Evaluation of the role of patch test in endogenous eczemas

Background: Endogenous eczemas have a significant effect on quality of life of patients and is a huge burden on healthcare. There is evidence that external factors play an important role in endogenous eczemas. The study was conducted to evaluate the role of patch test in endogenous eczemas and to identify any causal or aggravating allergen, the avoidance of which could augment response to standard therapy and prevent relapse.Methods: Four groups of 27 patients each, with clinical diagnosis of one of the major endogenous eczema namely, Atopic dermatitis, nummular eczema, pompholyx and seborrhoeic dermatitis satisfying the inclusion and exclusion criteria were included in the study. Demographic and clinical details were recorded and were patch tested with the Indian standard patch test battery. Dermatology life quality index (DLQI or children’s DLQI) was used at the presentation and after 03 months to assist in assessing the subjective improvement after avoidance of the agents incriminated by the patch test. Results: Of the 108 study participants, 61 (56.5%) patients had one or more positive results in the study, with maximum 21 (77.8%) in pompholyx and minimum of only 10 (37%) in patients of seborrhoeic dermatitis group. About, 36 (33.3%) patients had no change and 05 (4.6%) had worsening of their eczema.Conclusions: We found positive outcome in the form of clinical improvement or cure following the avoidance of allergens implicated by patch testing. This study recommends inclusion of patch test in the management protocol of endogenous eczemas.

AN AYURVEDIC APPROACH ON DARUNAKA – A Case Report

In the present era, Dharunaka is a common condition mostly affecting children to middle aged people due to improper lifestyle, lack of hygiene and stress. There is no specific etiology explained in Any Ayurvedic texts. Dharunaka can be compared with seborrhoeic dermatitis / Dandruff in contemporary science. Maintenance of proper hygiene is the most important thing in this disease. Otherwise the chances of recurrence are more. With Ayurvedic formulations we can give good result in this condition. A 30-year-old male patient with chief complaint of itching on the scalp, dryness on scalp and hairfall came to our hospital and herbal medicines like Aragwadadi Kashayam (orally), Triphala Choornam (external), Tankanabasma, Manjishtadi Kashayam, Prapoundarika Tailam were given and procedures like Shiroabhyanga with Durdoorapathradi oil and Nasya with Prapoundarikadi oil also given. This medication was found very effective in controlling signs and symptoms of Dharunaka and improving the overall condition of the scalp. The improvement provided by the treatment is assessed on the basis of sign and symptoms before and after the treatment.

Sociodemographic characteristics and spectrum of Malassezia species in individuals with and without seborrhoeic dermatitis/dandruff: A comparison of residents of the urban and rural populations

Seborrhoeic dermatitis/dandruff (SD/D) is a common, persistent, relapsing inflammatory condition affecting the areas rich in sebaceous glands. SD/D is widely prevalent in India but Malassezia species implicated are not well studied. To estimate the prevalence and spectrum of Malassezia species causing SD/D and understand the sociodemographic characteristics of SD/D in rural and urban populations, a total of 200 SD/D patients and 100 healthy controls (HC) from both rural and urban backgrounds were enrolled in this study. SD/D severity was clinically graded as mild, moderate, severe, and very severe. The isolates were identified by phenotypic characters and confirmed by ITS2 PCR-RFLP and sequencing of the ITS region of rDNA. Severe (59%) and very severe (71%) form of SD/D was higher in the rural population compared to the urban population (P = .004). The isolation rate of Malassezia was significantly higher in overall SD/D patients scalp (82%) compared to HC (67%) (P = .005). From the scalp of SD/D patients, M. globosa (36.2%) was predominantly isolated followed by M. restricta (31.3%), M. furfur (15.7%), a mixture of M. globosa and M. restricta (12%) or M. arunalokei (4.8%). Similarly, M. globosa (49.3%) was predominately isolated from the scalp of HC followed by M. restricta (22.4%). M. restricta was significantly higher in the scalp of SD/D patients compared to HC and/or nasolabial fold of both SD/D patients and HC (P = .0001). Our findings indicate that M. restricta has a high association with SD/D. More severe disease frequency was observed in the rural population. Precis Dandruff is associated with Malassezia restricta and very severe cases are higher in rural population, probably due the poor hygiene. Moderate to severe hair loss and itching were strongly associated with dandruff. Use of soaps to cleanse scalp appears to be better than shampoo in preventing dandruff.