bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of hematological parameters in coronavirus disease 2019: Comparison between intensive care unit and non-intensive care unit patients
Authors: Aden Durre , Tiwari Umesh , Kumar Vijay , Kaur Ravinder
Published: May 2024

Background:

There are ongoing waves of coronavirus disease 2019 (COVID-19) infection with many variants of this disaster, the latest being BF.7 are prevalent now as of December 25, 2022. There are various changes observed in the clinical, hematological, and biochemical parameters in the patients getting infected by COVID-19. At present, the knowledge of the disease and its severity are important for patient management and prediction of patient outcomes. The study aimed to analyze and compare the differences in the routine hematological parameters of intensive care unit (ICU) and non-ICU COVID-19 groups since their admission.

Materials and Methods:

A retrospective study conducted at a tertiary care hospital in New Delhi for 9 months from March 1, 2020 to November 30, 2020. Routine hematological data confirmed of COVID-19 cases, who were admitted in ICU or non-ICU were retrieved from the Departments of Pathology and Critical Care Medicine and analyzed. The hematological parameters comprising platelet count (109/L), hemoglobin concentration (g/dL), leukocyte count (LEU, 109/L), neutrophil count (NEU, %), eosinophil count (EO, %), lymphocyte count (LYM, %), and monocyte count (MONO, %) and their derivatives such as neutrophil-lymphocyte ratio (NLR) were evaluated.

Results:

The study showed that there was a significant difference (P < 0.05) in the value of hematological parameters between ICU and non-ICU patients with higher levels ofLEU, NEU, and NLR in the ICU group compared to the non-ICU group confirmed COVID-19 positive patients. It was also observed that there was significantly higherLEU, higher NEU count, higher NLR and lower EO, LYM, and MONO count in deceased COVID-19 patients compared with recovered COVID-19 patients (P < 0.05).

Conclusion:

This study helps in understanding the role of hematological parameters especially increased LEU count, higher NEU count, higher NLR, and LYM in severely infected COVID-19 positive patients, admitted in ICU-care settings and deceased COVID-19 patients. It also helps us in deriving a hypothesis that among all hematological parameters, the reduced LYM count can be a very specific prognosticator of the infected patients. Therefore, these hematological parameters can act as a biomarker to recognize the severity of the disease and to monitor the clinical course of COVID-19.
Knowledge, Attitude, and Practice of Publication of Manuscript in a Scientific Journal
Authors: Patil Anant , Langade Deepak
Published: May 2024

Objective:

To understand knowledge, attitude, and practice of health-care professionals related to the publication in a scientific journal.

Materials and Methods:

In this cross-sectional study, health-care professionals responded to a questionnaire consisting of 14 close-ended questions related to manuscript writing and submission.

Results:

One fifty healthcare professionals were included (mean standard deviation age 38 (8.8) years; clinical 79 (52.7%); nonclinical 20 (13.3%) and para-clinical 51 (34%). One hundred and eight (72%) participants were postgraduates by education. A total of 19 (12.7%), 85 (57.4%), 60 (40%), 31 (20.7%), 42 (28.8%), 115 (77.2%), 133 (88.7%), 59 (39.3%), 82 (55.4%), 125 (85%), 125 (84.5%), 141 (94%), and 97 (64.7%) were aware about quantitative indices other than impact factor, need of registration of clinical trial in clinical trial registry, guest author, ghost author, reporting standards, referencing styles, plagiarism, redundant publication, declaration of conflict of interest, need for permission for reproducing images/tables/figures, need of ethics committee permission for clinical studies, and open access journal, respectively. A total of 64 (43%) think about journal before writing the article. Sixty-three (42%) reported preference for open access journal and 93 (62.8%) favored online submission. Sixty-four (42.7%) respondents training for improving quality of manuscript, whereas 81 (54%) reported both training and inclusion of a chapter on manuscript writing in curriculum will be useful for improving quality of manuscript.

Conclusion:

There is a need to improve the awareness related to manuscript writing among health-care professionals.
Intussusception associated with rotavirus vaccination in a 2-month-old infant: A case report
Authors: Hu Shu-Wei , Kuo Min-Yung , Fan Hueng-Chuen
Published: May 2024

Intussusception is an intestinal disease usually occurring within 2 years of age. Most cases are idiopathic or caused by intestinal lymphadenopathy after viral infection. The rotavirus vaccine is a kind of oral live attenuated vaccine approved by the Department of Health in Taiwan since 2006. This vaccine reportedly increases the risk of intussusception, especially after the first dose. Herein, we report a case of intussusception after the first dose of oral rotavirus vaccination with surgical findings that could clarify the pathogenesis of rotavirus vaccine-induced intussusception.
Meta-analysis of the clinical efficacy and safety of T-DM1 in the treatment of HER2-positive breast cancer
Authors: Liu Furong , Li Yuehua , Yang Dinghua , Tang Li , Yang Qian , Jiang Majiao , Tian Leilei , An Jingjing
Published: May 2024

