bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of ELISA BP180 and BP230 Autoantibodies in Blister Fluid and Serum in the Diagnosis of Bullous Pemphigoid
Authors: Nagarajan Harish , Mahadevan Krishnaswamy , Rai Reena , Boppe Appalaraju
Published: May 2024

Bullous pemphigoid (BP) is a chronic subepidermal immunobullous disorder. Studies have demonstrated the presence of antibasement membrane zone antibodies (BP180 & BP230) in the blister fluid using enzyme-linked immunosorbent assay (ELISA). To detect and compare BP 180 and BP 230 autoantibodies in the blister fluid and serum of patients with BP by ELISA method. A total of 30 patients diagnosed as BP and not on treatment were included in the study. Blister fluid and serum were subjected to ELISA, and the results were compared. The sensitivity of ELISA BP 180 was found to be 95.8% in the blister fluid and 88.4% in the serum. The sensitivity of ELISA BP 230 in the blister fluid and serum was 20% and 16.6%, respectively. Association between ELISA antibodies done in blister and serum was analysed using Chi-square test and found to be statistically significant with P value <0.05. Blister fluid is an effective alternative to the serum in detecting BP 180 and BP 230 antibodies, especially in uncooperative and elderly patients with poor venous access.
Childhood Cutaneous Mastocytosis
Authors: Swarnkar Bhavya , Sarkar Rashmi
Published: May 2024

Cutaneous mastocytosis is a neoplasm characterized by the proliferation and accumulation of mast cells in the skin. There can be involvement of other organ systems as well. Cutaneous manifestations can vary from mastocytoma to maculopapular lesions to diffuse cutaneous form. There can be symptoms associated with mast cell mediators release like itching, flushing, hypotension, diarrhoea, abdominal pain, and anaphylaxis. Hence, the mainstay of treatment is avoidance of triggers causing these mediators to release, anti-histamines, topical/intra-lesional/systemic steroids, mast cell-targeted therapy, epinephrine, and omalizumab depending upon the severity of symptoms/signs. Childhood cases usually have a good prognosis except in a few cases, especially those with systemic involvement. Such situations might warrant cytoreductive therapy, polychemotherapy, or autologous stem cell transplantation. Here, we intend to review the English literature on childhood cutaneous mastocytosis.
A Study of miRNA 223 Expression and its Correlation with Disease Severity in Chronic Plaque Psoriasis
Authors: Bantwal Priya B. , Shetty Shilpa S. , Girisha Banavasi Shanmukha , Noronha Tonita M.
Published: May 2024

Background:

Psoriasis is a chronic immune-mediated inflammatory disease affecting the skin and/or joints. MicroRNAs (miRNA) are single-stranded non-coding RNA molecules that bind to messenger RNA (mRNA) and regulate gene expression. Studies on peripheral blood mononuclear cells (PBMCs) in psoriatic patients showed an upregulation of miRNA 223.

Aims and Objectives:

a) To estimate and compare the expression of miRNA 223 in cases of chronic plaque psoriasis and controls. b) To correlate the expression of miRNA 223 with the severity of chronic plaque psoriasis.

Materials and Methods:

This study included 80 subjects (40 with psoriasis and 40 with age- and sex-matched healthy controls) attending the dermatology OPD of a tertiary care hospital from January 2018 to June 2019. A detailed history, determination of Psoriasis Area Severity Index (PASI) score and estimation of miRNA 223 by quantitative real-time polymerase chain reaction (qRT-PCR), was done in all subjects.

Results:

The expression of miRNA 223 (ΔCt) was higher in cases than in controls. The observed mean ΔCt was higher in severe (12.90 ± 0.46) than in mild (9.81 ± 1.70) and moderate (10.58 ± 1.26) psoriasis. The difference in expression of miRNA with varying severity of psoriasis was significant. The mean difference of ΔCt between mild to severe was (3.09) (P ≤ 0.001) and moderate to severe was (2.31) (P = 0.013). Among cases, the expression of miRNA 223 was higher in those exhibiting Koebner's phenomenon compared to those without Koebner's phenomenon (P = 0.0424).

Conclusion:

Expression of miRNA 223 was higher in psoriatic patients than in controls and the expression increased with the severity and activity of the disease suggesting the upregulation of miRNA 223 with the progression and activity of the disease.
Intralesional Measles, Mumps and Rubella Vaccine Versus Formic Acid Puncture in the Treatment of Common Warts: A Prospective Randomised Study
Authors: D'Souza Myfanwy J. , Hundi Ganesh K. , Dandekeri Sukumar , Jayaraman Jyothi
Published: May 2024

Context:

Many therapeutic modalities have been reported for the treatment of warts: a common bothersome condition; however, no single treatment is completely effective.

Aims:

This study aimed to evaluate the efficacy and safety of intralesional injection of measles, mumps and rubella (MMR) vaccine and to compare its efficacy with 85% formic acid puncture for common warts.

Settings and Design:

This was a prospective comparative study.

Methods and Material:

A total of 60 patients, divided into two groups, were included in the study. Group A received an intralesional MMR vaccine of 0.3 ml per lesion, and group B received 85% formic acid puncture into each lesion with a maximum of 10 warts treated in each case. Five sessions were conducted every 2 weeks in each case with a follow-up period of 3 months to check for recurrence.

Statistical Analysis Used:

The Chi-square test, Fisher's test and t-test were used for statistical analysis. A P-value <0.05 was considered statistically significant.

Results:

In group A, the complete response was observed in 62.5%, partial response in 8% and no response in 4.1% of patients. In group B, the complete response was observed in 31.8%, partial response in 63.6% and no response in 4.5% of patients. The difference in cure rates was found to be statistically significant with a P value of 0.031. No recurrence was observed in both groups in the follow-up period.

