Biomedical subjects

Soni Nanda

Publications and source records attributed to Soni Nanda.

At least 19 recordsLinked to original sources

PubMed2006

Suction blister epidermal grafting for management of eyelid vitiligo: special considerations.

BACKGROUND: Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities. PATIENTS AND METHODS: The current study was carried out on six patients of stable eyelid vitiligo, not responding to medical treatment. Suction blister was obtained from the thigh using the suction apparatus and the roof was grafted on to the dermabraded eyelid. Certain precautions were taken during the procedure, which will be highlighted in the current study. RESULTS: Response was excellent in all the patients in 3 to 6 months, with no complications. CONCLUSIONS: If carried out properly, suction blister technique is the procedure of choice for cosmetically important sites like eyelids.

Blister↗

PubMed2006

En bloc excision of proximal nail fold for treatment of chronic paronychia.

BACKGROUND: Chronic paronychia is a very recalcitrant dermatosis, which is particularly prevalent in housewives. Medical treatment for this condition is unsatisfactory in a significant number of cases. Surgical approach forms an important part of management, however, this area has received little attention. Various surgical approaches have been tried in the past but a comparative analysis has not been attempted. OBJECTIVES: The present study aims at assessing the efficacy of en bloc excision of proximal nail fold (PNF). Moreover, a comparative analysis has been undertaken to assess whether or not simultaneous nail plate avulsion improves the treatment outcome. METHODS: Thirty patients of chronic paronychia with nail plate irregularities were randomly divided into two treatment groups (15 patients each). After a detailed evaluation, en bloc excision of PNF with or without nail plate removal was performed. Postoperative measures were advised and the patients were kept under regular follow-up thereafter. Assessment of postoperative complications was also performed. RESULTS: Twelve patients in group I and 13 patients in group II completed the treatment protocol. Of these, 70% of patients were cured in group II (en bloc excision with nail avulsion) whereas only 41% were cured in group I (en bloc excision without nail avulsion). CONCLUSION: En bloc excision of the PNF is a useful method in recalcitrant chronic paronychia. Simultaneous avulsion of the nail plate improves the surgical outcome. Strict avoidance of irritant exposure is necessary to ensure complete treatment and prevent recurrence.

Adolescent↗

PubMed2005

Efficacy of triamcinolone acetonide in various acquired nail dystrophies.

The treatment of nail disorders is currently an unsatisfying exercise. Isolated nail involvement generally does not warrant any systemic therapy. At the same time, treatment is requested because of significant cosmetic and functional handicap. Intralesional triamcinolone acetonide (TA) in the proximal nail fold was evaluated as a treatment modality in 30 patients with twenty-nail dystrophy, 14 with nail lichen planus, and 6 with nail psoriasis. The number of involved nails varied from 1-20, and 1-10 nails were treated with TA. Fourteen patients discontinued treatment after 1-2 sittings. Out of the 28 patients completing the treatment protocol, 16 showed 75-100% improvement. Predominant side effects included pain, subungual hematoma formation, proximal nail fold hypopigmentation, and atrophy. TA given as a single injection in the proximal nail fold produced good improvement in a significant number of patients completing the treatment protocol. Lower concentrations of TA (5 mg/ml) were quite effective in treating various dermatoses affecting the nail unit. Our technique had fewer side effects than needle-less injection or multiple injection techniques. Careful attention to injection technique further minimized the side effects associated with the procedure. Sixteen patients completed the six-month follow-up and a relapse of nail changes was seen in 10. The relapses were equally responsive to retreatment. TA injected into the proximal nail fold area is a useful, cheap and efficacious treatment for dermatoses affecting the nail unit.

Adolescent↗

PubMed2005

A case of extensive linear porokeratosis with evaluation of topical tretinoin versus 5-flourouracil as treatment modalities.

A 19-year-old male presented with linear raised lesions over extensive areas of his body that followed Blaschko's lines. The lesions were asymptomatic with ridged borders. Histopathology confirmed a diagnosis of porokeratosis. He was given topical tretinoin and topical flourouracil for local application on specified areas. The cosmetic acceptability and the safety profile of tretinoin were found to be better than those of flourouracil. However, both the agents were equally efficacious. A rare case of extensive porokeratosis with comparative evaluation of two treatment modalities is hereby presented.

Administration, Topical↗

PubMed2005

Nail biopsy: assessment of indications and outcome.

