A Questionnaire Based Study on the Concepts of Protein Supplementation in Exfoliative Dermatitis Among Dermatologists

Introduction: The impact of exfoliative dermatitis on protein metabolism results in a negative nitrogen balance, but the exact turnover of plasma proteins in this situation is not known. Timely addressing of this metabolic response to exfoliation is crucial in its management. Objectives: To study the understanding on the concept of protein supplementation in cases of exfoliative dermatitis, among dermatologists. Material and methods: A cross sectional questionnaire based survey study was conducted among dermatologists who attended annual state conference of IADVL, Kerala chapter. Analysis was based on responses to the questionnaire by 51 practicing dermatologists who had answered and returned the questionnaire, out of the total 84 who were approached for the study. Responses to questions from the interviews were summarized and expressed as numbers and percentages. Results: Majority (32, 62.7%) of the dermatologists attributes chronicity of illness to the severity of protein loss in exfoliative dermatitis. Though serum albumin level is considered as the criterion for protein supplementation, opinion regarding the frequency of estimation, mode and end point of supplementation varies. The majority (36, 70.6%) of dermatologists regards protein supplementation as mandatory in all cases of exfoliative dermatitis and that it helps in recovery of the condition, irrespective of etiology. Limitation: The small sample size is an obvious limitation Conclusion: Lack of a clear consensus and knowledge regarding the turnover of plasma proteins in exfoliative dermatitis and the correction of hypoalbuminemia, is clearly portrayed by our results. Further studies are needed to explore the exact pathophysiology of metabolic response to exfoliation and to fill the gaps in the understanding of the same. Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.9-1

Phenylthiourea Specifically Reduces Zebrafish Eye Size

Phenylthiourea (PTU) is commonly used for inhibiting melanization of zebrafish embryos. In this study, the standard treatment with 0.2 mM PTU was demonstrated to specifically reduce eye size in larval fish starting at three days post-fertilization. This effect is likely the result of a reduction in retinal and lens size of PTU-treated eyes and is not related to melanization inhibition. This is because the eye size of tyr, a genetic mutant of tyrosinase whose activity is inhibited in PTU treatment, was not reduced. As PTU contains a thiocarbamide group which is presented in many goitrogens, suppressing thyroid hormone production is a possible mechanism by which PTU treatment may reduce eye size. Despite the fact that thyroxine level was found to be reduced in PTU-treated larvae, thyroid hormone supplements did not rescue the eye size reduction. Instead, treating embryos with six goitrogens, including inhibitors of thyroid peroxidase (TPO) and sodium-iodide symporter (NIS), suggested an alternative possibility. Specifically, three TPO inhibitors, including those that do not possess thiocarbamide, specifically reduced eye size; whereas none of the NIS inhibitors could elicit this effect. These observations indicate that TPO inhibition rather than a general suppression of thyroid hormone synthesis is likely the underlying cause of PTU-induced eye size reduction. Furthermore, the tissue-specific effect of PTU treatment might be mediated by an eye-specific TPO expression. Compared with treatment with other tyrosinase inhibitors or bleaching to remove melanization, PTU treatment remains the most effective approach. Thus, one should use caution when interpreting results that are obtained from PTU-treated embryos

Wegener′s Granulomatosis An unusual Presentation

Wegenâ€s granulomatosis is characterized by necortising granulomatous inflammation and vasculitis affecting predominantly small arteries and veins. In its generalized from there is involvement of upper and lower respiratory tract, kidney and often other organs including skin. It may also present as limited organ involvement. A case of Wegenerâ€s granuolmatosis limited to skin is reporte

A Questionnaire Based Study on the Concepts of Protein Supplementation in Exfoliative Dermatitis Among Dermatologists

Introduction: The impact of exfoliative dermatitis on protein metabolism results in a negative nitrogen balance, but the exact turnover of plasma proteins in this situation is not known. Timely addressing of this metabolic response to exfoliation is crucial in its management.Objectives: To study the understanding on the concept of protein supplementation in cases of exfoliative dermatitis, among dermatologists.Material and methods: A cross sectional questionnaire based survey study was conducted among dermatologists who attended annual state conference of IADVL, Kerala chapter. Analysis was based on responses to the questionnaire by 51 practicing dermatologists who had answered and returned the questionnaire, out of the total 84 who were approached for the study. Responses to questions from the interviews were summarized and expressed as numbers and percentages.Results: Majority (32, 62.7%) of the dermatologists attributes chronicity of illness to the severity of protein loss in exfoliative dermatitis. Though serum albumin level is considered as the criterion for protein supplementation, opinion regarding the frequency of estimation, mode and end point of supplementation varies. The majority (36, 70.6%) of dermatologists regards protein supplementation as mandatory in all cases of exfoliative dermatitis and that it helps in recovery of the condition, irrespective of etiology.Limitation: The small sample size is an obvious limitationConclusion: Lack of a clear consensus and knowledge regarding the turnover of plasma proteins in exfoliative dermatitis and the correction of hypoalbuminemia, is clearly portrayed by our results. Further studies are needed to explore the exact pathophysiology of metabolic response to exfoliation and to fill the gaps in the understanding of the same.Nepal Journal of Dermatology, Venereology &amp; Leprology, Vol.14(1) 2016, pp.9-13</jats:p