Sunil Kumar

Abstract

Introduction: Diabetes mellitus (DM) is the common endocrine disorder, which affects all ages and socioeconomic groups. The prolonged hyperglycemia may responsible for the diabetic complications. Multiple factors contribute to the onset of cutaneous manifestations in diabetes mellitus. The present study aimed to study the pattern of various cutaneous manifestations associated with diabetes mellitus. Materials and Methods: The present study was conducted at Dermatology, Diabetic Clinic of a teaching tertiary care centre hospital. A total of 120 subjects were included in this study. Patients were selected on the basis of dermatological signs and/or symptoms. Detailed history and clinical examination with special emphasis on dermatological complaints and signs was done for all the study subjects. Under aseptic conditions, blood samples were collected and used for the estimation of blood glucose, bacterial infections- Gram stain and isolation of organism by culture, fungal infections- KOH (potassium hydroxide) mount, Gram stain (for Candida) and isolation of organism by culture. Skin biopsies were performed wherever necessary. Results: In the present study, 120 subjects were included from both genders. Pruritus was the predominant symptom observed. Acrochordons, Candidial Balanoposthitis, Tinea Corporis were observed in highest number of patients. Infective dermatoses were observed in 72 (60%) patients. The non-infective dermatoses was reported in 56 (46.7%) patients. On bacterial culture, Pyogenic Ulcer was observed in 4. KOH test and culture were carried on 14 candidal infections and 17 dermatophyte infection and observed KOH mount positive were observed in 11 cases and culture positive was observed in 8 cases. Conclusion: In the present study results indicates pruritus was the most common symptom in diabetic subjects. Infective dermatoses were more common than the non-infective dermatoses. Tinea corporis/cruris was most common clinical entity. 21.6% patients suffered from cutaneous bacterial infections, the most frequently encountered clinical entity being furunculosis. Staphylococcus aureus The commonest noninfective clinical entity was acrochordons (skin tags). Patients with diabetes may develop cutaneous manifestations of diabetic complications. Careful dermatological examination and follow-up of diabetes mellitus patients is required to provide them adequate skin management. Keywords: Acrochordons, Cutaneous manifestations, Dermatoses.

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Abstract

Introduction: Acne vulgaris (AV) is the most common chronic inflammatory skin disease. This study aimed to study the efficacy of Doxycycline vs Azithromycin in acne vulgaris patients. Materials and Methods: In this study, 40 acne vulgaris patients were included. Forty patients with pustules and nodules were included in this study. Group I patients were divided into two groups –Doxycycline group (100 mg OD for 12 weeks) and Azithromycin group (500 mg OD for 3 consecutive days in a week for 12 weeks). The change occurred in acne lesions were recorded every 2 weekly follow-up using global assessment improvement scale. Results: in the present study, at the end of 12th weeks of treatment, in Doxycycline group; good to excellent response was seen in 80% cases and poor to fair in 20% patients. In Azithromycin group ; good to excellent response was seen in 70% and poor to fair in 30% patients. There is no significant difference in these two groups. Conclusion: The study results indicate, t here is no significant difference in the efficacy between Doxycycline and Azithromycin groups. It may be suggesting that Doxycycline is equally efficacious as Azithromycin in moderate to severe degree of acne. Keywords: Acne vulgaris, Skin disease, Inflammation.

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Introduction: Acne vulgaris (AV), a human skin disease and commonly seen in adolescence. Affecting about 80–90% of teenagers in the Western population and lower rate are observed in rural societies. The present study aimed to compare the therapeutic efficacy of various drugs used in different grades of acne accordingly. Materials and Methods: This study prospective comparative study f orty patients with mild degree of acne were included as group I and 40 patients with moderate degree of acne were considered as group II. Group I patients were divided into Tretinoin(0.004%) group and Adapalene(0.1% gel). Group II patients were divided into Clindamycin (1%) group and Clindamycin 1% gel plus Benzoyl peroxide 5% cream. All these patients were given topical gel as per the dosage schedule over a period of 12 weeks. The change occurred in acne lesions were recorded every 2 weekly follow-up using global assessment improvement scale. Results: Efficacy and cutaneous tolerance were assessed at baseline and 2,4,6,8,10 and 12 weeks. At the end of 12 weeks treatment, 75% of patients using Tretinoin showed good response to excellent response and 25% patients showed poor to fair response. At the end of 12 weeks treatment, 80% of patients using Adapalene showed good to excellent response. There is no significant difference between two groups. Topical Adapalene is eqally efficacious as Tretinoin. At the end of 12 weeks treatment, 45% of patients using only Clindamycin showed good to excellent response. While 90% of patients using both Clindamycin and Benzoyl peroxide showed good to excellent response. Combination of Clindamycin 1% gel with Benzoyl peroxide cream more efficacious than Clindamycin 1% gel alone in reducing the number of lesions in grade 2 acne. Conclusion: The present study showed there is n o significant difference between Adapalene (0.1%) and Tretinoin (0.04%) after 12 weeks of treatment. Significant reduction in number of inflammatory and total lesions were demonstrated in patients using combination therapy (Clindamycin plus benzoyl peroxide) compared with those using only Clindamycin gel in grade 2 acne patients. Keywords: Tretinoin (0.04%), Adapalene (0.1%), Clindamycin (1%), Benzoyl peroxide (5%).

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