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Biomedical subjects

Amrinder J Kanwar

Publications and source records attributed to Amrinder J Kanwar.

At least 19 recordsLinked to original sources
PubMed2003

An open trial of calcium dobesilate in patients with venous ulcers and stasis dermatitis.

BACKGROUND: Venous leg ulcers and associated stasis dermatitis are a major cause of morbidity, economic loss, and decreased quality of life in afflicted patients. Hence, there has been a renewal of interest in the medical management of varicose veins and ulcers. Calcium dobesilate, a capillotropic agent, has been found to be beneficial in the treatment of varicose veins. METHODS: This is an open pilot study of 25 patients (15 with venous ulcers with/without stasis dermatitis, 10 with stasis dermatitis only) who were given calcium dobesilate, 500 mg twice daily, for 8 weeks. The clinical parameters were graded (0-4; 0, absent; 1, mild; 2, moderate; 3, severe; 4, very severe) both before and after therapy, and included pain, itching, tiredness, heaviness, paresthesia, cramps, and leg swelling. Evaluation also included subjective changes in tenderness, oozing, and pigmentation, and measurement of the circumference of the leg for swelling and malleolar edema (measured in millimeters). The venous ulcer sizes were also recorded both before and after therapy. Color Doppler studies were performed to confirm the diagnosis of varicose veins, determine the competence of the valves, and to rule out deep vein thrombosis. Serum biochemistry, hemogram, and urinalysis were performed both before and after treatment. The results were analyzed statistically using the Wilcoxon rank sum test and Student's t-test. RESULTS: A statistically significant improvement was observed post-therapeutically in the clinical parameters of pain, itching, tiredness, heaviness, and leg swelling. There was also a significant decrease in ulcer size. The serum biochemistry, hemogram, and urinalysis remained unaffected. Color Doppler studies before treatment revealed venous valvular incompetence in 20 patients. They were repeated in only 10 patients after treatment, four of whom showed improved valvular competence. Recurrence of venous ulcers was seen in five of 12 patients who were followed up after therapy. No significant side-effects were noted. CONCLUSIONS: Calcium dobesilate is an effective adjuvant therapy, with an absence of significant side-effects, in patients with venous ulcers and stasis dermatitis. More double-blind trials are required in the future to substantiate and evaluate the role of the drug in these two indications.

Adult↗
PubMed2003

Trichotillomania.

Trichotillomania, though uncommon, is one of the causes of unexplained hair loss, especially in children. Three girls in the age group of 4-6 years were observed in our pediatric dermatology clinic to have trichotillomania. In one child, there was co-existent alopecia areata. All were referred to the child guidance clinic and they all showed improvement with behavior therapy. A close liasion between the dermatologist, psychiatrist and parents would go a long way in preventing this alopecia

Alopecia Areata↗
PubMed2002

Acrodermatitis enteropathica in a full-term breast-fed infant.

Acrodermatitis enteropathica which is a manifestation of zinc deficiency, is rarely seen in breast-fed infants. A child with typical acral rash, zinc deficiency and low breast milk zinc levels is described. The importance of awareness of this entity in breast-fed infants along with differential diagnosis is being emphasized.

Acrodermatitis↗
PubMed2002

The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients: a comparative study.

BACKGROUND: Melasma continues to be a difficult condition to treat, especially in dark-skinned patients, although various topical modalities including hydroquinone, tretinoin, and/or topical steroids have been used singly or in combination with variable results. OBJECTIVE: To determine if serial glycolic acid peels provide additional improvement when combined with a time-tested topical regimen, a modification of Kligman's formula (hydroquinone 5%, tretinoin 0.05%, hydrocortisone acetate 1% in a cream base). All cases had epidermal melasma as detected by Wood's light examination. METHODS: Forty Indian melasma patients were divided into two groups of 20 each. One group received serial glycolic acid peel combined with a topical regimen, modified Kligman's formula. The other, a control group, received only modified Kligman's formula. The results were evaluated by a clinical investigator both subjectively and with photographs taken at baseline, 12 (before the fourth peel), and 21 (3 weeks after the sixth peel) weeks. For clinical evaluation, the Melasma Area and Severity Index (MASI) was used. RESULTS: A significant decrease in the MASI score from baseline to 21 weeks was observed in both groups (P <.001). The group receiving the glycolic acid peels showed a trend toward more rapid and greater improvement, with statistically significant results (P <.001). Only a few side effects were observed in the peel group. CONCLUSION: This study demonstrates that serial glycolic acid peels provide an additional effect to a topical regimen which is a modification of the time-tested Kligman's regimen for treating melasma in dark-complexioned individuals if used judiciously and under supervision. It demonstrates that superficial chemical peels are beneficial in the treatment of melasma.

Administration, Topical↗
PubMed2002

Co-existence of variants of porokeratosis: a case report and a review of the literature.

Rarely, different variants of porokeratosis may coexist in an individual patient or their family members. A patient with the linear form of porokeratosis present since birth subsequently developed the disseminated superficial actinic form at a later age. A review of the literature pertaining to the coexistence of variants of porokeratosis suggests a significant association between the linear and disseminated superficial actinic forms. Genetic linkage between different variants and the basis for their association is discussed.

Adult↗
PubMed2002

Severe angioedema induced by angiotensin converting enzyme inhibitors: role of precipitating factors.

Angiotensin converting enzyme inhibitors like captopril, enalapril, lisinopril, trandopril and ramipril may rarely induce a life threatening angioedema. We present two cases of severe angioedema induced by enalapril and ramipril along with possible precipitating factors observed in these patients. The importance of prompt recognition and early management of such cases is emphasized.

