Profile of Inflammatory and Infective Skin Diseases

Profile of Inflammatory and Infective Skin DiseasesContributors with their highest academic degreeGIRI VISHAL P*. , MD (PHARMACOLOGY)GIRI OM P. , MD (MEDICINE), PhD (MEDICINE)GUPTA SUDHIR K. , MD ( SKIN VD)SHUBHRA KANODIA , MDS (Std), (ORAL MEDICINE AND RADIOLOGY)Department(s) and institution(s) Clinico-Epidemiological Profile of Inflammatory and Infective SkinDiseases in a Tertiary Care Centre of South IndiaABSTRACTThe map medical audit-study was undertaken to analyze clinical and epidemiological profile of rabble-rousing and infective uncase unhealthinesss and to arrive at important facts about these diseases.1134 patients who attended the Dermatology of a checkup and College Hospital were the subjects of this study . The findings were recorded in a proforma for analysis and interpretation .Etiological analysis revealed that majority ( 599 52.82 % ) of dermatoses belonged to inflammatory host followed by infective crowd ( 535 47.18 % ). Of the inflammatory group, superse nsitized relate dermatitis ( 209 18.43 % ) was the al more or less common entity followed by irritant contact dermatitis (180 15.87 %) , seborrhroeic dermatitis( 120 10.58 % ), atopic dermatitis ( 50 4.41 % ), psoriasis ( 20 1.76 % ) and pompholyx ( 20 1.76 % ).Of the infective group, bacterial infection was the most common disease ( 349 30.78% ) followed by scabies (122 10.76 %) , fungal (57 5.02 %) and viral infection( 3 0.26 % ).This study provides a preliminary baseline data for future clinical query. It big businessman also help to assess the changing trends of inflammatory and infective skin diseases .Key Words inflammatory skin diseases, infective skin diseases, changing trends in skin diseases. INTRODUCTIONThe pattern of skin disease is a consequence of poverty , malnutrition , overcrowding , poor hygiene , illiteracy and social backwardness in umteen parts of India . The examination for skin diseases is an important component of health bid practice for all. Stat us of health , hygiene and personal cleaniness of a society contribute be judged from the prevalence of certain skin diseases in the community . The pattern of skin diseases vary from one clownish to another and within the same country from one state to another due to various climatic , cultural and socio-economic factors.1,2 MATERIAL AND METHODSThe relevant data available from medical case records of the Dermatology outpatient department of a Medical College and Hospital was collected by the investigator in person during period January 2011 to June 2012 . Name ,age ,gender , type and duration of disease were recorded in a proforma for analysis and interpretation of data .Total 1134 ( one thousand one hundred thirty four ) medical case records of inflammatory and infective skin diseases were collected and scrutinized for this observational ,perspective and medical audit- study. RESULTSOut of 1134 patients scrutinized , 220 ( 19.40 % ) patients were children up to five age of age and 149 ( 13.14 % ) children were 6 to 10 days of age . Most of adults 358 ( 31.57 % ) were aged 21 to 40 years and 146 ( 12.87 % ) adults belonged to 41 to 60 years age group . Females ( 581 51.23 % ) slightly outnumbered males ( 553 48.77 % ). table 1-6The majority ( 599 52.82 % ) of patients belonged to inflammatory group followed by infective group ( 535 47.18 % ). Table1,2 designing of inflammatory skin diseases revealed allergic contact dermatitis to be the commonest ( 209 18.43 % ) followed by irritant contact dermatitis (180 15.87 % ) , seborrhoeic dermatitis ( 120 10. 