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Narang T, Kamat D, Thakur V, Lavania M, Singh I, Ahuja M, Dogra S. Equal rates of drug resistance in leprosy cases with relapse and recurrent /chronic type 2 reaction; Time to revise the guidelines for drug resistance testing in leprosy. Clin Exp Dermatol 2021; 47:297-302. [PMID: 34382256 DOI: 10.1111/ced.14884] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leprosy relapse/recurrence is a serious concern especially in a leprosy endemic nation like India. It is believed that bacilli persisting even after multi-drug therapy could cause relapse; recently however drug resistance as a cause for recurrences and chronic erythema nodosum leprosum (ENL) has been speculated. Our objective was to study drug resistance patterns in cases of leprosy relapse and chronic/recurrent ENL's. METHODOLOGY This cross-sectional study conducted over a period of 1 year included patients diagnosed as leprosy relapse and those with chronic/recurrent (c/r) ENL. Skin biopsy specimens were subjected to conventional PCR for resistance testing for rifampicin, dapsone and ofloxacin, targeting rpoB, folP and gyrA gene of M.leprae respectively. RESULTS A total of 61 patients (25 smear negative) were included in the study. Of these, 37 were diagnosed as leprosy relapse and 24 had c/r ENL. Drug resistance to at least one drug was identified in 10 (16.4%) cases. Rates of drug resistance were 5.4% (2/37) for dapsone, 10.8% (4/37) for rifampicin and 2.7% (1/37) for ofloxacin amongst cases of relapse where as it was 12.5% (3/24) and 8.3% (2/24) for dapsone and rifampicin respectively amongst those with c/rENL.. Multi drug resistance was seen in 3.3% (2/61) patients. CONCLUSION Drug resistance rate amongst those with c/rENL was almost equaled that of relapse. Smear negative leprosy relapse cases also had resistance to bactericidal drugs. These findings call for modifications in criteria for testing under leprosy drug resistance surveillance and all cases of relapse and those with recalcitrant c/rENL should be tested.
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Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - D Kamat
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - V Thakur
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - M Lavania
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - I Singh
- Department of Molecular Biology, Stanley Browne Laboratory, TLM Community Hospital, New Delhi, India
| | - M Ahuja
- Department of Molecular Biology, Stanley Browne Laboratory, TLM Community Hospital, New Delhi, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Narang T, Ashraf R, Kaushik A, Dogra S. Apremilast in multibacillary leprosy patients with chronic and recurrent erythema nodosum leprosum: a prospective single-centre pilot study. J Eur Acad Dermatol Venereol 2021; 35:e917-e919. [PMID: 34365679 DOI: 10.1111/jdv.17585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/29/2021] [Indexed: 01/23/2023]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Ashraf
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kaushik
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Samanta J, Naidu G, Chattopadhyay A, Basnet A, Narang T, Dogra S, Sharma A. AB0545 COMPARISON BETWEEN METHOTREXATE AND APREMILAST IN PSORIATIC ARTHRITIS-A SINGLE BLINDED RANDOMIZED CONTROLLED TRIAL (APREMEPsA STUDY). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Both methotrexate and apremilast were found to be effective in controlling joint disease in psoriatic arthritis (PsA) patients [1-4]. However, there are no head-to-head trials comparing the efficacy of these two drugs in PsA.Objectives:Primary outcome measure was rate of major cDAPSA response (>85% change in cDAPSA score from baseline) at week 24 and secondary outcome measures were ACR 20 response, change in Psoriasis Area and Severity Index (PASI), Maastricht enthesitis score, Leeds dactylitis index, and health assessment questionnaire-disability index (HAQ-DI) and number of adverse events at week 24 between methotrexate and apremilast groups.Methods:Single blinded (physician), parallel group, randomized controlled trial was conducted at a single centre in India between October 2019 and December 2020. Adult PsA patients (age>18 years), fulfilling CASPAR criteria, not receiving methotrexate/apremilast in last 3 months and never receiving bDMARDs or, JAK inhibitors, having active articular disease (one or more swollen joint or, having one or more tender entheseal point) were recruited in this study.Results:A total of 31 patients were recruited (15 in apremilast arm and 16 in methotrexate arm) amongst whom 26 patients completed 24 weeks follow up (13 patients in apremilast arm and 13 patients in methotrexate arm). At baseline, median (IQR) swollen joints were 2 (1) in apremilast group and 2.5 (4) in methotrexate group. Median cDAPSA score at baseline was 23 (9) in apremilast group and 20 (21) in methotrexate group. Major cDAPSA response at week 24 was achieved in three (20%) subjects in apremilast arm and six (37.5%) subjects in methotrexate arm (p=0.433). Seven (46.67%) subjects in apremilast group and nine (56.25%) subjects in methotrexate group achieved ACR 20 response at 24-weeks (p=0.724). The change of PASI score from baseline was significant in apremilast group (2.0, p=0.003) and methotrexate group (0.35, p=0.003), but when compared between the two groups, there was no significant difference(p=0.378). Change in enthesitis score was not significant in both the groups (0.0 in apremilast group, p=0.285; 0.0 in methotrexate group, p=1.0). The median change in dactylitis score [0.0 (9.1), p=0.028] and HAQ-DI score (0.33, p=0.01) were significant in methotrexate group only. However, when compared to the change in apremilast group, the difference was not significant for both the parameters. A total of 9 minor adverse events, 3 with apremilast and 6 with methotrexate, were observed with transaminitis (number of events) being the commonest event noted with methotrexate. There were no serious adverse events noted in either of the groups.Conclusion:There was no significant difference between methotrexate and apremilast in terms of efficacy as measured by cDAPSA and ACR20 responses. Both the drugs were well tolerated by the study population. A larger study with head-to-head comparison between methotrexate and apremilast is needed to conform these findings.References:[1]Baranauskaite A, Raffayová H, Kungurov NV, et al; RESPOND investigators. Infliximab plus methotrexate is superior to methotrexate alone in the treatment of psoriatic arthritis in methotrexate-naive patients: the RESPOND study Ann Rheum Dis. 2012;71:541-8.[2]Mease PJ, Gladman DD, Collier DH, et al. Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase III Trial. Arthritis Rheumatol 2019;71:1112-24.[3]Gladman DD, Kavanaugh A, Gómez-Reino JJ, et al. Therapeutic benefit of apremilast on enthesitis and dactylitis in patients with psoriatic arthritis: a pooled analysis of the PALACE 1-3 studies. RMD Open. 2018;4(1):e000669.[4]Wells AF, Edwards CJ, Kivitz AJ, et al. Apremilast monotherapy in DMARD-naive psoriatic arthritis patients: results of the randomized, placebo-controlled PALACE 4 trial. Rheumatology (Oxford) 2018;57:1253-63.Disclosure of Interests:None declared.
