DERMATOLOGY AND VENEREOLOGY (2023)

DERMATOLOGYAND VENEREOLOGY

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FACULTY

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Facilities The department caters to the needsof more than 30,000 outpatients and 3000
inpatients per year. The followingfacilities are availlable for patients:

Treatment of skindiseases

Treatment of diseases ofhair, alopecia etc,

Treatment of Sexuallytransmitted diseases

Treatment of leprosy

Treatment of vitiligo,psoriasis, eczemas

Surgical Treatment ofSkin problems

Specialised treatment of Pemphigus

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Equipment and Facilities Available

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PUVAChambers

CO 2 Laser

Electrocautery

Pulse dye laser Coming soon

Hitopathology andImmunofluorescence

Mycology and fungalculture

AIDS testing andcounselling and beds

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TRAINING

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Undergraduate Training for MBBS students and Interns

Postgraduates MDDermatology and Venereology

Foreign Graduates Training in Tropical Dermatology and Venereology

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Short term Refresher training for thoseholding MD Dermatology

IADVL Fellowships in Contact Dermatitis,Pulse Therapy

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Achievementsof department

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New inventive technologies introduced in our Institute

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<![if !supportLists]>(i)<![endif]>Innovative management of skin diseases

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<![if !supportLists]>· <![endif]>Pemphigus: Dexamethasone cyclophosamide pulse therapy

Oral betamethasone pulsetherapy

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<![if !supportLists]>· <![endif]>Collagenvascular diseases: Dexamethasone pulsetherapy

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<![endif]>·Azathioprinein treatment of airborne contact dermatitis, lichen planus,

Atopic dermatitis

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<![if !supportLists]>·<![endif]>Alopeciaareata: Treatment withdiphencyprone

300 mg oral prednisolone bolus

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<![if !supportLists]>·<![endif]>Mycetoma: 2 step treatment for mycetoma

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<![if !supportLists]>(ii)<![endif]>Innovations

Indian standard series for patchtesting

New investigative procedures introduced by your Institute

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<![if !supportLists]>· <![endif]>Touch,pain & thermal sensation testing and grading devices, nasal filter

<![if !supportLists]>· <![endif]>Dermograder

<![if !supportLists]>· <![endif]>Cryostimulationtest

<![if !supportLists]>· <![endif]>Complete dietelimination for food allergy

<![if !supportLists]>· <![endif]>A fourweek therapeutic test for cutaneous TB

<![if !supportLists]>· <![endif]>Titre ofcontact hypersensitivity

<![if !supportLists]>· <![endif]>Provocationtest for severe drug reactions

<![if !supportLists]>· <![endif]>AluminiumPatch Test Chambers

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Research Completed 2000-2001

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A Broad Band UV-Bin the treatment of Vitiligo

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Seventeen patients (9 males, 8 females) between ages of 10to 40 years were treated with
broad band UV-B twice a week by Waldmann’s UV7001 K unit. Eleven patients received
25-44 (mean 33) exposure of UV-B over 4-6 months. Repigmentation was observed in8
(72.7%) out of 11 patients and remaining 3 showed no response.Repigmentation was
diffuse and to the extent of 10-25% only and none of thepatients had satisfactory cosmetic
improvement. It was concluded that broad band UV-B given twice a week over 4months
was not effective in vitiligo.

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<![if !supportLists]>A.<![endif]>Role of contact allergens in the etiology of pompholyx.

<![if !supportLists]>B.<![endif]>Natural history of parthenium dermatitis

<![if !supportLists]>C.<![endif]>Hydroxyurea in the treatment of psoriasis

<![if !supportLists]>D.<![endif]>Minodixil and betamethasone dipropionate combination in thetreatment of extensive
alopecia areata

<![if !supportLists]>E.<![endif]>Diphencyclopropenone in the treatment of alopeciauniversalis and totalis

<![if !supportLists]>F.<![endif]>Identification of risk factors for extensive vitiligo

<![if !supportLists]>G.<![endif]>Evaluation of the effficacy of intravenous cyclophosphamidemonthly pulse (15 mg/kg )
with daily oral prenisolone (1 mg/kg) in the therapyof pemphigus.

<![if !supportLists]>H. <![endif]>Reproducibilityof patch test at upper back, lower back and forearm in patients with
partheniumdermatitis.

<![if !supportLists]>I. <![endif]>Effectivenessof CO2 laser in benign vascular lesions, epidermal and sebaceous nevi,
angiofibromas & keloids

<![if !supportLists]>J. <![endif]>Azathioprine asa corticosteroid sparingagent in the treatment of air bornecontact dermatitis.

<![if !supportLists]>K. <![endif]>To evaluatethe role ofimmunosuppressive drugs for the treatment of chronic idiopathic
urticaria.