Conclusions:

Immunotherapy by intralesional MMR vaccine is a simple, well-tolerated, effective and cost–benefit modality for the treatment of warts and showed a statistically significant cure rate than formic acid therapy.
Evaluation of Dermatology Life Quality Index, Depression-Anxiety-Stress Scores of Patients with Genital Dermatoses
Authors: Temel Berkay , Orenay Ozge M. , Yigit Dilek , Kaymak Derya , Karaosmanoglu Nermin , Eksioglu Hatice M.
Published: May 2024

Background:

Genital dermatoses contain a group of diseases that affect the skin of the genital area. Genital dermatoses are classified as venereal and nonvenereal. They can affect a patient's life quality and can cause depression, anxiety and stress.

Aims:

This study aimed to evaluate and compare the quality of life index, depression, stress and anxiety in patients with genital dermatoses.

Materials and Methods:

Patients admitted to the dermatology outpatient clinic with genital skin complaints between October 2020 and March 2021 were included. A questionnaire including demographic information, a 10-item dermatology life quality index (DLQI) and a 21-item depression anxiety stress score (DASS-21) was filled out by the patients and was calculated.

Results:

A total of 103 patients were included in this study. Seventy-seven (74.8%) were male and 26 (25.2%) were female. A total of 48.5% (n = 50) patients had venereal genital dermatoses, and 51.5% (n = 53) of the patients had nonvenereal genital dermatoses. In the venereal diseases, syphilis had the highest DLQI, depression, anxiety and stress score while in the nonvenereal diseases, scabies had the highest DLQI, depression, anxiety and stress score. In the nonvenereal group, the mean DLQI score, depression, anxiety and stress scores were statistically significantly higher than the venereal genital dermatoses group (P < 0.01, P = 0.04, P = 0.03 and P = 0.02).

Conclusion:

The quality of life of patients with genital dermatoses is often poor, with significant levels of depression, anxiety and stress. We believe that screening these patients with DLQI and DASS-21 scores at their first admission and follow-up will benefit dermatologists and patients.
Desnutrin as a Biomarker for Insulin Resistance in Patients with Vitiligo Vulgaris
Authors: El-Hamd Mohammed Abu , Sedky Ahmed , Mahmoud Asmaa B. , Abd El-Magid Wafaa M.
Published: May 2024

Background:

Vitiligo is a common depigmented skin disorder characterised by the selective destruction of melanocytes.

Aims and Objectives:

This study aimed to assess serum desnutrin and its association with insulin resistance in patients with vitiligo vulgaris.

Materials and Methods:

This study was a cross-sectional case-control study. It included 45 patients with vitiligo vulgaris and 45 age- and sex-matched healthy controls. Patients were subjected to complete general and cutaneous evaluations. All participants were subjected to the assay of fasting blood glucose (FBG), cholesterol, triglyceride, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), fasting serum insulin and serum desnutrin. Homeostasis Model Assessment + insulin resistance (HOMA + IR) was calculated for all participants.

Results:

There were statistically significant differences between the patients with vitiligo vulgaris and healthy controls regarding HDL, FBG, fasting insulin, HOMA-IR, and serum desnutrin (P < 0.001). Desnutrin levels were negatively correlated with FBS, LDL, VLDL, fasting insulin, and HOMA-IR (P < 0.05). Unlikely, the level of desnutrin had a positive, non-significant correlation with HDL (rho = 0.17, P = 0.059).

Conclusion:

This study concluded that in patients with vitiligo vulgaris, as a result of increased serum levels of glucose and insulin, the serum desnutrin was suppressed, perhaps contributing to hyperlipidaemia and IR. So, low serum desnutrin could be a biomarker for IR in patients with vitiligo vulgaris. A multidisciplinary approach is essential for the early detection of diabetes mellitus, IR and hyperlipidemia among patients with vitiligo vulgaris to avoid cardiovascular and metabolic complications.
Emerging Treatments for Reactive Cutaneous Capillary Endothelial Proliferation
Authors: Liu Yi , Chen Tiancheng , Zhang Chao , Pan Weihua
Published: May 2024

Background:

Reactive cutaneous capillary endothelial proliferation (RCCEP) is a common, burdensome adverse event that occurs in up to 88% of patients treated with camrelizumab. Without treatment, RCCEP is associated with social stigma and low quality of life. However, the optimal management of RCCEP remains inconclusive.

Aims and Objectives:

to elucidate the pathogenesis and clinical manifestations of RCCEP and systematically review the existing different therapeutic options for this dermatologic toxicity to encourage the selection of the most appropriate approaches for individual comprehensive management.

Materials and Methods:

As far as we know, we have systematically reviewed all cases complicated with RCCEP worldwide, and summarized the advantages and disadvantages of existing treatment methods. In addition, we report a successful case of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in a 61-year-old male Chinese patient who developed RCCEP after camrelizumab immunotherapy. Owing to the patient's advanced age, complicated medication history, and hyperalgesia, ALA-PDT was performed. The multiple lesions on his chest and buttocks showed rapid relief within 1 week of a single treatment session. Clinical recurrence was not observed within 6 months following treatment.

Results:

The current treatment of RCCEP is challenging and there is a lack of globally recommendations based on strict therapeutic regimens or clinical trials. Based on this case, we found that ALA-PDT is a safe and effective treatment option for RCCEP. This case also highlights the coexistence of several camrelizumab-induced dermatologic immune-related adverse events, which has never been reported before.