BACKGROUND: For years, nail biopsy has been shunned as a difficult and scarring procedure, which is seldom required in day-to-day practice. Only a few studies with a limited number of patients have been carried out to assess its utility in dermatology. METHODS: We studied 270 patients with nail disorders (both infectious and noninfectious). In 205 cases, the clinical diagnosis could be confirmed with the help of routine diagnostic aids, in the form of potassium hydroxide preparation, fungal culture, and biopsy of associated skin lesions. In the remaining 65 cases, various types of nail biopsies were carried out after ruling out contraindications to nail surgery. RESULTS: Overall, the histopathologic changes were found to be diagnostic in 63% of cases. Findings were more characteristic in infectious disorders of the nail unit. The diagnostic yield varied with the type of biopsy procedure. Side effects in the form of scarring and nail dystrophy were seen in 29.2% of the patients. DISCUSSION: Nail biopsy is useful, especially in cases with isolated nail involvement, an absence of skin lesions, and disorders such as twenty-nail dystrophy. It should be advocated in cases in which the routine diagnostic procedures fail to yield results. Proper selection of cases, choice of biopsy technique, and attention to the surgical procedure help in minimizing the side effects associated with the procedure. CONCLUSION: Nail biopsy was found to be a simple, safe, and useful procedure, especially in cases in which the clinical diagnosis is otherwise obscure.

Adult↗

PubMed2005

Leprosy with neurofibromatosis--a diagnostic dilemma.

The coexistence of leprosy with neurofibromatosis is a rare finding and can pose a diagnostic dilemma. Neurofibromatosis coexisting with borderline tuberculoid leprosy has previously not been reported. We report such a case in a 13-year-old boy where biopsy of clinically uninvolved nerve revealed the presence of acid-fast bacilli. A careful diagnostic workup is needed in such cases to ensure proper treatment. Both disorders affect Schwann cells and their relationship merits further consideration.

Adolescent↗

PubMed2004

Leprosy with Guillain Barre Syndrome: a new neurologic manifestation?

A 19-year-old female patient of lepromatous leprosy with Type II reaction, on multidrug therapy and prednisolone, presented with acute onset flaccid quadriparesis. The cerebrospinal fluid examination revealed albumino-cytologic dissociation. Nerve biopsy showed infiltration with lepra bacilli, features of vasculitis, and demyelination. There were no other identifiable precipitating factors for Guillain Barre Syndrome in this patient. Her condition improved without any steroid therapy. This case emphasizes the hypothesis that cell injury caused by Type II reaction can expose neural antigens and incite an autoimmune reaction in the form of Guillain Barre Syndrome.

Adult↗

PubMed2004

Pigmentation: a potential cutaneous marker for AIDS?

Pigmentation of skin, nails and mucosae has frequently been described in HIV positive patients. Various causes for this phenomenon have been ascribed, which include intake of various drugs like zidovudine, opportunistic infections like toxoplasmosis and adrenocortical suppression. However, there has been no uniform explanation. We describe three AIDS patients with different personal and disease profiles but essentially the same pattern of pigmentation. This pattern of pigmentation is thereby discussed. We also propose that this pigmentation could be a result of late stage HIV disease per se and thus could serve as a useful cutaneous marker for the same.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Cardio-facio-cutaneous syndrome: report of a case with a review of the literature.

A sporadic case of cardio-facio-cutaneous syndrome occurring in an 18-year-old girl is reported, with a brief review of pertinent literature, for its rarity and clinical interest. She had a characteristic cranio-facial appearance, a wide range of ectodermal defects, dystrophic nails and teeth, palmo-plantar keratoderma, typical short, coarse, unruly hair, pulmonic stenosis and mild mental retardation. She had no history of consanguinity and genetic studies did not reveal any abnormality.

Abnormalities, Multiple↗

PubMed2004

Intralesional 5-fluorouracil as a treatment modality of keloids.

OBJECTIVE: To evaluate the efficacy and side effects of 5-fluorouracil (5-FU) as a therapeutic agent in the treatment of keloids of any duration or size. METHODS: This is a prospective, randomized, uncontrolled trial. Twenty-eight consecutive patients with keloids of varying size and duration were included in the study. All the patients were given intralesional 5-FU at weekly intervals for 12 weeks, and follow-up was done at 24 weeks. Improvement was assessed on a scale of five points, and the side-effects experienced were noted at each visit. RESULTS: The improvement was more than 50% in the majority of the patients, with no patient showing failure to therapy. The side effects commonly encountered were pain at the injection site, ulceration, and burning sensation. There was no recurrence of symptoms or the lesion during the follow-up period of 24 weeks in any of the patients. CONCLUSION: The efficacy of 5-FU is comparable to other singly used modalities as a treatment option for keloids. The lack of any serious side effects and the evidence of recurrence at 24 weeks of follow-up make this a promising modality.