This meta-analysis aims to comprehensively evaluate the efficacy and safety of T-DM1 in treating HER2-positive breast cancer, providing insights for clinical practice. We conducted a literature search in PubMed, Cochrane Library, and Embase databases up to September 2023, collecting randomized controlled trials and cohort studies on T-DM1 for HER2-positive breast cancer. Out of 316 initially retrieved articles, 12 studies meeting the quality and inclusion criteria were included after a rigorous screening process. We used RevMan 5.3 software for the meta-analysis, employing fixed or random-effect models. Odds ratios (RRs) and 95% confidence intervals (CIs) were calculated as effect size measures. We conducted sensitivity analyses and assessed publication bias to ensure the results’ stability and reliability. In seven studies, T-DM1 treatment significantly prolonged OS in patients with HER2-positive breast cancer [hazard ratio (HR) = 0.70, 95% CI: 0.64–0.77, P < 0.01], and the effect was especially pronounced in patients with advanced disease (HR = 0.64, 95% CI: 0.54–0.76, P < 0.001). Analysis of pCR rates did not show a significant difference (OR = 0.91, 95% CI: 0.48–1.73, P = 0.77). In five studies, ORR improved, but the difference between the two groups was not significant (OR = 1.16, 95% CI: 0.66–2.05, P = 0.61). Analysis of progression-free survival (PFS) showed a significant improvement in the experimental group relative to the control group (HR = 0.69, 95% CI: 0.57–0.84, P = 0.0003). Regarding the incidence of total adverse events, no significant difference was seen between the two groups (OR = 2.16, 95% CI: 0.98–4.79, P = 0.06), but for specific adverse events, such as leukopenia and neutropenia, the T-DM1 group demonstrated a significant reduction relative to the other treatment regimens. The results underscore the potential of T-DM1 in enhancing survival among patients with advanced HER2-positive breast cancer, yet they also highlight variability in effectiveness concerning pCR rate and ORR. The findings on adverse effects underscore the necessity of a balanced consideration of T-DM1’s risks and benefits. Future research should focus on a more detailed examination of responses in varied patient populations, long-term outcomes, and a thorough economic evaluation of T-DM1, along with an exploration into treatment resistance. This will provide a more nuanced understanding of T-DM1’s role in the treatment landscape of HER2-positive breast cancer.
Nevus Lipomatosus Cutaneous Superficialis
Authors: Palo Seetu , Balasubramanian Pradeep , Barsagade Ashwinkumar K.
Published: May 2024

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartomatous lesion, histopathologically characterized by the presence of ectopic dermal adipocytes. Herein, reported is the clinicopathological aspect of six cases of NLCS, consisting of three males and three females, with age at presentation ranging from 18 to 47 years and duration of lesion ranging from 2 to 18 years. Out of the six cases, five were of solitary NLCS, who presented with nodules or polypoidal masses of variable sizes and duration. The lone case of classical NLCS presented with multiple skin-coloured cerebriform nodules over the right lower back in zosteriform distribution. The commonest location was lower back and thigh. Histopathological examination revealed lobules of mature adipocytes in the papillary and/or reticular dermis in all cases, thereby establishing the diagnosis of NLCS. Additional microscopic features encountered were surface ulceration, focal myxoid degeneration, mild perivascular lymphocytic infiltrate and attenuation of adnexal structures.
Sebaceous Trichofolliculoma of the Scrotum
Authors: Lei Jie H. , Shen Hong
Published: May 2024

Sebaceous trichofolliculoma is a very uncommon skin tumour, the tumour occurred on the nose and consisted of a solitary lesion. Sebaceous trichofolliculoma occurring in patients of the scrotum is very rare; only one case has been reported to date. The patient has many small soft nodules on the scrotum for several years, then the number and the size of the nodules increased. Histological examination showed many large cystic cavities open to the skin surface and numerous sebaceous glands connected to the cavity. Plastic surgery excision or necessary skin grafting is planned for the patient until maturity is attained.
A Review on Sun Exposure and Skin Diseases
Authors: Merin KA , Shaji Merin , Kameswaran R
Published: May 2024

Skin is the thin layer of tissue forming the natural integumentary system of the body that acts as a barrier to protect it from exogenous and endogenous factors that induce undesirable biological responses in the body. Among these risk factors, skin damage triggered by solar ultraviolet radiation (UVR) is an escalating problem in dermatology with an increased incidence of acute and chronic cutaneous reactions. Several epidemiological studies have provided evidence for both beneficial and harmful effects of sunlight, particularly the solar UVR exposure of human beings. Due to overexposure to solar UVR on the earth's surface, outdoor professionals such as farmers, rural workers, builders and road workers are most vulnerable to developing occupational skin diseases. Indoor tanning is also associated with increased risks for various dermatological diseases. Sunburn is described as the erythematic acute cutaneous response in addition to increased melanin and apoptosis of keratinocytes to prevent skin carcinoma. Alterations in molecular, pigmentary and morphological characteristics cause carcinogenic progression in skin malignancies and premature ageing of the skin. Solar UV damage leads to immunosuppressive skin diseases such as phototoxic and photoallergic reactions. UV-induced pigmentation persists for a longer time, called long-lasting pigmentation. Sunscreen is the most mentioned skin protective behaviour and it is the most promoted part of the sun smart message along with other effective skin protection strategies such as clothing, that is, long sleeves, hats and sunglasses.
Clinico-Pathological Concordance Rate of Scalp Lesions Showing Alopecia
Authors: Jeong Soo Hyun , Oh Dong Yeol , Kim Kwang Joong , Kim Kwang Ho , Park Eun Joo
Published: May 2024

Background:

Some alopecic diseases can be diagnosed by detailed history taking and physical examination, but in many cases, biopsy must be performed to make a definite diagnosis.

Aims and Objectives:

This study aimed to evaluate the clinico-pathological concordance of scalp lesions showing alopecia.

