Papers by dr swapna khatu
International Journal of Research in Dermatology, Jan 25, 2019
Background: Clofazimine is a riminophenazine derivative which is useful both for treating the lep... more Background: Clofazimine is a riminophenazine derivative which is useful both for treating the leprosy and managing reactive episodes. Previous studies demonstrated that clofazimine may have a useful prophylactic role against neuritis/type 1 reaction and nerve damage. The WHO Technical Advisory Group (TAG), in its Third meeting in 2002, proposed that uniform MDT regimen (U-MDT) of 6 months duration should be considered to treat all types of leprosy. This study was aimed to determine any additional beneficial effects of clofazimine as part of UMDT in the prevention of nerve function impairment (NFI) in paucibacillary (PB) leprosy patients. Methods: Sixty paucibacillary leprosy patients were randomized into two groups, A and B consisting of 30 patients each. Group A received U-MDT for 6 months and group B received MDT-PB for 6 months. Nerve function assessment (NFA) using various modalities was done at the beginning (0 month) and at the completion of MDT (6 months) and results were compared. Results: No statistically significant difference in improvement or deterioration of NFI was found in two groups. Conclusions: On the basis of present study, we found that addition of clofazimine in standard dose as part of U-MDT has no beneficial role in prevention or improvement of NFI in PB leprosy patients. However, a larger longitudinal study taking substantial number of population in both groups might be helpful to derive any conclusion.
Medical Journal of Dr. D.Y. Patil University, 2014
We report a case of a 35-year-old male with minimally pruritic papular eruptions over the genital... more We report a case of a 35-year-old male with minimally pruritic papular eruptions over the genitalia. Histology of lesions revealed focal acantholysis with presence of dyskeratotic cells resembling corps ronds and grains. These clinical and histopathological findings were consistent with persistent papular acantholytic dyskeratosis, which is a rare disorder first described in 1984. We describe a rare case of persistent papular acantholysis over the male genitalia.
PubMed, Aug 1, 2014
Cryptococcosis is an opportunistic infection caused by Cryptococcus neoformans that typically pre... more Cryptococcosis is an opportunistic infection caused by Cryptococcus neoformans that typically presents in immunocompromised patients, most commonly in those with human immunodeficiency virus (HIV) infection. It rarely has been described in patients with diabetes mellitus (DM). Defects in the host defense mechanisms due to hyperglycemia predispose diabetic patients to opportunistic infections such as cryptococcosis. We present a rare case of disseminated cryptococcosis in a 48-year-old HIV-negative man with DM.
International Journal of Trichology, 2013
Term Piedra, which means stone in Spanish is used to describe an asymptomatic fungal infection of... more Term Piedra, which means stone in Spanish is used to describe an asymptomatic fungal infection of the hair shaft. Two different varieties of piedra are generally distinguished; white piedra and black piedra. In regard to the lack of any report in Iran and also with consideration to tropical weather and high humidity of northern area of Iran, the authors decided to find the prevalence of this infection among the students of guidance schools through a survey. Methods: This was a descriptive cross sectional study that was conducted among guidance school students of Sari city-Iran in 2013. Sampling was performed through the taking samples from the different clusters of students. In the beginning check list contain demographic data and several questions related to hygiene and public health situation distributed among students. Then scalp hair and axillary part of subjects were evaluated by examiners. Direct examination was done via slides that were prepared by KOH 20% to observe hyphe or any fungi components. After that, all samples were cultured in Sabouraud's dextrose agar (Merck,Germany) containing cloramphenicol (Merck, Germany) and incubated at 27 degrees of centigrade for four weeks. The samples were seen by medical mycologist every day. Data was analyzed via descriptive tests through the SPSS 18.0. P.value ≤0.05 was determined as significant. Results: Subjects were 1273 (44.3%) male and 1600 (55.7%) female. From the all examined students only 271 (9.43%) students sampled which 224 (82.5%) were female and 47 (17.5%) were male. Out of 271 sampled students no case of piedra was identified. Beside the piedra no other dermatophite or pathologic fungi were observed by direct examinations. Conclusion: prevalence of trichomycosis nodularis in the studied area was zero. It sounds very likely that the presence of health centers in the studied areas of sari, also routine visit of the students by schools nurses and inhabitation in downtown were the reasons for lack of infection by piedra.
Clinical dermatology review, 2023
Indian Journal of Dermatology, 2013
Lichen sclerosus et atrophicus (LSA) is a rare, chronic, mucocutaneous disease of unknown cause. ... more Lichen sclerosus et atrophicus (LSA) is a rare, chronic, mucocutaneous disease of unknown cause. Onset can occur in subjects of any age but more prevalent in adult females around the time of menopause. In both the sexes anogenital involvement is more common. Extragenital cases are rare, and common localizations are neck and shoulders, axilla, upper arms, flexor aspects of wrists and around the umbilicus. Bullous LSA is an unusual manifestation of the disease. Isolated extragenital bullous LSA is a distinctly rare event with very few cases reported till date.