<![if !supportLists]>L. <![endif]>Long-term safety and toxicity of azathioprinein patients of air-borne contact dermatitis.

<![if !supportLists]>M. <![endif]>Evaluation of efficacy of fixed duration (12 weeks)multidrug therapy with newer antileprosy
bactericidal drugs in multibacillaryleprosy.

<![if !supportLists]>N.<![endif]> A comparative study of punch grafting followed by topicalconticosteroids vs punch grafting
followed by PUVA therapy in stable vitiligo.

<![if !supportLists]>O. <![endif]>Further evaluation of Dexamethasone Cyclophosphamide Pulsetherapy in pemphigus.

<![if !supportLists]>P. <![endif]>Evaluation of punch grafting in halo naevi with/withoutlimited vitiligo.

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Collaborative research project completed

<![if !supportLists]>A.<![endif]>Evaluation of PCR in the diagnosis of cutaneous tuberculosis(Microbiology, Pathology
and Biostatistics).

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The laboratory diagnosis oftuberculosis rests on the direct demonstration of Mycobacterium
tuberculosis insmears or biopsies and culture of the organism. However, because most type
of cutaneous tuberculosis arepaucibacillary, it is often difficult to demonstrate or grow the

organism fromthe skin. Over the last few years, somereports have documented the use of

PCR in identifying M. tuberculosis DNA inlesions of cutaneous tuberculosis.However, the

test has not been prospectively evaluated in the diagnosisof the disease. We performed PCR

usingprimers and probes based on the published sequence of immunogenic proteinMPB64,

a gene unique to the M. tuberculosis complex. The test was performed in 64 cases and 45

controls. For the purposes of this study, cases weredefined as patients who had all of the

following: skin lesions morphologicallysuggestive of cutaneous tuberculosis, a positive

Mantoux test, skin biopsyshowing granulomatous dermatitis and aclinical response to

standard anti-tubercular therapy. Controls were defined as those patients whoshowed clinical

and/or biopsy findings definitely indicative of a diagnosisother than cutaneous tuberculosis.

Eighteen out of 64 cases and 11 out of 45 controls showed a positiveresult on PCR.Thus,

the test had asensitivity of 28.1% a specificity of 75.6% and a likelihood ratio of apositive
result of 1:1. PCR forcutaneous tuberculosis does not appear to be a useful test in our hands.

Thesearch for a reliable diagnostic test for cutaneous tuberculosis must continue.

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<![if !supportLists]>B.<![endif]>Clinical evaluation of the efficacy and safety of topicalbutenafine in comparison with topical

clotrimazole in tines cruris and tinescorporis (Microbiology, Laboratory Medicine).

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Butenafine hydrochloride is a newbenzylamine derivative which has primary fungicidal activity
against dermatophytes.We evaluated theefficacy and safety of butenafine in comparison with
topical clotrimazole inthe treatment of tinea cruris and tinea corporis in patients attending the
skinOPD at our hospital during the study period (February to December 2000). All patients
who fulfilled the inclusioncriteria for the study were randomly allocated to treatment with butenafine

once daily for 2 weeks or clotrimazole twice daily for 4 weeks in a doubleblind manner.
Clinical examination andmicroscopy of potassium hydroxide preparations of scrapings and

culture fordermatophytes were conducted at baseline and at 1 week, 2 weeks, 4 weeks, 6weeks
and 8 weeks following initiation of therapy. Efficacy was evaluated by the presence of mycological

andclinical cure. Adverse reactions, ifany, were recorded at each visit.Seventy-five patients

were enrolled into the study, 37 were in thebutenafine group and 38 in the clotrimazole group.

Fourteen patients in the butenafine group and nine in theclotrimazole group were lost to follow-up
.The sign and symptom score declined significantly in both thegroups. At the end of 8 week the
numberof patients showing mycologic cure (on KOH preparation) in the butenafine andclotrimazole

treatment groups was 20/22 patients and 27/28 patientsrespectively. Three patients in eachgroup

showed relapses after treatment cessation. Butenafine 1% cream is as effective as topically

applied clotrimazole 1% cream in the treatment oftinea cruris and corporis with the advantage

of once-daily application andshorter duration of treatment.

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<![if !supportLists]>C.<![endif]>A two-step schedule for the treatment of actinomycoticmycetomas (Microbiology)

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Actinomycotic mycetomas usually respond slowly totreatment with antibiotics. In anattempt to

hasten clinical resolution, we used a 2-step regimen consisting ofan intensive phase of therapy
with penicillin, gentamicin and co-trimoxazolefor 5-7 weeks followed by maintenance therapy with amoxycillin andco-trimoxazole. Seven patients weretreated, all of whom showed significant

reduction in discharge and swellingafter the intensive phase. Maintenancetherapy was continued

until the lesions completely healed clinically and upto 6months beyond that maintenance therapy
was given for 6-16 months (mean 10.7months), and patients remained free ofdisease during a
mean post-treatment follow up of 6-4 months. The other 2patients have also responded
satisfactorily and continue to receive maintenancetherapy. Side effects necessitating a

modification of the treatment schedule occurred in 2 patients but reversed onstopping the
responsible drugs. This treatment schedule produces a rapidclinical response during the initial intensive phase and promotes compliancewith the longer maintenance phase of treatment necessary to achieve a completecure.

