflammatory hyperpigmentation and hypopigmentation may occur. 37 Prognosis The prognosis for PR is excellent. Patients may return to work or school because they are not considered to be contagious. 38 Psoriasis 39 Objectives Identify the pathogenic factors for development of psoriasis List the clinical features of psoriasis Describe the progressive management of the clinical features of psoriasis List the adverse effects of psoriatic treatments 40 Psoriasis Chronic skin disorder; "itch" = psora Incidence Other derm conditions 41 Psoriasis T-cell mediated inflammatory dz Epidermal hyperproliferation 2O to activation of immune system Altered maturation of skin Inflammation Vascular changes 42 43 44 Background Epidemiology Age Genetic Scandinavian/European descent Risk Factors 45 Psoriasis, an inherited disease If you have psoriasis, what is the risk to: Your unrelated neighbor? About 2% Your sibling? 15-20% Your identical twin? 65-70% Your child? 25% 46 N P Disorganized O STRATUM S R CORNEUM O Neutrophil M STRATUM R accumulation GRANULOSUM A I L STRATUM A SPINOSUM S Immaturity I S Proliferation STRATUM BASALE DERMIS 47 48 Psoriasis: Associated Factors Genetic Factors: - 30% of people with psoriasis have had psoriasis in family - Autosomal dominant inheritance
Load more

Recommended publications
  • Clinical Study of Nail Changes in Papulosquamous Disorders
    Original Research Article Clinical study of Nail changes in papulosquamous disorders Vishal Wali1, Trivedi Rahul Prasad2* 1Associate Professor, 2Post Graduate, Department of Dermatology, Venereology and Leprology, Mahadevappa Rampure Medical College, Sedam Road, Kalaburagi (Gulbarga) 585105, Karnataka, INDIA. Email: [email protected] Abstract Background: Nail disorders comprise ~10% of all dermatologic conditions. Nail disorders include those abnormalities that effect any portion of the nail unit. The nail unit includes the plate, matrix, bed, proximal and lateral folds, hyponychium, and some definitions include the underlying distal phalanx. These structures may be effected by heredity, skin disorders, infections, systemic disease, and aging process, internal and external medications, physical and environmental agents, trauma, and tumours, both benign and malignant. The main contributors being papulosquamous disorder. Nail changes in papulosquamous disorder have been inadequately discussed and only limited studies are present. This study aims to throw some light about frequency of nail involvement in papulosquamous disorders and its various patterns. Methodology: This is the descriptive study. It was conducted in department of DVL of Mahadevappa Rampura Medical college and Basaveshwar teaching and general hospital, Kalaburagi from July 2019 to Feb 2021. General, systemic and dermatological examinations were done. Nails were examined in detail. Special investigations like skin biopsy and potassium hydroxide (KOH) mount was done in relevant cases. Results: There were 50 cases of papulosquamous disorder. The most common papulosquamous disorder was psoriasis, followed by lichen planus and PRP. Out of these the most common nail change was pitting (81%) and lest common was dorsal pterygium (%) Conclusion: Nail being an important appendage affecting various dermatosis and acts as window in diagnosis.
    [Show full text]
  • Pediatric Psoriasis
    Pediatric Papulosquamous and Eczematous Disorders St. John’s Episcopal Hospital Program Director- Dr. Suzanne Sirota-Rozenberg Dr. Brett Dolgin, DO Dr. Asma Ahmed, DO Dr. Anna Slobodskya, DO Dr. Stephanie Lasky, DO Dr. Louis Siegel, DO Dr. Evelyn Gordon, DO Dr. Vanita Chand, DO Pediatric Psoriasis Epidemiology • Psoriasis can first appear at any age, from infancy to the eighth decade of life • The prevalence of psoriasis in children ages 0 to 18 years old is 1% with an incidence of 40.8 per 100,000 ppl • ~ 75% have onset before 40 years of age What causes psoriasis? • Multifactorial • Genetics – HLA associations (Cw6, B13, B17, B57, B27, DR7) • Abnormal T cell activation – Th1, Th17 with increased cytokines IL 1, 2, 12, 17, 23, IFN-gamma, TNF-alpha • External triggers: – Injury (Koebner phenomenon) – medications (lithium, IFNs, β-blockers, antimalarials, rapid taper of systemic corticosteroids) – infections (particularly streptococcal tonsillitis). Pediatric Psoriasis Types: • Acute Guttate Psoriasis – Small erythematous plaques occurring after infection (MOST common in children) • 40% of patients with guttate psoriasis will progress to develop plaque type psoriasis • Chronic plaque Psoriasis – erythematous plaques with scaling • Flexural Psoriasis – Erythematous areas between skin folds • Scalp Psoriasis – Thick scale found on scalp • Nail Psoriasis – Nail dystrophy • Erythrodermic Psoriasis– Severe erythema covering all or most of the body • Pustular Psoriasis – Acutely arising pustules • Photosensitive Psoriasis – Seen in areas of sun
