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Biomedical subjects

S Dhar

Publications and source records attributed to S Dhar.

At least 109 records · Page 6Linked to original sources

Spectrum of reticulate flexural and acral pigmentary disorders in northern India.

Reticulate pigmentary disorders are rare in India. Only 15 cases of reticulate acropigmentation of Kitamura (RAPK) and 9 cases of Dowling-Degos disease (DDD) have been reported previously. To the best of our knowledge, there has been no earlier report of acropigmentation of Dohi. We herein describe 10 patients with various reticulate pigmentary abnormalities: 6 with RAPK, 2 with DDD, 1 with RAPK-DDD overlap, and 1 with acropigmentation of Dohi. Palmar pits and/or breaks in epidermal ridge pattern were absent in 2 of 6 patients with RAPK. A 23-year-old male patient had RAPK-DDD overlap. Periorbital pigmentation and pigmentation over the mucosal surface of the prepuce and corona of the glans penis were some unique features observed in this patient. His sister and mother had RAPK and DDD, respectively. We concluded that RAPK and DDD are varying manifestations of a single entity. Their presence in other family members probably depends on the degree of penetrance.

Adolescent↗

Factors responsible for death in patients with pemphigus.

The records of 10 patients who died with pemphigus have been examined for factors affecting and contributing to death. Early initiation of therapy, the age at onset of the disease, and the mode of administration of corticosteroids, conventional or in pulse form, did not affect the survival. The cutaneous involvement was extensive in all 10 patients; it ranged between 30-80%. Septicemia was the commonest event preceding death; in 4 cases, it was due to Staphylococcus aureus.

Adolescent↗

Further experience with pemphigus in children.

Seven children had pemphigus: six had pemphigus vulgaris and one pemphigus foliaceus. Four who had pemphigus vulgaris were administered dexamethasone pulses. Follow-up from six months to one year was uneventful; the disease was under control and there were no complications due to therapy. Our observations suggest that the clinical features, course, and principles of therapy for pemphigus in children are essentially the same as those in adults.

Adolescent↗

Methotrexate in childhood psoriasis.

We treated childhood psoriasis with methotrexate (MTX) in seven children (4 boys, 3 girls) over 7.5 years. Their ages and duration of disease varied from 3.5 to 16 years (mean 12.14 yrs) and 4.8 months to 5 years (mean 2.2 yrs), respectively. Psoriatic erythroderma was seen in three patients, generalized pustular psoriasis in two, recalcitrant psoriasis and psoriatic arthropathy in one each. Pre-MTX liver biopsy performed in 4 children showed grade I changes. Methotrexate was given in a single weekly oral dose of 3.75 to 25 mg (mean 16.6 mg). The duration of treatment necessary to control the disease varied from 6 to 10 weeks (mean 7.9 wks). Total duration of MTX therapy was 31.2 to 46.4 weeks (mean 38.8 wks). Posttherapy disease-free interval ranged between 14.4 and 16.8 weeks (mean 15.5 wks). Follow-up after withdrawal of MTX was 16 to 28 weeks (mean 22.3 wks). Total cumulative MTX dose ranged from 390 to 960 mg (mean 683.6 mg). Side effects were nausea and vomiting in three patients.

Administration, Oral↗

Forefoot arthroplasty and changes in plantar foot pressures.

The aim of this study was to determine how effective forefoot arthroplasty is at reducing the pressures under the forefoot. The EMED F pressure measuring system was used. Fifteen patients (23 feet) were included in the study. All patients had foot pressure studies performed before and after surgery. Our results show a significant increase in total pressure and pressure-time integral under the foot after surgery. This increase was most marked under the first metatarsal head region (P < .005). However, the midmetatarsal region showed a slight decrease in pressure, but this was not significant. Symptomatically, 13 patients felt improved by the operation. The results suggest that the procedure is successful because it transfers the pressure to areas better able to tolerate it, rather than reduces the total pressure.

Adult↗

Sporotrichosis in north-west India.

Twelve culture proven patients of sporotrichosis were seen over a period of 4 1/2 yr in the north-western region of this country. Most of the patients (75%) were from Himachal Pradesh, with slight female preponderance. The right upper limb was commonly (58.3%) involved; gardeners and housewives being the common sufferers. Localised lymphocutaneous variety was the commonest presentation (91.7%), except in one patient, where after initial involvement of the face, the lesion extended to the right upper limb and trunk. All but one patient responded to oral potassium iodide therapy; this patient with mixed infection of Sporothrix schenckii and Cladosporium species, required in addition, amphotericin B therapy.

Amphotericin B↗