Indian Journal of Dermatology, Venereology and Leprology, 2011
Four types of elastosis perforans serpiginosa (EPS) have been described in literature: 1) idiopat... more Four types of elastosis perforans serpiginosa (EPS) have been described in literature: 1) idiopathic EPS, 2) reactive perforating elastosis associated with connective tissue disorders, 3) in some instances of pseudoxanthoma elasticum (PXE), disease-specific calcified elastic tissue is extruded, producing a clinical picture indistinguishable from other types, may also be seen in patients undergoing hemodialysis and 4) EPS induced by long-term treatment with D-penicillamine is observed in patients suffering from Wilson's disease. Long term D-penicillamine therapy causes an alteration in the dermal elastic tissue. D-penicillamine induced EPS has a distinctive histopathologic feature - serrated appearance of elastic fibers due to perpendicular budding from their surface giving a "lumpy-bumpy" look. D-penicillamine induced elastic fiber alteration may not always manifest clinically as EPS. We report a case of D-penicillamine induced widespread alteration in skin elastic tissue with distinct histopathologic features.
Clinical dermatology review, 2022
Fetal varicella syndrome (FVS) is an extremely rare condition of the newborn, characterized by cu... more Fetal varicella syndrome (FVS) is an extremely rare condition of the newborn, characterized by cutaneous scars, limb defects, ocular, and central nervous system abnormalities. It follows maternal varicella infection during early pregnancy. We are reporting a 4-day-old female child who presented with a linear, depressed, erythematous, localized scarring over the right knee with hypoplasia of the right lower limb and malformed right great toe. Clinical presentation of her right foot was resembling congenital talipes equinovarus. Mother had a history of varicella during the first trimester of pregnancy. Ocular examination revealed subretinal hypopigmented exudation with scanty vitreous hemorrhage and tunica vasculosa lentis seen on indirect ophthalmoscopy in the right eye. Ultrasonic A/B scan of the right eye was suggestive of microphthalmia. We confirmed the diagnosis of FVS based on characteristic history, clinical features, and varicella-zoster IgG antibodies were positive.
Indian Dermatology Online Journal, 2013
Melanoacanthoma is very rare variant of seborrheic keratosis presenting as a deeply pigmented ben... more Melanoacanthoma is very rare variant of seborrheic keratosis presenting as a deeply pigmented benign proliferation of melanocytes and keratinocytes usually presenting over the head, neck and trunk of elderly people. A sixty-two-years-old male was presented with a solitary slow growing asymptomatic hyperpigmented verrucous outgrowth with cerebriform surface measuring 15 cm by 8 cm present over the left inguinal region extending on to the scrotum since past 8 years. There was no associated lymphadenopathy. The histopathology revealed hyperkeratosis, papillomatosis, acanthosis with presence of melanocytes at all levels of epidermis with abundant melanin giving the diagnosis of melanoacanthoma. The patient further underwent surgical excision of the lesion. The case is being reported for its rarity, unusual location, massive size and clinical resemblance to a verrucous carcinoma.
Clinical Dermatology Review
Atypical mycobacterial infections are caused by mycobacteria other than those from the Mycobacter... more Atypical mycobacterial infections are caused by mycobacteria other than those from the Mycobacterium tuberculosis complex and Mycobacterium leprae. They are ubiquitous, aerobic, nonmotile, and acid-fast bacilli seen in soil and water. Here, we report the case of a 31-year-old married female who presented with multiple painful pus-filled lesions over both the breast, abdomen, and back associated with yellow-colored discharge for 6 months. Tuberculosis-polymerase chain reaction revealed the presence of atypical mycobacteria which on further investigation with matrix-assisted laser desorption/ionization-time of flight isolated Mycobacterium abscessus species.
Indian Dermatology Online Journal, 2013
Eruptive vellus hair cysts were first described in 1977. They usually appear as yellow to reddish... more Eruptive vellus hair cysts were first described in 1977. They usually appear as yellow to reddish-brown papules on the chest. Usual onset is between ages 17 and 24 years, but they may be congenital. Some believe that they may be inherited as an autosomal dominant disorder. Histologically the cyst has a stratified squamous epithelium and it contains laminated keratin and vellus hairs. They are felt to be caused by an abnormality at the infundibular level of the vellus hair. We present this because of this patient's unusual distribution of eruptive vellus hair cysts.