    [Show full text]
  • Pityriasis Lichenoides Chronica Following Cesarean Delivery
    Case Report DOI: 10.6003/jtad.1372c2 Pityriasis Lichenoides Chronica Following Cesarean Delivery İlknur Balta,1 MD, Özlem Ekiz,2 MD, Pınar Özuğuz,3 MD, Bilge Bülbül Şen,2 MD, Mehmet Doğan,4 MD Address: 1Department of Dermatology, Keçiören Training and Research Hospital, Ankara, Turkey; 2Department of Dermatology, Mustafa Kemal University, Tayfur Ata Sökmen Medical School, Hatay, Turkey, 3Department of Dermatology, Kocatepe University, School of Medicine, Afyon, Turkey, 4Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey E-mail: [email protected] * Corresponding Author: İlknur Balta MD, Ankara Keçiören Training and Research Hospital, 06380, Keçiören, Ankara, Turkey Published: J Turk Acad Dermatol 2013; 7 (2): 1372c2 This article is available from: http://www.jtad.org/2013/2/jtad1372c2.pdf Key Words: pityriasis lichenoides chronica, delivery Abstract Observations: Pityriasis lichenoides is a papulosquamous disorder with remissions and exacerbations. The aetiology of pityriasis lichenoides is unclear. There are isolated reports of the development of pityriasis lichenoides et varioliformis acuta during pregnancy. But pityriasis lichenoides chronica following cesarean delivery was never reported so far. We present a case of pityriasis lichenoides chronica that occurred within15 days after giving birth to her first child by cesarean section. Pregnancy is a condition with profound endocrine and metabolic alterations that are generally well tolerated by the body. However, it is known to generate a state of humoral and cellular immunosuppression. We have thought that is pityriasis lichenoides chronica following cesarean delivery may be associated with decreased immunosuppression after delivery. Introduction or infections and was otherwise healthy. She re- ported that pruritic papules appeared within 15 Pityriasis lichenoides (PL) is a papulosqua- days after giving birth to her first child by cesarean mous disorder with remissions and exacerba- section, six months ago.
    [Show full text]
  • Histomorphology of Papulosquamous Skin Lesions with Special Stain Application-An Analysis”
    “HISTOMORPHOLOGY OF PAPULOSQUAMOUS SKIN LESIONS WITH SPECIAL STAIN APPLICATION-AN ANALYSIS” Dissertation submitted in Partial fulfillment of the regulations required for the award of M.D. DEGREE In PATHOLOGY – BRANCH III THE TAMILNADU DR. M.G.R. MEDICAL UNIVERSITY CHENNAI MAY 2018 DECLARATION I hereby declare that the dissertation entitled “HISTOMORPHOLOGY OF PAPULOSQUAMOUS SKIN LESIONS WITH SPECIAL STAIN APPLICATION-AN ANALYSIS” is a bonafide research work done by me in the Department of Pathology, Coimbatore Medical College during the period from July 2016 to June 2017 under the guidance and supervision of Prof.Dr. C.Lalitha, M.D., Professor and Head of the Department, Department of Pathology, Coimbatore Medical College. This dissertation is submitted to The Tamilnadu Dr.MGR Medical University, Chennai towards the partial fulfilment of the requirement for the award of M.D., Degree (Branch III) in Pathology. I have not submitted this dissertation on any previous occasion to any University for the award of any Degree. Place: Coimbatore Date: Dr.V.Uma CERTIFICATE This is to certify that the dissertation entitled “Histomorphology of papulosquamous skin lesions with special stain application-an analysis” is a record of bonafide work done by Dr.V.Uma in the Department of Pathology, Coimbatore Medical College, Coimbatore under the guidance and supervision of Dr.G.S.Thiriveni Balajji M.D., Associate Professor, Department of Pathology, Coimbatore Medical College and submitted in partial fulfilment of the requirements for the award of M.D. Degree (Branch III) in Pathology by The Tamilnadu Dr. MGR Medical University, Chennai. Guide Head of the Department Dr.G.S.Thiriveni Balajji, M.D., Prof.