Adolescent↗

PubMed2004

Efficacy of hydroquinone (2%) versus tretinoin (0.025%) as adjunct topical agents for chemical peeling in patients of melasma.

BACKGROUND AND OBJECTIVES: In recent years, chemical peels have become increasingly popular in the treatment of melasma. However, postpeel hyperpigmentation is a frequently encountered side effect, especially in dark-skinned individuals. The role of priming agents in preventing this complication has not been adequately evaluated. Hence, we studied the effect of hydroquinone versus tretinoin as priming agents in minimizing the incidence of this side effect in a double-blind, randomized clinical trial of 50 patients with melasma. METHODS: Of a total of 50 patients, 25 patients each with a similar skin phototype, the nature and severity of melasma were assigned to groups I and II. The patients were primed with 2% hydroquinone in group I, and in group II with 0.025% tretinoin once daily (night time) 2 weeks before starting trichloroacetic acid peels. Subsequently, all of them received trichloroacetic acid peels at intervals of 2 weeks for 12 weeks, followed by monthly peels for next 12 weeks during the follow-up period. Patients continued to use a sunscreen with an SPF of greater than 15 and the recommended priming agent during the follow-up. Final assessment was made at 6 months, based on the impression of the patient, clinical examination by the physician, and photographic analysis. RESULTS: A total of 50 patients (25 in each group) participated in the study. The predominant Fitzpatrick skin type observed among them was type IV (56%), and the type of melasma was mixed (44%). The final results at 12 weeks were comparable in two groups. However, a significant difference was seen in the two groups during the follow-up period, with continued improvement in 24% and worsening in 28% of patients in group I and continued improvement in only 16% and worsening in 40% in group II patients. CONCLUSIONS: Hydroquinone is superior to tretinoin as a priming agent in maintaining the results achieved with peels and in decreasing the incidence of postpeel reactive hyperpigmentation.

Administration, Topical↗

PubMed2003

PUVA-induced lichen planus.

A 28-year-old male with histologically proven psoriasis vulgaris was administered oral 8-methoxypsoralen UVA therapy (PUVA). The plaques of psoriasis gradually responded to treatment, however numerous pruritic, violaceous papules over the right forearm and left thigh developed 5 months after starting PUVA (45 sittings with a cumulative dose of 156 J/cm(2)). Histopathologic examination of these lesions was compatible with the diagnosis of lichen planus (LP). On stopping PUVA therapy, the lesions subsided in one month. This case emphasizes the hypothesis that cell injury caused by PUVA therapy could expose some sequestered antigens to autoreactive lymphocytes and induce lichen planus.

Adult↗

PubMedDate not supplied

Analytical study of pustular eruptions in neonates.

Pustular eruptions are commonly encountered in neonatal practice. Much confusion exists among clinicians because of the similarity in clinical lesions, paucity of relevant literature, and varied nomenclature used for these diseases. This often results in inappropriate diagnoses and therapies, besides subjecting the neonates to invasive and traumatic investigative procedures. We conducted a comprehensive study of pustular eruptions in 100 neonates, using the clinical examination and simple laboratory tests to arrive at a practical diagnostic and therapeutic approach to this problem. Of the 100 neonates with pustular eruptions, 36% were in the early neonatal period (first week of life). A slight male preponderance with a male:female ratio of 1:0.79 was observed. The majority of the families of these infants had poor socioeconomic status (96%) and were living in slums (71%). A study of their educational status revealed that 54% of the mothers were uneducated. Fifty-seven percent of the neonates were born at home. The clinical pattern of diseases among these neonates was that 58% of them had infections [impetigo (23%), intertrigo (14%), scabies (6%), and viral diseases (6%)]. Noninfectious diseases (42%) included miliaria pustulosa, erythema toxicum neonatorum, epidermolysis bullosa, and contact dermatitis. Simple laboratory investigations helpful in establishing the diagnosis were smears processed with Gram (24%) and Giemsa (39%) stains and wet mounts with 10% potassium hydroxide (KOH) solution (27%) for direct microscopic examination. More than half (53%) of the patients required no specific treatment except for counseling and medications to alleviate symptoms, while others with an infectious etiology responded to topical and or systemic antibiotics/antifungals. Pustular eruptions in neonates include both infectious and noninfectious diseases. Simple laboratory tests such as Gram- and Giemsa-stained smears, direct microscopy with 10% KOH wet mounts, bacterial and fungal cultures are helpful in establishing the diagnosis and occasionally skin biopsy is needed. A practical diagnostic and therapeutic approach to this problem is discussed.

Diagnosis, Differential↗

PubMedDate not supplied