Materials and Methods:

We retrospectively reviewed the electronic medical records and biopsy slides of patients who underwent biopsy for evaluating scalp lesions showing alopecia. Based on the definitions of clinico-pathological concordances, scalp alopecic disease was evaluated.

Results:

A total of 121 patients were enrolled in the study. A total of 203 clinical differential diagnoses were made before performing a biopsy. Thirty-one patients showed full concordance, and 58 patients showed partial concordance; thus overall concordance was shown in 89 patients (73.55%). Folliculitis decalvans and alopecia areata showed a higher full concordance rate than average (P < 0.05), whereas dissecting folliculitis showed a lower overall concordance rate than average, and folliculitis decalvans showed a higher overall concordance rate than average (P < 0.05). The overall concordance rate of alopecia areata was 100% (P = 0.061).

Conclusion:

In diagnosing folliculitis decalvans and alopecia areata, which showed high full and overall concordance, performing a biopsy to make a definite diagnosis is not always necessary, especially when patients show typical clinical features. Dissecting folliculitis, which showed low overall concordance, was less likely to be suspected as a clinical differential diagnosis, making it difficult to distinguish based on clinical findings alone. Therefore, when it is suspected, a detailed evaluation including a biopsy is recommended.
N-Terminal 5-Mer Peptide Analog P165 of Amyloid Precursor Protein Repairs Skin Photodamage Induced by UVB through the Nrf2 Signaling Pathway
Authors: He Li , Sui Changlin , Li Jiangbin , Yao Yingying , Li Man , Wang Rong , Zhu Wei
Published: May 2024

Background:

Acute photodamage is an acute inflammatory reaction of the skin after ultraviolet (UV) irradiation. Many drugs have been successfully used for the treatment and prevention of photodamage.

Aims:

To evaluate the molecular mechanism of N-terminal 5-mer peptide analog P165 of amyloid precursor protein in repairing photodamaged rat skin.

Materials and Methods:

We establish a rat model of acute UVB photodamage. The ratskin was treated with or without 250, 500, and, 1000 μM P165. Histological analysis was performed by hematoxylin and eosin staining. Apoptotic cells were analyzed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The kits were used to measure the levels of protein carbonyl (PC), malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione (GSH). Western blotting was used to measure Nrf2.

Results:

P165 repaired UVB-induced cutaneous erythema and edema, and reduced apoptosis of skin cells. The levels of PC, MDA, and 8-OHdG in 250 and 500 μM P165 groups were all lower than those in the solvent group. Activities of SOD, CAT, and GPx, and the level of GSH in P165 groups were higher than those in the solvent group. Nrf2 expression in the solvent group was higher than that in the negative group, whereas in the 500 μM P165 group was higher than in the solvent group.

Conclusions:

Our findings suggest that P165 repairs the rat skin with acute photodamage by reducing oxidative stress. These activities may be mediated by promoting the Nrf2 signaling pathway. Thus, P165 may be a promising agent for the treatment of acute photodamage, which may be used in cosmetics and postsun repair.
Could “Islets of Sparing” Be a Clue for Neutral Lipid Storage Disease with Ichthyosis in Patients with Congenital Ichthyosiform Erythroderma?
Authors: Demir Filiz Topaloglu , Cayhan Baran , Karaoglan Cagla , Turkoglu Zafer , Buyukbabani Nesimi , Ayer Mesut , Duz Bugrahan , Uyanık Bulent
Published: May 2024

The prevalent form of ichthyosis in neutral lipid storage disease (NLSDI) is nonbullous congenital ichthyosiform erythroderma (CIE) characterized by fine, whitish scales on erythematous skin over the whole body. Here, we report a late-diagnosed, 25-year-old woman with NLSDI presenting with diffuse erythema and fine whitish scales throughout the body with patches of apparently normal skin, “islets of sparing” on her lower extremities. We observed that the size of the normal skin islets changed with time, and even the entire lower extremity was covered with erythema and desquamation like the rest of the body. Frozen section histopathological examinations were made from lesional skin and normal-looking skin; no difference was observed in terms of lipid accumulation. The only noticeable difference was the thickness of the keratin layer. In CIE patients, observation of patches of apparently normal skin or “islets of sparing” might be a clue for NLSDI to be distinguished from other CIE conditions.
A Comparative Study of Microneedling Combined with Topical 5-Fluorouracil versus Microneedling Alone in Treatment of Localized Stable Vitiligo
Authors: Chhabra Shaiphali , Chahar Yatendra S , Singh Akanksha
Published: May 2024

Context:

Vitiligo is an acquired pigmentary disorder of the skin that is characterized by circumscribed, depigmented macules, and patches.

Aims:

To compare the therapeutic efficacy and safety of microneedling combined with topical 5-fluorouracil solution versus microneedling alone on stable patches of vitiligo.

Settings and Design:

Hospital-based interventional prospective study.

Methods and Material:

We selected 46 patients in the age group of 10–50 years having patch stability of at least 1-year duration. The patients were randomly assigned into two groups of 23 patients each. Group A was treated with microneedling followed by application of 5-fluorouracil which was available in the form of a solution (50 mg/mL) whereas Group B was treated with microneedling alone. The procedure was repeated after every 15 days up to 4 months and patient follow-up along with the grading of repigmentation was done till 6 months. The side effects were noted.

Statistical Analysis Used:

Statistical Package for Social Sciences (SPSS) software, version 25.0. The results were analyzed using the Chi-square test and t-test and P < 0.05 was considered significant.