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Collaborativeresearch continuing

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<![if !supportLists]>A. <![endif]>Dermatological complications in renal transplant recipient patients - A follow up study of500

patients (Department ofNephrology).

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<![if !supportLists]>B. Role ofelectron beam radiation therapy for the treatment of mycosis fungoides(Department of

RadiationOncology).

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1. SharmaVK. Patch testing with Europeanstandard series and compositae extracts in patients

with air borne contactdermatitis. Contact Dermatitis 2001:44:49-50.

2. Penchalaiah S, Handa S,Bijaya Lakshmi, Sharma VK, Kumar B. Sensitizers commonly causing

allergiccontact dermatitis from cosmetics. Contact Dermatitis 2000; 43:311-312.

3.Sharma VK, Sahoo B.Prurigo-nodularis like lesion in parthenium dermatitis. Contact Dermatitis 2000;42 (4):235.

4.Sood A, Sharma S, Sharma VK. Morphoea with mucin deposits masquerading asscleromyxoedema. Indian J DermatolVenereol Leprol 2000;66:109.

5.Vatve M, Sharma VK, Sawhney IMS, Kumar B. Evaluation of patch test in identificationof causative agent in drug rashes due to antiepileptics. Indian J DermatolVenereol Leprol 2000; 66:132-135.

6.Sharma VK, Prasad HRY. Management of AndrogenicAlopecia. Indian J Dermatol2000:45:54-61.

7.Sharma N, Sharma VK,Gupta A, Kaur I, Ganguly VK.Immunological defect in leprosy patient altered T-lymphocytesignals. FEMS Immunol Microbiol. 1999;23 (4):355-62.

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8.Sarkar R, Kaur I, DasA, Sharma VK. Macular lesions inleprosy: a clinical, bacteriological and histopathological study. J Dermatol. 1999 26(9):569-76.

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9.Gupta A, Sharma VK,Vohra H, Ganguly NK. Inhibition ofapoptosis by ionomycin and zinc in peripheral blood mononuclear cells (PBMC) ofleprosy patients. Clin Exp Immunol. 1999 117 (1):56-62.

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10.Srinivasan S, Nehru VI,Bapuraj JR, Sharma VK, Mann SB. CTfindings in involvement of the paranasal sinususes by lepromatous leprosy. Br J Radiol. 1999; 72(855):271-3.

11.Gupta A, Sharma VK,Vohra H, Ganguly NK. Spontaneousapoptosis in peripheral blood mononuclear cells of leprosy patients: role ofcytokines. Immunol Med Microbiol. 1999 24(1):49-55.

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12.Soni A, Mittal BR, KaurI, Sharma VK, Pathak CM, Kumar B. Bone scintigraphy in leprosy. Int J Lepr1998; 66(4):483-4.

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13. Sirka CS, Ramam M, Mital R,Khaitan BK, Verma KK. Olmstedsyndrome. Indian J Dermatol VenereolLeprol 1999; 65:237-239.

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14.Ramam M, Manchanda Y,Verma KK, Sharma VK. Reproducibility oftitre of contact hypersensitivity to Parthenium hysterophorus. Contact Dermatitis 2000; 42:366.

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15.Ramam M, Garg T, D’Souza P, Verma KK, Khaitan BK, Singh MK,Banerjee U. A two-step schedule for the treatment of actinomycoticmycetomas. Acta Derma-Venereol, 2000;80:378-380.

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16.Verma KK, Lalhanpal S, Sirka CS, Khaitan BK, Ramam M,Banerjee U. Primary cutaneousactinomycosis. ActaDerm-Venereol,1999;78:327.

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17.Grover JK, Vats V, Gopalakrishna R, Ramam M. Thalidomide: a relook. Natl Med J india2000; 13:132-141.

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18.Sharma VK, Achar A, Ramam M, Singh MK. Multiple cutaneous horns overlying lichenplanus hypertrophicus. Br J Dermatol 2001; 144:424-425.

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19.Ramam M, D’Souza P, Ravindraprasad JS, Iyer KV, SinghMK. Mycosis fungoides treated with PUVAand topical corticosteroids. Ind JDermatol Venereol Leprol 2000;66:251-253.

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20.Ramam M, Kumrah L.Systemic corticosteroid therapy and the hypothalamo-pituitary adrenalaxis. Ind, J. of Dermatol, 2001;46:1-7.

