Open Access Case Study

Lymhocytic Vasculitis on Top of Stevens-Johnson Syndrome (SJS): Case Report

Mahmoud Khalifa Marzouq, Howaida Mahmoud Hagag, Samia Omar Abdulmalk, Ahmed Mahmoud Khalifa, Khadiga Ahmed Ismail

Asian Journal of Research in Dermatological Science, Page 1-8

Stevens-Johnson syndrome is a rare, serious disorder of skin and mucous membranes that usually occurs due to any type of medication and other disease (infections). The outer most layer of the skin is affected due irrational death of the cells. Lymhocytic vasculitis is another severe patho-dermatological condition that causes damages of the blood vessels of on the upper most layer of the skin due to harmful effects of lymphocytes of the blood. Sometimes its effects over shed the other serious conditions of SJS syndrome. Patients at their primary stage may be suspected as SJS syndrome but its severity may leads to get turn over cutaneous vasculities within sometimes. Beside all the serum experiments, histological tests show major outcome in confirming the pathological condition. Signs and symptoms of this particular disease do not affirm that the person is actually suffering from this disorder but histo-pathological sketch contributes major respond in this regard. Medications like oral colchicine 0.5 mg once daily and oral prednisolone 30 mg is said to be used clinically for getting improved result.

Open Access Minireview Article

Retronychia

Emilio Sudy, Francisco Urbina, Ximena Wortsman

Asian Journal of Research in Dermatological Science, Page 1-9

Background: Retronychia is an inflammatory process of the proximal nailfold produced by the backward ingrowth of the nail plate.

Etiology: It appears secondary to proximal nail plate rupture induced principally by wearing tight shoes, or related to a traumatic origin such as sports or dance.

Clinical Findings: In the acute form the proximal nail fold appears painful, with signs of inflammation, whereas in the chronic state, besides the inflammation,  the nail plate appears yellowish and thickened. It affects predominantly the great toe, sometimes bilaterally, and also occasionally the fingers. Sometimes it is accompanied by the formation of granulation tissue near the proximal nail fold.

Treatment: Nail avulsion is the treatment of choice and it is curative.

Comments: Retronychia may be an underdiagnosed disease, with only a few reports found in the english, french, spanish and asian literature. A review on this subject is presented, illustrated with clinical and ultrasound figures.

Open Access Original Research Article

Self-­-Use of Skin Bleaching Products among Female Attending Family Medicine Clinic at Prince Mansour Military Hospital, Taif 2017

Zinab A. Al-Atawi

Asian Journal of Research in Dermatological Science, Page 1-8

Importance: The cosmetic use of skin bleaching products is a common practice in coloured-skinned women. The use of skin lightening creams is common and widespread in the African. Asian, and North American populations. Use of skin bleaching agents has been reported in Saudi Arabia. The long-term use of these products for several months to years may cause cutaneous or systemic side-effects.

Aims: This study aimed was to assess the prevalence of self-use of skin bleaching agents among Saudi women as well as the level of awareness, attitudes and practice towards the use of these agents.

Methods: A cross-sectional study was conducted by selection of systematic random sampling of female attending family medicine clinic at Prince Mansour Military Hospital from October to December, 2017. The data collected by a structured questionnaire included information about background variables, attitudes, awareness and practice regarding the use of skin bleaching agents. The data were analyzed using statistical software to yield descriptive and inferential statistics.

Results: A total of 358 women aged between 18-55 years old were included in this study. About 25% of the women were current users of skin bleaching agents, while 39.6% were only previous users. Thus, more than half of these women were either current or previous users, while 12% of them used creams previously and still use it currently. About a third of women used bleaching creams as a treatment for hypo or hyperpigmented skin and 29.4% used them for cosmetic purposes. Regarding the source of these agents, 38% of women obtaining them by medical prescription and 27.8% were from a pharmacy without prescription, while the remaining women obtaining them from the market. The reason of using skin bleaching creams was varying among females, 51.6% of females used creams for increase beauty, 51% for making a new look, 6% for rising self-confidence, and 4.3% to increase the stability of marriage. About 56% of women reported that cortisone is the most dangerous component of the skin bleaching agents. About 33% of women agreed to use a quick whitening agent from an unknown source. Significant associations were detected between the use of skin bleaching agents and each of education, income, and occupation, while the associations with marital status and age were not statistically significant.