    [Show full text]
  • Home Phototherapy Order Form
    Physician’s Written Order for Home Phototherapy Fax to: 605-322-2475 or Email: [email protected] This form is a Prescription and Statement of Medical Necessity for Daavlin home phototherapy products Rx used for the treatment of skin conditions such as psoriasis. All fields required for insurance approval. First Name _______________________ Last Name _________________________ DOB ____/____/____ Gender: M F Address _____________________________________________ City_________________________ State_____ Zip__________ Patient Info: Patient Phone #________________________________ Alt Phone # or Email _______________________________________________ HCPCs: Product and Description: Physician Name ___________________________________ DermaPal: Hand-held treatment wand for scalp, Practice __________________________________________ E0691 spot treatment or travel. Includes comb attachment. NPI# ______________________________________________ E0691 1 Series: Small, light-weight panel for hands, face, Address _________________________________________ feet, elbows, or any other localized treatment area. City ______________________ State ____ Zip _________ 7 Series 8 Lamp: Six foot tall, multi-directional unit Info: Physician Prescribing Phone (____)______________*Fax (____)______________ Home Phototherapy Product: Home Phototherapy E0694 for large areas and/or full body treatment. * IMPORTANT: We will use this fax number to fax the Prescriber’s Dosing Guide ICD-10 Code: Description: ICD-10 Code Estimated Duration of Need: ___ Months (
    [Show full text]
  • Unique Clinical Presentations of Pityriasis Rosea
    Volume 23 Number 2 | February 2017 Dermatology Online Journal || Case Presentation DOJ 23 (2): 11 Unique clinical presentations of pityriasis rosea: aphthous ulcers, vesicles and inverse distribution of lesions Naeha Gupta MS1, Jacob O Levitt MD2 Afliations: 1Edward Via College of Osteopathic Medicine, 2016 Candidate, Blacksburg, Virginia , 2Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York Corresponding Author: Jacob O Levitt, MD, Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029, Tel. (914) 661-1726 Fax. (212) 987-1197, Email: [email protected] Abstract primary herald patch, the lack thereof can lead to an incorrect diagnosis. We wish to highlight some Pityriasis Rosea (PR) is a common skin disorder atypical presentations of PR with cases that involve encountered in daily practice. Although its etiology aphthous ulcers, vesicles, and inverse patterns. has not been established, there has been widespread research into possibilities. The lack of its characteristic Discussion manifestations, specifcally the herald patch and truncal involvement, can lead to pitfalls in diagnosis. Possible Etiologies Whereas other conditions in the diferential diagnosis Although no etiology has been confrmed for PR, should be considered, PR can at times also manifest in there has been widespread research conducted an atypical manner. We wish to illustrate three cases of possible causes. In particular, HHV 6 and 7 have of PR including those that presented with aphthous been extensively studied as precipitating factors. ulcers, vesicles, and an inverse pattern. HHV 6 and 7 are commonly acquired in childhood with seroprevalence in the general population being Keywords: pityriasis rosea; inverse pityriasis; 80-90% [6].
    [Show full text]
  • Differential Diagnosis and Treatment of Itching in Children and Adolescents
    biomedicines Review Differential Diagnosis and Treatment of Itching in Children and Adolescents Seok-Young Kang † , Ji-Young Um † , Bo-Young Chung , Jin-Cheol Kim , Chun-Wook Park and Hye-One Kim * Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul KS013, Korea; [email protected] (S.-Y.K.); [email protected] (J.-Y.U.); [email protected] (B.-Y.C.); [email protected] (J.-C.K.); [email protected] (C.-W.P.) * Correspondence: [email protected] † Authors equally contributed. Abstract: Itching is prevalent in children with skin disorders and associated with effects on their mood, quality of life, and social functioning. Surprisingly, there are no data on childhood prevalence of pruritus in the general population. The aim of this article is to explore the epidemiology, clinical manifestation, and treatment for itch (pruritus) in the pediatric population (from infancy to adoles- cence), and to be helpful to primary care physicians who assess and diagnose pediatric patients with itching. In this study, we searched for specific keywords using PubMed and MEDLINE (Ovid) and, then, refined the retrieved searches for each cause and treatment. As a result of reviewing the litera- ture, atopic dermatitis was shown to be the most common cause of itching, especially during infancy and through preschool. Not only skin disorders but also systemic diseases, drugs, and postburn states can predispose an individual to itching in childhood. There are traditional and newly developed treatment modalities for itching in pediatric patients. However, because the pharmacokinetics and Citation: Kang, S.-Y.; Um, J.-Y.; pharmacodynamics of childhood are different from those of adults, the medications for itching have Chung, B.-Y.; Kim, J.-C.; Park, C.-W.; to be applied carefully for these age groups.
