03.10.2012

Bellary.

From,

Dr. Manjunatha.H,

Postgraduate student,

Department of Dermatology Venereology and Leprology,

Vijayanagar Institute of Medical Sciences, Bellary.

To,

The Principal,

Vijayanagar Institute of Medical Sciences, Bellary.

THROUGH PROPER CHANNEL

Sir,

Sub: Acceptance of registration and forwarding of dissertation topic.

* * * * *

In accordance with the above cited topic, I the undersigned studying in Postgraduate course in M.D. Dermatology Venereology and Leprology has been allotted the dissertation topic “CLINICO-EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADOLESCENTS”under the guidance of Dr. Veeresh, Professor, Department of Dermatology Venereology and Leprology, VIMS, Bellary.

I request you kindly to forward the dissertation topic in the prescribed form for the University for Approval.

Thanking you,

Yours faithfully,

(Dr.Manjunatha.H)

Signature of Guide,

(Dr. Veeresh)

03.10.2012

Bellary.

From,

The Professor and Head,

Department of Dermatology Venereology and Leprology,

Vijayanagar Institute of Medical Sciences,

Bellary.

To,

The Registrar,

Rajiv Gandhi University of Health Sciences,

Bangalore.

THROUGH PROPER CHANNEL

Sir,

Sub: Submission of synopsis for registration and forwarding.

* * * * *

As per regulation of the University for Registration of dissertation topic, the following Postgraduate student M.D (Dermatology, Venereology and Leprology) has been allotted the dissertation topic as follows by the official registration committee of all qualified and eligible of the Departmet of Dermatology Venereology and Leprology.

Name / Topic / Guide
Dr Manjunatha,H,
Postgraduate student,
Department of DVL,
VIMS, Bellary. / “CLINICO-EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADOLESCENTS” / Dr. Veeresh,
Professor,
Department of DVL,
VIMS, Bellary.

Therefore, I kindly request you to communicate the acceptance of the dissertation topic allotted to the PG student at an early date.

Thanking you,

Yours faithfully,

(DR. KARJIGI SIDDALINGAPPA)

Professor and head

Department of DVL,VIMS,Bellary.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Name of the Candidate
And Address
(in block letters) / DR. MANJUNATHA. H
P.G. IN DERMATOLOGY
VENEREOLOGY & LEPROLOGY,
VIMS, BELLARY, KARNATAKA
Name of Institution / VIJAYANAGAR INSTITUTE OF MEDICAL SCIENCES, BELLARY
Course of study and subject / M.D. IN DERMATOLOGY VENEREOLOGY AND LEPROLOGY
Date of Admission to course / 16/08/2012
Title of the topic / “CLINICO-EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADOLESCENTS”
Brief resume of the intended work:
6.1 Need for the study:
WHO defines “adolescents” as individuals in the 10-19 years age group and “youth”as the 15-24 year age group. These two overlapping age groups are combined in the group “young people”coveringthe age range 10-24 years.1 There are about 1.2 billion adolescents worldwide and one in every five people in the world is an adolescent. Adolescents constitute 18-25% of the population in member countries of South East Asia Region.
Skin diseases are a major health problem affecting a high proportion of the population and causing distress and disability.2 There are important differences in range, presentation, treatment and prognosis of skin disorders at various points in life. Skin along with other organ systems undergoes some degree of maturation before puberty. Skin disorders in children in part reflect these physiological changes, but many troublesome cutaneous problems result from intrinsic genetic abnormalities conditioned by environmental influences e.g. atopic dermatitis. School-going years bring exposure to a wide variety of infections and contagions such as scabies, impetigo, measles, chicken pox, warts and head lice.
Adolescent period of life is associated with gross somatic and psychological changes in body. The gonadotrophic releasing hormone (GRH) from hypothalamus stimulates pituitary gland to secrete follicle-stimulating hormone (FSH) and leutinizing hormone (LH). Similarly, adrenocorticotrophic hormone (ACTH) from pituitary stimulates adrenal cortex to secrete glucocorticoids, mineralocrticoids and androgens.3,4
The androgens with growth hormone induce rapid growth spurt, while it alone promotes growth of pubic and axillary hair, sebaceous glands and sebum production.
These androgens also result in scalp seborrhea and thinning of scalp hair.5 Ovarian development in females occurs under the action of FSH and LH. The ovary in turn secretes estrogens that results into increased pigmentation of facial skin. The net sum of these hormonal changes around the time of puberty is growth and development of sebaceous glands, increased sebum production, development of apocrine glands, growth of pubic and axillary hair, appearance of hair in male pattern, seborrhea, dandruff and thinning of scalp hair.6 Therefore, disorders pertaining to these glandular structures occur with increased frequency and severity at this stage of life.
These, combined with other dermatoses resulting from constitutional and exogenous factors such as eczema, folliculitis, bacterial and parasitic infections make these patients more vulnerable to psychological upset. Increased consciousness of youth of their body and beauty of face further aggravates their anxiety.7,8
6.2 Review of literature :
A study from Pakistan among 1350 female adolescent students found acne to be the commonest disorder followed by pigmentary disorders, dandruff hirsutis, etc.9
In study by Biswas et, al, among four hundred patients showed higher prevalence of acne in adolescent with a male, preponderance.10
A study from Mumbai shows the prevalence of infective dermatoses in the age group of 8-14 years was 80% while in 15-20 years aged groups it was found to be 35% only.11
In study conducted among pediatric patients in a teaching hospital of Western Nepal shows infections were the most commonly seen dermatoses followed by eczema and urticaria. Among the infectins bacterial infections were the commonest followed fungal, viral and parasitic infestation. Impetigo was predominant among the bacterial infections.12
Five hundred patients of age group 0-12 years were studied for different types of dermatoses, pyoderma, scabies and eczema were the most common dermatological conditions followed molluscum contagiosum, popular urticaria with insect bite, vitiligo etc.13
6.3 Objective of the study:
  • To study the clinical features of facial dermatoses among adolescents (10- 19 years) attending department of dermatology Venereology & Leprology
  • To study the epidemiological determinants of facial dermatoses among these patients