Conclusion:

New therapies for RCCEP have emerged in recent years. Dermatologists should raise better awareness of the complexity of drug eruption and the need for early diagnosis and medical intervention.
Anti-Inflammatory Effect of Cinnamaldehyde in a Mouse Model of 2,4-Dinitrofluorobenzene-Induced Atopic Dermatitis
Authors: Ustaoglu Eda , Turkoglu Zafer , Ulgen Ovgu A. , Caytemel Ceyda , Agirgol Senay
Published: May 2024

Background:

This study aims to investigate the anti-inflammatory effects of cinnamaldehyde in atopic dermatitis (AD) in the mouse model.

Materials and Methods:

Twenty-four mice were divided into four groups: Group A (control), group B [AD with no treatment (AD + NoTre)], group C [AD with corticosteroids (AD + Cort)] and group D [AD with cinnamaldehyde (AD + Cin)]. 2,4-dinitrofluorobenzene was used to form the AD model. Topical corticosteroid was applied to group C, and oral cinnamaldehyde was administered to group D. Dorsal skin biopsies were evaluated immunohistochemically with interleukin (IL)-25, IL-33, thymic stromal lymphopoietin and caspase-3.

Results:

Epithelial thicknesses were significantly higher in group B–D mice compared to group A (P = 0.002, 0.009, 0.004, respectively). Significantly, higher staining with IL-25 was observed in group B (AD + NoTre) and group D (AD + Cin) than in group A (control) (P = 0.003, 0.002, respectively). However, no significant difference was observed between group D (AD + Cin) and group B (AD + NoTre). All three groups (B–D) had significantly higher staining in terms of diffuseness of IL-33 compared to group A (control) (P = 0.002, 0.002, 0.002, respectively). Caspase-3 staining was significantly lower in group D (AD + Cin) than in group B (AD + NoTre) (P = 0.003, 0.002, respectively). Moreover, caspase-3 staining intensity was significantly lower in group D (AD + Cin) than in group C (AD + Cort) (P = 0.002).

Conclusions:

Our study demonstrated that IL-33, IL-25 and caspase-3 have a role in the pathogenesis of AD. Furthermore, cinnamaldehyde reduced caspase-3 activity more than topical corticosteroids and anti-inflammatory effects might be investigated in AD therapy with future studies.
Cutaneous Adnexal Tumours
Authors: Sharma Nitu , Nakra Tripti , Agarwal Shipra , Gupta Vishal , Singh Manoj Kumar , Arava Sudheer
Published: May 2024

Background:

Cutaneous adnexal tumours (CATs) are one of the commonest clinical presentations in dermatology outpatients. They constitute a subset of skin tumours with a common clinical presentation and variable histological findings. Almost all of them clinically present as a subcutaneous nodule. Depending upon the site and distribution, the clinician can suspect the diagnosis. However, histopathological examination is the gold standard for the definitive diagnosis and proper subtyping of CATs.

Aims:

The present study is conducted to see the overall spectrum, incidence and distribution of CATs in a large cohort at the tertiary care centre with their clinical profile.

Methods:

This was a retrospective study in which all the CATs diagnosed over a period of 5 years (2015 to 2019) in a tertiary care hospital were studied. Clinical data were recorded from the histopathology requisition forms.

Results:

Three hundred and ninety-five cases of CATs were retrieved. Approximately 90% of cases were benign and 10% were malignant. The age of presentation ranged from 8 months to 81 years with male preponderance in all the histological subtypes. The most common site was the head and neck followed by the extremities. Morphologically, the maximum cases showed a differentiation towards sweat glands (44%), followed by sebaceous (29%), follicular (26.5%) and apocrine differentiation (5.3%). Malignant tumours were common in the elderly age group with sebaceous carcinoma being the commonest.

Conclusion:

CATs comprise of a wide spectrum of tumours occurring in all age groups. Malignant CATs are rare and common in older age groups. Histopathological examination is the gold standard in distinguishing between the different subtypes.
Trichoscopy in Alopecia Areata and Trichotillomania in Skin of Colour
Authors: Mani Siddharth , Raut Aradhana , Neema Shekhar , Khandare Manish , Golas Prateksha , Sandhu Sunmeet , Kothari Rohit , Rajput Gopalsing. R. , Oberoi Bhavni
Published: May 2024

Alopecia areata (AA) and trichotillomania (TTM) are the two common causes of localised non scarring alopecia. While AA is an autoimmune disorder, TTM is an impulse control disorder which makes the treatment of the two entities completely different. Trichoscopy is a non-invasive tool used to diagnose hair disorders, which not only is extremely helpful in diagnosing AA and TTM but also differentiates them from other hair disorders as well. The aim of our study is to describe the various trichoscopic features of AA and TTM and to compare the frequency of each trichoscopic feature in order to establish diagnostic clues for differentiating AA and TTM. Trichoscopy was performed on clinically diagnosed cases of AA and TTM with DL4 dermoscope and the images were analysed by 2 dermatologists independently. The frequency of trichoscopic features in AA and TTM was compared using chi square test. Twenty-four patients of TTM and 50 patients of AA were included in the study with mean age of AA being 30 years and mean age of TTM being 23.4 years. Exclamation mark hair, tapered hair, coudability hair, pigtail hair, clustered vellous hair, clustered regrowing hair and white hair were significantly more in alopecia areata. Conversely broken hair of different length, trichoptilosis, flame hair, mace hair, coiled hair, hair powder, fractured hair, v sign and burnt matchstick sign were the common features in TTM. To conclude, even though there is an overlap of trichoscopic features in AA and TTM, it is possible to distinguish the two if an assemblage of specific features are present.
Assessment of Effects of Low-Level Light Therapy on Scalp Condition and Hair Growth
Authors: Kim Jin Hee , Son Hyung Seok , Yu Da-Ae , Choe Yong Beom , Lee Yang Won
Published: May 2024

Background:

The appearance of the scalp and hair is very important aesthetically regardless of age or sex. Although there are many drugs and treatment methods for scalp problems and hair loss, the treatment response is still insufficient.

