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Biomedical subjects

Sujay Khandpur

Publications and source records attributed to Sujay Khandpur.

At least 19 recordsLinked to original sources
PubMed2006

Necrotizing fasciitis.

Necrotizing fasciitis is an uncommon, rapidly spreading infection, affecting primarily the deep fascia, which may result in secondary necrosis of the subcutaneous tissue, fascia and muscle. We report a patient that had the cardinal features; namely, excruciatingly painful lesions, demonstration of gas in the tissue and an obnoxious foul odor, prominent erythema, induration, patchy necrosis, and loss of sensation in the left buttock and thigh. Its onset probably followed inadvertent trauma/injury of the left buttock. Corroborative microscopic pathology confirmed the diagnosis. Debridement and intensive supportive therapy comprising antibiotics, analgesics and fluids were given. The outcome of the therapy was gratifying.

Aged↗
PubMed2006

Evaluation of desmoglein enzyme-linked immunosorbent assay (ELISA) in Indian patients with pemphigus vulgaris.

OBJECTIVE: To evaluate the role of the enzyme-linked immunosorbent assay (ELISA) test for the detection of antibodies to desmoglein 1 (dsg1) and desmoglein 3 (dsg3) in the diagnosis of pemphigus vulgaris (PV), and its correlation with disease severity and clinical presentation (mucosal PV, cutaneous PV, mucocutaneous PV). METHODS: Twenty-seven active PV patients and 26 controls with other dermatologic disorders were included in the study. The severity of oral and cutaneous involvement was assessed and recorded. ELISA test for the measurement of anti-dsg1 and anti-dsg3 antibodies was performed (Medical and Biological Laboratories Co. Ltd., Nagoya, Japan). The cut-off ELISA value for both anti-dsg1 and anti-dsg3 was taken as 20. RESULTS: Of the 27 patients, 26 were ELISA positive for anti-dsg1 antibodies and 23 for anti-dsg3 antibodies. Of the controls, two were positive for anti-dsg1 and none for anti-dsg3 antibodies. The sensitivity and specificity of ELISA for anti-dsg1 in the diagnosis of PV were 96.3% and 92.3%, respectively. For anti-dsg3, they were 85.2% and 100%, respectively. The different morphologic types of PV could not be differentiated on the basis of antibody profile; however, a direct correlation between anti-dsg3 titers and the severity of oral disease was noted, and also between anti-dsg1 titers and the severity of cutaneous disease. CONCLUSIONS: ELISA (dsg1 and dsg3) is an efficient tool for confirming the diagnosis of PV. Specific antibody titers correlate with disease severity; however, desmoglein testing cannot differentiate between the various morphologic subtypes of PV.

Autoantibodies↗
PubMed2006

Unilateral nevoid telangiectasia--response to pulsed dye laser.

BACKGROUND: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous etiology. The therapeutic role of pulsed dye laser in this condition, especially in individuals with skin types III and IV, has not been elucidated completely. The aim of this study was to assess the response to flash-lamp pulsed dye laser of UNT in Indian patients. METHODS: A detailed analysis of nine confirmed cases of UNT patients was undertaken to determine the possible etiologic association of this disease. Six cases were treated with pulsed dye laser in combination with cryogen cooling using the following parameters: spot size, 7 mm; fluence, 5-7.5 J/cm2; wavelength, 585 nm; pulse duration, 450 micros. The procedure was repeated every 4-6 weeks and the response was assessed both clinically and photographically before each session. RESULTS: The cases had a mean age of presentation of 20.6 years with an age of onset varying from 2.5 to 23 years. The lesions were located on the head and neck region in four patients, upper limb in four, and lower limb in one. No significant etiologic association could be established. Of the six cases treated with pulsed dye laser, a moderate response (26-50% lightening) was achieved in all cases after a mean of 2.33 sessions, a good response (51-75% lightening) was observed in four patients after 3.25 sessions, and an excellent response (>75% lightening) was found in three patients after 3.66 sessions. Mild and reversible pigmentary alterations occurred in five cases, with mild textural change in one case. There was no scarring. No recurrence was observed. CONCLUSION: Pulsed dye laser is a useful modality for treating UNT in Indian patients. Reversible pigmentary changes are the major side-effects.

Adolescent↗
PubMed2005

Comparison of minipunch grafting versus split-skin grafting in chronic stable vitiligo.

