title: Therapeutic Response of Vitamin A, Vitamin B Complex, Essential Fatty Acids (EFA) and Vitamin E in the Treatment of Phrynoderma: A Randomized Controlled Study.
abstract: BACKGROUND
  In the treatment of phrynoderma, various nutrients have been tried in different dosages and routes with variable therapeutic outcomes.
  
  
  OBJECTIVE
  The present study was undertaken to compare the efficacy of various nutrients in the treatment of phrynoderma.
  
  
  METHODS
  An open label randomized controlled study was conducted in the out-patient department of Dermatology in a tertiary care hospital.
  
  
  METHODS
  The patients were divided into group of five and each patient received one of the five regimens [10 injections of Vitamin A 1 lakh units, intramuscularly (IM) on alternate day, 10 injections of Vitamin B complex, 2cc IM on alternate day, 2 table spoon of safflower oil, two times daily with meals, Tab Vitamin E 400mg once daily, and only topical keratolytic (salicylic acid 3% ointment) two times daily] respectively. The first four regimens also received topical keratolytic. The primary outcome measured was therapeutic response at the end of regimen. The response was graded based on the percentage of flattening and decrease in number of lesions. Less than 25% improvement was graded as poor, 26-50% improvement as moderate, 51-75% improvement as good, and more than 75% improvement as excellent response. In the statistical analysis, comparison was done using Chi-square and Fisher's exact test.
  
  
  RESULTS
  A total of 125 patients were included in the study with 25 patients each in five regimen groups. There were 79 (63.2%) males and 46 (36.8%) females with a ratio of 1.72:1. The age of the patients ranged from 3 to 26 years with mean of 10.1±4.3 years. Out of 125 patients, 105 completed the study. In regimen 1 and 2, significant number of patients showed good to excellent response whereas significant number of patients in remaining regimen showed moderate to poor response with a p value of <0.05. The therapeutic response to Vitamin A and Vitamin B complex therapy was significantly better than other regimens.
  
  
  CONCLUSIONS
  Intramuscular injections of Vitamin A or Vitamin B are effective in the treatment of phrynoderma. Addition of topical keratolytics helps in faster clearance of keratotic lesions.
authors.affiliation: Associate Professor, Department of Dermatology, Venereology and Leprosy, Sri Siddhartha Medical College Agalakote, Tumkur-572107, Karnataka, India .
authors.forename: Ragunatha
authors.initials: R
authors.lastname: S
authors.affiliation: Professor and Head, Department of Dermatology, Venereology and Leprosy, SS Institute of Medical Sciences , Davangere, Karnataka, India .
authors.forename: Jagannath
authors.initials: J
authors.lastname: Kumar V
authors.affiliation: Professor and Head, Department of Dermatology, Venereology and Leprosy, JJM Medical College , Davangere, Karnataka, India .
authors.forename: Murugesh
authors.initials: M
authors.lastname: S B
authors.affiliation: Professor and Head, Department of Dermatology, Venereology and Leprosy, Sri Siddhartha Medical College , Agalakote, Tumkur-572107, Karnataka, India .
authors.forename: Ramesh
authors.initials: R
authors.lastname: M
authors.affiliation: Associate Professor, Department of Dermatology, Venereology and Leprosy, Sri Siddhartha Medical College Agalakote, Tumkur-572107, Karnataka, India .
authors.forename: Narendra
authors.initials: N
authors.lastname: G
authors.affiliation: Resident, Department of Dermatology, Venereology and Leprosy, Sri Siddhartha Medical College Agalakote, Tumkur-572107, Karnataka, India .
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Kapoor
keywords: Essential fatty acids; Follicular hyperkeratosis; Nutritional deficiency disorders; Phrynoderma; Vitamin A; Vitamin B complex; Vitamin E ligament