Aims and Objectives:

To evaluate the efficacy of low-level light therapy in a helmet-like device.

Materials and Methods:

This study was designed as a 24-week trial with 50 participants. All participants used a helmet-shaped device emitting 630–690, 820–880, and 910–970 nm light wavelengths, for 20 minutes, daily for 24 weeks. A phototrichogram for hair density and thickness, Global Aesthetic Improvement Scale score, erythema index, and sebum secretions of the scalp were evaluated at baseline and at 12 and 24 weeks.

Results:

After 24 weeks of treatment, hair density and hair thickness were found to have significantly increased (P <.01 and P =0.013, respectively) and sebum secretion of vertex area had decreased significantly (P <.01). Of 49 participants, 73.47% of the participants showed improvement in the overall appearance of the scalp (n = 36).

Conclusion:

A helmet-like low-level light therapy device can improve the appearance of the hair, with thickening and increase in the density of the hair, and can improve scalp condition by decreasing sebum secretion.
Correlation between Antimicrobial Resistant Propionibacterium Acnes and Severity of Acne Vulgaris: Findings from a Tertiary Hospital
Authors: Gozali Maria Mayfinna , Kurniawati Yuli , Devi Mutia , Bahar Erial , Dewi Lisa , Yahya Yulia Farida , Rusmawardiana  , Zulkarnain Sarah Diba , Kartowigno Soenarto
Published: May 2024

The study of antimicrobial-resistant Propionibacterium acnes was not conducted regularly, especially in Indonesia. Conversely, regular monitoring of antibiotic efficacy through in vitro testing to assess the evolution of current resistance patterns is obligated; thus, filling the gap caused by a lack of appropriate antibiotic surveillance is required. Analyse the correlation between resistance patterns of P. acnes to doxycycline, clindamycin, erythromycin and azithromycin with the severity of acne vulgaris. This is an analytic observational laboratory study with a cross-sectional design of mild to severe acne vulgaris (AV) patients. Specimens were obtained from comedones of 71 patients, which were cultured and identified using biochemical examination. Antimicrobial resistance (doxycycline, clindamycin, erythromycin and azithromycin) to P. acnes was tested by disc diffusion method. Among 71 samples collected, 40 (56.3%) P. acnes isolates were cultured and identified. The incidence of P. acnes resistance to more than one antimicrobial was 45%. Antimicrobial resistances were clindamycin 42.5%, erythromycin 40%, azithromycin 23.5% and doxycycline 12.5%, respectively. According to the contingency coefficient test, there was moderate correlation between the resistance pattern of P. acnes to clindamycin (r = 0.485, P = <0.001) and doxycycline (r = 0.433, P = 0.002) and AV severity. There was weak correlation between the resistance pattern of P. acnes to erythromycin (r = 0.333; P = 0.025) and azithromycin (r = 0.321; P = 0.032) and AV severity. In conclusion, there is a correlation between the pattern of P. acnes resistance to doxycycline, clindamycin, erythromycin, azithromycin and severity of AV.
Clinical Profile, Risk Factors and Complications of Paediatric Herpes Zoster Ophthalmicus—A Case Series
Authors: Christy Josephine S. , Prasad Sushad , Gulani Aaishwariya A
Published: May 2024

To study the clinical profile, risk factors and complications of paediatric Herpes zoster ophthalmicus (HZO). Case records of clinically diagnosed paediatric HZO over the past five years period were collected. An analysis was done with the existing data to determine the patient's clinical presentation, risk factors and treatment outcomes. Among seven children (three males and four females), two were less than ten years. Risk factors like previous history of chickenpox were present in one patient and immunosuppression in another. Child with immunosuppression also had h/o viral encephalitis three days before the onset of HZO. While two patients presented with disciform keratitis and three with anterior uveitis, the remaining did not have anterior segment involvement. Six out of seven patients retained 6/6 visual acuity at one month follow-up. Paediatric HZO is prevalent even in immunocompetent children without any identifiable risk factor. It generally has a good prognosis with minimum residual complications.
Tuberous Sclerosis Complex—Varied Presentations in Family Clusters
Authors: Sopori Ayush , Sharma Seema , Sharma Kavya , Sharma Milap
Published: May 2024

Tuberous sclerosis complex (TSC) is a disease of varying presentations characterised by the presence of multiple hamartomas in various organ systems in the body. This is an Autosomal dominant disease with damages in two suppressor genes namely TSC1 and TSC2 located on chromosome 9 (9q34-hamartin) and chromosome 16 (16p13.3-tuberin). It is a lifelong disease with neurological manifestations, for example, epilepsy, mental retardation and autism and major dermatological features like facial fibromas (adenoma sebaceum), periungual fibromas, shagreen patches and hypopigmented macules. Some conditions, for example, autosomal dominant polycystic kidney disease can co-exist with TSC as a result of concurrent deletion of both polycystic kidney disease 1 and TSC2 genes present on chromosome 16p13.3. We present a cluster of three families with TSC having varied presentations.
Squamomelanocytic Tumors
Authors: López-Llunell Cristina , Garbayo-Salmons Patricia , Cañada Marta G. , Artacho Empar S. , Fernández-Sartorio Clara
Published: May 2024

Cutaneous neoplasms from different cell types can exist within the same lesion. These can be classified into four subtypes which are collision tumour, combined tumour, colonization and biphenotypic tumour. The presence of a melanoma component in these tumours is very rare. Herein we present a singular case of two synchronous dineoplastic cutaneous tumours: a squamomelanocytic tumour and a collision consisting of melanoma and seborrheic keratosis. Additionally, we performed a literature review of all squamomelanocytic tumours published until date, including our case.
A Study of NLRC4 in Patients with Leprosy
Authors: Batta Salma Masaad , El Far Nashwa Naeem , Soliman Nema Ali , Nassar Samia Othman
Published: May 2024

Background:

Activation of the NLRC4 inflammasome appears to start many signalling processes inside the host, including caspase-1, the principal protease responsible for converting proIL-1β and IL-18 to active, secreted IL-1β and IL-18, resulting in pyroptosis.