Journal of Dr. NTR University of Health Sciences, 2017
Background: Warts are benign tumors involving skin and mucous membrane that are caused by human p... more Background: Warts are benign tumors involving skin and mucous membrane that are caused by human papillomavirus (HPV). Several treatment modalities are available for treating multiple warts, but without any significant response or cost-effectiveness. Aims: This study aimed to evaluate the safety and efficacy of autoimplantation therapy in the treatment of recalcitrant and multiple warts. Materials and Methods: A total of 40 patients of multiple warts (more than five warts per patient), palmoplantar warts, recurrent warts, and resistant warts were enrolled in this study. A small piece of warty tissue was introduced in the wound with the help of 26 no. needle. Patients were assessed monthly and resolution after 3 months was considered complete clearance. Result: Out of 40 patients, 21 patients of verruca vulgaris (75%) and 10 patients of palmoplantar warts (83.3%) showed resolution within 3 months, accounting for a total clearance rate of 77.5%. Conclusion: Autoimplantation of wart using the pared stratum corneum of wart is a safe, efficacious, less painful, and in-office procedure for the treatment of multiple, recurrent, and palmoplantar warts.
Indian Journal of Psychiatry, 2018
Context: Patients with dermatological problems have higher prevalence of psychiatric illnesses th... more Context: Patients with dermatological problems have higher prevalence of psychiatric illnesses than the general population. Melasma, hyperpigmentation of skin over sun-exposed areas, has bidirectional cause-effect relationship with depression and stress through psycho-neuro-endocrine pathways. Aims: The aim of this study is to study the psychiatric morbidity and perceived stress in patients with melasma and statistically compare objective study parameters with those without melasma. Settings and Design: This cross-sectional descriptive study was carried out in Tertiary hospital in urban setting, jointly by psychiatrist and dermatologist. Methods and Materials: The study involved 50 consecutive patients with melasma and 30 relatives of patients coming to dermatology clinic not having any skin disorder. Cases were assessed by psychiatrist as per the International Classification of Diseases-10 Diagnostic Criteria for Research, Cohen's 4 item perceived stress scale, Disability Assessment Scale 2.0 by WHO and Hospital Anxiety Depression Scale (HADS) and Dermatologist calculated melasma area severity index score (MASI). Results: Majority patients were females (88%) in the reproductive age group. The most common psychiatric morbidity seen in 42% cases was major depressive disorder. Adjustment disorder (26%) was the second most common diagnosis. Nonparametric analysis using Mann–Whitney U test revealed significantly more perceived stress (P = 0.001), more disability (P = 0.000) and anxiety-depression on HADS (P = 0.0 16) in cases than in their relatives. Limitations: This was a hospital-based study and thus melasma patients in the community are not represented. Small sample size, less number of controls, lack of structured diagnostic interview are other limitations of this study. Conclusions: There is high psychiatric comorbidity (76%) of depressive and stress disorders, higher functional disability and perceived stress in patients with melasma compared to controls.
Medical Journal of Dr. D.Y. Patil University, 2017
Introduction: Lichen planus (LP) is a common, chronic, inflammatory pruritic disorder involving t... more Introduction: Lichen planus (LP) is a common, chronic, inflammatory pruritic disorder involving the skin, mucous membranes, nails, and hair follicles. Systemic corticosteroids have long been treatment of choice for generalized LP. However, use of corticosteroids is limited due to multiple side effects. Methotrexate (MTX) can be used as alternative and safe modality in generalized LP. Materials and Methods: Twenty-two cases of generalized LP with comorbidities such as diabetes mellitus and hypertension and steroid-resistant and patients with side effects of long-term corticosteroids were included in this study. MTX was initiated at the dose of 7.5 mg/week. Clinical evaluation for improvement in lesions and pruritus was performed at 2 nd , 4 th , 8 th , and 12 th weeks. Results: After 12 weeks, 80% patients had excellent improvement. Patients with an excellent response were followed up. In the 6-month follow-up, four patients showed recurrence while all the remaining 12 showed complete remission. Conclusion: Results of this small study suggest that the use of weekly oral MTX can be highly effective and tolerable treatment alternative for generalized LP.
Medical Journal of Dr. D.Y. Patil University, 2014
We report a case of a 35-year-old male with minimally pruritic papular eruptions over the genital... more We report a case of a 35-year-old male with minimally pruritic papular eruptions over the genitalia. Histology of lesions revealed focal acantholysis with presence of dyskeratotic cells resembling corps ronds and grains. These clinical and histopathological findings were consistent with persistent papular acantholytic dyskeratosis, which is a rare disorder first described in 1984. We describe a rare case of persistent papular acantholysis over the male genitalia.
