Study Of Matrix Metalloproteinase 9 And Histopathology In Sinonasal Diseases Before And After Endoscopic Surgery

Abstract

Background Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease characterized by intense pruritus. To aid the diagnosis of AD, various criteria are available among which Hanifin and Rajka’s criteria is the most commonly used in the hospital set-up by clinicians. Hanifin and Rajka’s criteria consist of 4 major and 23 minor criteria. Three criteria from each category are required in making a diagnosis of AD. The frequency of minor criteria may vary population-wise. Objective To estimate the frequency of minor diagnostic criteria of Hanifin and Rajka in children with atopic dermatitis. Methodology It is a hospital based cross-sectional study. A total of 174 patients with atopic dermatitis aged ≤16 years, irrespective of gender, were enrolled for the study. Detailed history with respect to the present age, age of onset of disease, pruritus, chronicity of the disease, personal and/or family history of atopy, tendency toward cutaneous infections and nonspecific hand/foot dermatitis, recurrent conjunctivitis, itch when sweating, intolerance to wool and lipid solvents, food hypersensitivity, influence of environmental and/or emotional factors on course of disease was recorded from the parents. Clinical and ophthalmological iv examination were done and findings were recorded. Blood test to assess serum IgE level was conducted at laboratory. Results The most common minor criteria observed in our study were Dennie-Morgan infraorbital fold (71.8%), early age of onset (67.8%), palmar hyperlinearity (67.8%), xerosis (67.2%), p.alba (57.5%) and perifollicular accentuation (47.7%). Out of 143 cases whose serum was tested for IgE level, elevation was seen in 92. History of winter exacerbation was seen in 8% of the cases while summer exacerbation was seen in none. On ophthalmological examination of 111 cases, ‘high reading with no obvious keratoconus’ was present in 2 cases while 3 cases were labelled as ‘keratoconus suspect’. Anterior subcapsular cataract was not noted in any of the study subjects. Criteria such as nipple eczema, recurrent conjunctivitis, food hypersensitivity and white dermographism were not observed in any of the patients. Conclusion Clinical features of AD may be variable. Prevalence of AD varies country-wise and within a country, region-wise. The prevalence and severity of AD are influenced by several factors like ethnic/racial factors, environmental factors, dietary habits, etc. Therefore it is relevant for the dermatologists to have a knowledge regarding common clinical features of AD in a given population to diagnose the condition and thereby provide treatment to reduce the morbidity along with appropriate counselling. Keywords: Atopic