Aims:

To evaluate NLRC4 level in patient's blood serum to highlight its role in the pathogenesis of leprosy.

Materials and Methods:

This prospective study was conducted on 40 patients with leprosy and 30 healthy individuals of matched ages and sexes. All patients were subjected to complete history taking, general and dermatological examination, laboratory investigations, slit skin smear with bacillary index, and clinical classification of the studied leprosy group patients regarding disability according to disability grading. And finally, measurement of serum NLRC4 level by ELISA.

Results:

In the paucibacillary (PB) group, NLRC4 serum level ranged from 0.9 to 1.8 ng/ml with 1.43 ± 0.28 ng/ml, while in the multibacillary (MB) group, it ranged from 1.2 to 5.7 ng/ml with 2.83 ± 1.11 ng/ml. NLRC4 serum level had increased significantly in MB patients compared to PB patients (P < 0.05). There was a significant difference among the three studied groups, regarding the serum level of NLRC4 (P < 0.05). In leprosy patients, significant positive correlations were found between serum levels of NLRC4 and bacillary index and duration of leprosy.

Conclusions:

Leprosy patients had considerably greater serum levels of NLRC4 than controls. It was much greater in MB patients than in PB patients.
Immune Cell Profiling of Atopic Dermatitis Patients Before and After Treatment with Halometasone Cream Wet-Wrap Therapy by Single-Cell Sequencing
Authors: Gu Xiao-Guang , Yu Xin , Zhou Bo-Yang , Li Ming , Xu Wei , Li Yan , Li Lin-Feng
Published: May 2024

Objectives:

Peripheral blood immune cell profiling of atopic dermatitis patients before and after treatment by single-cell RNA sequencing technique has not been reported. To study the immune Cell Profiling of Atopic Dermatitis Patients Before and After Treatment with Halometasone Cream Wet-Wrap Therapy.

Methods:

We used single cell sequencing to detect the proportion change and gene expression change of immune cells in 2 patients before and after treatment, and then used real-time PCR to confirm the mRNA level of differential genes.

Results:

In this study, scRNA-seq in two patients with severe AD before and after halometasone cream wet-wrap therapy showed that in the mild severity of AD after treatment, Th2 cells were significantly decreased (41.2% vs 13.4%), Th1 and Th17 cells were increased (23.3% vs 43.7%, 2.3% vs 4.8% respectively). The proportion of Th22 cells did not change much (1.3% vs 1.9%). Tregs were significantly increased also (1.5% vs 5.0%). In the regulatory T cells, the expression of IL-27, PD-1, CD103, CTLA-4, ZNF-66, IL-β, CD7 gene was specifically increased after treatment, and CD39, P21, TOX2, CD151, CD79A, S100A12, TRAP1 gene was specifically decreased after treatment. In the TH2 cells, the expression of CD27, CD68, EZH1, RAD1, EGFR, CCR10, BCL11A, KLF4 gene was specifically increased after treatment and CCL26, CD180, IL-31, CCL22, LEF1, OX40 gene was specifically decreased after treatment.

Conclusions:

These genes may be new target for further study.
Rare Tumors of Skin
Authors: Özkan Melekber Ç. , Kaya Caner , Çiçek İlker , Doğan Zeynep D.A. , Kocaaslan Nihal D. , Saçak Bülent , Cinel Zeliha L.
Published: May 2024

Background:

Cutaneous adnexal tumors (CATs) are a large group of neoplasms of the skin and the pathological diagnosis can be challenging.

Objective:

The aim of this study was to examine clinicopathological features of malignant cutaneous adnexal tumors (MCATs) and to identify therapeutic and prognostic implications.

Materials and Methods:

Twenty-six patients diagnosed with MCATs and operated in our center were included. Demographic and clinical characteristics of patients, tumor size, histological subtype, perineural and lymphovascular invasion, re-excision status, lymph node metastasis, distant metastasis, recurrence, follow-up, and treatment choice were recorded. All lesions were excised with 1 to 2-cm surgical margin. Surgical margin was determined according to tumor size.

Results:

Of 26 patients, 14 were males and 12 were females (median age: 66 years). Median follow-up was 52.08 months. Tumor location was the face in 69.2% (n = 18) patients, followed by scalp and neck region. Four patients had coexisting skin tumors. Majority of MCATs (69.2%, n = 18) originated from sweat glands. Median tumor diameter was 4 (range, 0.8 to 17) cm. There was a statistically significant correlation between presence of perineural invasion and advanced disease (P = 0.036). Majority of the patients had Stage 1-2 disease, while two patients had Stage 4 disease. In six patients (23.1%), re-excision was performed due to surgical margin positivity.