Conclusion: The lifetime use of skin bleaching agents was relatively high divided evenly into cosmetic and curative purposes. The level of awareness about these agents is low since a considerable proportion of them agreed to use agents from unknown sources. In addition to the high use of skin bleaching agents obtained without medical or pharmacist consultation.

Open Access Original Research Article

Treatment of Chronic Idiopathic Urticaria with Fexofenadine and Hydroxyzine Hcl in Libyan Patients

Fathi. AlBallali, Iman. Amghaiab, Omran. Bugrein

Asian Journal of Research in Dermatological Science, Page 1-6

Chronic Idiopathic Urticaria (CIU) is characterised by short-lived circumscribed erythematous, edematous and itchy wheals usually lasting for few hours to few days. It may last for a period of at least six weeks or more without an identifiable causes and negative influence on the quality of life. It's a disabling affliction that considerably limits patients' daily activities. Fexofenadine hydrochloride is a carboxylated metabolic derivative of Terfenadineand third generation selective histamine H1-receptor antagonist with non-sedative effects. Hydroxyzine Hcl (Atarax) is a antihistamine H1 blocker with anticholinergic and sedative properties that relieve the symptoms of allergy.

Aim: The present study aims at assessing the efficacy and safety of combined administration of the Fexofenadine and Hydroxyzine Hcl for the treatment of CIU.

Methodology: The study was conducted on 48 Libyan patients (22 females and 26 males), with a mean age of 37 years (21-65 year olds). All patients were diagnosed with CIU. The study was done during January 2016 to December 2016. The average duration of the disease was 6 months (4-10months).  All patients were examined to rule out any triggers. Patients were treated with 120 mg of fexofenadine in the day time and 25 mg of hydroxazine at the night, for a period of 3 weeks, with a follow up at zero, two and three weeks for treatment response.

Results: The combination of Fexofinadine and Hydroxyzine was found to be effective against Urticariasymptoms in the 48 patients with CIU. A good response was observed in 16 patients (33%) and a very good response was found in 18 patients (37.5 %) whereas, a satisfactory response was seen in 8 patients (17%). In 6 patients (12.5 %) an unsatisfactory response was noted. Moreover a good tolerance against the combination of Fexofinadine and Hydroxyzine in the patient sample was reported.

Conclusion: The combination of Fexofenadine and Hydroxazineappears was found to be an effective and safe treatment for CIU, as it was found to improve Urticaria symptoms and the quality of life. Additionally it might also benefit patients who do not respond to single anti-allergic drug.

Open Access Original Research Article

Clinical Efficacy of Oral Terbinafine, Fluconazole and Itraconazole in the Treatment of Tinea Corporis

Walid Momin, Divya Vupperla

Asian Journal of Research in Dermatological Science, Page 1-10

Context: Comparing terbinafine, fluconazole and itraconazole for its efficacy.

Aims: This study was aimed to assess the clinico-mycological efficacy of oral terbinafine, fluconazole and itraconazole in the treatment of tinea corporis in a tertiary care hospital.

Study Design: This is a randomised comparative study with a sample size of 60 patients.

Methods: Patients were enrolled after considering various inclusion and exclusion criteria into three groups. Group A (oral terbinafine 250 mg daily for 2 weeks), group B (fluconazole 150 mg once weekly for 4 weeks) and group C (itraconazole 200 mg once daily for 2 weeks). Clinical assessment was performed weekly on the basis of physician global assessment grading the severity of pruritus, erythematic, vesicle and desquamation.

Statistical Analysis Used: Fisher exact test was used to calculate the statistical significance between the pre and post interventional results.

Results: Of the 60 patients, 51 completed the study on a comparison between the three groups terbinafine (n=15), itraconazole (n=18) and fluconazole (n=18), it was observed that terbinafine was more effective on pruritis (80%), erythema (40%) and desquamation (80%). Itraconazole showed effectiveness on vesicle (66.66%).

Conclusions: Terbinafine was better than itraconazole and fluconazole in relieving signs and symptoms during the study period.