Results:

At the end of 6 months, excellent response (>75% repigmentation) was reported in 35 patches (48.6%) in Group A treated with microneedling combined with 5-fluorouracil whereas only 12 patches (16.9%) showed an excellent response in Group B treated with microneedling alone.

Conclusions:

Combining microneedling with 5-fluorouracil is a simple, safe, well tolerable, and effective modality than microneedling alone for treating small localized vitiligo patches.
Utility of Immunofluorescence Antigen Mapping in Hereditary Epidermolysis Bullosa
Authors: Rao Raghavendra , Shetty Varsha M.
Published: May 2024

Background:

Epidermolysis bullosa (EB) is characterized by blisters and erosions on the trauma-prone areas of the body. It occurs as a result of mutation in the genes encoding structural proteins. Transmission electron microscopy (TEM) is considered the gold standard test in the laboratory diagnosis of EB. However, this test requires a lot of expertise and is not widely available. Immunofluorescence antigen mapping (IFM) is considered a suitable alternative with comparable sensitivity and specificity. However, there is paucity of studies analyzing the utility of IFM in the diagnosis of EB.

Aims and Objectives:

To study the utility of IFM in the laboratory diagnosis of EB.

Materials and Methods:

A cross-sectional study was conducted involving 179 biopsy specimens of patients with EB. IFM was carried out using a panel of monoclonal antibodies against K14, laminin 332, type IV collagen, and type VII collagen.

Results:

Diagnosis of EB simplex (EBS), junctional EB (JEB), and dystrophic EB (DEB) was made in 104, 28, and 26 biopsy specimens, respectively. The overall concordance rate was 41.3% with higher concordance rates in EBS.

Conclusion:

The present study is conducted to assess the efficacy of IFM in the diagnosis of EB with large sample size. Our study serves to establish IFM as an important tool in the diagnostic armamentarium of EB as the prognosis mainly rests on diagnosing the type of EB.
Demographic Characteristics of the Patients with Cutaneous Vasculitis Due to COVID-19 Infection
Authors: Iraji Fariba , Mokhtari Fatemeh , Zolfaghari Azadeh , Aghaei Maryam , Ostadsharif Negar , Sami Niusha , Hosseini Sayed Mohsen , Sokhanvari Fatemeh , Ghasemi Marziye , Siadat Amir Hossein , Shariat Sheila
Published: May 2024

Background:

Cutaneous manifestations of coronavirus disease 2019 (COVID-19) range from mild skin rashes to severe vasculitis. In the current study, we evaluated the demographic characteristics of the patients with cutaneous vasculitis following COVID-19 infection.

Materials and Methods:

In the current study, we evaluated 799 hospitalised patients with COVID-19 infection for development of cutaneous vasculitis. Demographic and clinical characteristics of the patients were obtained using questionnaires and patients' records. Cutaneous vasculitis of the suspected patients were confirmed using skin biopsy and direct immunofluorescence.

Results:

We detected 24 hospitalised cases with cutaneous vasculitis presenting with petechia, purpura, livedoretcularis and acrocyanosis. Our data showed a significant relationship between male sex, advanced age, C-reactive protein (CRP) level and presence of comorbidities with development of cutaneous vasculitis. In addition, we found a positive association between the severity of COVID-19 infection and occurrence of cutaneous vasculitis.

Conclusion:

Our findings are suggestive that clinicians must be aware of cutaneous vasculitis risk as prognostic value in the patients with severe COVID-19 infection.
Anti CD-6 Monoclonal Antibodies in the Management of Generalised Pustular Psoriasis
Authors: Kura Mahendra M. , Sodhi Anmol , Sajgane Avinash , Karande Ashish
Published: May 2024

Generalised pustular psoriasis (GPP) is an uncommon, severe, life-threatening variant of psoriasis requiring careful therapeutic approach. Conventional treatment modalities have unsatisfactory outcomes, poor side effect profiles and toxicities that have led to an emerging use of biological therapies. Itolizumab, an anti-CD-6 humanised monoclonal IgG1 antibody, is approved for the management of chronic plaque psoriasis in India. We share our experience of using this drug in three cases of GPP that were failing conventional therapies. Its upstream effect on co-stimulatory pathway in disease pathogenesis is the postulated mechanism. Our experience warrants further large-scale exploration of the role of itolizumab in the management of GPP, which would benefit this severely affected population of patients. Although the definite pathogenesis of GPP is unknown fully, molecules blocking CD-6, which plays a role in the interaction between T cells and antigen-presenting cells (APCs), are expected as new promising treatment options for GPP.
Immunohistochemical Analysis of Differences of Toll-Like Receptor 2, Mast Cells, and Neurofilaments between Granulomatous Rosacea and Non-Granulomatous Rosacea
Authors: Jang Ye Ji , Hong Eun Hye , Park Eun Joo , Kim Kwang Joong , Kim Kwang Ho
Published: May 2024

Background:

Granulomatous rosacea is a distinct variant of rosacea because of its unique histopatholiogic findings. However, the pathogenesis of granulomatous rosacea has not yet been clearly demonstrated.

Aims and Objectives:

The aim of this study was to investigate the expression of toll-like receptor 2, mast cells, and neurofilaments in the granulomatous rosacea compared with the non-granulomatous rosacea.

Materials and Methods:

Biopsy specimens were obtained from 12 patients with erythematotelangiectatic rosacea, 11 patients with granulomatous rosacea, and 11 control patients. Biopsy tissue blocks were subjected to immunohistochemical staining using antibodies against toll-like receptor 2, mast cells, and neurofilaments.