Conclusion:

Incidence of MCATs has an increasing trend with advanced age and these tumors are more commonly seen in men and in visible sites of the body such as head and neck and scalp. Wide resection according to tumor size is the first-line treatment.
The Comparison between Microneedling and Fractional CO2 Laser for Amniotic Membrane Stem Cell-Conditioned Medium and Vitamin C in Photoaging Treatment
Authors: Indramaya Diah M. , Listiawan Muhammad Y. , Citrashanty Irmadita , Sari Maylita , Umborowati Menul A. , Adiningtyas Vidyani , Pitasari Dyah A. , Ayu Agatha A. , Rantam Fedik A. , Prakoeswa Cita R. S.
Published: May 2024

Context:

Photoaging correlates with ultraviolet radiation (UVR). In addition to direct and indirect DNA damage, UVR leads to a breakdown of collagen, resulting in enlarged pores, visible wrinkles, also uneven skin tones and pigmentations. Amniotic membrane stem cell (AMSC) can be a useful modality in cell regeneration. Vitamin C has been known as an agent of depigmentation, antioxidants, and collagen synthesis. A topical combination of amniotic membrane stem cell-conditioned medium (AMSC-CM) and vitamin C is expected to improve photoaging. Fractional CO2 laser and microneedling served as transdermal drug delivery.

Aims:

To compare between microneedling and fractional CO2 laser for the administration of AMSC-CM and vitamin C in photoaging treatment.

Methods and Material:

Sixty Indonesian women with photoaged skins participated in this experimental analytic, controlled, matching research and were divided into two groups. Thirty women received fractional CO2 laser, and others received microneedling. All participants received a topical combination of AMSC-CM and vitamin C. Three treatment sessions were repeated at a four-week interval for fractional CO2 laser and a two-week interval for microneedling. We evaluated the progression and side effects using a skin analyzer on weeks 0, 4, and 8 for the microneedling group and for the fractional CO2 laser group on weeks 0, 4, and 12.

Results:

Assessment of wrinkles, UV spots, skin tone, and pore revealed a statistically significant effect of a topical combination of AMSC-CM and vitamin C after fractional CO2 laser (p < 0.05).

Conclusions:

Combination of AMSC-CM and vitamin c using fractional CO2 laser can improve photoaging and is better compared to microneedling.
Griscelli Syndrome in Skin of Color
Authors: Shah Swapnil D. , Ankad Balachandra S. , Smitha Sankappanavara V.
Published: May 2024

Introduction:

Griscelli syndrome (GS) is a very rare autosomal recessive disorder, belongs to group of “silvery hair syndromes” which includes Chediak-Higashi syndrome (CHS) and Elejalde syndrome. Hair light microscopy helps in the differentiation of GS and CHS, as both manifest with clinical features. Trichoscopy is useful in the diagnosis of many hair shaft disorders. Here, authors describe the trichoscopic features of GS in skin of color.

Materials and Methods:

This was an observational study conducted in a private dermatology clinic and in a tertiary care hospital. A total of 5 cases of suspected GS were referred by pediatrician. Consent was obtained. The demographic data in terms of age, gender, consanguinity, and clinical history was documented. Trichoscopic examination was performed with FotoFinder videodermoscope with 20× magnification, the clinical images were captured with Medicam 1000. Trichoscopy showed large and irregular pigment clumps in 4 cases. One case demonstrated hypopigmentation of hair without pigment clumps [Figure 3a].

Results:

Trichoscopy showed large and irregular pigment clumps in 4 cases. One case demonstrated hypopigmentation of hair without pigment clumps.

Conclusion:

Trichoscopy shows characteristic features GS. It is a useful method when facility for light or polarized microscope is unavailable.
Clinical Effects of Pulsed Dye Laser Dynamically Combined with Triamcinolone Acetonide in the Treatment of Postoperative Recurrence Keloids
Authors: Liu Zhennan , Zhang Jiamin , Guo Xin
Published: May 2024

Purpose:

This study aimed to explore the clinical effects of pulsed dye laser (PDL) dynamically combined with triamcinolone acetonide (TAC) in the treatment of post-operative keloids recurrence.

Materials and Methods:

This study retrospectively analysed the clinical data of 29 keloid patients (with 39 keloids) from April 2014 to February 2020. The patients were divided into TAC group (14 patients with 19 keloids) and dynamic treatment group (15 patients with 20 keloids) according to the post-operative treatment that they received. The keloids were assessed by Vancouver scar scale (VSS), patient and observer scar assessment scale (POSAS) and the effect of keloids on the quality of life of patients was evaluated with dermatology life quality index (DLQI) scale before the surgical treatment, at any time of relapse, and 24 months after the surgical treatment. The recurrence-free interval, relative cure time, and the cumulative times of TAC injection when the relative cure could be assessed as achieved, and the incidence of adverse reactions were calculated.

Results:

Patients experiencing a recurrence within 2 years after surgery included 19 keloids (25.33%) that developed a recurrent event within 6 months, 34 keloids (45.33%) that within 12 months, and 39 keloids (52.00%) that within 24 months after surgery. Anterior chest keloid had the highest recurrence rate and ear keloid had the lowest recurrence rate. The total pigmentation and vascularity (VSS and POSAS) scores of patients' keloids in TAC group and dynamic treatment group 24 months after treatment were significantly lower than those before treatment and at relapse (P < 0.05), the total VSS and POSAS scores were significantly lower at 24 months than before treatment and at relapse (P < 0.05), and the DLQI scale score was significantly lower at 24 months than before treatment (P < 0.05). The VSS and POSAS scores of patients' keloids at 24 months after treatment were significantly lower in the dynamic treatment group than in the TAC group. The relative cure time of patients' keloids in the dynamic treatment group was 6.47 ± 2.72 months, which was significantly shorter than 8.65 ± 3.67 months in the TAC group (P < 0.05). The cumulative number of TAC injections that were given to achieve a relative cure of patients' keloids in dynamic treatment group was 3.60 ± 1.76, which was significantly less than 5.24 ± 2.25 in TAC group. The total incidence of adverse reactions was lower in the dynamic group than in TAC group, but this difference did not reach statistical significance (P > 0.05).