BACKGROUND: Minipunch grafting (MPG) and split-skin grafting (SSG) are common outpatient procedures for the surgical treatment of chronic stable vitiligo. However, there is a paucity of literature comparing the two procedures by the same group of investigators. OBJECTIVE: To compare the two techniques in patients with chronic stable localized vitiligo. METHODS: Sixty-four patients with stable vitiligo of 6 months duration were randomized into two groups to be taken up for MPG or SSG in a representative patch followed by PUVAsol therapy for 3 months. They were evaluated 3 months postoperatively for the degree of repigmentation and side effects. RESULTS: In the MPG group, 644 grafts, 2.5 mm in size, were placed on a total vitiliginous area of 521.25 cm2, whereas in the SSG group, 153 grafts covered a 1,489 cm2 recipient area. Three months postoperatively, in the first group, 15 cases (44.1%) showed very good to excellent (> 75%) repigmentation compared with 25 cases (83.3%) in group 2. Following MPG, 81 grafts (12.57%) were rejected. Cobblestoning was the main side effect, occurring in 13 cases (38.23%), and a variegated appearance was observed in 7 (20.58%) patients. The complications noted after SSG were achromic fissuring in four (13.3%) cases, graft contracture in four grafts (2.61%) in three patients, and rejection of seven grafts (4.57%) in one case; tire-pattern appearance in two patients (6.6%); milia formation in four (13.3%) patients; and depigmentation of the grafts in two (6.6%) cases. In both groups, superficial scarring was noted at the donor site in all cases, whereas hypertrophic scarring occurred in 3 (10%) patients after SSG. CONCLUSION: SSG carries a distinct advantage over MPG in producing excellent cosmetic matching over larger areas using fewer grafts, especially over the face and extremities.

Adolescent↗
PubMed2003

Rare association of xanthoma disseminatum with skeletal involvement.

A ten-year-old boy presented with a 2.5-year history of painful shoulder and hip joints, 1.5 years of yellow-brown papules and plaques on the face, flexures and trunk, and 6 months of polyuria and polydipsia. Skin biopsy revealed histological and immunohistochemical features typical of xanthoma disseminatum. Lytic bone lesions were seen in the femur and pelvis and sclerotic changes in the humerus on X-ray. Diabetes insipidus was also diagnosed

Biopsy↗
PubMed2003

Longitudinal nail biopsy: utility in 20-nail dystrophy.

BACKGROUND: Twenty-nail dystrophy (TND) is an inflammatory disorder of the nail unit. It is frequently encountered in childhood and is believed to be a common clinical manifestation of several nail pathologies. Varying associations and histopathologic features have been reported previously. OBJECTIVES: To evaluate the clinical and histopathologic profile of TND and the utility of longitudinal nail biopsy (LNB) for the same. METHODS: Thirty-two consecutive patients with TND were screened clinically. The histopathologic features of skin and longitudinal nail biopsies were also evaluated. The efficacy of nail unit biopsy was thereby assessed. RESULTS: Young males in the 10- to 20-year-old age group were most commonly affected (52%). Alopecia areata was the most commonly associated dermatosis (22%). LNB revealed a specific diagnosis of either psoriasis or lichen planus in 52% of the cases, whereas the rest showed nonspecific histologic changes (spongiotic trachyonychia). Scarring was a major risk associated with LNB, as evident in 28% of the patients studied. CONCLUSIONS: These data reveal the clinical profile and common associations of TND. They also confirm the diagnostic utility of nail biopsy in TND patients and advocate this procedure in cases in which the clinical diagnosis is otherwise obscure. However, it cannot be recommended in the routine evaluation of patients with a relatively benign disorder such as TND. Furthermore, nail biopsy is proven to be a relatively simple and useful procedure.

Adolescent↗
PubMed2003

Successful treatment of multiple premalignant and malignant lesions in arsenical keratosis with a combination of acitretin and intralesional 5-fluorouracil.

A case of arsenical keratosis with multiple lesions of Bowen's disease and squamous cell carcinoma is described. The patient was successfully treated with a combination of acitretin and intralesional 5-fluorouracil. All the lesions resolved after three months of therapy with no side effects and no recurrence during four months of follow-up.

Acitretin↗
PubMed2002

Itraconazole therapy for white piedra affecting scalp hair.