Results:

In granulomatous rosacea, the expression of mast cells increased significantly, compared to the erythematotelangiectatic rosacea and the control group (P-value = 0.001 and 0.013, respectively). Additionally, the expression of toll-like receptor 2 in the granulomatous rosacea group was higher than that in the control group (P-value = 0.04).

Conclusion:

The results of this study suggest that the increased expression of mast cells may be a sign of chronic, later stage of granulomatous rosacea compared to the erythematotelangiectatic rosacea. The increased expression of toll-like receptor 2 suggests that cathelicidin-induced neuroimmune pathogenesis also contributes to the pathophysiology of granulomatous rosacea.
Current Status of using Scale Bar on Clinical Images and Methods to Insert it
Authors: Mondal Himel , Mondal Shaikat
Published: May 2024

Clinical images are of utmost importance for the majority of dermatological research and publications. The rich collection of clinical images in medical journals may help in formulating machine learning programs in the future or facilitate image-based meta-analysis. However, the presence of a scale bar in those images is required for measuring the lesion from an image. We audited recent issues of three widely circulated Indian dermatology journals and found that among 345 clinical images, 2.61% had a scale with the unit. With this background, in this article, we provided three methods for capturing and processing clinical images with scale. This article would help dermatologists to think about incorporating a scale bar in the image for the progress of science.
Prevalence and Risk Factor of Occupational Skin Complaints among Male Tannery Workers of Kanpur, India
Authors: Kashyap Gyan Chandra , Singh Shri Kant , Chauhan Bal Govind
Published: May 2024

Background:

Occupational skin illnesses are the second most common occupational health hazard following musculoskeletal disorders. Tannery workers have frequent and prolonged exposure to skin irritants and allergens and may have a higher risk of developing occupational dermatitis.

Aims and Objectives:

The aim of this study is to examine the extent of skin problems and their determinants among male tannery workers.

Materials and Methods:

The data for the present research was drawn from a cross-sectional household study of tannery and nontannery workers in the Jajmau area of Kanpur, Uttar Pradesh. A total of 284 tannery and 289 nontannery workers were interviewed using purposive sampling technique. Descriptive statistics and multivariate techniques have been used.

Results:

Tannery workers experienced itching hands or fingers with fissures (21%), scaling of hands or fingers with fissures (18%), red and swollen hands or fingers (11%), and vesicles on the hands or between the fingers (11%). The workers who had moderate/high dermal exposure to chemicals were 35(P < 0.001), and they were 31 (P < 0.001) times more likely to experience vesicles on scaling hands or fingers with fissures, and itching hands or fingers with fissures. The tannery workers engaged in wet finishing work were significantly 3.9 (P < 0.1) times more likely to experienced scaling on hands or fingers with fissures.

Conclusion:

The study acclaims the mechanization of tannery activities at workplaces, so that risk of skin complaints can be minimized among tannery workers. As the risk of skin complaints is very high with the dermal exposure to chemicals, personal protective equipment must be provided and their use should be included in the curriculum of the ternary workers.
Chronic Dermatophytosis
Authors: Sooriya S , Jayapalan Sabeena , Mini G , Manjusree S , Nandakumar Lakshmy
Published: May 2024

Background:

Recent years have witnessed a dramatic increase in chronic unresponsive dermatophytosis. A study was conducted to quantify the proportion of patients with chronic dermatophytosis and to determine the clinico-mycological predictors of chronicity including antifungal susceptibility.

Methods:

Hospital-based cross-sectional study design was adopted. Four hundred and twenty-five patients were studied. The outcome variable was chronic dermatophytosis and the determinants were clinico-mycological characteristics. Chi-square and odds ratio (OR) with 95% confidence interval (CI) were calculated.

Results:

Chronic dermatophytosis was seen in 29.4%. Past history of dermatophytosis, OR 0.44 (95% CI 0.28–0.68); family history of dermatophytosis, OR 1.66 (95% CI 1.06–2.56); HIV infection, OR 9.88 (95% CI 1.09–89.33); treatment with topical antifungals, OR 2.4 (95% CI 1.5–3.9); systemic antifungals, OR 3.9 (95% CI 2.5–6.1); topical steroids, OR 2.02 (95% CI 1.25–3.25); multiple-site infection, OR 1.97 (95% CI 1.24–3.13); and tinea unguium, OR 6.52 (95% CI 2.89–14.7) were the significant determinants. Trichophyton mentagrophytes (73.6%) was the most common isolate followed by Trichophyton rubrum and Microsporum gypseum (13.2%) each. A percentage of 77.4 of the isolates were resistant—73.6% isolates to terbinafine and 3.8% isolates to fluconazole. None of the isolates were resistant to itraconazole.

Conclusion:

Significant determinants were host-related factors. Thorough history taking, patient examination, and education can improve the present scenario. Microbiological resistance was not a significant predictor. High proportion of resistant strains should be an eye opener. Developing and adopting a standard uniform treatment protocol throughout the country should be the need of the hour.
Oral and Systemic Manifestations in Leprosy a Hospital Based Study with Literature Review
Authors: Vohra Puneeta
Published: May 2024

Introduction:

Leprosy is a chronic granulomatous disease of the peripheral nerve and muscle of upper respiratory tract. Consequence to the neighbouring primary site, oral lesions have been seen in 20-60% of patients with leprosy mainly lepromatous leprosy. The lepromatous nodules may be infective and may lead to the spread of disease and hence require proper diagnosis.

