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   Table of Contents - Current issue
January-June 2018
Volume 4 | Issue 1
Page Nos. 1-46

Online since Tuesday, July 10, 2018

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Omalizumab in the treatment of chronic urticaria p. 1
Kiran Godse
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Bilastine: A novel antihistamine Highly accessed article p. 3
Jeet Gandhi, Kiran Godse, Gauri Godse
Bilastine is a new second generation H1-antihistamine approved for the symptomatic treatment of allergic rhinitis (AR) and chronic urticaria (CU) in patients older than 12 years of age. AR and urticaria are very common clinical conditions that represent one of the most frequent reasons for a patient to visit their general practitioner or allergist or dermatologist. Bilastine, with its efficacy and safety profile epitomizes the evolution of research on antihistamines.
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Comparision of oral levofloxacin and minocycline in treatment of inflammatory acne vulgaris: A randomized control trial p. 7
Swapna Khatu Sheth, Ankita Mundada, Neeta Gokhale, Pradeep Mahajan
Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. This disease occurs worldwide and usually starts in adolescence and resolves by mid-twenties. It is the most common skin disorder, and different studies have shown prevalence rates ranging from 28.9% to 91.3% in adolescents. Aims: The aim of this study is to assess, compare, and correlate therapeutic efficacy of oral levofloxacin and minocycline combine with benzoyl peroxide gel in the treatment of acne vulgaris. Methods: The study comprised 60 acne vulgaris patients. They were allotted randomly in two groups, 30 in each group. Baseline investigations were performed at 1st visit. Baseline photographs were taken. Levofloxacin was given at dose of 500 mg/day for 30 days along with topical benzoyl peroxide gel in one group, and another group received minocycline 100 mg for 3 months along with topical benzoyl peroxide gel. Results were assessed at 2, 4, 8, and 12 weeks after starting treatment according to the global acne grading system and compared with each other statistically using t-test. Results: There was a significant decrease in acne score in levofloxacin group as compared to minocycline group. (P = 0.05) at 4 weeks. At 8 weeks and 12 weeks, decrease in the score was more in minocycline group (P < 0.024) and (P < 0.001), respectively. According to the percentage of decrease in inflammatory count from baseline, there was a decrease in inflammatory lesion count by 58% at 4 weeks which increased to 81.1% at the end of 12 weeks in levofloxacin group. In minocycline group, a decrease in inflammatory lesion count at 4 weeks was 36.6% and 12 weeks was 68%.
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Use of over-the-counter topical medications in dermatophytosis: A cross-sectional, single-center, pilot study from a tertiary care hospital p. 13
Rajeshwari Dabas, Manasa Shettisara Janney, Radhakrishnan Subramaniyan, Sandeep Arora, V Sandeep Lal, Navya Donaparthi
Background: Dermatophytosis is a common, superficial fungal infection of the skin. In developing countries like India, casual attitude toward seeking medical attention and lax drug control policies lead to indiscriminate use of irrational over-the-counter (OTC) medications. Studies on OTC topical medication abuse in dermatophytosis are lacking despite its frequent occurrence. Aims: To assess the magnitude of OTC topical medication use in dermatophytosis by studying the demographic variables, source of prescription, and their adverse effects. Materials and Methods: This cross-sectional, observational, questionnaire-based pilot study was carried out in a tertiary care center. One hundred consecutive, mycologically confirmed dermatophytosis patients were questioned about the use of OTC medications and examined for adverse effects of the preparations used. Results were documented in a predesigned pro forma and the data were expressed in terms of means and proportions. Results: The study population consisted of 75 males and 25 females. Tinea cruris was the most common pattern observed. Only 32% of the patients consulted a dermatologist on developing a rash, whereas the majority (68%) used medicines suggested by others. Clobetasol-based preparations were commonly misused, and 63.23% of the study population experienced adverse effects. Furthermore, majority (89%) of the study population were unaware of steroids and their adverse effects. Conclusions: The growing threat of OTC drug abuse in India is evident from this study. Stringent drug control policies and awareness of adverse effects of OTC topical medication abuse are truly the need of the hour to control this menace.