Conclusions:

Compared with TAC injection alone, PDL dynamically combined with TAC in the treatment of keloid with post-operative recurrence can shorten the relative cure time, reduce the number of TAC injections and improve the clinical efficacy.
Dermoscopy in the Diagnosis of Palmoplantar Eczema and Palmoplantar Psoriasis
Authors: Chauhan Payal , Meena Dilip , Jindal Rashmi , Roy Samarjit , Shirazi Nadia
Published: May 2024

Introduction:

Palmoplantar hyperkeratotic lesions pose a diagnostic difficulty when differentiating clinically between palmoplantar psoriasis (PPP) and palmoplantar eczema (PPE). Dermoscopy can provide valuable clues in reaching the final diagnosis.

Objectives:

To identify and compare dermoscopic findings seen in PPP and PPE.

Methods:

This was a cross-sectional, comparative study carried out prospectively between March 2019 and June 2020. All adult, consenting patients visiting the dermatology outpatient department who were clinically diagnosed and histopathologically confirmed as PPP and PPE were recruited into two groups. The dermoscopic examination was done, and images were taken from the representative area. The findings were analysed by two dermatologists who were unaware of the diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of these findings were assessed.

Result:

A total of 81 patients were recruited (39 patients of PPP and 42 patients of PPE). Significant findings seen in psoriatic plaques were the presence of regular vessels (84.6%, P < 0.001), with diffuse scales (87.2%) over a dull red/pink background (69.2%, P < 0.001). Dermoscopy of PPE displayed a significant presence of yellowish scales (76.2%, P < 0.001), with focal (61.9%) or absent vessels (35.7%), brown/orange-brown dots and/or globules (66.7%), yellow/yellow-orange crusts (57.1%) over a yellow/yellow-brown background (88.1%).

Conclusion:

Distribution of vessels, distribution of scales and the colour of scales, presence of brown/orange-brown dots and/or globules, yellow/yellow-orange crust and background colour (dull red vs. yellow/yellow-brown) of the plaques can be useful clues in the diagnosis of PPP and PPE.
The Efficacy and Safety of 5-Aminolevulinic Acid Photodynamic Therapy for Lichen Sclerosus
Authors: Qing Chun , Mao Xiaoyong , Liu Gaoqing , Deng Yibin , Yang Xiaokun
Published: May 2024

Background:

Lichen sclerosus (LS) is a chronic inflammatory dermatosis that occurs mainly in the anogenital area and causes itching, soreness, atrophy and scarring, which may result in burying of the clitoris in females and phimosis in males. Photodynamic therapy (PDT) has been suggested during the past years as an alternative non-invasive treatment for LS, but there is still no meta-analysis to evaluate its efficacy and safety.

Aims:

To assess the efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for treatment of LS.

Methods:

We undertook a meta-analysis using the methodology of the Cochrane Collaboration and the guideline of PRISMA. A systematic literature search was carried out in PubMed, EMBASE, The Cochrane Library, WanFang Data, CBM and CNKI up to 30 June 2020. Randomized controlled trials (RCTs) were compared with ALA-PDT, corticosteroids or tacrolimus ointments for treating LS. The risk of bias for each trial was rated according to the Cochrane Handbook. Risk ratios (RR) with 95% confidence intervals (CI) were utilized to express the comparative outcomes.

Results:

We included 4 RCTs with a total of 184 participants. The meta-analysis showed ALA-PDT was better than topical ointments in treating LS (total effective rate: RR 1.38 [95% CI 1.19-1.60]).

Conclusions:

The current limited evidence supports the efficacy and safety of ALA-PDT in treating LS. The adverse reactions included pain, swelling, redness and exfoliation which would decrease with the continuing sessions of treatment. Further high-qualified RCTs of large samples are necessarily needed.
Aging Skin and Natural Bioactives that Impede Cutaneous Aging: A Narrative Review
Authors: Sriram Rajashree , Gopal V
Published: May 2024

The skin aging which entails modifications in the entire skin and skin support system is caused as a result of complex blend of intrinsic and extrinsic factors. The main objective of this review is to provide critical insights into the effect of the aging determinants (intrinsic and extrinsic) on aging skin and to focus on a few classes of natural bioactives that were reported to counteract symptoms of cutaneous aging, pose potential, and beneficial health effect on aging skin supported with relevant scientific evidence. The narrative review of this cutaneous antiaging study incorporating the literature findings was retrieved from the search of computerized databases PubMed and Scopus, hand searches, and authoritative books. The antiaging skin care approach of using bioactives are basically nutritional hormetins, available from our natural heritage, identified as potent free radical scavengers, antioxidants, moisturizers, cell repairing agents, and ultraviolet protectives which have started to seek considerable attention among researchers and consumers due to the undesirable effect of chemical-based constituents on human health and environment. With the booming antiaging strategies, beauty has become the prime factor in considering one's health and overall “wellness”. As promoting healthy aging is essential, the objective of aesthetic dermatology should shift from cosmetic interventions to the betterment of quality of life of aging society. The paper also discusses on certain artificial learning/machine-based algorithms, useful in screening of bioactive ingredients, helpful in developing of more tailored formulations. This narrative overview on skin antiaging natural bioactives and artificial learning–based bioactive screening approaches contributes for the improvement in dermatological drug discovery, in the development of novel targeted lead compounds and accelerates aging research and pharmaceutical research.
A Case-Control Study of Serum and Tissue Catalase among Morphological Variants of Vitiligo
Authors: Periasamy Nandhini , Ramesh V , Matlani Monika
Published: May 2024

Background:

Role of oxidative stress in the pathogenesis of vitiligo.