Aim:

To assess oral lesion in leprosy patients. To assess the disease and the occurrence of oral lesion according to age and gender. To detect any primary lesion in oral cavity and compare these lesions in duration to study.

Material and Methods:

One hundred patients with leprosy were examined and their oral manifestations were recorded.

Results:

It was found that 70 (70%) leprosy patients showed oral manifestations. Eighteen (25%) had chronic generalized periodontitis, 9 (12.8%) cases of oral melanosis, 7 (10%) atrophy of papillae and loss of taste sensation each, 6 (8.5%) complained of aphthous and candidiasis each, 5 (7.14%) depigmentation and 4 (5.71%) smokers palate, oral submucous fibrosis and fissured tongue.

Conclusion:

Our clinical findings are in conjugation with previous studies; however, as per the review of literature, this is the first study worldwide where we have examined 100 cases of leprosy which has not been documented till date. We suggest that the lesser incidence of oral lesions is observed recently compared to older reports because of more effective present treatment which is initiated earlier.
The Effects of Acitretin on Insulin Resistance, Glucose Metabolism, and Lipid Levels in Patients with Psoriasis
Authors: Sachdev Satnam Singh , Jamil Adawiyah , Gunabalasingam Preamala , Safdar Najeeb Ahmad
Published: May 2024

Context:

Acitretin increases serum lipids. Data on its effects on insulin resistance and glucose metabolism are sparse and contradicting.

Aims:

The aim of this study is to investigate the effects of acitretin on insulin resistance, glucose metabolism, and lipids.

Methods:

Dermatology clinic in a public tertiary hospital. A cross sectional study involving chronic plaques psoriasis patients on acitretin plus topical therapy or topical therapy alone was performed. Fasting blood glucose (FBG), serum lipids, serum insulin, and glucose tolerance test (GTT) were performed. Homeostatic model of insulin resistance (HOMA-IR) was calculated. Psoriasis severity was evaluated using Psoriasis Area and Severity Index. Chi square and t-tests determined differences between cases and controls. Pearson's correlation coefficient test determined the relationship between continuous variables.

Results:

A total of 60 patients participated, 30 were on acitretin while 30 were on topical therapy. Psoriasis duration, disease severity, BMI, presence of metabolic syndrome, and other comorbidities between the two groups were similar. There were no significant differences in GTT, FBG, HOMA-IR, and serum lipids. Patients on acitretin >25 mg daily had lower FBG [4.4 (0.8) versus 4.9 (0.9), P = 0.04] and triglyceride [1.05 (0.33) versus 1.57 (1.03), P = 0.02] compared with doses ≤25 mg. Higher acitretin dose correlated with lower FBG (r = −0.36, P = 0.05) and triglycerides (r = −0.37, P = 0.05) while longer therapy duration correlated with lower total cholesterol (r = −0.37, P = 0.05). HOMA-IR showed inverse correlation with acitretin dose and duration (r = −0.10, P = 0.61 and r = −0.12, P = 0.53, respectively).

Conclusion:

Acitretin therapy resulted in increased triglyceride. The effect of acitretin on glucose metabolism and insulin resistance maybe dependent on the dose and duration of therapy.
Multiple Disseminated Pyogenic Granuloma Post-Oil Burning
Authors: Iraji Fariba , Jelvan Minoo , Ganjei Zakiye , Rajabi Parvin
Published: May 2024

Pyogenic granuloma (PG) is a common acquired vascular tumor and may appear mostly as a solitary papulonodular lesion on the face, trunk, and extremities. Although the etiology of PG is unclear, trauma, infections, and hormones may play a role. Multiple disseminated PGs are a very rare form and mostly are seen after traumas such as burn. We presented a patient with multiple PGs secondary to oil burning. There has been no report of PG caused by scald burn due to oil before. We also reviewed the literature in English and found 24 other cases of disseminated PG that most of them developed post-boiling milk.
Association of Moderate–Severe Atopic Dermatitis with Dental Anomalies
Authors: Tan Sean Y. , M. Leong Sean W. , Hsu Chin-ying S. , Chandran Nisha S.
Published: May 2024

Atopic dermatitis is a common inflammatory skin condition with an underlying pathophysiology that may have impact beyond the skin. Previous studies showed a higher prevalence of dental cavities in patients with atopic dermatitis. Our study aimed to establish an association of other dental anomalies in patients with moderate–severe atopic dermatitis. We prospectively recruited 15 patients with moderate–severe atopic dermatitis for a formal dental examination by a paediatric dentist. Hypodontia and microdontia were more prevalent in patients with moderate–severe atopic dermatitis as compared to reference populations and were statistically significant. Dental caries, enamel hypoplasia and agenesis of 3rd molars were also prevalent but did not reach statistical significance. Our study shows a novel finding of higher prevalence of dental anomalies in patients with moderate–severe atopic dermatitis which may warrant further investigation due to its clinical implications.
Differential Expression and in Silico Functional Analysis of Plasma MicroRNAs in the Pathogenesis of Non-segmental Vitiligo
Authors: Pektaş Suzan Demir , Kara Murat , Doğan Gürsoy , Pektaş Mehmet Bilgehan , Baloğlu Mehmet Cengiz , Sadi Gökhan
Published: May 2024

