Aneesh S

Abstract

Background: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy typified by oligoovulation or anovulation, signs of androgen excess, and multiple small ovarian cysts. The prevalence and incidence of PCOS is on the rise with rapid modernisation and changes in lifestyle. The correlation of cutaneous findings and sonographic changes in ovaries in PCOS has not been studied extensively in Indian population. The present study was conducted to evaluate this correlation. Objectives: To study and correlate the cutaneous features and ultrasonographic findings of ovaries in PCOS. Settings and Design: This was hospital based cross sectional, observational study. Materials and Methods: All the patients fulfilling the inclusion criteria were enrolled in the study. Both ovaries were examined sonographically for ovarian diameter, ovarian volume, follicular number and arrangement of follicles. Clinical and radiological findings were analysed statistically for correlation. Results: An appraisal of 50 subjects showed that 40 (80%) patients experienced menstrual disorders. Cutaneous manifestations observed included acne, acanthosis nigricans, hirsutism, androgenic alopecia, seborrhoea, acro chordons of which acne and hirsutism were most commonly observed. Majority of study subjects, 24(48%) were found to have ovaries with follicular number of 15-16. All the cutaneous manifestations were noted to be significantly increased in 24 patients having a follicular number 15-16. 56% of cases had elevated free testosterone levels. Free testosterone levels correlated significantly with number of follicles (p=0.037). Conclusion: The cutaneous features of acne and hirsutism were most commonly observed in the study. Majority, 44% cases had consistent features of polycystic ovaries (PCO) on USG, 6 had normal study with no correlation between number of follicles in the ovaries and the cutaneous features. Keywords: Acne vulgaris, Acanthosis nigricans, Androgenetic alopecia, Polycystic ovarian syndrome.

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Background: The etiology of lichen planus is predominantly autoimmune, with various associations. A variable association of oral lichen planus with hepatitis- C infection has been reported extensively in the literature. The same association has not been studied in this geographical region. The present study was undertaken to evaluate the association of all clinical types of lichen planus with hepatitis-C virus infection in subjects hailing from this region. Objectives: To evaluate the association of lichen planus with hepatitis-C infection. Settings and design: The study was conducted in a tertiary care hospital. This was an observational, case control study. Materials and Methods: The study comprised of 100 cases and an equal number of age and sex matched healthy controls. The serum of both the groups was subjected to 4th generation HCV tridot test to detect anti HCV antibodies. Statistical analysis: The data was subjected to descriptive and inferential statistical analysis using mean, percentage, frequency and Chi square test. Results: The seropositivity of HCV antibody could not be demonstrated in any of the cases or control subjects. Conclusion : The association of lichen planus with hepatitis C virus infection could not be demonstrated in our study. Keywords: Lichen planus- A case control study on association of lichen planus with hepaitits C virus infection.

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Introduction: The immunobullous disorders have severe impact on the patients and their family and have severe economic and health related consequences associated with pain, agony and loss of manpower. Tzanck smear being a bed side test can aid in establishing the clinical diagnosis with ease and rapidity and can serve as an adjunct to routine histological study. This study was undertaken to assess the utility of Tzanck test for early diagnosis of various immunobullous disorders and correlate the findings with histopathology and direct immunofluorescence. Objectives: 1.To study Tzanck smear, histopathology, and immunofluorescence patterns in immunobullous disorders. 2.To evaluate diagnostic efficacy and sensitivity of Tzanck smear findings in comparison to histopathology and direct immunofluorescence in clinically suspected cases of immunobullous disorders. Materials and Methods: A total of 38 cases clinically diagnosed immunobullous disorders were appraised during the study. The patients were subjected to Tzanck smear, skin biopsy for histopathology and direct immunofluorescence. The specimen was sent in 10% buffered formalin and normal saline for routine histological analysis and DIF respectively to the department of Pathology. The resulting data was tabulated and statistically analysed for comparison using sensitivity test. Conclusion: Tzanck smear served as a simple, rapid and non invasive bedside diagnostic tool, which was cost effective and yield ed quick results. It can be concluded that in pemphigus group of disorders, Tzanck smear is 100% sensitive, can yield quick results and can serve as first line of investigation rather than histopathology and DIF which is expensive and takes time for reporting. Results: Pemphigus vulgaris was the most common immunobullous disease seen in this study, followed by bullous pemphigoid. Tzanck smear served as a rapid diagnostic tool and showed 100% sensitivity in all the pemphigus group of disorders which was compar ed with histopathological findings, which also showed 100% sensitivity whereas DIF was positive in 93.54% of cases. Keywords: Direct immunofluorescence, Histopathology, Immunobullous disorders, Tzanck smear.

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