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Coondoo A.,West Dermatology
Indian Journal of Dermatology | Year: 2014

Topical corticosteroids (TC) have been available for more than six decades during which they have completely changed the face of therapy of dermatological disorders. Despite being the most useful drug for such treatment they are known to produce serious local, systemic and psychological side-effects when overused or misused. Though the drug has been misused sporadically earlier, the menace has become more acute during the last two decades. In India, damaging effects to the human body particularly the skin have been reported regularly during the last decade. The misuse occurs at various levels such as manufacturing, marketing, prescription, sales and end-use by patients and laymen. During the last decade dermatologists in India have been regularly campaigning against such misuse. However, the menace keeps on increasing alarmingly. The need to accelerate the momentum of the campaign against TC misuse has been increasingly felt by dermatologists all over India. This symposium aims to contribute significantly to the campaign against misuse of TC.

Das N.K.,West Dermatology
Indian journal of dermatology, venereology and leprology | Year: 2014

BACKGROUND: In spite of the availability of multiple treatment options, viral warts are known for their persistence and recurrence, causing frustration to patients and treating physicians.AIMS: To study the effectiveness and safety of autoinoculation as a treatment modality in cutaneous warts.METHODS: A double-blind, placebo-controlled study was carried out. In the treatment group, full-thickness warty tissue was excised, minced and implanted in a small dermal pocket. In the control group, warty tissue was only excised and not implanted, though a dermal pocket was made. Patients were evaluated every four weeks with lesion counts. The procedure was repeated at 4 and 8 weeks. Response was assessed at each visit and at 12 weeks.RESULTS: Forty-eight patients with cutaneous warts (male: female=32:16) were randomized into autoinoculation and control groups. The number of warts at baseline was comparable in both groups (P=0.293). Reduction in the number of warts was significantly more in the autoinoculation group (8.50±13.88) than in the control group (10.04±5.80) from 8 weeks onwards (P=0.010). Complete resolution occurred only in the autoinoculation group, in 62.5% of cases. Adverse effects were seen in 11 patients, including infection of the donor site (5 cases), keloid formation (3) and hypopigmentation (3).CONCLUSION: Autoinoculation may be an effective therapeutic modality for cutaneous warts and two sessions may be required for optimum results.

Sarma N.,West Dermatology
Indian Journal of Dermatology, Venereology and Leprology | Year: 2013

Hand, foot, and mouth disease (HFMD), first reported in New Zealand in 1957 is caused by Coxsackievirus A16 (CVA16) and human enterovirus 71 (HEV71) and occasionally by Coxsackievirus A4-A7, A9, A10, B1-B3, and B5. This is characterized by erythematous papulo vesicular eruptions over hand, feet, perioral area, knees, buttocks and also intraorally mostly in the children. HFMD has been known for its self limiting course. Only small scale outbreaks have been reported from United States, Europe, Australia, Japan and Brazil for the first few decades. However, since 1997 the disease has conspicuously changed its behavior as noted in different Southeast Asian countries. There was sharp rise in incidence, severity, complications and even fatal outcomes that were almost unseen before that period. Following the near complete eradication of poliovirus, HEV71, the non-polio enterovirus, may become the greatest threat to cause significant neurological complications. This adds to the fact that effective therapy or vaccine is still a far reaching goal. There are reports of disease activity in different corners of India since 2004. Although of milder degree, continuous progress to affect larger parts of the country may indicate vulnerability of India from possible future fatal outbreaks. Low level of awareness among the health care providers may prove critical.

Zip C.M.,West Dermatology
Dermatologic Clinics | Year: 2010

Metronidazole is a synthetic nitroimidazole derivative with antimicrobial and antiinflammatory properties. It was the first topical therapy approved solely for rosacea and remains a cornerstone of rosacea management. This article reviews the optimal use of topical metronidazole in the treatment of rosacea and other innovative but off-label dermatologic uses reported in the literature. © 2010 Elsevier Inc.

Tollefson M.M.,West Dermatology
Pediatric Clinics of North America | Year: 2014

Psoriasis is increasing in both children and adults. The association of comorbidities, specifically obesity and other components of the metabolic syndrome, are also increasing. The precise cause is unknown but genetic and complex immunologic factors play a role in the development of the disease and its comorbidities. There are multiple clinical variants, and the severity of the disease can range from mild localized lesions in most patients to severe generalized involvement in some. Most patients with mild to moderate disease can be controlled with topical treatments. © 2014 Elsevier Inc.

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