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21.Verma KK, Mittal R, Manchanda Y Khaitan BK : Lichen planustreated with betamethasone oral mini pulse therapy. Indian J Dermatol Venereol Leprol 2000; 66: 34-35.

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22.Verma KK, Rathi S,Pasricha JS: Failure of pentoxifylline to affect airborne contact dermatitiscaused by Parthenium. Ind J Dermatol Venereol Leprol 2000; 66: 129-131.

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23.Verma KK, Lakhanpal S,Sirka CS, Khaitan BK, Banerjee U: Disseminatedmucocutaneous blastomycosis inan immunocompetant Indian patienttreated with ketoconazole. JEuro Acad Dermatol Venereol 2000; 14:332-333.

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24.Verma KK, Parida DK,Rath GK: Cutaneous T-cell lymphoma treated with electron beam radiation -Indian experience. J Euro Acad Dermatol Venereol 2000; 14 (suppl 1): W 41(Abst).

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25.Verma K and Verma KK:Infantile periocular haemangioma treated with betamethasone oral mini pulsetherapy. Ind J Ped 2001; 68: 367-368.

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26.Khaitan BK, Mittal R, Ramam M, Jain Y. Flexural keratoderma,recurrent purpura, gastroenteritis and respiratory tract infection. Indian JPediatr Dermatol, 2000; 3: 23-24.

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27.Sood A, Khaitan BK,Khanna NK, Kumar R, Singh MK. Syringocystadernoma papilliferum at unusualsites. Indian J Dermatol Venereol Leprol2000; 66:328-329.

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Chapters in books and monographs

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1.Sharma VK, Treatment of Cutaneous tuberculosis andMycobacterial Infections. In, Workbookof 4^th National CME on Dermato Pathology, New Delhi, 2000.

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2.Sharma VK: Treatment of Difficult Psoriasis, In, DermatologyUpdate-2000, Edited by Col. S.K. Sayal, Base Hospital, Delhi Cantt.

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3.Ramam M, Satish D, Thomas J, Parikh DA, Skin diseases in children, In:Parthasarathy A, MenonPSN, Nair MKC, Lokeshwar MR, Srivastava RN, Bhave SY et al, Editors, IAPTextbook of Pediatrics New Delhi, 1999, p 814-820.

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4.Ramam M. Cutaneoustuberculosis. In: Sharma SK, Mohan A,Editors, Tuberculosis, New Delhi, Jaypee brothers Medical Publishers (P) Ltd.,2001, P 261-272.

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5.Ramam M, Gupta LK, Dermatologic Emergencies in Children. In:Singh M, Editor, Medical Emergencies in Children, 3^rd edition, NewDelhi, 2000, p 587-601.

6.Khaitan BK, Mittal R. “Role of vitamin E as an antioxidantin Dermatology.

In, Sacchinand S, Editor, “Role ofAntioxidants in Dermatology” published by 28^th National conferenceof IADVL, 2000: 57-60.

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7.Khaitan BK. Pulse Therapy in Dermatology

In, ‘Dermatology Update-2000’Edited by Col. S.K. Sayal, Base Hospital, Delhi Cantt.

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8.Khaitan BK, Dattagupta, S, D’Souja P. Fungal Infections

In, Workbook of 4^th NationalCME on Dermatopathology, New Delhi, 2000.

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9. Current Literature Dermatology 1999-2000.

Pasricha JS,Misra RS, Ramesh V, Ramam M, Khaitan BK et al.

IADVL (Delhi State Branch), New Delhi.

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10. Verma KK and Singh MK: Vesiculobullous Disorders, inWork-book - 4th National CME on Dermatopathology, AIIMS, New Delhi, 2001;
p 1-6.

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Significant events

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1 Indo US workshop on Sexually Transmitted Diseases andReproductive Tract Infections, New Delhi (Nov. 8-10,2000) in colloboration withDepartment of Biotechnology & Department of Pathology.

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2. 4^th National CME onDermatopathology in collaboration with Department of pathology on Feb. 24=25^th, 2001.

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4.Prof. V.K. Sharma received Indian Council of MedicalResearch “Lala Ram Chand Kandhari” award for Dermatology and SexuallyTransmitted Diseases.

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5.Prof. V.K. Sharma served as President, Indian Association ofDermatologists, Venereologists &Leprologists(Delhi State Branch) for the Year 2000 and Honorary Secretary –Contact and Occupational Dermatoses Forum of India (CODFI) for the year 2000.

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6.Dr. B.K. Khaitan served as Vice-President, IndianAssociation of Dermatologists, Venereologists & Lepropolgists (DSB) for theyear 2000.

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7.Dr. K.K. Verma served as Honorary Secretary – IndianAssociation of Dermatologists, Venereologists and Leprologists (DSB) for theyear 2000.

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