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Kumar S, Vinay K, Parsad D, Bishnoi A, Narang T, Muthu S, Dogra S. Comparison of recipient‐site preparation by electrofulguration‐assisted manual dermabrasion versus conventional manual dermabrasion in non‐cultured epidermal cell suspension procedure for stable vitiligo: an open‐label comparison study. J Eur Acad Dermatol Venereol 2020; 34:e337-e339. [DOI: 10.1111/jdv.16313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Kumar
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - K. Vinay
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - D. Parsad
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - A. Bishnoi
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - T. Narang
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - S.K. Muthu
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - S. Dogra
- Department of Dermatology, Venereology and Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
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Elmamoun M, Eraso M, Anderson M, Maharaj A, Coates L, Chandran V, Abogamal A, Adebajo AO, Ajibade A, Ayanlowo O, Azevedo V, Bautista-Molano W, Carneiro S, Goldenstein-Schainberg C, Hernandez-Velasco F, Ima-Edomwonyi U, Lima A, Medina-Rosas J, Mody GM, Narang T, Ortega-Loayza AG, Ranza R, Sharma A, Toloza S, Vega-Espinoza L, Vega-Hinojosa O. International league of associations for rheumatology recommendations for the management of psoriatic arthritis in resource-poor settings. Clin Rheumatol 2020; 39:1839-1850. [PMID: 31950441 PMCID: PMC7237392 DOI: 10.1007/s10067-020-04934-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/26/2019] [Accepted: 01/06/2020] [Indexed: 01/17/2023]
Abstract
Background Psoriatic arthritis (PsA) is a challenging heterogeneous disease. The European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and PsA (GRAPPA) last published their respective recommendations for the management of PsA in 2015. However, these guidelines are primarily based on studies conducted in resource replete countries and may not be applicable in countries in the Americas (except Canada and USA) and Africa. We sought to adapt the existing recommendations for these regions under the auspices of the International League of Associations for Rheumatology (ILAR). Process The ADAPTE Collaboration (2009) process for guideline adaptation was followed to adapt the EULAR and GRAPPA PsA treatment recommendations for the Americas and Africa. The process was conducted in three recommended phases: set-up phase; adaptation phase (defining health questions, assessing source recommendations, drafting report), and finalization phase (external review, aftercare planning, and final production). Result ILAR recommendations have been derived principally by adapting the GRAPPA recommendations, additionally, EULAR recommendations where appropriate and supplemented by expert opinion and literature from these regions. A paucity of data relevant to resource-poor settings was found in PsA management literature. Conclusion The ILAR Treatment Recommendations for PsA intends to serve as reference for the management of PsA in the Americas and Africa. This paper illustrates the experience of an international working group in adapting existing recommendations to a resource-poor setting. It highlights the need to conduct research on the management of PsA in these regions as data are currently lacking.Key Points • The paper presents adapted recommendations for the management of psoriatic arthritis in resource-poor settings. • The ADAPTE process was used to adapt existing GRAPPA and EULAR recommendations by collaboration with practicing clinicians from the Americas and Africa. • The evidence from resource-poor settings to answer clinically relevant questions was scant or non-existent; hence, a research agenda is proposed. |
Electronic supplementary material The online version of this article (10.1007/s10067-020-04934-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Elmamoun
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - M Eraso
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - M Anderson
- Library and Information Services, University Health Network, Toronto, Canada
| | - A Maharaj
- Prince Mshiyeni Memorial Hospital, Durban, South Africa
| | - L Coates
- University of Oxford, Oxford, UK
| | - Vinod Chandran
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada. .,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Canada. .,Institute of Medical Science, University of Toronto, Toronto, Canada. .,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada. .,Department of Medicine, Memorial University, St. John's, Canada.
| | | | - A Abogamal
- Al-Azhar Faculty of Medicine Cairo, Nasr City, Egypt
| | - A O Adebajo
- University of Sheffield UK, Western Bank, Sheffield, S10 2TN, UK
| | - A Ajibade
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria
| | - O Ayanlowo
- College of Medicine, University of Lagos/Lagos University Teaching Hospital Nigeria, Ishaga Rd, Idi-Araba, Lagos, Nigeria
| | - V Azevedo
- Federal University of Parana, Curitiba, PR, Brazil
| | - W Bautista-Molano
- University Hospital Fundación Santa Fe de Bogotá and School of Medicine Universidad Militar Nueva Granada, Bogota, Colombia
| | - S Carneiro
- State University of Rio de Janeiro and Federal University of Rio de Janeiro, Av. Pedro Calmon, 550 - Cidade Universitária da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-901, Brazil
| | - C Goldenstein-Schainberg
