Shwetha S

Abstract

Background: Macular amyloidosis (MA) is the subtlest of the cutaneous varieties of amyloidosis. In general, the treatment of MA is disappointing. Hence, this study was aimed at comparing the two treatment modalities for the same. Objective: To compare the efficacy of 30% TCA chemical peel with Q switched Nd-YAG laser 1064nm in the treatment of macular amyloidosis. Materials and Methods: 50 patients of MA attending our Dermatology outpatient department were enrolled in the study. The study involved application of 30% TCA in 25 patients at an interval of 2 weeks for 10 sittings and Q switched Nd-YAG laser 1064 in 25 patients at an interval of 1 month for 5 sittings. Digital photographs were taken before treatment and then periodically. The response was graded percentage of reduction in pigmentation both by the patient and the observer. The patients were followed up for 5 months post treatment for recurrence. Results: Both TCA peel and Q switched Nd-Yag laser 1064nm were effective in the treatment of macular amyloidosis. switched Nd-Yag laser 1064nm showed better response compared to TCA peel at the end of the treatment, both by subjective and objective methods and in terms of less number of sittings and fewer side effects. The difference was statistically significant (P Conclusion: Both these treatment modalities are effective and safe in the treatment of MA. Q switched Nd-Yag laser 1064nm was found to be marginally superior to TCA peel.   Keywords: Macular amyloidosis(MA), Nd-YAG laser

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Abstract

Background: Healthy nails appear smooth and have consistent coloring. Nail dyschromias have a wide variety of presentation. There are numerous causes of discoloration of the nail affecting the nail plate, nail attachments, or the substance of the nail. Different pattern of nail dyschromias can point out certain dermatological or systemic diseases. Aim: To evaluate the causes of nail dyschromias in our clinical setting. Setting and Design:  Cross sectional observational study. Materials and Materials: 200 patients presenting with nail dyschromias were included in the study from April 2015 to July 2015. Detailed history was taken and cause for nail dyschromias was evaluated. Results:  115 (57.5%) were males and 85 (42.05%) were females. The most seen nail dyschromia in this study was melanonychia (86.5%) followed by leukonychia (5%), blue chromonychia (5%), brown chromonychia (2%) yellow chromonychia (1.5%). The cause of nail dyschromias were:60 cases(33.3%) were due to antiretroviral drugs, 25(12.5%) due to HIV, 30(15%) physiological melanonychia, 7(3.5% of onychomycosis, 8(4%) of lichen planus, 7(3.5%) of eczema, 15(7.5%) vitamin B12 deficiency,   10(5%) chemotherapy induced blue chromonychia, 3(1.5%) haematoma, 10(5%) leukonychia, 3(1.5%) jaundice 2(1%) Addison’s disease induced, 3(1.5%) cosmetic induced and 17(7.5%) due to other dermatological and systemic conditions. Conclusions: Examination of nail should always be a part of routine cutaneous examination and presentation with nail dyschromias should be worked up with the help of a good history and examination. Careful examination of the nail may help in identifying the root cause and many a times unravels some underlying systemic disorder   Keywords: Melanonychia, Chromonychia

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