7 / Material and methods:
7.1 Source of data:
The cases presented in the this study will be those adolescent patients attending with features of facial dermatoses to Department of Dermatology, Venereology and Leprology, VIMS, Bellary.
7.2 Method of collection of data (including sampling procedure if any):-
  • Study design: Case series
  • Study setting: Department of Dermatology Venereology and Leprology, VIMS, Bellary, Karnataka
  • Study period: Jan 2013 to Dec 2013
  • Study subjects: adolescent patients attending Department of Dermatology Venereology and Leprology with features of facial dermatoses
  • Sample size: is based on number of patients attending department during study period
  • Sampling technique: Non probability purposive sampling
  • Data collection: after informed written consent. A detailed clinical history including onset and evoluation of lesion, socio economic factors and environment in which the patient is living will be noted
A thorough clinical examination and relevant laboratory investigations if needed will be done. The data thus collected will be entered in to a specially designed Case Record Form and subjected to statistical analysis like proportion, Chi-square test and independent‘t’ test.
Inclusion criteria :
All adolescent patients presenting with symptoms of facial dermatoses including leprosy.
Exclusion criteria:
  • Not willing to participate
  • Drug reactions
  • Non genital STIs affecting face
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
No animal interventions required.
Investigations required:
-Routine investigations
-Complete haemogram,
-Absolute eosinophil count,
-KOH mount
-Gram stain
-Bacterial/fungal culture
-Blood urea, Serum Creatinine, RBS
-Urine albumin, sugar, microscopy,
-HIV, HBsAg
Special investigation if necessary
  • Biopsy done wherever it is unavoidable
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes
8 / REFERENCES:
  1. World Health Organization, SEAR office accessed on 16/09/2012
  1. Abolfotouh MA, Bahamadan K. Skin diseases among blind and deaf male students in southwestern Saudi Arabia. Annals of Saudi medicine 2000;20:161-9.
  1. Vikas. B. Extent and pattern of infective dermatoses in rural areas of Central India. Indian J Dermatol Venerol Leprol 1997;63: 22-25.
  1. Bhansali KM, Mathur GM, Sharma RA. Study of morbidity pattern in children (Udaipur). Indian J Dermatol Venerol, Leprol 1979; 46: 13-17.
  1. De Groot, L, Jameson JL, eds. Endocrinology, 4th edition, London: WB Saunders 2000;954-958.
  1. Wilson JD, Foster DW, Kronenberg HM, Larsen PR. William’s Textbook of Endocrinology, 9th edition. London; WB Saunders 1998; 1509-1625.
  1. Ebling, FJG, Hale PA, Randall VA. Hormones and hair growth, In: Goldsmith L, ed. Biochemistry and Physiology of the Skin, 2nd edn. New York: Oxford University Press 1991; 299-306.
  2. About endocrine physiology and disorders. Web page available at Accessed on 23.09.2012.

  1. Bajaj D.R. Devrajani B.R., Ghouri R.A, Matlani B.L. Pattern of skin disorders among adolescent female students at Hyderabad, Sindh J. Pak Assoc. of Dermatol 2009; 19: 79-85.
  1. Biswas S, Mondal K.K, Saha I, Cliinco-epidemiological Features of Acne Vulgaris; A Tertiary Hospital – Based Study. Iranian Journal of Dermatology 2010; 13: 37-41.
  1. Mukherjee K, Quazi S.Z. Gaidhane A. Study of Infective Dermatoses among Street Children and Adolescents in Mumbai. Indian Journal of Community Medicine 2006; 31:100.
  1. Neupane S, Pandey. Spectrum of Dermatoses among Paediatric Patients in a Teaching Hospital of Western Nepal. Ind J Dermatol 2012;1:199-203.
  1. Sadhan K. Ghosh, Dilip K. Saha and Alok K. Roy A. Clinico – etiological Study of Dermatoses in Paediatric Age Group. Ind J Dermatol 1995;40(1):29-30.

9 / Signature of candidate
10 / Remarks of the guide / Recommended and forwarded
11 / Name & Designation of
(in block letter)
11.1 Guide / DR. VEERESH
PROFESSOR
DEPARTMENT OF DERMATOLOGY,
VENOROLOGY AND LEPROLOGY
VIMS, BELLARY.
11.2 Signature
11.3 Co-Guide (if any)
11.4 Signature
11.5 Head of Department / DR. KARJIGI SIDDALINGAPPA,
PROFESSOR AND HEAD OF THE DEPARTMENT,
DEPARTMENT OF DERMATOLOGY,
VENOROLOGY AND LEPROLOGY,
VIMS, BELLARY.
11.6 Signature
12 / Remarks of the
Chairman & Principal
12.2 Signature