    [Show full text]
  • Topographic Differential Diagnosis of Chronic Plaque Psoriasis
    Journal of Clinical Medicine Review Topographic Differential Diagnosis of Chronic Plaque Psoriasis: Challenges and Tricks Paolo Gisondi * , Francesco Bellinato and Giampiero Girolomoni Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy; [email protected] (F.B.); [email protected] (G.G.) * Correspondence: [email protected] Received: 29 September 2020; Accepted: 5 November 2020; Published: 8 November 2020 Abstract: Background: Psoriasis is an inflammatory skin disease presenting with erythematous and desquamative plaques with sharply demarcated margins, usually localized on extensor surface areas. Objective: To describe the common differential diagnosis of plaque psoriasis classified according to its topography in the scalp, trunk, extremities, folds (i.e., inverse), genital, palmoplantar, nail, and erythrodermic psoriasis. Methods: A narrative review based on an electronic database was performed including reviews and original articles published until 1 September 2020, assessing the clinical presentations and differential diagnosis for psoriasis. Results: Several differential diagnoses could be considered with other inflammatory, infectious, and/or neoplastic disorders. Topographical differential diagnosis may include seborrheic dermatitis, tinea capitis, lichen planopilaris in the scalp; lupus erythematosus, dermatomyositis, cutaneous T-cell lymphomas, atopic dermatitis, syphilis, tinea corporis, pityriasis rubra pilaris in the trunk and arms; infectious intertrigo in the inguinal and intergluteal folds and eczema and palmoplantar keratoderma in the palms and soles. Conclusions: Diagnosis of psoriasis is usually straightforward but may at times be difficult and challenging. Skin cultures for dermatophytes and/or skin biopsy for histological examination could be required for diagnostic confirmation of plaque psoriasis. Keywords: psoriasis; plaque psoriasis; differential diagnosis; diagnosis; papulosquamous lesions 1.
    [Show full text]
  • Mallory Prelims 27/1/05 1:16 Pm Page I
    Mallory Prelims 27/1/05 1:16 pm Page i Illustrated Manual of Pediatric Dermatology Mallory Prelims 27/1/05 1:16 pm Page ii Mallory Prelims 27/1/05 1:16 pm Page iii Illustrated Manual of Pediatric Dermatology Diagnosis and Management Susan Bayliss Mallory MD Professor of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine Director, Pediatric Dermatology St. Louis Children’s Hospital St. Louis, Missouri, USA Alanna Bree MD St. Louis University Director, Pediatric Dermatology Cardinal Glennon Children’s Hospital St. Louis, Missouri, USA Peggy Chern MD Department of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine St. Louis, Missouri, USA Mallory Prelims 27/1/05 1:16 pm Page iv © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park Abingdon, Oxon OX14 4RN, UK Tel: +44 (0) 20 7017 6000 Fax: +44 (0) 20 7017 6699 Website: www.tandf.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention.