Aim:

Estimation of serum and tissue catalase levels in morphological variants of vitiligo.

Settings and Design:

A prospective case-control study was conducted in the outpatient department of Dermatology in Safdarjung hospital.

Materials and Methods:

We estimated levels of serum and tissue catalase in 30 vitiligo patients and 30 matched healthy controls.

Statistical Analysis:

The data analysis was done in Statistical Package for Social Sciences (SPSS) version 21.0. Normality of data was tested by Kolmogorov–Smirnov test.

Results:

Serum and tissue catalase was lower in vitiligo patients than controls. Serum catalase was lowest in vulgaris type, whereas in the acrofacial type had lowest tissue catalase levels.

Conclusion:

Vitiligo patients have a generalized oxidative stress functioning at a higher pace as seen with decreased serum and tissue CAT which can well be taken as a marker of active disease and they can be helped with topical pseudoCAT preparations.
Inverted Follicular Keratosis
Authors: Baklouti Massara , Sellami Khadija , Mellouli Manel , Rekik Mariem , Chaabouni Rim , Masmoudi Abderahmen , Sellami Tahya , Turki Hamida
Published: May 2024

Inverted follicular keratosis (IFK) is a rare benign tumour of the follicular infundibulum characterized by exo-endophytic growing. Generally, the diagnosis of IFK is histopathologically made because clinical differentiation from other lesions is difficult. We present a retrospective series with thirteen patients with histologically confirmed IFK to evaluate the epidemiological, clinical and histopathologic characteristics of IFK. The mean age of the patients at the time of the excision was 53 years with extremes ranging from 19 to 82 years. The sex ratio M/F was 3.3. The lesions affected the face in nine patients mainly the moustache, followed by the scalp in three cases and the arm in one case, and 92% of the localizations are sun-exposed. The diagnosis was never clinically evoked. The lesion had a pink colour in ten cases and was pigmented in two cases and hypopigmented in one case. More than half of the lesions (53%) had a keratotic centre. Histopathological examination showed endophytic intradermal proliferation of basaloid cells with a variable degree of squamoid differentiation. Horn cysts were present in all cases. According to our series, the IFK occurs predominantly in young men, in the face and more specifically in the moustache. Dermoscopy may suggest the diagnosis of the IFK. In fact, a histopathological examination is the gold standard for the diagnosis of the IFK and helps differentiate these benign tumours from possible malignant neoplasms.
An Updated Mutation Spectrum of the γ-Secretase Complex
Authors: Ratnamala Uppala , Jain Nayan K. , Jhala Devendrasinh D , Prasad Pullabatla V.S. , Saiyed Nazia , Nair Sreelatha , Radhakrishna Uppala
Published: May 2024

Background:

Hidradenitis suppurativa (HS) is a complex, chronic inflammatory skin disorder whose pathophysiology is poorly understood. Genetic studies have shown that HS is predisposed by mutations in the γ-secretase gene, but only a proportion of familial and partial sporadic cases have been shown to possess such mutations. HS has high genetic heterogeneity and is thought to be triggered by a combination of genetics and environmental factors.

Aims:

The study aimed to investigate the genetic causes of HS in a large cohort of patients and to update the mutation spectrum of γ-secretase complex genes.

Methods:

We conducted mutational screening of 95 sporadic HS cases and one large family with both HS and acne conglobata (AC) to identify mutations in the coding and splice junction region of γ-secretase complex genes (nicastrin (NCSTN), presenilin 1 (PSEN1), presenilin enhancer 2 (PSENEN), and aph-1 homolog B, gamma-secretase subunit (APH1B)).

Results:

Our study identified a nucleotide substitution of 1876C>T in the NCSTN gene, which caused a stop codon (p.Arg626X) in the affected members of a large family with HS and AC. No pathogenic variants were detected in 95 sporadic cases of HS, indicating there is possible genetic heterogeneity.

Conclusion:

We report a new family with a nonsense mutation in the NCSTN gene that supports the role of the γ-secretase complex genes in HS with AC. The updated γ-secretase mutation spectrum for HS now includes 78 mutations.
Clinical Study of Pleural Effusion in Elderly
Authors: Chordia Rohit Ravindra , Heda Mamata R. , Dubey Gaurav R.
Published: May 2024

Background:

The usual sign of a wide variety of diseases is the formation of fluid in the pleural region. Pleural effusion (PE) is a prevalent condition in regular medical practice and has a wide range of underlying medical conditions as causes. The prognosis and treatment of PE can be greatly affected by the cause; hence, accurate differential diagnostic classification is essential.

Materials and Methods:

This prospective and observational clinical study was conducted between August 2013 and February 2015. A total of 100 patients were enrolled in the study. The clinical history and physical examination were done. For radiological evaluation X-ray of the chest was taken, and if necessary, ultrasonography and computed tomography were done. Thoracocentesis was performed after obtaining informed consent, and all necessary investigations were done.

Results:

Out of 511 patients, 100 patients were included in the study who were 60 or above 60 years of age. The most common comorbid condition was hypertension, which was found to be (32.81%) in males and (30.56%) in females. In exudative PE, tuberculosis (TB) was mostly found in males (53.13%) and malignancy in females (25%), while in transudative PE, the cardiac cause was mostly found in females (30.56%) as compared to males (15.63%).

Conclusion:

In India incidence of tubercular PE is more common than malignant. Accurate diagnosis and treatment can prevent disease progression and complications.