- Disciplina de Reumatologia, LIM-17, Hospital das Clinicas HCFMUSP, Faculty of Medicine - University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - U Ima-Edomwonyi
- College of Medicine, University of Lagos/Lagos University Teaching Hospital Nigeria, Ishaga Rd, Idi-Araba, Lagos, Nigeria
| | - A Lima
- Regional University of Blumenau (FURB), Blumenau, SC, Brazil
| | - J Medina-Rosas
- Posthumous, University of Valle, University of La Sabana, Imbanaco Medical Center, Cali, Colombia
| | - G M Mody
- University of KwaZulu-Natal, Durban, South Africa
| | - T Narang
- Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - A G Ortega-Loayza
- Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd, Portland, USA
| | - R Ranza
- Rheumatology Unit, Federal University of Uberlandia, Uberlândia, MG, Brazil
| | - A Sharma
- Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - S Toloza
- Ministry of Health, Catamarca, Catamarca, Argentina
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Narang T, Kaushik A, Dogra S. Apremilast in chronic recalcitrant erythema nodosum leprosum: a report of two cases. Br J Dermatol 2019; 182:1034-1037. [DOI: 10.1111/bjd.18233] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2019] [Indexed: 01/21/2023]
Affiliation(s)
- T. Narang
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - A. Kaushik
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - S. Dogra
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
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Affiliation(s)
- A Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - D Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Vinay K, Kamat D, Chatterjee D, Narang T, Dogra S. Dermatoscopy in leprosy and its correlation with clinical spectrum and histopathology: a prospective observational study. J Eur Acad Dermatol Venereol 2019; 33:1947-1951. [DOI: 10.1111/jdv.15635] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Affiliation(s)
- K. Vinay
- Department of Dermatology, Venereology, Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - D. Kamat
- Department of Dermatology, Venereology, Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - D. Chatterjee
- Department of Histopathology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - T. Narang
- Department of Dermatology, Venereology, Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - S. Dogra
- Department of Dermatology, Venereology, Leprology Post Graduate Institute of Medical Education and Research Chandigarh India
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Narang T, Bishnoi A, Dogra S, Singh TD, Mahajan R, Kavita K. Disease burden and prescription patterns treating dermatophytosis in North India: salient findings from an online survey of 1041 dermatologists. J Eur Acad Dermatol Venereol 2019; 33:e391-e393. [PMID: 31102538 DOI: 10.1111/jdv.15686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T D Singh
- Department of Preventive Medicine, School of Public Health, PGIMER, Chandigarh, India
| | - R Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Kavita
- College of Nursing, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Vinay K, Kaushik A, Narang T, Dogra S. Ichthyosiform sarcoidosis: a mimic of leprosy? Reply from authors. Clin Exp Dermatol 2019; 44:589-590. [PMID: 30903704 DOI: 10.1111/ced.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Affiliation(s)
- K Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dabas G, Sharma K, Narang T, Sharma M, Chatterjee D, Dogra S, Sharma A, Radotra BD, Handa S. Cutaneous mycobacterial co-infection in a patient with systemic lupus erythematosus. Clin Exp Dermatol 2019; 44:797-800. [PMID: 30614035 DOI: 10.1111/ced.13884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- G Dabas
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India
| | - K Sharma
- Department of Medical Microbiology, PGIMER, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India
| | - M Sharma
- Department of Medical Microbiology, PGIMER, Chandigarh, India
| | - D Chatterjee
- Department of Histopathology, PGIMER, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India
| | - A Sharma
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - B D Radotra
- Department of Histopathology, PGIMER, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India
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Kaushik A, Vinay K, Narang T, Saikia UN, Modi M, Prakash M, Dogra S. Ichthyosiform sarcoidosis: a mimic of leprosy? Clin Exp Dermatol 2018; 44:677-680. [DOI: 10.1111/ced.13863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 01/07/2023]
Affiliation(s)
- A. Kaushik
- Department of Dermatology, Venereology and LeprologyPGIMERChandigarh India
| | - K. Vinay
- Department of Dermatology, Venereology and LeprologyPGIMERChandigarh India
| | - T. Narang
- Department of Dermatology, Venereology and LeprologyPGIMERChandigarh India
| | - U. N. Saikia
- Department of Histopathology PGIMER Chandigarh India
| | - M. Modi
- Department of Neurology PGIMER Chandigarh India
| | - M. Prakash
- Department of Radiodiagnosis PGIMER Chandigarh India
| | - S. Dogra
- Department of Dermatology, Venereology and LeprologyPGIMERChandigarh India
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Dabas G, Dogra S, Kaushik A, Narang T, Aggarwal D, Kumaran MS, Radotra BD. Image Gallery: Multiple cutaneous and oral nodules in histoid leprosy. Br J Dermatol 2018; 179:e227. [PMID: 30508228 DOI: 10.1111/bjd.17030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- G Dabas