58 % ) , atopic dermatitis ( 50 4.41 % ) , psoriasis ( 20 1.76 % ) and pompholyx ( 20 1.76 % ). Table 1 Among infective skin diseases , bacterial infection ( 349 30.78 % ) was most common entity . Scabies was recorded in 122 ( 10.76 % ) patients . Fungal infection was recorded in 57 ( 5.03 % ) and viral infection 3 ( 0.26 % ) patients . Table 2 Seasonal variation pattern was observed in some disea ses . Impetigo and dermatophytosis were recorded mainly in rainy and summer seasons. Scabies was recorded mainly in winter and rainy seasons . Atopic dermatitis and seborrhoeic dermatitis were documented more in winter season . DISCUSSION human body of inflammatory and infective skin diseases has varied in antithetical studies. In this study , majority ( 599 52.82 % ) of skin diseases belonged to inflammatory group followed by infective group ( 535 47.18 % ) . A similar pattern of dermatoses has also been reported in several other studies .3-8 However, in other studies infective group has been the predominant dermatoses.9-22Of the inflammatory dermatoses , allergic contact dermatitis was the commonest ( 209 18.43 % ) out of all 1134 patients followed by irritant contact dermatitis( 180 15.87 % ), seborrhoeic dermatitis ( 120 10.58 % ), atopic dermatitis ( 50 4.41 % ), psoriasis ( 20 1.76 % ) and pompholyx (20 1.76 % ). In chidren aged up to five years atopic dermatitis was the c ommonest ( 8 0.71 % ) followed by seborrhoeic dermatitis ( 7 0.62 % ) , irritant contact dermatitis ( 60.53 % ) and pompholyx ( 2 0.18 % ). Similar finding has been observed in other studies . 2,5,6Of the infective dermatoses, bacterial infections (349 30.78 %) were the most common followed by fungal ( 57 5.03 % ) and viral infections ( 3 0.26 % ). Similar pattern has been observed in some other studies as well .2,5 Studies withdraw reported fungal infection to be more common.13,14,22 Viral infections out-numbered bacterial and fungal infections in few studies .7,8 Impetigo was the commonest ( 158 13.93 % ) bacterial infection followed by secondary pyoderma ( 133 11.73 % ), folliculitis ( 25 2.20 % ), furunculosis ( 20 1.76 % ) and acute genus Paronychia ( 13 1.15 % ). Scabies was the most common infestation seen in 122 ( 10. 76 % ) patients in the present study . CONCLUSION majority of dermatoses belonged to inflammatory group followed by infective group , though the differenc e is narrow (64 5.64 % ).Of the infective group bacterial infection was the most common disease followed by scabies , fungal and viral infection. This study points towards changing trends in dermatoses .This study provides preliminary baseline data for the future epidemiological and clinical research . It might also help to assess the changing trends of dermatoses.REFERENCES1. William H.C. Epidemiology of skin diseases in Burns T, Breathnach.S COXN Griffiths editors, Rooks Textbook of Dermatology, 7th ed. Oxford Blackwell science 2004 81 06-21.2. Balal M , Khare AK , Gupta LK , Mittal A , Kuldeep CM. bod of paediatric dermatosis in a tertiary care centre of South West Rajasthan . Indian J Dermatol 