Prevalence of scalp disorders among outpatients attending dermatology department in a semi-urban setup: a cross sectional observational study.
MATERIAL AND METHODS: The study was conducted at Department of Dermatology, Mahatma Gandhi Hospital, Sitapura, Jaipur. Scalp of first all patients attending the department over a fortnight were examined for any disease, disorder or abnormality. Demographic details including age, sex, residential background (urban/rural) and occupation were noted. Details of scalp examination and the presenting diagnosis were noted and a note was made whether the scalp condition, if present, was related to the presenting diagnosis or was entirely incidental. The findings were then analysed.
RESULTS: 602 patients were examined comprising of 280 males (46.5%) and 322 females (53.5%). 382(63.5%) attendees were from the urban background while 220(36.5%) from rural. The patients' age ranged from 7 months to 76 years. (Table 1).
Most of the patients were students (233, 38.7%). Rest of the patients comprised of teachers, retired servicemen and servicewomen, housewives, farmers, shopkeepers, self-employed, labourers, army servicemen and young children. (Table 2).
The complaints for which patients attended the outpatient department were variable. The dermatological diagnoses made on the patients are shown in Table 3.
109 patients (18.1%) had scalp involvement which was related to the signs and symptoms the patients presented with, while 181 patients (30%) had scalp findings unrelated to the presenting features and diagnoses. The incidental findings in scalp in the latter group included dandruff, male pattern alopecia, premature greying, matting of hair, hemangioma, cradle cap, sparse hair and woolly hair. (Table 4).
DISCUSSION: Scalp disorders, diseases and abnormalities are quite prevalent in general population, though many of these are not a cause of concern for the patients or parents. However, these features may be very helpful in diagnosing the patient's disorder, and moreover may need treatment.
Our study had slightly more females (53.5%) than males, with most patients from urban background (63.5%). Most outpatient attendees belonged to the age range 16-29 years. The above findings are most likely due to the location of our hospital in an institutional area, with many educational institutions in the surrounding. The hospital has easy access not only from adjacent Jaipur town area, but regular transport is available from surrounding villages too. Majority of the patients were students studying in the surrounding institutions. Housewives were the second largest group followed by farmers and labourers. The most common presenting diagnosis was acne, which is quite evident considering that adolescents formed the major group attending our department. Eczematous diseases formed the second major group with airborne contact dermatitis and photodermatitis being the most common conditions.
Dermatological diagnoses which were directly related to scalp included male/female pattern alopecia, eczema, pediculosis, psoriasis, bacterial infections, seborrheic capitis and telogen effluvium. However, examining scalp of 602 outpatient attendees revealed presence of scalp findings in an additional 181 patients forming 30% of the group. These findings included dandruff, male pattern alopecia, premature greying, matting of hair, hemangioma, cradle cap, sparse hair and woolly hair. These findings can not only help in getting to the dermatological diagnosis, but may need treatment as well. It is therefore imperative that scalp examination should be included as part of complete skin examination in all patients attending dermatology outpatients.
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Ram Gulati , Manisha Nijhawan , Savita Agarwal , Isha Gupta , Shilpa Soni , Vibhor Goyal , Pallavi Goyal , Dinesh Mathur 
[1.] Ram Gulati
[2.] Manisha Nijhawan
[3.] Savita Agarwal
[4.] Isha Gupta
[5.] Shilpa Soni
[6.] Vibhor Goyal
[7.] Pallavi Goyal
[8.] Dinesh Mathur
PARTICULARS OF CONTRIBUTORS:
[1.] Assistant Professor, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[2.] Professor, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[3.] Senior Resident, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[4.] Senior Resident, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
FINANCIAL OR OTHER COMPETING INTERESTS: None
[5.] Resident Doctor, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[6.] Resident Doctor, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[7.] Resident Doctor, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
[8.] Professor & HOD, Department of DVL, Mahatma Gandhi Hospital, RIICO Institutional Area, Jaipur.
NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Ram Gulati, Flat B-1, 367, Adarsh Nagar, Jaipur-302004, Rajasthan.
Date of Submission: 07/04/2015.
Date of Peer Review: 08/04/2015.
Date of Acceptance: 01/05/2015.
Date of Publishing: 08/05/2015.
Table 1: Age distribution of the patients Age range (years) Number (n = 602) Percentage Less than or equal to 15 71 11.8% 16-29 280 46.5% 30-44 113 18.8% 45-59 77 12.8% More than or equal to 60 61 10.1% Table 2: Occupation of patients Occupation Number (n = 602) Percentage Students 233 38.7% Housewives 131 21.8% Farmers 88 14.6% Labourers 33 5.5% Teachers 25 4.1% Self employed 23 3.8% Shopkeepers/assistants 22 3.7% Young children (< 5 yrs) 22 3.7% Retired servicemen/women 20 3.3% Army servicemen 5 0.8% Table 3: Dermatological diagnoses of patients attending the OPD Diagnosis Number (n = 602) Percentage Acne 128 21.3% Eczematous disorders 122 20.3% Male/female pattern alopecia 54 9% Scabies/pediculosis 41 6.8% Urticaria 39 6.5% Papulosquamous disorders 37 6.1% Superficial fungal infections 28 4.6% Viral infections 23 3.8% Disorders of hyperpigmentation 22 3.6% Bacterial infections 22 3.6% Seborrheic capitis 16 2.7% Vitiligo 12 2% Plantar keratoderma/callosity 11 1.8% Steroid induced facial 11 1.8% telangiectasiae Immunobullous disorders 10 1.6% Telogen effluvium 6 1% Miscellaneous 20 3.2% Table 4: incidental scalp findings in patients attending OPD for other reasons Incidental Scalp findings Number (n=181) Dandruff 96 Male pattern alopecia 33 Premature greying 27 Sparse hair 15 Cradle cap 7 Matting of hair 1 Hemangioma 1 Woolly hair 1
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|Title Annotation:||ORIGINAL ARTICLE|
|Author:||Gulati, Ram; Nijhawan, Manisha; Agarwal, Savita; Gupta, Isha; Soni, Shilpa; Goyal, Vibhor; Goyal, Pa|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Date:||May 11, 2015|
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