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Background: The increasing average lifespan has led to an increase in an elderly patient encountered in day-to-day practice. Despite this, there is a lack of statistical data about dermatosis in the elderly. Objectives: This study has been performed with the objectives of studying the spectrum of skin diseases in the elderly and study associations of these with various demographic characteristics such as age, gender, and residence with clinical diagnosis. Methodology: This was a cross-sectional study based in a tertiary care teaching hospital, which included patients aged 60 years and above, presenting to the outpatient department of dermatology. Results: A total of 440 patients were enrolled. The mean age was 65.92 years, with maximum belonging to the 60-69 years' age group (73%) and a male preponderance (1.97:1). The most common systemic ailment was diabetes mellitus (18.2%). The most common physiological change was wrinkling (92.3%). Among pathological conditions, infections were the most common group (51.3%). Fungal infections were seen in 24.1% and leprosy in 6.8% of patients. Wrinkling, neoplasia, and nail changes were significantly higher in males. Metabolic dermatosis was significantly higher in diabetics. Generalized pruritus, neoplasia, and pigmentary disorders were significantly more common in urban residents, whereas infections were significantly higher in rural residents. Conclusion: The most common physiologic finding among the elderly was wrinkles while the most common dermatosis were infections. Dermatosis in the elderly has atypical presentations due to an interplay of physiological and pathological factors. With increasing average lifespan, dermatological demands of the aged are growing. Thus, it is important to study the problems of the aged individuals, so proper dermatological care can be provided to them. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo in an adult patient has a profound effect on the quality of life (QoL) of that particular patient. Although it is known that vitiligo in adult patient affects QoL in their family, very little information is available regarding QoL in a family having children suffering from vitiligo. Materials and Methods: This is a cross-sectional, hospital-based study to ascertain the effect children suffering from vitiligo have on the QoL of their respective families. Study participants were fifty healthy parent/immediate caregivers of fifty corresponding children suffering from vitiligo. The QoL in the family of these vitiliginous children was assessed with the help of Family Dermatology Life Quality Index (FDLQI). Results: There was significantly more impairment of FDLQI among respondents if vitiliginous child was female compared to male. The total FDLQI showed a significant negative correlation with duration of vitiligo in children. Analysis of individual items in FDLQI revealed emotional distress as the most impaired facet of FDLQI and housework as the least affected item. Conclusion: Presence of vitiligo in children affects the QoL of that particular child and his/her family. This impairment of FDLQI is more if the child suffering from vitiligo is female. Treatment of vitiligo in pediatric age group should include psychological counseling and support for the child as well as their parents/caregivers. [ABSTRACT FROM AUTHOR]

Objective To determine level of depression and correlate it with gender, duration, severity and scarring in patients having acne vulgaris. Methods All the patients of acne vulgaris over a time period of one year were included in the study. Beck Depression Inventory (BDI) scores were used to assess depression levels. Grading of acne and postacne scars was done based on consensus criteria. SPSS software was used to determine Pearson correlation between different variables. Results Males had more significant scarring compared to females. BDI scores significantly correlated with acne severity, duration of acne and post acne scarring. Negative correlation between BDI scores and education level was also noticed. Conclusion In a patient of acne vulgaris proper attention should be paid towards psychological impairments and patient's self-assessment of depression levels. Prompt and effective treatment should be instituted for acne vulgaris, as well as, postacne scarring. Improving education levels may alleviate severity of depression in patients of acne vulgaris. [ABSTRACT FROM AUTHOR]

Introduction. Topical application of local anesthetics is currently considered to be the easiest, most effective, and convenient way for treatment of patients who may be undergoing superficial dermatosurgical procedures. Materials and Methods. This study compares the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lignocaine and 7% tetracaine combination cream for radio ablative dermatosurgery when applied, under occlusion, for 30 minutes. 40 subjects of achrocordons were enrolled in this split-side randomized trial. Result. The pain severity experienced by subjects in terms of visual analogue scale score was significantly lesser for lignocaine/tetracaine combination cream as compared to lidocaine/prilocaine combination. Conclusion. This small study proves the efficacy of lidocaine/tetracaine combination as a topical anesthetic cream when applied for a short time interval of 30 minutes. This will help a dermatosurgeon to perform various dermatological procedures in a better and efficient manner with a shorter waiting period for analgesia to set in. [ABSTRACT FROM AUTHOR]

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection. [ABSTRACT FROM AUTHOR]

Context: Removal of impacted third molar is a procedure that is often associated with post-operative complications. The rate of complications is somewhat high because of its proximity to the vital structures. Inferior alveolar nerve paresthesia is one of the common complications of impacted their molar surgery. This is due to intimate relationship between roots of mandibular third molar and inferior alveolar canal. To access the proximity of inferior alveolar canal to third molar many diagnostic methods are suggested but in conventional radiography orthopantamogram is considered as the best. There are many findings onorthopantamogram that are suggestive of close proximity ofnerve to the canal. In this study authors reviewed seven radiographic findings related to proximity of roots to the inferior alveolar nerve as seen on orthopantamogram and try to find a relationship between these radiographic variables and presence of postoperative paresthesia. Study Design: The study containd 100 impacted third molars need to be removed. Presence of radiographic findings onorthopantamogram were noted and analyzed, to find a relationship with occurrence of post-operative inferior alveolar nerve paresthesia. Materials and Methods: This study comprises of 100 impacted third molar teeth indicated for extraction. Cases were randomly selected from the patients, needs to undergo extraction of impacted mandibular third molar. After extraction cases were evaluated for occurrence of inferior alveolar nerve paresthesia. Stastical Analyisis: Data was transferred to SPss 21 software for frequency calculation, and two tailed p-values were obtained betweens these variables and post-operative paresthesia, by applying Fischer's exact test (GRAPH PAD SOFTWARE). Results: Out of seven, four radiological findings that are grooving of roots, hooked roots, bifid roots and obliteration of white line are significantly related to post-operative paresthesia while bending of canal, narrow canal and darkening of tooth roots over the canal are not significantly associated with post-operative morbidity of facial nerve. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Idiopathic acquired persistent true partial to total leukonychia," by S. Z. Arsiwala in the 2012 issue.