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - A Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - D Aggarwal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - M S Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - B D Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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Narang T, Singh S. Response to: Midface toddler excoriation syndrome (MiTES) can be caused by autosomal recessive biallelic mutations in a gene for congenital insensitivity to pain, PRDM12. Br J Dermatol 2018; 180:431. [PMID: 30339713 DOI: 10.1111/bjd.17338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Chandigarh, 160012, India
| | - S Singh
- Department of Psychiatry Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Affiliation(s)
- S. Dogra
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research (PGIMER); Sector 12 Chandigarh 160012 India
| | - A. Bishnoi
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research (PGIMER); Sector 12 Chandigarh 160012 India
| | - T. Narang
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research (PGIMER); Sector 12 Chandigarh 160012 India
| | - S. Handa
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research (PGIMER); Sector 12 Chandigarh 160012 India
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Narang T, Kumar S, Handa S, Dogra S. Hydroxyurea and acitretin as a novel combination therapy in severe plaque psoriasis. Br J Dermatol 2018; 179:1212-1213. [PMID: 29927478 DOI: 10.1111/bjd.16899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - S Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
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Bishnoi A, Narang T, Handa S. Response to: bullous pemphigoid inguinalis? J Eur Acad Dermatol Venereol 2017; 32:e197-e198. [PMID: 29178331 DOI: 10.1111/jdv.14709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- A Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Chauhan P, De D, Handa S, Narang T, Saikia UN. A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus. Dermatol Ther 2017; 31. [DOI: 10.1111/dth.12563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/22/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Affiliation(s)
- P. Chauhan
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - D. De
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - S. Handa
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - T. Narang
- Department of Dermatology, Venereology and Leprology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - U. N. Saikia
- Department of Histopathology; Postgraduate Institute of Medical Education and Research; Chandigarh India
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Bishnoi A, Narang T, Handa S, Vishwajeet V, Saikia UN, Kapoor R, Mavuduru RS. Paraneoplastic bullous pemphigoid associated with penile squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 32:e140-e141. [PMID: 29024082 DOI: 10.1111/jdv.14635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - V Vishwajeet
- Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - U N Saikia
- Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R Kapoor
- Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R S Mavuduru
- Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Affiliation(s)
- K Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - U N Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Khullar G, De D, Narang T, Saikia UN, Saikia B, Handa S. Pigmented macular variant of chronic cutaneous lupus erythematosus: an under-recognized subset in dark skin. Clin Exp Dermatol 2017; 42:793-795. [PMID: 28590034 DOI: 10.1111/ced.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 11/27/2022]
Affiliation(s)
- G Khullar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - B Saikia
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Affiliation(s)
- K Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - U N Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Chhabra S, Narang T, Joshi N, Goel S, Sawatkar G, Saikia B, Dogra S, Bansal F, Minz R. Circulating T-helper 17 cells and associated cytokines in psoriasis. Clin Exp Dermatol 2016; 41:806-10. [PMID: 27480070 DOI: 10.1111/ced.12845] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recently, a new population of IL-17-producing CD4 T helper (Th) cells, named Th17, was identified and shown to be involved in various inflammatory and autoimmune diseases, including psoriasis. AIM To determine the frequency of Th17 cells and related cytokines in peripheral blood of patients with psoriasis, and to analyse their association with disease severity. METHODS This was a prospective study comprising 34 patients with psoriasis and 24 healthy controls. Clinicoepidemiological details of patients were recorded, and severity of psoriasis was assessed by means of the Psoriasis Area and Severity Index. Circulating Th1 and Th17 cells in untreated patients with psoriasis and healthy controls were quantified by flow cytometry. In sera collected from patients with psoriasis and healthy controls, concentrations of IL-17A and IL-23 were examined by ELISA. RESULTS Increased frequencies of CD4+ IL-17A+ T cells were seen in peripheral blood of patients with psoriasis vulgaris (P < 0.001). Although serum IL-17A and IL-23 concentrations were higher in patients with psoriasis than in controls, the results did not reach statistical significance. We could not find any correlation between the studied T cells or related cytokines and the disease severity. CONCLUSION Increased serum levels of circulating Th17 cells and related cytokines may contribute to the cutaneous pathology of psoriasis, as well as the inflammatory process that is a hallmark of psoriasis.