    [Show full text]
  • A Dissertation on a CLINICAL STUDY of NAIL CHANGES in PAPULOSQUAMOUS DISORDER
    A Dissertation on A CLINICAL STUDY OF NAIL CHANGES IN PAPULOSQUAMOUS DISORDER Dissertation Submitted to THE TAMILNADU Dr.M.G.R. MEDICAL UNIVERSITY CHENNAI - 600 032 With partial fulfillment of the regulations for the award of M.D. DEGREE IN DERMATOLOGY , VENEREOLOGY AND LEPROLOGY (BRANCH – XII) COIMBATORE MEDICAL COLLEGE, COIMBATORE MAY 2018 DECLARATION I Dr. A. AMUTHA solemnly declare that the dissertation entitled “A CLINICALSTUDY OF NAIL CHANGES IN PAPULOSQUAMOUS DISORDER ” is a bonafide work done by me at Coimbatore Medical College Hospital during the year JUNE 2016- JUNE 2017 under the guidance & supervision of Dr.M .REVATHY M.D.,D.D., Professor & Head of Department, Department of Dermatology, Coimbatore Medical College & Hospital. The dissertation is submitted to Dr.MGR Medical University toward partial fulfilment of requirement for the award of MD degree branch XII Dermatology, Venereology and Leprology. PLACE: Dr A. AMUTHA DATE : COPYRIGHT DECLARATION BY THE CANDIDATE I hereby declare that The Tamilnadu Dr. M.G.R Medical University, Chennai shall have the rights to preserve, use and disseminate thisdissertation / thesis in print or electronic format for academic / researchpurpose. PLACE: COIMBATORE Dr.A.AMUTHA DATE: CERTIFICATE This is to certify that the dissertation entitled “A CLINICAL STUDY OF NAIL CHANGES IN PAPULOSQUAMOUS DISORDER” is a bonafide original work done by Dr. A. AMUTHA post graduate student in the Department of Dermatology, Venereology and Leprology, Coimbatore Medical College Hospital during the year JUNE 2016- JUNE 2017 under the guidance & supervision of Dr.M.REVATHYM.D (Derm)., Professor & Head of Department, Department of Dermatology, Coimbatore Medical College & Hospital. The dissertation is submitted to Dr.MGR Medical University toward partial fulfilment of requirement for the award of MD degree branch XII Dermatology, Venereology and Leprology.
    [Show full text]
  • Clinical Pattern of Papulosquamous Dermatoses: an Observational Study Conducted at Tertiary Care Center, Ujjain, Madhya Pradesh, India
    International Journal of Research in Dermatology Varma K et al. Int J Res Dermatol. 2020 Mar;6(2):230-236 http://www.ijord.com DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20200602 Original Research Article Clinical pattern of papulosquamous dermatoses: an observational study conducted at tertiary care center, Ujjain, Madhya Pradesh, India Krishnendra Varma, Ujjwal Kumar, Varun Kumar* Department of Dermatology, Venereology and Leprology, R.D Gardi Medical College, Ujjain, Madhya Pradesh, India Received: 11 November 2019 Accepted: 10 January 2020 *Correspondence: Dr. Varun Kumar, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Papulosquamous dermatoses is a complex group of disorder characterized by scaly papules and plaques. There is a need to study the exact, pattern and prevalence of this disorder in different age groups and their line of treatment. Objective of the study was to observe the clinical pattern of various papulosquamous dermatoses and their prevalence at tertiary care center, Ujjain. Methods: This was an observational study done in R.D. Gardi Medical college, Ujjain over a period of one year. A total of 229 cases including male and female of papulosquamous dermatoses were enrolled from the outpatient department. All patients were studied clinically and relevant data was recorded. Microsoft excel was used for data entry and analysis was done using SPSS version 23.
    [Show full text]
  • A Clinicopathologic Study of Lichen Planus Dr
    DOI: 10.21276/sjams.2017.5.3.77 Scholars Journal of Applied Medical Sciences (SJAMS) ISSN 2320-6691 (Online) Sch. J. App. Med. Sci., 2017; 5(3F):1122-1126 ISSN 2347-954X (Print) ©Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources) www.saspublisher.com Original Research Article A Clinicopathologic Study of Lichen Planus Dr. Karumbaiah KP1, Dr Arshiya Anjum2, Dr Mallikarjun M3 1Associate. Prof. of Pathology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India 2Consultant Pathologist, Cloudnine Hospital, Jayanagar, Bengaluru, Karnataka, India 3Prof &Head, Dept.of Dermatology, K.V.G. Medical College, Sullia, D.K., Karnataka, India Department of Pathology, K.V.G .Medical College, Sullia, D.K, Karnataka, India *Corresponding author Dr.K.P. Karumbaiah Email: [email protected] Abstract: Papulosquamous group of skin lesions have certain common clinical presentations and lead to confusion in diagnosis. We undertook this study to analyze the histomorphological findings of lichen planus, one of the most common and important Papulosquamous lesions of skin in detail, and to correlate the clinical findings with histomorphological features. Biopsy of clinically diagnosed/suspected cases of lichen planus lesions were performed in the department of dermatology and sent to the department of pathology in 10% formalin. The specimens obtained were subjected for tissue processing after fixation. Tissue sections are prepared from paraffin block and stained with haematoxylin and eosin, followed by microscopic examination. A total of 17 cases were studied. Lesions occurred in all age groups but were common in middle aged. Males were commonly affected. There is an overlap in morphology and distribution of these lesions leading to difficulty in diagnosis.
    [Show full text]