2012 57 275 -8 .3. rabbit DA, Haldar HS, Das DJ, Mazumdar MG, Biswas BS, Sarkar SJ. Dermatological disease pattern in an urban institution in Kolkata. Ind J Dermatol 20055022-3.4. Symvoulakis EK, Krasagakis K, Komninos ID, Kastrinakis I, Lyronis I, Philalithis A, et al. Primary c are and pattern of skin diseases in a Mediterranean island. BMC Fam Pract 200676.5. Gul U ,Cakmak SK, Gonul M, Kilic A , Bilgili S . Pediatric skin disorders encountered in a dermatology outpatient clinic in Turkey .Pediatr Dermatol 2008 25 277-78 .6. Nanda A, Hasawi FA, Alsaleh QA. 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Devi T, Zamzachin G, Pattern of skin diseases in Imphal.Indian J.Dermatology, 2006 51 149-50.Table 1 Pattern of skin inflammation in both sexesDiseases Male Female Total nary(prenominal) % No. % No. % Allergic contact dermatitis 105 9.26 104 9.17 209 18.43Irritant contact dermatitis 81 7.14 99 8.73 180 15.87Seborrhoeic dermatitis 71 6.26 49 4.32 120 10.58Atopic dermatitis 19 1.68 31 2.73 50 4.41Psoriasis 11 0.97 9 0.79 20 1.76Pompholyx 8 0.70 12 1.06 20 1. 76Total 295 26.01 304 26.81 599 52.82Table 2 Pattern of skin infection in both sexesDiseases Male Female Total No. % No. % No. % Impetigo 72 6.35 86 7.58 158 13.93Secondary pyoderma 72 6.35 61 5.38 133 11.73Folliculitis 10 0.88 15 1.32 25 2.20Furunculosis 8 0.70 12 1.06 20 1.76Acute paronychia 5 0.44 8 0.70 13 1.15Scabies 56 4.94 66 5.82 122 10.76Pediculosis 2 0.18 2 0.18 4 0 .35Dermatophytosis 22 1.94 15 1.32 37 3.26Pitiriasis versicolor 11 0.97 9 0.79 20 1.76Molluscum contagiosum 0 0 3 0.26 3 0.26 Total 258 22.75 277 24.43 535 47.18Table 3 Pattern of skin inflammation in different age groups (years)Diseases up to 5 6-10 11-20 No. % No. % No. %Allergic contact dermatitis 0 0 4 0.35 33 2.91Irritant contact dermatitis 6 0.53 7 0.62 27 2.38Seborrhoeic dermatitis 7 0.62 14 1.23 29 2.56Atopic dermatitis 8 0.71 5 0.44 4 0.35Psoriasis 0 0 0 0 0 0Pompholyx 2 0.18 5 0.44 3 0.26Total 23 2.03 35 3.09 96 8.47Table 4 Pattern of skin inflammation in different age groups ( years )Diseases 21-40 41-60 61-100No. % No. % No. %Allergic contact dermatitis 80 7.05 47 4.14 45 3.97Irritant contact dermatitis 104 9.17 30 2.65 6 0.53Seborrhoeic Dermatitis 40 3.53 20 1.76 10 0.88Atopic dermatitis 20 1.76 3 0.26 10 0.09Psoriasis 13 1.15 3 0.26 4 0.35Pompholyx 10 0.88 0 0 0 0Total 267 23.54 103 9.08 75 6.61Table 5 Pattern of skin infection in different age groups ( years ) Diseases up to 5 6-10 11-20 No. % No. % No. %Impetigo 96 8.47 37 3.26 15 1.32Secondary pyoderma 59 5.20 35 3.09 23 2.02Folliculitis 1 0.09 1 0.09 3 0.26Furunculosis 1 0.09 1 0.09 4 0.35Acute paronychia 0 0 1 0.09 1 0.09Scabies 37 3.26 34 3.00 23 2.03Pediculosis 0 0 0 0 3 0.26Dermatophytosis 1 0.09 4 0.35 4 0.35Pitiriasis versicolor 0 0 0 0 0 0Molluscum contagiosum 2 0.18 1 0.09 0 0Total 197 17.37 114 10.05 76 6.70 Table 6 Pattern of skin infection in different age groups (years) Diseases 21- 40 41- 60 61- 100 No. % No. % No. %Impetigo 7 0.62 3 0.26 0 0Secondary pyoderma 8 0.70 4 0.35 4 0.35Folliculiti s 15 1.32 4 0.35 1 0.09Furunculosis 10 0.88 3 0.26 1 0.09Acute paronychia 4 0.35 6 0.53 1 0.09Scabies 20 1.76 4 0.35 4 0.35Pediculosis 0 0 0 0 2 0.18Dermatophytosis 17 1.50 10 0.88 2 0.18Pitiriasis versicolor 10 0.88 9 0.79 1 0.09Molluscum contagiosum 0 0 0 0 0 0Total 91 8.02 43 3.80 16 1.411