BACKGROUND: Treatment of white piedra remains an area of therapeutic frustration. Several topical and systemic antifungal agents have failed to eradicate the fungus and prevent disease recurrence. Itraconazole is a safe and effective systemic antifungal agent for various superficial and deep mycotic infections of the skin and hair. In vitro studies have shown significant antifungal activity against Trichosporon beigelii. OBJECTIVE: Our study was intended to assess the efficacy of itraconazole in the treatment of uncomplicated white piedra affecting the scalp hair. METHODS: The study was designed as an open trial involving 12 female patients with white piedra of the scalp hair. They were administered oral itraconazole 100 mg once daily until culture negativity was achieved; they were then followed up for 3 months. RESULTS: Eleven patients (91.67%) showed disease remission after 8 weeks of treatment. One patient (8.33%) showed no improvement, and the disease recurred in 2 patients (16.67%) after completion of therapy. No significant side effects were noted.

Adolescent↗
PubMed2002

Multiple cutaneous metastases from carcinoma of the penis.

A 65-year-old male patient with carcinoma of the penis in association with bilateral inguinal lymphadenopathy and widespread cutaneous dissemination is described. Histopathological examination of the primary tumor and metastatic sites was suggestive of undifferentiated squamous cell carcinoma. The patient was administered combination chemothrapy using cisplatin, methotrexate, and bleomycin with a good response after three cycles. The case is unique because of the rapid onset and widespread nature of skin metastasis and rare presentation.

Aged↗
PubMed2002

Comparative efficacy of various treatment regimens for androgenetic alopecia in men.

Our understanding of the aetiology of androgenetic alopecia (AGA) has substantially increased in recent years. As a result, several treatment modalities have been tried with promising results especially in early stages of AGA. However, as far as has been ascertained, there is no comprehensive study comparing the efficacy of these agents alone and in combination with each other. One hundered male patients with AGA of Hamilton grades II to IV were enrolled in an open, randomized, parallel-group study, designed to evaluate and compare the efficacy of oral finasteride (1 mg per day), topical 2% minoxidil solution and topical 2% ketoconazole shampoo alone and in combination. They were randomized into four groups. Group I (30 patients) was administered oral finasteride, Group II (36 patients) was given a combination of finasteride and topical minoxidil, Group III (24 patients) applied minoxidil alone and Group IV (10 patients) was administered finasteride with topical ketoconazole. Treatment efficacy was assessed on the basis of patient and physician assessment scores and global photographic review during the study period of one year. At the end of one year, hair growth was observed in all the groups with best results recorded with a combination of finasteride and minoxidil (Group II) followed by groups IV, I and III. Subjects receiving finasteride alone or in combination with minoxidil or ketoconazole showed statistically significant improvement (p<0.05) over minoxidil only recipients. No signifcant side-effects related to the drugs were observed. In conclusion, it is inferred that the therapeutic efficacy is enhanced by combining the two drugs acting on different aetiological aspects of AGA.

5-alpha Reductase Inhibitors↗
PubMedDate not supplied

A study of phenotypic correlation with the genotypic status of HTM regions of KRTHB6 and KRTHB1 genes in monilethrix families of Indian origin.

We investigated 21 affected individuals in two unrelated monilethrix families of Indian origin and identified point mutation (g.4624G>A) in the HTM motif (exon-7) of the KRTHB6 gene in all the affected members leading to E413K change in this basic keratin. The HTM motif of KRTHB1, however, showed previously unreported two allelic variants, one with three novel variations (SNPs) in cis: g.4421insT (intronic); g.4461T>C (exonic); g.4485A>G (exonic) and second with only intronic variation (SNP) (g.4421insT). Interestingly, the two distinct phenotypes of: localized severe hair defect with beaded appearance confined to the scalp of all the affected members of Family 1 and of generalized unbeaded hair defect of moderate severity in Family 2, segregated in the two families, respectively, correlating with the two separate genotypes for the functionally critical HTM region of KRTHB1 gene in the background of E413K mutation in the KRTHB6 gene. Presence of E413K mutation in the HTM of KRTHB6 gene was not observed in the background of the allelic variant with three SNPs in KRTHB1 gene in homozygous condition in all the affected members of Family 1, affected with a localized but severe form of the disease. However, the same (E413K) mutation existed in the KRTHB6 gene in the background of the allelic variant with three SNPs in the KRTHB1 gene in homozygous condition, consistently in all the affected members of Family 2, where all its affected members showed the segregation of a milder form of the disease. Presence of both E413K mutation in the KRTHB6 and the variations in the KRTHB1 genes were not observed together in randomly selected 150 unaffected controls outside the two affected families. This is also the first report of HTM mutation of KRTHB6 gene in monilethrix cases of Indian origin and the first report of SNPs in the KRTHB1 gene in literature to our knowledge.

Base Sequence↗