Sudanese Journal of Dermatology

Detection of Helicobacter pylori Reactive IgA and IgG Antibodies Using Enzyme Linked Immunsorbent Assay (ELISA)

A Bolad

Background: Helicobacter pylori (H. pylori) infection is usually acquired
during the early years of life and persists for several years. Recent investigations pointed to a potential role of H. pylori infection of the upper gastrointestinal tract as a possible causative agent in chronic urticaria (CU).
Objectives: This study is aiming at evaluating the relationship between H. pylori and chronic urticaria in Sudanese patients.
Methods and patients: Fifty patients with idiopathic CU, twenty five of
other skin disorder and ten healthy controls were enrolled estimated for serum H.pylori Immunoglobulin G (IgG) and A (IgA) antibodies levels using Enzyme Linked Immunsorbent Assay (ELISA). All the results were analyzed using the Microsoft Office Excel (Microsoft Office Excel for windows; 2003) and SPSS (SPSS for windows 17).
Results and discussion: The IgG and IgA levels of control group were
significantly lower compared with both patients with chronic urticaria (P = 0.001 for IgG) (P = 0.001 for IgA) and patients with other skin disorders (P = 0.011 for IgG) (P = 0.006 for IgA). Receiver Operating Characteristic curve (ROC curve) analysis revealed that the area under ROC curves of IgA is higher compared to IgG (0.80 0Vs 0.890). In conclusion the current study revealed that patients with H. pylori infection have an increased tendency to develop urticaria. H. pylori reactive IgA antibodies correlate best with the infection.

Papular Urticaria - An early marker of Atopic March

T Jayakar

Background: Papular urticaria is a common and often annoying disorder
manifested by chronic or recurrent papules caused by a hypersensitivity reaction to the bites of mosquitoes, fleas, bedbugs, and other insects. Objective: To study the association of papular urticaria and atopy and its relevance with serum Ig E levels and ‘absolute eosinophil count’. Methods: Fifty consecutive papular urticaria patients were included in the study. History of atopy and features of cutaneous atopic disease complex was noted down. Serum Ig E and absolute eosinophil count was recommended in all patients. Results: Of included patients, 70% had history of atopy, of which 24% had personal history of atopy and 46% had family history of atopy. Only nine patients returned with Serum Ig E and absolute eosinophil count (AEC) results and all had elevated serum Ig E and AEC levels.

Conclusion: The history of atopy (both personal and family) should
be viewed seriously in all papular urticaria patients. This study reflects the atopic tendency in all papular urticaria patients and its early recognition and treatment will prevent the so called ‘atopic march’ in the child.

Bullous Lichen Planus in an Indian female

N Puri

Bullous lichen planus is a rare entity. We describe bullous lichen planus in an
Indian female who had itchy erythematous papular lesions with vesicles and
bullae predominantly over the dorsa of both legs. The patient was subjected
to histopathological examination after which the diagnosis was confirmed. The
patient was put on oral steroids and dapsone.

Addisons disease in an Indian female – A rarity

BK Brar

Addisons disease or primary adrenal insufficiency is a rare disease usually
caused by autoimmune destruction of adrenal gland cortex. Those with Addisons disease have a deficiency of cortisol and aldostreone. These deficiencies are accompanied by adrenal androgen depletion. A case report of 43 year old female is hereby reported. The patient presented with hyperpigmentation of nipples, genitals, lips, palate and face along with loss of weight since four years.