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Biomedical subjects

A H Patki

Publications and source records attributed to A H Patki.

At least 37 records · Page 2Linked to original sources
PubMed1991

Significance of nail changes in leprosy: a clinical review of 357 cases.

Leprosy can cause many nail changes, which have been observed in up to 64% of infected patients. The manifestations of leprosy (clinical, bacteriologic, and histological) are profoundly affected by the patient's immunological status, which also determines the prognosis. Nail changes in leprosy can be caused by neuropathy and trauma, vascular impairment, infections, and miscellaneous changes. Often more than one factor will be important. Paradoxically, nail changes in tuberculoid and lepromatous patients are similar, despite wide differences in pathology. This may be because etiological factors common to both are implicated. Factors only associated with lepromatous disease are invasion of the bones of terminal phalanges by lepromatous granulomas and endarteritis occurring during type 2 lepra reactions. Otherwise, the only difference from tuberculoid leprosy is the time of onset and the symmetry of lesions. Lepromatous patients develop nail changes late in the course of disease. The presentation is usually bilaterally symmetrical. However, these changes are not specific to leprosy, and may be observed in other peripheral neuropathies.

Bacterial Infections↗
PubMed1989

Dapsone-induced erythroderma with Beau's lines.

A 35-year-old female with borderline lepromatous (BL) leprosy who suffered from dapsone-induced erythroderma is reported. Sudden onset of erythroderma gave rise to a temporary arrest of the function of nail matrix with the resultant Beau's lines. She rapidly recovered with omission of dapsone and therapy with systemic corticosteroids and a topical emollient. In view of the potentially fatal hypersensitivity reaction, we suggest that any patient on multidrug therapy for leprosy needs an urgent referral to a dermatologist if the patient develops a skin rash during the first two months of treatment.

Adult↗
PubMed1989

A study of dermatological conditions in leprosy in-patients.

Three hundred and sixty six in-patients in a leprosy hospital were examined for other dermatological conditions. Eighty eight of them displayed ichthyosiform changes. A peculiar condition of a verrucous hyperkeratotic growth on the anterior aspect of ankle, not described previously, was observed in four patients. It was noted that 11 out of 12 patients with scabies did not have the classical lesions in web spaces of the hands.

Clofazimine↗
PubMed1989

Pterygium unguis in a patient with recurrent type 2 lepra reaction.

A 35-year-old man with long-standing lepromatous leprosy and history of recurrent, severe type 2 lepra reaction was found to have pterygium unguis and destruction of the fingernails. We propose that the obliterative angiitis and endarteritis due to severe type 2 lepra reaction were responsible for these nail changes.

Adult↗
PubMed1988

'Flu' syndrome on once monthly rifampicin.

Two cases of 'flu' syndrome on once monthly rifampicin are reported. The symptoms were reproduced in one patient with the next supervised dose. In the second patient they did not recur probably because she was receiving systemic steroids for left ulnar neuritis.

Adult↗
PubMedDate not supplied

Comparison of two multidrug regimens in multibacillary leprosy.

One of the technical problems relating to the multidrug therapy of leprosy is the slow decrease in the bacteriological index (BI) in multibacillary patients. In this study we have compared a regimen containing rifampicin given daily for 9 months with the standard WHO multidrug regimen for multibacillary leprosy. We have found, at the end of two years, a significantly greater fall of BI in patients who had received the regimen containing daily rifampicin as compared to those who had received pulsed doses of rifampicin. The doses of dapsone and clofazimine were similar in these two groups. It appears that daily administration of rifampicin may be useful in treating multibacillary patients in whom reduction in the BI is slower than expected. However, in view of its high cost and the very much increased incidence of type-2 lepra reactions and hepatitis, daily rifampicin therapy cannot be recommended for a control programme.

Adolescent↗
PubMedDate not supplied

Hyperkeratotic and verrucous skin lesions on lower extremities of leprosy patients.

Three morphological varieties of hyperkeratotic and verrucous skin lesions on the anterior aspect of ankle joints in patients with leprosy are described: (i) verrucous lesions with thread-like horny projections similar to filiform warts; (ii) irregular compact hyperkeratotic lesions with deep fissures in between; and (iii) hyperkeratotic lesions with linear fissures corresponding to the transverse creases on the anterior aspect of the ankle. Chemical cautery was useful for the treatment of the first two varieties, and a potent topical corticosteroid with salicylic acid was useful for the third.

Adult↗
PubMedDate not supplied

Thalidomide in type-2 lepra reaction--a clinical experience.

A clinical experience of using thalidomide in type-2 lepra reaction (ENL) in 90 male patients--57 with lepromatous leprosy (LL) and 33 with borderline lepromatous leprosy (BL)--is described. All the patients responded well although some took a longer time to improve. No major side effects were observed except for giddiness in 10 and gastrointestinal upsets in 7 patients. Thalidomide thus appears to be a very effective drug in the treatment of severe type-2 lepra reaction and apart from its historically well-documented embryopathic effects, does not seem to have any other serious side effects in the patients under study.

Adolescent↗