Preetham Sharanappa

Abstract

Introduction: Hair fall from the scalp is a common complaint by females attending a dermatologist’s out-patient clinic. The most common cause is telogen effluvium and the most common pattern is chronic diffuse non-scarring hair fall from the scalp. Objectives: The aim of our study was to analyze deficiency status and correlate hemoglobin, ferritin, cobalamin, folic acid in females of reproductive age group. Materials and Methods: This is a descriptive study was conducted in the DVL department of a tertiary care medical college hospital between 2018-2019. Clinical and demographic data were collected and hemoglobin, ferritin, cobalamin, folic acid levels were investigated. Results: A total of 85 patients were studied. Mean Hemoglobin was found at 11.92 g/dl and Anemia was recorded at 59.32%. Ferritin levels were lower than normal in 90% of the cases. Folate levels were in the normal range in the majority of our cases. Cobalamin was deficient in 50% of our patients. Conclusion: Ferritin and cobalamin levels were better indicators than hemoglobin levels alone in assessing chronic nonscarring hair loss from the scalp in females of reproductive age group.   Keywords: Chronic nonscarring diffuse hair fall of scalp, Cobalamin, Ferritin

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Abstract

Background: Atopic Eczema (AE) is a specific chronic relapsing dermatitis with varied presentations. The etiopathogenesis of AE is largely speculative and over years has led to origin of various criteria like Hanifin, Rajka’s criteria (HRC), United Kingdom working party’s diagnostic criteria (UKWPDC) and millennium diagnostic criteria (MDC). These have originated in western countries and is used among Indian population without much validation studies. Objective: To validate HRC, UKWPDC and MDC in the diagnosis of AE among Indian population.  Materials and Methods: A case-control study including 50 cases of AE and 30 age matched controls who are presenting to the DVL OPD of a tertiary teaching hospital. Defined case proforma was prepared highlighting the criteria’s of HRC, UKWDPC and MDC posing as a questionnaire to the cases/subjects. Total Serum IgE levels were estimated. Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and Relative value were calculated for all criteria. Results: The Sensitivity, specificity, PPV and NPV was 100% for HRC and UKWPDC whereas there was a compromise in the specificity (32.5%) and lower relative value of (22.5%) for MDC. Some minor features of HRC and MDC criteria showed lower validity compared to major features. Conclusions: Though many upgradations are going on in HRC, UKWPDC it could still be considered and used as a diagnostic criterion considering the high sensitivity, specificity and accuracy for diagnosis of AE. Keywords: Atopic Eczema, Total serum IgE, Hanifin & Rajka criteria, UK working party diagnostic criteria, Millennium diagnostic criteria.

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Introduction: The main features of atopic dermatitis or eczema are skin barrier disturbance and immune dysregulation. Milder form of Atopic dermatitis (AD) is reported to occur in India. There is demonstrable association between Serum IgE and AD. Aim: To find out the clinical pattern of AD cases and to determine Serum IgE levels. Materials and Methods: A cross-sectional study done among 80 subjects (50 cases and 30 controls) in Department of Dermatology, Venereology and Leprosy (DVL) outpatient department (OPD) of KIMS, Hospital, Hubli, Karnataka. AD cases and controls were selected as per the Hanifin and Rajka’s criteria and Serum IgE levels was as per the Clinical and Laboratory standards 2008. Statistical analysis: Collected data was analysed for frequency, percentage, mean, standard deviation, Chisquare test and Karl- Pearsons Correlation coefficient. Results: Twenty two (44%) cases had elevated IgE levels. The mean IgE in AD cases was 186.78170.50IU and in controls were 24.719.3IU. The association between less than 2 years age and increase in IgE levels among AD cases was statistically significant (p group presented with lesions commonly on the face and extensors of extremities (83.4%), whereas children between 2-12 years and above mostly had lesions on flexor aspect of their extremities. Conclusion: IgE levels were higher among younger children compared to older children and adults and the commonly involved areas are face and extensors in young children. So IgE levels may be helpful as a predictor of atopic dermatitis in less than 2 years age group. Keywords: Atopic dermatitis, Eczema, IgE level, Atopy.

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