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Affiliation(s)
- S Chhabra
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Joshi
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Goel
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - G Sawatkar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B Saikia
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - F Bansal
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Minz
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Kaur M, Narang T, Bala M, Gupte S, Aggarwal P, Manhas A. Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tertiary Care Hospital, Punjab. Indian J Med Microbiol 2013; 31:270-4. [DOI: 10.4103/0255-0857.115636] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Genital elephantiasis is a disease that is characterized by massive enlargement of the genitalia. Early aetiological diagnosis is of paramount importance so that development of genital elephantiasis can be prevented; otherwise it is not completely reversible with medical therapy and often requires surgical intervention. Chronic mental distress and disability can result as it interferes with daily/routine activities of the affected individual. Over time, the infectious causes of genital elephantiasis have evolved, from syphilis in the pre-penicillin era to donovanosis, lymphogranuloma venereum and recently filariasis, tuberculosis, leishmaniasis, HIV and chromoblastomycosis. With a declining prevalence globally, donovanosis is at risk of being forgotten as a cause of genital swelling; however, it is known to persist for years without treatment and can lead to complications such as lymphoedema and genital mutilation. We herein present a case of genital elephantiasis that was eventually diagnosed as being due to donovanosis.
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Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Sciences and Research Chandigarh, Chandigarh, India
| | - A J Kanwar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Sciences and Research Chandigarh, Chandigarh, India
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Narang T, Dogra S, Kanwar AJ, Radotra BD. Disfiguring ulcerated plaques. Clin Exp Dermatol 2008; 33:805-7. [PMID: 18954422 DOI: 10.1111/j.1365-2230.2007.02658.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Bhatnagar A, Kanwar AJ, Parsad D, Narang T, De D. Confetti-like hypopigmentation: a rare complication of common phototherapeutic modality. J Eur Acad Dermatol Venereol 2007; 21:1276-7. [PMID: 17894733 DOI: 10.1111/j.1468-3083.2007.02170.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- T Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
BACKGROUND Mondor's disease of penis is an uncommon genital condition involving the penile sulcus in a circumferential manner. Although this disorder is almost always self limited, it is associated with considerable psychological stress and sexual disharmony. METHODS All patients attending the sexually transmitted disease clinic during 1991-2003 were examined for evidence of Mondor's disease of penis. Detailed history and clinical findings were recorded in a specially designed proforma. Histopathological examination and staining with CD31 and CD34 monoclonal antibodies was also done in 11 patients. RESULTS 18 out of 1296 patients attending the sexually transmitted diseases (STD) clinic during the study period were found to have penile Mondor's disease, giving an incidence of 1.39%. 17 patients had history of one or more episodes of STDs. Histopathological specimens showed prominent vessels with plump endothelial cells and thickened blood vessel walls. The occasional vessel showed complete occlusion of its lumen. CONCLUSIONS In our study we did not find any evidence of lymphatic involvement. Non-lymphatic vessels, mainly veins, were predominantly involved. In our opinion Mondor's phlebitis of penis or Mondor's disease of penis are better terms to describe the condition rather than non-venereal sclerosing lymphangitis.
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Affiliation(s)
- B Kumar
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh-160 012, India.
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