Vitiligo is a disease characterized by acquired depigmentation, white macules, and patches on the skin due to the dysfunction of epidermal melanocytes. In this study, we attempt to profile the microRNA (miRNA) expression patterns and predict the potential targets, assessing the biological functions of differentially expressed miRNAs in the blood of generalized vitiligo patients. Peripheral blood samples were taken from all participants, and the expression levels of 89 identified miRNAs were analyzed with real-time quantitative polymerase chain reaction (PCR). The results indicated significant upregulation of six miRNAs and downregulation of 19 miRNAs in the plasma of vitiligo patients. The top three upregulated miRNAs were hsa-miR-451a, hsa-miR-25-3p, and hsa-miR-19a-3p, and the top three downregulated miRNAs were hsa-miR-146a-5p, hsa-miR-940, and hsa-miR-142-3p. Moreover, the miRNA expression profiles of patients with Type 3 and Type 4 phototypes were substantially different in such a way that the patients with Type 3 phototype would be more prone to the emergence of melanoma and cancer. While significant variations in the expression patterns of miRNAs in male and female vitiligo patients were demonstrated, miR-let-7i-5p, miR-19a-3p, miR-25-3p, and miR-451a were commonly upregulated, and miR-142-3p and miR-146a-5p were commonly repressed in both sexes. This study may shed light on the roles of differentially expressed miRNAs in vitiligo patients by examining the miRNA expression patterns and the combined effects of miRNA and their predicted targets.
Cross-Sectional Study to Identify Potential Risk Factors for Eczema within the Common Household Environment in Taiwan
Authors: Wang Yu-Hao , Wu Pi-Hsiung , Su Hsing-Hao , Wang Chung-Yang , Hsu Lan
Published: May 2024

Background:

Much attention has been focused on environmental risk factors and their roles in eczema development. In this regard, the specific eczema risk factors in Taiwan were relatively unknown. As such, this study investigated the common indoor risk factors present in Taiwanese households.

Aims:

To discuss the effects of several indoor risk factors on the prevalence of atopic eczema in Taiwan.

Materials and Methods:

A cross-sectional, population-based study was performed in Kaohsiung, Taiwan, using both survey investigation and fungal culturing. A total of 998 participants were enrolled in the survey, with 513 participants selected for fungal culture. Risks of atopic eczema were calculated as odds ratios for various risk factors using logistic regression. The correlation between potential risk factors and the fungal level was analyzed with linear regression.

Results:

Pet and house plants have an adjusted odds ratio of 1.434 (95% CL: 1.011–2.033) and 1.820 (95% CL: 1.229-2.696), respectively. Additionally, smoking was shown to possess an odds ratio of 1.461 (95% CL: 1.064-2.006). Wood wall has an adjusted odds ratio of 2.143 (95% CL: 1.235-3.658). Frequent bedroom shower use (β = 0.254) and hours of opened windows (β = 0.106) have shown significant positive associations with indoor fungal level.

Conclusion:

Pets, house plants, and smoking were concluded to be major risk factors for atopic eczema. Wood wall remained controversial due to its limited sample size and possible confounders. Bedroom shower and window-opening have been shown to increase mold growth, but the lack of association with eczema suggested other allergens besides mold to be the primary eczema trigger.
COVID-19 and Healthcare Worker
Authors: Jakhar Deepak , Grover Chander , Kaur Ishmeet , Das Anupam , Kaul Subuhi
Published: May 2024

COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic.
Oxidative Stress-Related miRNAs in Patients with Severe Acne Vulgaris
Authors: Caliş Betul , Yerlikaya Fatma Humeyra , Ataseven Arzu , Temiz Selami Aykut , Onmaz Duygu Eryavuz
Published: May 2024

Background:

Acne vulgaris is a common chronic inflammatory skin disease in adolescents and oxidative stress plays an important role in acne pathology. However, the pathology of acne has not yet been fully elucidated. miRNAs are small noncoding RNAs, and there is increasing evidence for their role in the pathogenesis of skin diseases such as psoriasis, atopic dermatitis, and other inflammatory diseases.

Aims and Objectives:

The aim of the study was to investigate serum malondialdehyde (MDA) and glutathione (GSH) levels with plasma miRNA expression profile related with oxidative stress in patients with severe acne vulgaris.

Materials and Methods:

Fifty seven female patients with severe acne and 40 healthy women were included in the study. Plasma miRNA-31, miRNA-200a, and miRNA-21 levels were evaluated by using real-time quantitative polymerase chain rection analysis. MDA and GSH levels were measured as per the manufacturer's procedures using commercial ELISA kits.

Results:

Plasma miRNA-21 levels were statistically significantly higher in patients with severe acne compared to the control group (P =0.003). Plasma miRNA-200a (P =0.303) and miRNA-31 (P =.652) levels were slightly higher in patients with severe acne compared to the control group, but this difference was not statistically significant. Serum MDA levels (P =.047) were higher in patients with severe acne compared to control group, while serum GSH levels (P =.001) were lower.