Pigment International, 2018
Context: Vitiligo is a cosmetically disfiguring condition especially in dark-skinned individuals,... more Context: Vitiligo is a cosmetically disfiguring condition especially in dark-skinned individuals, thereby adversely affecting their quality of life (QOL). Studies have reported higher psychiatric morbidity in patients with vitiligo, but a comparative study between patients with stable and unstable vitiligo has not been reported. Aims: To compare the psychiatric morbidity, perceived stress, and QOL in patients suffering from stable versus unstable vitiligo. Settings and Design: This was a clinical observational, cross-sectional liaison study conducted over a period of 2 years and included 100 consecutive patients with vitiligo, who came for treatment to the dermatology clinic of a tertiary care hospital. Materials and Methods: A dermatologist clinically assessed the patients and calculated their vitiligo area severity index score and dermatology life quality index. A psychiatrist evaluated the patients on the basis of the perceived stress scale (PSS), hospital anxiety and depression scale (HADS), and clinically established diagnosis using International Classification of Diseases (ICD-10). Statistical Analysis: The aforementioned variables between the two groups were compared using chi-square test and independent t test. Results: High psychiatric morbidity (65%) was reported in patients with vitiligo, with adjustment disorder being the most common morbidity. The most common reported stress was grief or emotionally significant loss. Psychiatric morbidity, scores on HADS, and PSS were significantly higher in patients with unstable vitiligo in comparison to patients with stable vitiligo. The quality of life (QOL) was mildly affected among the patients in both the groups. Conclusions: There is higher psychiatric morbidity in patients with unstable vitiligo along with a worse QOL in comparison to those with stable vitiligo. Patients with vitiligo should be assessed for stability as well as psychiatric morbidity, because it will have significant management implications.
Clinical Dermatology Review, 2022
Fetal varicella syndrome (FVS) is an extremely rare condition of the newborn, characterized by cu... more Fetal varicella syndrome (FVS) is an extremely rare condition of the newborn, characterized by cutaneous scars, limb defects, ocular, and central nervous system abnormalities. It follows maternal varicella infection during early pregnancy. We are reporting a 4-day-old female child who presented with a linear, depressed, erythematous, localized scarring over the right knee with hypoplasia of the right lower limb and malformed right great toe. Clinical presentation of her right foot was resembling congenital talipes equinovarus. Mother had a history of varicella during the first trimester of pregnancy. Ocular examination revealed subretinal hypopigmented exudation with scanty vitreous hemorrhage and tunica vasculosa lentis seen on indirect ophthalmoscopy in the right eye. Ultrasonic A/B scan of the right eye was suggestive of microphthalmia. We confirmed the diagnosis of FVS based on characteristic history, clinical features, and varicella-zoster IgG antibodies were positive.
International Journal of Trichology, 2022
Eruptive vellus hair cyst (EVHC) is a rare follicular developmental abnormality of the vellus hai... more Eruptive vellus hair cyst (EVHC) is a rare follicular developmental abnormality of the vellus hair follicles. The usual onset is between 17 and 24 years but may be congenital. It can arise sporadically or may be inherited in an autosomal dominant fashion. They are caused by an abnormality at the infundibular level of vellus hairs. They usually appear as yellow to reddish-brown papules over the chest, limbs, and abdomen. Histologically, cyst has a stratified squamous epithelium and it contains lamellated keratin and several vellus hairs. We present this rare case of a 12-year-old male because of its unusual morphology and distribution and also to generate awareness about this rarely diagnosed condition. To the best of our knowledge, no case of an axillary variant of EVHC has been reported till date.
Indian Journal of Drugs in Dermatology, 2021
International Journal of Research in Dermatology, 2021
Background: Androgenic alopecia is most common type of non-scarring alopecia in men. It is associ... more Background: Androgenic alopecia is most common type of non-scarring alopecia in men. It is associated with high risk of cardiovascular events. Aim was to study the prevalence of metabolic syndrome in male patients of early onset androgenic alopecia.Methods: A case-control study was conducted at the dermatology out-patient department over a period of 6 months which included 100 patients of androgenic alopecia and 100 age matched controls. All subjects were aged 20 to 35 years and underwent detailed history, clinical examination including trichoscopic examination and measurement of waist circumference and blood pressure. Fasting blood sugar, triglyceride and high-density lipoproteins were tested following overnight fasting. Diagnosis of metabolic syndrome was based on criteria of national cholesterol education program (NCEP) adult treatment panel III. Chi square test was used as a test of significance. P value <0.05 was considered statistically significant.Results: Prevalence of me...
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Papers by dr swapna khatu