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Role of omalizumab in refractory chronic spontaneous urticaria: A single referral center experience p. 18
Gautam Kumar Singh, Manas Chatterjee, Rajesh Verma
Background: Multiple evidence have shown that omalizumab, a subcutaneous (SC) anti-IgE monoclonal antibody, is highly effective for the treatment of chronic spontaneous urticaria (CSU). Objective: The objective is to evaluate the safety and efficacy of omalizumab administered 300 mg SC 1st month followed by 150 mg every month for another 5 months in cases of refractory CSU in a routine clinical setting. Materials and Methods: This was open-label, prospective, pilot study to know the efficacy and safety profile of omalizumab administered 300 mg SC first 1st month followed by 150 mg every month for another five 5 months in refractory CSU. The study was conducted at tertiary center in routine clinical setting. The primary efficacy evaluation was a change in Urticaria Activity Score-7 (UAS-7) and Urticaria Control Test (UCT) from baseline. Results: A total of 13 patients (7 females and 6 males) were enrolled in the study with the mean age of 35 years, having CSU from the mean duration of 3.15 years. Mean UAS-7 of patients decreased from 31.62 at baseline to 6.85 after the first dose of omalizumab treatment. This further reduced to 2.31 after 6 months (P = 0.001). Mean UCT increased from 4.46 at baseline to 13.92 after 1 month and further increased to 14.85 after 6 months (P = 0.001). A total of 11 patients (84.6%) achieved complete remission. Conclusion: Injection omalizumab is safe and highly effective therapy for refractory CSU in the routine clinical setting. It can be made cost effective without compromising the efficacy in resource-poor country of Indian subcontinent if barring first dose other can be halved of recommended dose. However, small number of patients, uncontrolled study and lack of long-term follow-up data are the limitations of the study.
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Efficacy of doxycycline monotherapy in treating rhinoscleroma p. 23
Mithali Jage, Kinjal Deepak Rambhia, Uday S Khopkar
Rhinoscleroma, also known as Mikulicz disease, is a chronic granulomatous infection of the nasopharyngeal nucosa causing disfigurement and debilitation. A 27-year-old male presented with nasal mass and obstruction. Histopathology revealed dense, diffuse, mixed inflammatory infiltrate consisting of neutrophils, lymphocytes, plasma cells, and foamy macrophages. Mikulicz cells which are foamy macrophages containing filamentous, granular, and fragmented bacilli were seen. The patient was diagnosed as rhinoscleroma and was started on capsule doxycycline 100 mg twice daily. After 6 weeks, marked improvement in the lesions and symptoms was noticed.
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Peculiar acral and oral pigmentation after docetaxel therapy: An unresolved dilemma p. 26
Guneet Awal, Tanreet Kaur
Taxanes, which are widely used chemotherapeutic agents for treating breast carcinoma, are known to cause various cutaneous side effects with incidence as high as 65%. These cutaneous manifestations range from minor nonspecific dermatological manifestations to perplexing atypical manifestations of classic entities such as hand-foot syndrome. We report a case of 51-year-old previously healthy postmenopausal woman diagnosed with T1N1M0 adenocarcinoma breast, on docetaxel adjuvant chemotherapy, who developed peculiar oral and acral violaceous hyperpigmentation. Recognition of this type of presentation as part of HFS or a separate entity is still a debatable conundrum.
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Good response to oral acitretin monotherapy in a case of verrucous carcinoma of sole p. 29
Rameshwar Gutte, Bhushan Madke
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Successful use of plasmapheresis as an adjuvant therapy in phenytoin induced toxic epidermal necrolysis p. 31
Vasudha V Sardesai, Sahil G Moriwala, Vidyadhar R Sardesai
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A rare case of rifampicin-induced urticaria confirmed by drug provocation test p. 32
Satyendra Kumar Singh, Bandana Jha
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Symmetrical drug related intertriginous and flexural exanthema after ranitidine therapy: A probable causal association in an 18-year-old girl p. 34
Nidhi Yadav, Sumit Kar, Varsha Verma, Komal Ramteke
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Combination of 308 nm excimer light with topical tacalcitol ointment for vitiligo treatment p. 36
Kiran Godse, Gauri Godse
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Bullous fixed drug eruption due to diclofenac p. 37
Pendota Srihitha, Surabhineni Sre Akshaya Kalyani
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Managing a side effect: Cyclosporine-Induced nephrotoxicity p. 39
Manasi Shirolikar, Sushil Pande, Milind Borkar, Sachin Soni
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News from regulatory corner: Safety communication and recent drug approvals p. 45
Pugazhenthan Thangaraju, Sajitha Venkatesan
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