Conclusion:

These results show that oxidative damage is involved in acne etiopathogenesis and especially miRNA-21 may have an important role in the pathogenesis of acne vulgaris.
Mucormycosis
Authors: Vasudevan Biju , Hazra Nandita , Shijith KP , Neema Shekhar , Vendhan Senkadhir
Published: May 2024

Mucormycosis is an invasive fungal infection that has been increasing in incidence over the years. Increase in the number of diabetics, malignancy patients, and use of immunosuppressants has mainly led to this gradual upward surge. Mucormycosis has various clinical forms, including rhino-orbito-cerebral, pulmonary, gastrointestinal, and cutaneous. Fungi belonging to Mucorales are thermotolerant and ubiquitous, found growing on organic substrates such as bread, decaying fruits and vegetables, crop debris in soil, compost, and animal excreta. During this second wave of the COVID-19 pandemic, the number of cases of mucormycosis has increased manifold in a short span of time. Associated comorbidity of diabetes mellitus, increased use of higher doses and prolonged duration of systemic corticosteroids, the glucogenic and prothrombotic propensity of the virus, hypoxic environment, COVID pneumonia, increased hospitalization, ICU admissions, and mechanical ventilation have all contributed toward this high rise in numbers. The rhin-orbito-cerebral form is the commonest manifestation of mucormycosis in COVID. Rhizopus oryzae, the main species causing mucormycosis, is identified by hyaline, sparsely-septate, broad, ribbon-like hyphae with irregular right-angle branching ribbon-like hyphae with rhizoids. For the early diagnosis of this infection, 10% KOH mount is very important. These fungi are very rapidly growing and thus can be differentiated from their main ally, Aspergillus. Treatment is mainly in the form of extensive surgical debridement along with liposomal amphotericin B. Posaconazole and isavuconazole are second-line agents, which can also be used for maintenance. Control of diabetes and COVID-19, along with judicious use of antibiotics and systemic corticosteroids, are equally important as management strategies in these pandemic times.
Tofacitinib for the Treatment of Twenty-Nail Dystrophy
Authors: Dube Vineet , Bhushan Ravi
Published: May 2024

Twenty nail dystrophy refers to the condition of trachyonychia affecting all the twenty nails. The term trachyonychia is used to describe thin brittle nails with excessive longitudinal ridging. Treatment of twenty nail dystrophy is difficult due to poor bioavailability of drugs in nails. Tofacitinib is novel JAK-STAT inhibitor that has been used successfully for the treatment of nail dystrophy with alopecia areata suggests the possibility of the drug being used for twenty nail dystrophy.
An Observational Study of Clinical, Metabolic and Hormonal Profile of Pediatric Acne
Authors: Pareek Vipul , Khunger Niti , Sharma Shobha , Dhawan Indrani
Published: May 2024

Objectives:

To study the biochemical, metabolic and hormonal profile among children presenting with acne and to determine the correlation of these parameters with acne grading.

Methods:

The observational cross-sectional study was conducted for a duration of 18 months on a total of 50 children between 1 and 12 years of age with clinical features of acne. The detailed information regarding the type of acne, biochemical profile (lipid profile, blood sugar levels), hormonal profile and associated illnesses were recorded. Spearman's rank correlation coefficient was used to find out the correlation of acne grading with hormonal and metabolic changes.

Results:

The mean age of the children was 11.4 years. Among the various lesions, comedones were seen in 98% cases, papules in 94.00% cases, a scar in 14.00% and pustule in 4.00% cases. As compared to children of age 1-7 years, those in age group 8-12 years had significantly more comedones (48 vs 1, P = 0.04), significantly fewer pustules (0.00% vs 100.00%, P = 0.001), and a comparable number of papules and scars. Most of the children (88.00%) had acne vulgaris grade 1. There was a significant negative correlation of Blood sugar-fasting (r = -0.312, P = 0.0275) and a significant positive correlation of HDL (r = 0.28, P = 0.0491) with acne grading.

Conclusion:

Comedones and papules are the commonest and the earliest forms of pediatric acne. Severe forms of acne are rarely seen below 12 years, age group. Preadolescent acne is commoner than mid-childhood acne, with no difference between male and females. Blood sugar levels and lipid profile derangements have a weak correlation with acne grading.
Epidemiological Trends and Clinicomycological Profile of Chronic Dermatophytosis
Authors: Rajamohanan Remya , Raj Renu , Chellam Janaki , Rengasamy Madhu
Published: May 2024

Background:

Chronic dermatophytosis refers to persistent or recurrent episodes of dermatophytosis lasting for more than 1 year despite adequate treatment with topical and systemic antifungal agents. The rise in the number of these cases is alarming over the past 5 to 6 years, and a thorough knowledge about the reasons for chronicity of dermatophytosis may go a long way in the treatment and prevention of this infection.

Aims and Objectives:

The aim of this study was to investigate the epidemiology, various clinical types, and factors associated with chronicity in patients with chronic dermatophytosis, and to isolate the etiological agents and study the clinicomycological correlation.

Materials and Methods:

Detailed history and clinical details of all patients with chronic dermatophytosis who presented to our tertiary care center over a span of 1 year were recorded. Skin scrapings from these patients were subjected to potassium hydroxide mount and culture in modified Sabouraud's dextrose agar medium.

Results:

Sixty-four patients were enrolled in this study with a mean age of 44.5 years. The mean duration of infection was 3.14 years. Tinea corporis was the most common clinical type seen in 46 (71.9%) patients, affecting commonly the waist area in females and the back in males. Bronchial asthma was the most frequent systemic association affecting 20 (31.3%) patients followed by diabetes mellitus, which was present in 13 (20.3%) patients. About 34% patients had a history of long-term steroid use. Among the 28 isolates, Trichophyton mentagrophytes was the most frequent species isolated (46.4%), followed by Trichophyton rubrum (39.3%). Trichophyton tonsurans and Trichophyton verrucosum were isolated from two patients each.

Conclusion:

Extensive area of involvement, atopy, diabetes, and long-term use of systemic corticosteroids were associated with chronicity. Unlike in the yesteryears, T. mentagrophytes has emerged as the most common etiological agent of chronic dermatophytosis.