Aged↗
PubMed2002

Erythema annulare centrifugum following pancreatico-biliary surgery.

Annular erythemas are distinct cutaneous eruptions associated with a variety of causes. Occurrence of erythema annulare centrifugum, a variant of annular erythemas, in the immediate post-operative period in a patient with surgical intervention in the gall bladder and pancreas region is being described for the first time. Its probable association with surgical trauma is discussed.

Aged↗
PubMed2002

Squamous cell carcinoma in long-standing untreated lichen sclerosus et atrophicus of the penis.

Lichen sclerosus et atrophicus is an uncommon disease of skin and genital mucosa in both sexes. Involvement of the male genital mucosa is usually complicated by recurrent balanoposthitis, ulceration, phimosis, and meatal stenosis. The development of a squamous cell carcinoma is extremely rare in genital lichen sclerosus et atrophicus in males as compared with females. We report a 70-year-old male with a squamous cell carcinoma of the glans superimposed on long-standing lichen sclerosus et atrophicus of glans and prepuce. The patient in addition had a basal cell carcinoma on his face. Awareness of this rare complication of lichen sclerosus et atrophicus in males is emphasized.

Aged↗
PubMed2002

A comparative study of 20% azelaic acid cream monotherapy versus a sequential therapy in the treatment of melasma in dark-skinned patients.

BACKGROUND: Melasma is a commonly found hyperpigmentary disorder in dark-complexioned persons, which is rather difficult to treat. Azelaic acid (AZA) 20% is considered efficacious in the treatment of melasma, although the response is rather slow. It has also been combined synergistically with topical retinoic acid, where the results were satisfactory. OBJECTIVE: The study was done to evaluate the usefulness of a sequential therapy of potent topical steroids +20% AZA cream versus only 20% AZA cream in the treatment of melasma. METHODS: This was a prospective, single-blind, right-left comparison pilot study with (1). twice daily application of 20% AZA to one half of the face for 24 weeks and (2). a potent topical steroid, 0.05% clobetasol propionate cream, to be applied for 8 weeks only and then to be followed by 20% AZA cream only for the next 16 weeks on the other half. Concomitant use of a broad-spectrum sunscreen was also mandatory. Thirty Indian patients (25 females, 5 males), whose ages ranged from 21 to 45 years and who were not pregnant, nursing or on any concurrent therapy, completed the study. Clinical evaluation, photography and the overall response were assessed at 4, 8, 16 and 24 weeks. RESULTS: At 4, 8 and 16 weeks, the lightening of melasma was significantly more marked on the side receiving the sequential therapy rather than the side receiving only 20% AZA cream (p < 0.001). However, at 24 weeks, although the difference was still significant (p = 0.0052), as many as 96.7 and 90% of patients of each group (sequential therapy and AZA) had good to excellent responses to treatment. The side-effects noted were mostly mild and transient and mainly local irritant effects. CONCLUSIONS: A sequential therapy of topical potent steroids +20% AZA cream can be considered as another alternative treatment for melasma, which combines the beneficial effects of both besides perhaps increasing the compliance of the patients. 20% AZA monotherapy itself is also an effective and well-tolerated therapy for melasma in dark-skinned races.

Administration, Topical↗
PubMed2002

Genital elephantiasis.

Genital elephantiasis (esthiomene), which is the dramatic end-result of lymphatic obstruction, is rather rare. Although mainly associated with filariasis and sexually transmitted diseases, such as lymphogranuloma venereum and donovanosis, it could also be an uncommon complication of tubercular lymphadenitis, a common infection in tropical countries. We report a rare case of a 32-year-old Indian female in whom genital elephantiasis occurred as a complication of tubercular lymphadenitis.

Adult↗
PubMedDate not supplied

Anticonvulsant hypersensitivity syndrome.

Anticonvulsant hypersensitivity syndrome is an acute, life-threatening, idiosyncratic drug reaction seen with the aromatic antiepileptic drugs, phenytoin, carbamazepine, phenobarbital, and primidone, with frequent cross sensitivity. It usually occurs 2-8 weeks after initiation of therapy and the hallmark clinical features are fever, rash, and lymphadenopathy. Hematologic abnormalities such as eosinophilia, atypical lymphocytes, and internal organ involvement also occur with varying severity. A case of hypersensitivity syndrome due to carbamazepine with cross sensitivity to phenytoin is reported. It is emphasized that this serious drug reaction with diverse clinical presentations should be recognized and treated promptly.

Adolescent↗
PubMedDate not supplied

Lichen scrofulosorum: a rare manifestation of a common disease.

Tuberculids develop as hypersensitive immunologic reactions in the skin to an occult internal focus of tuberculosis. These eruptive lesions are due to hematogenous dissemination of bacilli in a host with a high degree of immunity against Mycobacterium tuberculosis. Although rare, these specific lesions are important diagnostic markers of tuberculosis. Lichen scrofulosorum is one of the recognized tuberculids, usually seen in children and young adults. We report three children with lichen scrofulosorum; in two children it developed during treatment of tuberculosis. The appearance of lichen scrofulosorum after initiation of treatment due to a probable increase in cell-mediated immunity is emphasized.

Adolescent↗
PubMedDate not supplied

Cutis laxa in seven members of a north-Indian family.

Congenital cutis laxa, characterized by cutaneous laxity and loose skin, may be autosomal dominant or autosomal recessive. The autosomal dominant variety is usually not associated with any systemic defects and has a good prognosis. We report an unusual family in which seven members were affected by the autosomal dominant variant of this disorder. We suggest that close monitoring of the cardiorespiratory systems may be worthwhile to detect any systemic complications, although these complications are rare in the autosomal dominant variant of cutis laxa.

Child↗